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

• DOI: 10.1016/j.jalz.2013.11.006
• Publication Date: 2014-02-02T23:30:22Z
• Authors: Deborah E. Barnes; Alexa S. Beiser; Anne Lee; Kenneth M. Langa; Alain Koyama; Sarah R. Preis; John Neuhaus; Ryan J. McCammon; Kristine Yaffe; Sudha Seshadri; Mary N. Haan; David R. Weir
• Keywords: Male; Aging; Biological Psychology; Clinical Sciences; Clinical sciences; Risk Assessment; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Clinical Research; Predictive Value of Tests; Health Sciences; Behavioral and Social Science; Acquired Cognitive Impairment; Psychology; Humans; Mass Screening; Risk prediction modeling; Neurology and Neurosciences; Aged; Proportional Hazards Models; Biomedical and Clinical Sciences; Primary Health Care; Prevention; Neurosciences; Health Services; Primary care; Brain Disorders; 3. Good health; Good Health and Well Being; Geriatrics; Screening; Biological psychology; Dementia; Female

AbstractBackgroundDetection of “any cognitive impairment” is mandated as part of the Medicare annual wellness visit, but screening all patients may result in excessive false positives.MethodsWe 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.ResultsThe 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/m2 (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).ConclusionsThe 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.