Older Primary Care Patients’ Attitudes and Willingness to Screen for Dementia

Objective. To understand older primary care patients’ perceptions of the risks and benefits of dementia screening and to measure the association between attitudes and screening behaviors.Methods. Eligible patients completed the Perceptions Regarding Investigational Screening for Memory in Primary Care (PRISM-PC) questionnaire and then were asked to undergo dementia screening by a telephone screening instrument.Results. Higher scores on the PRISM-PC questionnaire items that measure attitudes about benefits of screening were associated with decreased odds of refusing screening. Participants who refused screening had significantly lower PRISM-PC questionnaire scores on the items that measure perceived benefits compared to those who agreed to screening. Participants who refused screening were less likely to agree on screening for other conditions, such as depression and cancer. Participants who know someone with Alzheimer’s disease (AD) were less likely to refuse screening.Discussion. Patients’ attitudes about the benefits of dementia screening are associated with their acceptance of dementia screening.

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IDENTIFYING COGNITIVE IMPAIRMENT WITH PRIMARY CARE IMPLEMENTATION OF THE BRIEF INTERVIEW FOR MENTAL STATUS

Innovation in Aging ◽

10.1093/geroni/igz038.2437 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S658-S658

Author(s):

Karen L Gilbert

Keyword(s):

Alzheimer’S Disease ◽

Primary Care ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mental Status ◽

Care Practice ◽

Cognitive Screening ◽

Palm Beach County ◽

Primary Care Patients ◽

Cognitively Intact

Abstract Overview: An estimated 5.7 million Americans are affected by Alzheimer’s disease (AD; 2018 Alzheimer’s disease facts and figures, 2018, p. 367). Cognitive impairment fails to be identified in the primary care setting as often as 76% of the time (Moyer, 2014, p. 793). Screening can identify patients with emerging impairment who might otherwise appear cognitively intact Grober, Wakefield, Ehrlich, Mabie & Lipton, 2017, p.191). Early identification of cognitive impairment promotes evaluation of treatable causes (Possin et al., 2018, p. 150), and access to early treatment for irreversible disease, facilitating future planning (Swallow, 2017, pp. 57, 63). Methods: This quantitative study’s aim was to identify patients with occult cognitive impairment. After training staff in a Palm Beach County Florida primary care practice, the Brief Interview of Mental Status (BIMS) was administered to patients aged 45 years and older. Results: Seven of 120 screened patients, with no known AD diagnosis, scored as moderately impaired. One of these patients was 64 years of age, the remaining six ranged from age 71 to 93. Fourteen patients scored at the lowest range of “cognitively intact,” eight were under age 65. Conclusion: Cognitive screening of primary care patients with no known diagnosis of AD identified approximately 7% scoring as moderately impaired; an additional 12% scored at the lowest range of “cognitively intact,” suggesting a potentially emerging cognitive impairment warranting follow up evaluation for treatable causes, developing AD, or a related neurocognitive disorder.

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Validation of the Cognitive Telephone Screening Instrument (COGTEL) for detecting mild cognitive impairment and dementia due to Alzheimer's disease (AD)

Alzheimer s & Dementia ◽

10.1002/alz.041461 ◽

2020 ◽

Vol 16 (S6) ◽

Author(s):

Panagiotis Alexopoulos ◽

Maria Skondra ◽

Marina Charalampopoulou ◽

Souzana Aligianni ◽

Evangelia Kontogianni ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Screening Instrument ◽

Telephone Screening

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Promoting Conversations About Cognitive Decline Between Older Adults and Primary Care Providers

Innovation in Aging ◽

10.1093/geroni/igaa057.513 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 157-158

Author(s):

Benjamin Olivari ◽

Christopher Taylor ◽

Nia Reed ◽

Lisa McGuire

Keyword(s):

Alzheimer’S Disease ◽

Primary Care ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Chronic Conditions ◽

