Premium
Development and validation of a brief dementia screening indicator for primary care
Author(s) -
Barnes Deborah E.,
Beiser Alexa S.,
Lee Anne,
Langa Kenneth M.,
Koyama Alain,
Preis Sarah R.,
Neuhaus John,
McCammon Ryan J.,
Yaffe Kristine,
Seshadri Sudha,
Haan Mary N.,
Weir David R.
Publication year - 2014
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.2013.11.006
Subject(s) - dementia , medicine , false positive paradox , gerontology , framingham heart study , primary care , body mass index , cohort , stroke (engine) , statistic , cohort study , cognitive impairment , framingham risk score , cognition , family medicine , psychiatry , disease , mechanical engineering , statistics , mathematics , machine learning , computer science , engineering
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.