The College of Physicians & Surgeons of Alberta (CPSA) is the medical regulatory authority (MRA) for physicians in the province of Alberta. The work at CPSA is directed by the Health Professions Act (HPA), which mandates the following organizational requirements:
1. Registering physicians
2. Accrediting health facilities
3. Supporting the continued competence of physicians
4. Investigating and resolving complaints
5. Contributing to public policy affecting healthcare delivery
6. Guiding professional conduct and ethical behaviour
The overarching mission at CPSA is to protect the public and ensure trust by guiding the medical profession. Consequently, an area in need of further investigation to ensure the safety of Albertans is age-related cognitive decline in physicians. A physician’s ability to practice safely and competently is critical for patient safety; therefore, CPSA is looking to further understand how aging impacts physicians and their ability to practice over time. As a result, the primary goal of this project is to assess the relevant literature surrounding age-related cognitive decline in physicians.
In keeping with the HPA and CPSA’s mandate, the Physician Health Monitoring Program (PHMP) at CPSA is looking to fund a systematic review and meta-analysis focusing on, but not limited to the following research questions:
1. Which specific cognitive domains and/or cognitive abilities* are impacted by age-related cognitive decline?
2. Are there specific cognitive domains and/or cognitive abilities that are impacted at the time of initial onset of age-related cognitive decline and that might be used as early markers of disease onset?
How is age-related cognitive decline best assessed both in terms of disease severity and functional capacity?
4. Are there known factors that interact with age to either negatively or positively influence cognitive decline and the functional impact of any decline?
5. Is there a threshold for cognitive decline that is representative of a significant decline in competence for physicians such that they might no longer be considered fit to practice?
6. What are the important methodological considerations when assessing age-related cognitive studies?
7. Is there evidence supporting the mandatory assessment of cognition in physicians? If so, at what age?
*How to theoretically classify cognitive ability functions/domains can vary (Harvey, 2019, “Domains of cognition and their assessment”)
The project should follow the typical protocol for systematic review and meta-analyses and utilize preferred reporting guidelines (e.g. PRISMA), as well as a standard grading scheme for assessing the level of evidence (e.g. GRADE). The final report can follow the standard scientific writing outline generally accepted by most academic journals (i.e. Introduction, Methods, Results and Discussion).