Memory Loss ◽

Primary Care Providers ◽

Subjective Cognitive Decline ◽

Care Providers

Abstract Alzheimer’s disease and related dementias often begin with symptoms of mild memory loss, eventually leading to more severe cognitive impairment, functional impairment, and ultimately, death. Data from the Behavioral Risk Factor Surveillance System core questions related to chronic diseases and from the cognitive decline optional module on subjective cognitive decline (SCD) from the years 2015-2018 were aggregated across the participating 50 states, D.C., and Puerto Rico for this analysis. Among U.S. adults aged 65 years and older, only 39.8% (95%CI=37.6-42.1) of those experiencing SCD reported discussing their SCD symptoms with a healthcare provider. The prevalence of discussing SCD symptoms with a provider was higher among those with at least one chronic condition than among those with no chronic conditions. 30.7% (28.6-32.8) of those aged 65 years and older reported that their SCD led to functional limitations and 28.8% (26.5-31.2) needed assistance with day-to-day activities. For patients aged 65 years and older, Welcome to Medicare visits and Medicare Annual Wellness Visits are critically underutilized primary care access points. Primary care providers can manage chronic conditions, cognitive health, and initiate referrals for testing. Efforts to promote the use of toolkits and diagnostic codes that are available to primary care providers to initiate conversations about memory loss with patients may be utilized to improve detection, diagnosis, and planning for memory problems. Discussions may lead to earlier detection and diagnosis of cognitive impairment, such as Alzheimer’s disease, or other treatable conditions such as delirium or pressure in the brain and avoid costly hospitalizations.

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The Japanese version of the Rapid Dementia Screening Test is effective compared to the clock-drawing test for detecting patients with mild Alzheimer's disease

Psychogeriatrics ◽

10.1111/psyg.12144 ◽

2015 ◽

Vol 16 (4) ◽

pp. 233-239 ◽

Cited By ~ 4

Author(s):

Yasushi Moriyama ◽

Aihide Yoshino ◽

Kaori Yamanaka ◽

Motoichiro Kato ◽

Taro Muramatsu ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Screening Test ◽

Japanese Version ◽

Clock Drawing Test ◽

Clock Drawing ◽

Dementia Screening ◽

Drawing Test

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Mild cognitive impairment in primary care: a clinical review

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2018-136035 ◽

2018 ◽

Vol 94 (1117) ◽

pp. 647-652 ◽

Cited By ~ 3

Author(s):

Georges Assaf ◽

Maria Tanielian

Keyword(s):

Alzheimer’S Disease ◽

Primary Care ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Clinical Review ◽

Primary Care Physicians ◽

Early Recognition ◽

Neuropsychiatric Symptoms ◽

Evidenced Based

Dementia is projected to become a global health priority but often not diagnosed in its earlier preclinical stage which is mild cognitive impairment (MCI). MCI is generally referred as a transition state between normal cognition and Alzheimer’s disease. Primary care physicians play an important role in its early diagnosis and identification of patients most likely to progress to Alzheimer’s disease while offering evidenced-based interventions that may reverse or halt the progression to further cognitive impairment. The aim of this review is to introduce the concept of MCI in primary care through a case-based clinical review. We discuss the case of a patient with MCI and provide an evidence-based framework for assessment, early recognition and management of MCI while addressing associated risk factors, neuropsychiatric symptoms and prognosis.

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PDI-4A: An Augmented Provisional Screening Instrument Assessing 5 Additional Common Anxiety-Related Diagnoses in Adult Primary Care Patients

Postgraduate Medicine ◽

10.3810/pgm.2011.09.2463 ◽

2011 ◽

Vol 123 (5) ◽

pp. 89-95 ◽

Cited By ~ 6

Author(s):

John P. Houston ◽

Kurt Kroenke ◽

Jonathan R. Davidson ◽

Lenard A. Adler ◽

Douglas E. Faries ◽

...

Keyword(s):

Primary Care ◽

Screening Instrument ◽

Primary Care Patients

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A new 17 point memory test evaluating the treatment of patients with probable Alzheimer's disease in a busy primary care practice

Neurobiology of Aging ◽

10.1016/s0197-4580(00)83406-5 ◽

2000 ◽

Vol 21 ◽

pp. 237

Author(s):

Edward Gillie

Keyword(s):

Alzheimer’S Disease ◽

Primary Care ◽

Alzheimer's Disease ◽

Primary Care Practice ◽

Memory Test ◽

Care Practice

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A Quick Test of Cognitive Speed: norm-referenced criteria for 121 Italian adults aged 45 to 90 years

International Psychogeriatrics ◽

10.1017/s1041610214000787 ◽

2014 ◽

Vol 26 (9) ◽

pp. 1493-1500 ◽

Cited By ~ 4

Author(s):

Ferdinando Petrazzuoli ◽

Sebastian Palmqvist ◽

Hans Thulesius ◽

Nicola Buono ◽

Enzo Pirrotta ◽

...

