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J Am Geriatr Soc. 2013 Jul;61(7):1141-5. doi: 10.1111/jgs.12309. Epub 2013 Jun 3.

Feasibility and validity of dementia assessment by trained community health workers based on Clinical Dementia Rating.

Author information

  • 1School of Nursing, The Johns Hopkins University, Baltimore, Maryland 21205, USA. hhan3@jhu.edu

Abstract

OBJECTIVES:

To determine the level of agreement between dementia rating by trained community health workers (CHWs) based on the Clinical Dementia Rating (CDR) and the criterion standard: physician diagnosis.

DESIGN:

Cross-sectional validation study.

SETTING:

Community gathering places such as ethnic churches, senior centers, low-income elderly apartments, and ethnic groceries in the Baltimore-Washington metropolitan area.

PARTICIPANTS:

Ninety community-dwelling Korean-American individuals aged 60 and older.

MEASUREMENTS:

The CDR is a standardized clinical dementia staging instrument used to assess cognitive and functional performance using a semistructured interview protocol. Six CHWs trained and certified as CDR raters interviewed and rated study participants. A bilingual geriatric psychiatrist evaluated participants independently for dementia status.

RESULTS:

CHWs rated 61.1% of the participants as having mild cognitive impairment (MCI; CDR = 0.5) or dementia (CDR≥1), versus 56.7% diagnosed by the clinician. A receiver operating characteristic (ROC) curve analysis demonstrated good predictive ability of CDR rating by trained CHWs (area under the ROC curve = 0.86, 95% confidence interval = 0.78-0.93, sensitivity = 85.5%, specificity = 88.6%) in detecting MCI and dementia.

CONCLUSION:

The findings provide preliminary evidence that trained CHWs can effectively identify community-dwelling elderly Korean adults with MCI and dementia for early follow-up assessment and care in a community with scarce bilingual caregivers and programs.

© 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

KEYWORDS:

Korean; clinical dementia rating; community health worker; dementia; elderly adults

PMID:
23730928
[PubMed - indexed for MEDLINE]
PMCID:
PMC3714359
Free PMC Article
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