Identifying memory impairment and early dementia in primary care.
Identifying memory impairment and early dementia in primary care.
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DOI：
10.1016/j.dadm.2017.01.006
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发表时间：
2017-01-01
期刊：
影响因子：
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通讯作者：
Lipton, Richard B
中科院分区：
文献类型：
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作者：
Grober, Ellen;Wakefield, Dorothy;Lipton, Richard B
前言：这项研究考察了两阶段病例发现的操作特点，以识别记忆障碍和非常轻微的痴呆。方法：初级保健患者接受两阶段测试和随后的诊断评估，以评估结果。对在《老年人认知功能减退告密者问卷》中筛选出主观认知功能减退阳性的患者进行即刻回忆的自由和线索选择性回忆测验的记忆测试。结果是在没有获得这些数据的情况下确定的。结果：563例患者中有117例(21%)有痴呆，68例(12%)有记忆障碍，但没有痴呆。在发现和确认的样品中，操作特征相似。在合并样本中，记忆障碍或痴呆患者的敏感度(72%)和特异度(90%)都很好。种族、教育水平或年龄的差异(≤75)不影响分类的准确性。讨论：两阶段筛查有助于有效地识别患有记忆障碍或痴呆症的老年人。
INTRODUCTION: This study examined the operating characteristics of two-stage case finding to identify memory impairment and very mild dementia.METHODS: Primary care patients underwent two-stage testing and a subsequent diagnostic assessment to assess outcomes. Patients who screen positive for subjective cognitive decline on the Informant Questionnaire on Cognitive Decline in the Elderly undergo memory testing with the Free and Cued Selective Reminding Test with Immediate Recall. Outcomes were determined without access to these data. A split-half design with discovery and confirmatory samples was used.RESULTS: One hundred seventeen of 563 (21%) patients had dementia and 68 (12%) had memory impairment but not dementia. Operating characteristics were similar in the discovery and confirmatory samples. In the pooled sample, combined, patients with memory impairment or dementia were identified with good sensitivity (72%) and high specificity (90%). Differences in ethnicity, educational level, or age (≤75, >75) did not affect classification accuracy.DISCUSSION: Two-stage screening facilitates the efficient identification of older adults with memory impairment or dementia.