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

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

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

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/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). 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.

Original languageEnglish (US)
Pages (from-to)656-665.e1
JournalAlzheimer's and Dementia
Volume10
Issue number6
DOIs
StatePublished - Nov 1 2014
Externally publishedYes

Keywords

  • Dementia
  • Primary care
  • Risk prediction modeling
  • Screening

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience

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  • Cite this

    Barnes, D. E., Beiser, A. S., Lee, A., Langa, K. M., Koyama, A., Preis, S. R., Neuhaus, J., McCammon, R. J., Yaffe, K., Seshadri, S., Haan, M. N., & Weir, D. R. (2014). Development and validation of a brief dementia screening indicator for primary care. Alzheimer's and Dementia, 10(6), 656-665.e1. https://doi.org/10.1016/j.jalz.2013.11.006