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Alzheimers Dement. 2014 Nov;10(6):656-665.e1. doi: 10.1016/j.jalz.2013.11.006. Epub 2014 Feb 1.

Development and validation of a brief dementia screening indicator for primary care.

Author information

1
Department of Psychiatry, University of California, San Francisco, CA, USA; Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA; Veterans Affairs Medical Center, San Francisco, CA, USA. Electronic address: Deborah.barnes@ucsf.edu.
2
Department of Neurology, Boston University, Boston, MA, USA; Department of Biostatistics, Boston University, Boston, MA, USA.
3
Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA.
4
Institute for Social Research, University of Michigan, Ann Arbor, MI, USA; Department of Medicine, University of Michigan, Ann Arbor, MI, USA; Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, MI, USA.
5
Northern California Institute for Research and Education, San Francisco, CA, USA.
6
Department of Neurology, Boston University, Boston, MA, USA.
7
Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
8
Department of Psychiatry, University of California, San Francisco, CA, USA; Department of Neurology, University of California, San Francisco, CA, USA; Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA; Veterans Affairs Medical Center, San Francisco, CA, USA.

Abstract

BACKGROUND:

Detection of "any cognitive impairment" is mandated as part of the Medicare annual wellness visit, but screening all patients may result in excessive false positives.

METHODS:

We developed and validated a brief Dementia Screening Indicator using data from four large, ongoing cohort studies (the Cardiovascular Health Study [CHS]; the Framingham Heart Study [FHS]; the Health and Retirement Study [HRS]; the Sacramento Area Latino Study on Aging [SALSA]) to help clinicians identify a subgroup of high-risk patients to target for cognitive screening.

RESULTS:

The final Dementia Screening Indicator included age (1 point/year; ages, 65-79 years), less than 12 years of education (9 points), stroke (6 points), diabetes mellitus (3 points), body mass index less than 18.5 kg/m(2) (8 points), requiring assistance with money or medications (10 points), and depressive symptoms (6 points). Accuracy was good across the cohorts (Harrell's C statistic: CHS, 0.68; FHS, 0.77; HRS, 0.76; SALSA, 0.78).

CONCLUSIONS:

The Dementia Screening Indicator is a simple tool that may be useful in primary care settings to identify high-risk patients to target for cognitive screening.

KEYWORDS:

Dementia; Primary care; Risk prediction modeling; Screening

PMID:
24491321
PMCID:
PMC4119094
DOI:
10.1016/j.jalz.2013.11.006
[Indexed for MEDLINE]
Free PMC Article

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