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

项目摘要/摘要 需要对各种神经认知敏感的高效和用户友好的神经认知屏幕 向初级保健提供紊乱的陈述。加州大学旧金山分校的脑健康评估被开发成有效地 测量在神经认知衰退的早期阶段可能受到影响的认知域，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 可选的信息调查通过吸引人的平板电脑界面和自动评分进行管理 和提供者的反馈。初步验证研究表明，联合检测的敏感度和特异度良好 受过中等到高教育程度的说英语的老年人的认知障碍。这个 拟议工作的主要目标是优化和验证老年人的BHA，这些老年人在 教育术语和口语，对由该基金资助的其他范式进行交叉验证研究 评估和解决初级保健中发现认知障碍的障碍。教育和 英语作为第二语言都会影响认知测试成绩，也是准确检测 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。 受过教育，且主要语言为西班牙语、普通话或广东话的人 实施研究。在目标1中，我们将评估BHA在检测认知功能方面的有效性 具有良好特征并经专业诊断的说英语的老年人的低、中、或 高等教育。在目标2中，我们将评估BHA在检测儿童认知障碍方面的有效性。 说西班牙语、广东话或普通话的老年人有很好的性格特征和熟练的诊断。在《目标3》中， 我们将确定并解决初级保健实践中的实施挑战，为不同领域的患者提供服务 教育术语和口语。如果成功，该项目将增加对认知能力的检测 日常社区环境中的损害，这是实现鉴别诊断和改善的关键 在美国，对包括痴呆症在内的认知障碍患者的医疗管理。

PROJECT SUMMARY / ABSTRACT 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.