MyCog - Rapid detection of cognitive impairment in everyday clinical settings

认知障碍(CI)和痴呆症是严重的公共卫生负担，可能会产生深远的社会影响 以及对老年人的情绪影响。早期检测CI是必要的，以便识别潜在的 可治疗的潜在原因疾病，以及在无法治愈的情况下，提供支持性服务 将CI的影响降至最低。虽然初级保健和其他临床环境是识别CI的理想场所，但它 经常不被发现。现有的筛选工具可能不适合在这样的环境中实施 因为它们的长度、成本或需要专门的设备或训练有素的管理员。我们的项目， MyCog：在日常临床环境中快速检测认知障碍，将创建一个简短、容易的 提供一套标准的CI筛选措施，适用于不同的环境和不同的 人口。由NIH评估工具箱中的两个认知测量组成 神经和行为功能®和日常认知、自我和告密者-报告测量和 MyCog作为一个可下载的应用程序实施，将在一大批老年人(65岁以上)中进行验证 参加“LitCog III：老年人的健康素养和认知功能”。现场测试MyCog 在LitCog III中，将允许在多个临床工作流程和非裔美国人中验证健康差异 人口。我们提议的项目将1)使用现有的NIHTB认知测试创建一个独立的MyCog应用程序 和Everyday Cognition Self/Proxy报告将筛查结果报告为“No CI “检测到”或“检测到CI”，并为每个结果提供后续建议和指导方针；2) 在初级保健环境中验证MyCog(UH3阶段)，并确定其在检测早期指标方面的敏感性 使用现有队列(LitCog III)的CI，该队列由65岁、具有良好特征、种族和种族多样性的成年人组成- 85；3)评估MyCog在初级保健环境中临床实施的成功情况；4)优化MyCog 通过调整评分算法以最大限度地提高效率并结合功能，在临床环境中使用 促进临床整合；以及5)如果被选中这样做，协调整个联盟的活动。

Cognitive impairment (CI) and dementia are significant public health burdens that can have profound social and emotional effects on older adults. Early detection of CI is imperative in order to identify potentially treatable underlying causal conditions, and in cases where cure is not possible, to provide supportive services to minimize the effects of CI. While primary care and other clinical settings are ideal places for identifying CI, it frequently goes undetected. Available screening tools may be unsuitable for implementation in such settings because of their length, cost, or need for specialized equipment or highly trained administrators. Our project, MyCog: Rapid detection of cognitive impairment in everyday clinical settings, will create a brief, readily available, standard set of CI screening measures applicable for use in diverse settings and with diverse populations. Comprised of two cognitive measures drawn from the NIH Toolbox for Assessment of Neurological and Behavioral Function® and the Everyday Cognition self- and informant-report measures and implemented as a downloadable app, MyCog will be validated in a large sample of older adults (ages 65+) enrolled in “LitCog III: Health Literacy and Cognitive Function among Older Adults”. Field testing MyCog within LitCog III will allow validation in multiple clinical workflows and in African-Americans, a health disparities population. Our proposed project will 1) Create a standalone MyCog App using existing NIHTB cognition tests and Everyday Cognition self-/proxy report measures that will report screening results as either “No CI detected”, or `CI detected” and provide follow-up recommendations and guidelines for each outcome; 2) Validate MyCog (UH3 Phase) in primary care settings and determine its sensitivity in detecting early indicators of CI using an existing cohort (LitCog III) of well-characterized, ethnically and racially diverse adults ages 65- 85; 3) Evaluate the success of MyCog clinical implementation in primary care settings; 4) Optimize MyCog for use in clinical settings by adjusting scoring algorithms to maximize efficiency and incorporating features that facilitate clinical integration; and 5) if selected to do so, coordinate consortium-wide activities.