Keyword(s):

Primary Care ◽

Mmse Score ◽

Age Groups ◽

Quick Test ◽

Dementia Screening ◽

Primary Care Patients ◽

Cognitive Speed ◽

Color Form ◽

Criterion Referenced ◽

Age Range

ABSTRACTBackground:A Quick Test of Cognitive Speed (AQT) is a brief test that can identify cognitive impairment. AQT has been validated in Arabic, English, Greek, Japanese, Norwegian, Spanish, and Swedish. The aim of this study was to develop Italian criterion-referenced norms for AQT.Methods:AQT consists of three test plates where the patient shall rapidly name (1) the color of 40 blue, red, yellow, or black squares (AQT color), (2) the form of 40 black figures (circles, squares, triangles, or rectangles; AQT form), (3) the color and form of 40 figures (consisting of previous colors and forms; AQT color–form). The AQT test was administered to 121 Italian cognitively healthy primary care patients (age range: 45–90 years). Their mean Mini-Mental State Examination (MMSE) score was 28.8 ± 0.9 points (range 26–30 points). AQT naming times in seconds were used for developing preliminary criterion cut-off times for different age groups.Results:Age was found to have a significant moderate positive correlation with AQT naming times color (r = 0.65, p < 0.001), form (r = 0.53, p < 0.001), color–form (r = 0.63, p < 0.001) and a moderate negative correlation with MMSE score (r = –0.44, p < 0.001) and AQT naming times differed significantly between younger (45–55 years old), older (56–70 years old), and the oldest (71–90 years old) participants. Years of education correlated positively but weakly with MMSE score (r = 0.27, p = 0.003) and negatively but weakly with AQT color (r = –0.16, p = ns), form (r = –0.24, p = 0.007), and color–form (r = –0.19, p = 0.005). We established preliminary cut-off times for the AQT test based on +1 and +2 standard deviations according to the approach in other languages and settings.Conclusions:This is the first Italian normative AQT study. Future studies of AQT – a test useful for dementia screening in primary care – will eventually refine cut-off times for normality balancing sensitivity and specificity in cognitive diagnostics.

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Effect of Severe External Airborne Agents’ Exposure on Dementia

Journal of Clinical Medicine ◽

10.3390/jcm9124069 ◽

2020 ◽

Vol 9 (12) ◽

pp. 4069

Author(s):

Seunghyun Lee ◽

Joon Yul Choi ◽

Jin-Ha Yoon ◽

Wanhyung Lee

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Elderly Population ◽

Standardized Incidence Ratio ◽

Dementia Screening ◽

Confounding Variables ◽

Occupational And Environmental Exposure ◽

The Impact ◽

International Awareness ◽

Incidence Of Dementia

The impact of occupational and environmental exposure to external airborne agents on cognitive function, especially in incidence of dementia, is understudied. The present study was conducted to elucidate the association between severe external airborne agents’ exposure and incidence of dementia among an elderly population and to explore the effects of exposure to severe external airborne agents on preclinical dementia using the screening test of dementia. From the National Health Insurance Service-Health Screening Cohort (NHIS-HealS, 2002–2015), 514,580 participants were used for data analysis. We estimated the standardized incidence ratio (SIR) according to the exposure to external airborne agents. Of the total participants (n = 514,580), 1340 (0.3%) experienced severe external airborne agents exposure, and 26,050 (5.1%) had been diagnosed with dementia. The SIRs (95%CI) of dementia in Alzheimer’s disease, vascular dementia, dementia in other diseases, and unspecific dementia were 1.24 (1.01–1.49), 0.88 (0.37–1.32), 1.16 (0.01–2.77), and 0.69 (0.36–1.02), respectively. The risk of testing positive in the dementia screening significantly increased with exposure to severe external airborne agents after adjusting for all confounding variables. This study found that exposure to severe external airborne agents is a potential risk factor for dementia, especially in Alzheimer’s disease. It is essential to create international awareness regarding the effect of airborne agents’ exposure on dementia.

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