Promoting Inclusivity in Dementia Education and Screening in an Ethnically Diverse, Rural Community During a Pandemic

Rural, ethnically diverse older adults experience disparities in dementia detection/management. The Covid-19 quarantine exacerbated these disparities, and threatened faith-based dementia education and screening activities. We investigated the effectiveness of a telephone-based outreach for increasing dementia knowledge and detecting cognitive risk among a rural, diverse, underserved community of 89% African American, Hispanic, and Haitian Creole residents, Faith-based health educators, trained using virtual Alzheimer’s Association resources, contacted church congregants who responded to radio worship service announcements. Participants completed telephone measures of basic dementia knowledge and cognitive risk. Of the estimated 120 persons across five churches who received an invitation, 75% (n = 90) participated in dementia education and memory screening via telephone. Twelve (80%) of the 15 participants assessed as being at risk followed up with their provider. Rural residents are known for preferring face-to-face contact. Their willingness to complete health-promoting research activities by telephone highlighted the community’s interest in dementia awareness.

Adaptation and Validation of the Memory Alteration Test (M@T) in Greek Middle-Aged, Older, and Older-Old Population with Subjective Cognitive Decline and Mild Cognitive Impairment

Background: The Memory Alteration Test (M@T) is a verbal episodic and semantic memory screening test able to detect subjective cognitive decline (SCD). Objective: To adapt M@T, creating a Greek version of the Memory Alteration Test (M@T-GR), and to validate M@T-GR compared to the Mini-Mental State Examination (MMSE), SCD-Q MyCog and TheirCog. Methods: 232 people over 55 years old participated in the study and they were classified as healthy controls (HC, n = 65), SCD (n = 78), or MCI (n = 89). Results: The ANCOVA showed that the M@T-GR’s total score was significantly different in HC and SCD (I-J = 2.26, p = 0.032), HC and MCI (I-J = 6.16, p < 0.0001), and SCD compared to MCI (I-J = 3.90, p < 0.0001). In particular, a cut-off score of 46.50 points had an 81%sensitivity and 61%specificity for discriminating HC from SCD (AUC = 0.76, p < 0.0001), while a cut-off score of 45.50 had a sensitivity of 92%and a specificity of 73%for discriminating MCI (AUC = 0.88, p < 0.0001), and a cut-off score of 45.50 points had a sensitivity of 63%and a specificity of 73%for discriminating SCD from those with MCI (AUC = 0.69, p < 0.0021). Exploratory factor analysis indicated that there was one factor explaining 38.46%of the total variance. Internal consistency was adequate (α= 0.75), while convergent validity was found between M@T-GR and MMSE (r = 0.37, p < 0.0001) and SCD-Q TheirCog (r = –0.32, p < 0.0001). Conclusion: The M@T-GR is a good to fair screening tool with adequate discriminant validity for administration in people with SCD and MCI in Greece.

Community Memory Screening as a Strategy for Recruiting Older Adults into Alzheimer’s Disease Research

Background Growing awareness of Alzheimer’s disease (AD) has prompted a demand for quick and effective ways to screen for memory loss and cognitive decline in large numbers of individuals in the community. Periodic Memory Screening Day events provide free, brief cognitive screening aimed at those 65 years and older, and can serve as an opportunity to gauge participants’ attitudes towards AD research and recruit them into ongoing research projects. Methods Over 6 single-day events in 2 years, more than 574 individuals were individually screened using the MoCA and a story recall task (immediate and delayed), given feedback about their performance, and introduced to AD research and opportunities to participate. Results Screening classified 297 individuals (52.0%) as having “ No Decline ”, 192 (33.6%) as “ Possible decline ” and 82 (14.4%) as “ Likely decline ”. Those with “ Likely decline ” were older and less educated, had more memory concerns, were more likely to be men, and were less likely to have a positive family history of dementia than those with “ No Decline ”. Subsequent validation of screening procedures against a full clinical evaluation showed 72% classification accuracy with a skew towards over-calling Possible and Likely decline and thereby guiding questionable individuals to a more thorough evaluation. Of those screened, 378 (66%) agreed to additional research and consented to being listed in a research registry; and a majority (70-85%) of those consenting reported they were amenable to various AD research procedures including lumbar puncture, MRI and autopsy. Overall, 19.1% of those screened met inclusion criteria for ongoing studies and were successfully recruited into AD research. Conclusions Conducting a few concentrated community memory screening events each year may help meet the public’s demand for brief assessment of memory concerns and can be a relatively effective and efficient recruitment strategy for AD research.

Community Memory Screening as a Strategy for Recruiting Older Adults into Alzheimer’s Disease Research

Background: Growing awareness of Alzheimer’s disease (AD) has prompted a demand for quick and effective ways to screen for memory loss and cognitive decline in large numbers of individuals in the community. Periodic Memory Screening Day events provide free, brief cognitive screening aimed at those 65 years and older, and can serve as an opportunity to gauge participants’ attitudes towards AD research and recruit them into ongoing research projects. Methods: Over 6 single-day events in 2 years, more than 574 individuals were individually screened using the MoCA and a story recall task (immediate and delayed), given feedback about their performance, and introduced to AD research and opportunities to participate.Results: Screening classified 297 individuals (52.0%) as having “No Decline”, 192 (33.6%) as “Possible decline” and 82 (14.4%) as “Likely decline”. Those with “Likely decline” were older and less educated, had more memory concerns, were more likely to be men, and were less likely to have a positive family history of dementia than those with “No Decline”. Subsequent validation of screening procedures against a full clinical evaluation showed 72% classification accuracy with a skew towards over-calling Possible and Likely decline and thereby guiding questionable individuals to a more thorough evaluation. Of those screened, 378 (66%) agreed to additional research and consented to being listed in a research registry; and a majority (70-85%) of those consenting reported they were amenable to various AD research procedures including lumbar puncture, MRI and autopsy. Overall, 19.1% of those screened met inclusion criteria for ongoing studies and were successfully recruited into AD research. Conclusions: Conducting a few concentrated community memory screening events each year may help meet the public’s demand for brief assessment of memory concerns and can be a relatively effective and efficient recruitment strategy for AD research.

Elderly Latino community members make an educational video: an academic-community collaboration to promote memory evaluations

ABSTRACTObjectives:To develop an educational video to reach elderly Latinos in order to improve understanding and encourage evaluation of cognitive changes by 1) using focus groups to identify dementia knowledge gaps, health communication preferences and trusted advisors for health concerns; 2) collaborating with elderly Latino community members to create a video; and 3) collecting survey data regarding community response to the video.Design:Grounded theory qualitative approach using focus groups; collaborative community based model to create the video and anonymous survey at community screenings.Setting:Community senior centers in East Harlem, New York.Participants:A team of low-income mono and bilingual elderly Latino community residents, researchers, clinicians, and a film professional.Measurements:Thematic analysis of focus group transcripts; three item survey.Results:A collaboratively produced video and initial assessment in 49 Latino elders that indicated the video had a positive effect on interest in obtaining a brief memory screening at outreach events (71%).Conclusions:The project demonstrates the feasibility of this interdisciplinary partnership to create a culturally and linguistically sensitive video to promote service use concerning memory loss and cognitive evaluations among elderly Latinos. Initial survey results suggested a positive response and an increase in interest in memory screening.