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

Development and validation of a brief dementia screening indicator for primary care.
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DOI:
10.1016/j.jalz.2013.11.006
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发表时间:
2014-11
期刊:
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子:
--
通讯作者:
Weir DR
Weir DR
中科院分区:
其他
文献类型:
--
作者:
Barnes DE;Beiser AS;Lee A;Langa KM;Koyama A;Preis SR;Neuhaus J;McCammon RJ;Yaffe K;Seshadri S;Haan MN;Weir DR

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“任何认知障碍”的检测是医疗保险年度健康访问的一部分,但筛查所有患者可能会导致过多的假阳性。我们使用四项正在进行的大型队列研究(心血管健康研究[CHS];心脏病研究[FHS];健康与退休研究[HRS];萨克拉门托地区拉丁裔老龄化研究[SALSA])的数据开发并验证了一个简短的痴呆症筛查指标,以帮助临床医生确定一个高风险患者亚组,以进行认知筛查。最终的痴呆筛查指标包括年龄(1分/年;年龄,65-79岁)、受教育不足12年(9分)、中风(6分)、糖尿病(3分)、体重指数小于18.5 kg/m2(8分)、需要金钱或药物援助(10分)和抑郁症状(6分)。各队列的准确性良好(Harrell's C统计:CHS,0.68; FHS,0.77; HRS,0.76; SALSA,0.78)。痴呆症筛查指标是一个简单的工具,可能是有用的,在初级保健设置,以确定高风险患者的目标认知筛查。
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. 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. 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). 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.
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