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An update of the evidence for dementia risk reduction
Author(s) -
Farrow M.
Publication year - 2009
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2009.05.266
Subject(s) - dementia , medicine , risk factor , gerontology , psychiatry , psychology , disease
consequent morbidity, health expenditure and societal burden. We have already shown that detection of cognitive decline is associated with increased risk of PET-PIB amyloid accumulation, and that a computerized battery can be used in a longitudinal aging study to detect objective subtle decline. The current study used CogHealth in the community to determine whether concerned but healthy persons: (i) tolerate 3 monthly screening over a year, and (ii) show impairment or serial decline. Methods: Community volunteers ( 50 years) willing to undergo 3 monthly computerized testing over 12 months (M) were recruited by brief media announcements. A subgroup participated in focus groups after the first and last visit. Participants with impairment defined as failure to pass simple integrity checks or >1.65 standard deviations below the mean compared with population-based normative data or serial decline using linear regression will be offered further medical assessment. Participants’ doctors interest was also surveyed. Results: 301 volunteers without existing cognitive impairment were recruited from a total of 394 screened by telephone interviews. Mean age was 61.8 6 7.2 years (89M, 212F). Focus group interviews suggested high participant enthusiasm for screening. The proportion of participants who failed integrity checks or timed out at each time point was: baseline 13% (n1⁄4301); 3M 6% (n1⁄4271); 6M 3% (n1⁄4253), 9M 3% (n1⁄4258) and 12M 3% (n1⁄4263). 87% participants completed 12M testing. Overall, 20% failed one or more integrity check over the course of the study. Only 11% of participant doctors returned completed surveys. Conclusions: Concern about early AD appears high in the community with enthusiastic demand for study entry, and high motivation to complete serial screening. In contrast practitioner interest was low. Serial monitoring in the community with such brief computerized test batteries appears to be feasible and acceptable. Future work is required to evaluate the sensitivity of demonstrated impairment or serial decline to significant medical conditions, and cost-effectiveness.