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P2‐306: Help‐Seeking for Subjective Memory Complaints (SMC) in Older Adults in New Brunswick
Author(s) -
Pakzad Sarah,
Bourque Paul,
Bhalla Dinesh,
Tahir Laeeq,
Fallah Nader,
French Christina
Publication year - 2016
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.2016.06.1436
Subject(s) - dementia , distress , help seeking , cognition , psychology , psychological distress , gerontology , sample (material) , perception , clinical psychology , medicine , psychiatry , mental health , disease , chemistry , pathology , chromatography , neuroscience
available to neurologists. Based on previous recommendations for classifying PD-MCI (Litvan et al., 2012), participants in this study were classified as PD-MCI (n1⁄465) if MoCA score was <26 or if they scored 1 standard deviation below the normative mean in two or more domains. The remaining 117 participants were classified as normal. The sensitivity and specificity for the clinical detection of PD-MCI was determined by examining the clinical determination of cognitive status compared to participants classified as normal or PD-MCI based on neuropsychological test performance. Results: Overall accuracy for the clinical detection of PD-MCI participants was 63.4%; while clinical determination was highly specific (88.0%), sensitivity was poor, as only 24.6% of individuals demonstrating impairment on neuropsychological testing were clinically identified as PD-MCI. Only 30% of neurologists endorsed utilizing cognitive data. Reported use did not affect classification accuracy, c(1,182)1⁄40.01, p1⁄4.523. In cases of clinically determined normal cognition, clinicians were 90-100% confident of their decision 92.8% of the time. In cases where PD-MCI was diagnosed, a high level of confidence was endorsed 60.0% of the time c(1,182)1⁄424.36, p<.001. Conclusions:The sensitivity of clinical judgment in identifying MCI in PD is low. PD is a subcortical disease process where language and memory are less impacted than other cognitive domains. Therefore, identifying MCI based upon clinical interview alone appears to be insufficient. In cases where cognitive impairment is detected, diagnostic confidence is lower than in cases where impairment is not suspected. In both clinical and research settings, the inclusion of objective cognitive test data interpreted by a trained neuropsychologist may decrease rates of false negative findings.