The UCSF Brain Health Assessment for the Detection of Cognitive Impairment Among Diverse Populations in Primary Care

需要高效且用户友好的神经认知屏幕，其对神经认知的多样性敏感。 疾病介绍到初级保健。UCSF脑健康评估旨在有效地 测量在神经认知衰退的最早阶段可能受到影响的认知领域，包括 记忆、执行功能/速度、视觉空间技能、语言、行为和功能。四个子测试和 通过吸引人的平板电脑界面和自动评分， 提供者反馈。初步的验证研究表明， 认知功能障碍的英语为母语的老年人与中等至高等教育水平。的 拟议工作的主要目标是优化和验证BHA，以适应不同年龄段的老年人， 的教育和语言口语的条款，执行交叉验证研究的其他范式资助的这一点， 奖励，并评估和解决在初级保健中发现认知障碍的障碍。教育和 英语作为第二语言的每一种都会影响认知测试的表现，并且是准确检测 认知障碍该项目将通过纳入不同水平的人来解决这些健康差距问题。 教育程度以及主要语言为西班牙语、普通话或广东话的人在验证和 执行研究。在目标1中，我们将评估BHA检测认知障碍的有效性。 具有低、中、高或低水平英语的老年人的特征明确且经专业诊断的损伤 高等教育。在目标2中，我们将评估BHA检测认知障碍的有效性， 特征鲜明且经过专业诊断的讲西班牙语、粤语或普通话的老年人。在目标3中， 我们将确定和解决初级保健实践中的实施挑战，为不同类型的患者提供服务， 受教育程度和使用的语言。如果成功的话，这个项目将导致更多的认知检测， 日常社区环境中的损伤，这对于进行鉴别诊断和改善 在美国，对认知障碍（包括痴呆症）患者的医疗管理。

Efficient and user-friendly neurocognitive screens are needed that are sensitive to the variety of neurocognitive disorder presentations to primary care. The UCSF Brain Health Assessment was developed to efficiently measure the cognitive domains that can be affected in the earliest stages of neurocognitive decline, including memory, executive functions / speed, visuospatial skills, language, behavior, and function. Four subtests and an optional informant survey are administered via an appealing tablet interface and with automated scoring and provider feedback. Preliminary validation studies indicate excellent combined sensitivity and specificity to cognitive impairment among English-speaking older adults with moderate to high levels of education. The primary goals of the proposed work are to optimize and validate the BHA for older adults who are diverse in terms of education and language spoken, to perform cross-validation studies of other paradigms funded by this award, and to evaluate and address barriers to detecting cognitive impairment in primary care. Education and English as a second language each impact cognitive test performance and are barriers to accurate detection of cognitive impairment. This project will address these health disparities by including persons with diverse levels of education and persons whose primary language is Spanish, Mandarin, or Cantonese in both validation and implementation studies. In Aim 1, we will evaluate the validity of the BHA for the detection of cognitive impairment in well-characterized and expertly diagnosed English-speaking older adults with low, moderate, or high education. In Aim 2, we will evaluate the validity of the BHA for the detection of cognitive impairment in well-characterized and expertly diagnosed Spanish-, Cantonese-, or Mandarin-speaking older adults. In Aim 3, we will identify and address implementation challenges in primary care practices that serve patients diverse in terms of education and language spoken. If successful, this project will lead to increased detection of cognitive impairment in everyday community settings, which is essential to enable differential diagnosis and to improve medical management for people with cognitive impairment, including dementia, in the United States.