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5-Cog Battery to improve detection of cognitive impairment and dementia

5-Cog 电池可改善认知障碍和痴呆症的检测

基本信息

批准号：
10263305
负责人：
JOE VERGHESE
金额：
$ 82.17万
依托单位：
ALBERT EINSTEIN COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-25 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10263305
关键词：
African American Assessment tool Biological Assay Cognitive Complex Computerized Medical Record Control Groups Cost Effectiveness Analysis Coupled Data Decision Trees Dementia Detection Diagnosis Drug Prescriptions Educational Background Electronic Health Record Ethnic Origin Ethnic group Evaluation Event Gait Health Professional Hispanics Human Resources Impaired cognition India Individual Internet Intervention Investigation Laboratories Logistics Low Literacy Population Measures Medical Medicare Memory impairment Mental Depression Methods Motor Neuropsychological Tests Outcome Outpatients Paper Patient Care Persons Phase Population Primary Care Physician Primary Health Care Procedures Process Questionnaires Randomized Randomized Clinical Trials Registries Risk Rural Services Single-Blind Study Site Social Work Specialist Specificity Standardization Syndrome System Test Result Testing Training Validation Visit Work active control base cognitive testing cohort cost dementia care experience feasibility testing follow-up grasp group intervention health care service utilization health disparity populations health literacy high risk implementation barriers improved informant literacy mild cognitive impairment multi-ethnic older patient patient population primary care setting recruit screening socioeconomics tool validation studies

项目摘要

Cognitive impairment related to dementia is frequently under-diagnosed in primary care settings despite the availability of numerous assessment tools. Missed detection delays treatment of reversible conditions as well as provision of support services and critical planning. This problem is more prevalent among older African- Americans and Hispanics than among older whites. Our group has two decades of experience developing tools to detect dementia in health disparate populations. Notably, we developed the Picture-based Memory Impairment Screen (PMIS) that relies on culture fair pictures and does not need to be administered by a medical professional. We also validated the Motoric Cognitive Risk syndrome (MCR). This highly accessible test relies on the presence of slow gait and cognitive self-complaints to identify individuals at high risk of converting to dementia. Both the PMIS and the MCR are highly sensitive and specific first-line assays that can be followed up with more thorough and complex cognitive testing. Building on our work, we propose to develop and validate a 5-minute screen (5-Cog) to identify persons at high risk of developing dementia and to flag them for further evaluation. We propose to do this in urban, multi-ethnic Bronx primary care populations with socio-economic challenges. The 5-Cog battery will include the PMIS, MCR syndrome diagnosis, and a 2-item depression screener. In the 18-month UG3 phase, we propose to fine-tune the components of the 5-Cog that will be tested in a health disparate population in the Bronx, and could be extended to other participating sites under this RFA. We will also test the feasibility of administering the 5-Cog by non-physicians to increase accessibility of our battery in primary care settings. In the 42-month UH3 phase, we propose a single-blind, randomized clinical trial in 1,200 older primary care patients presenting with cognitive complaints who will be randomized to receive either the 5-Cog battery (intervention group) or a 5-minute health literacy questionnaire (control group). Non-physicians will administer the intervention and control tests in primary care sites, and test results will be provided to primary care physicians for further action. ‘Improved dementia care’ will be measured by using a composite endpoint including new Mild Cognitive Impairment syndrome (MCI) or dementia diagnoses, laboratory investigations to rule out reversible causes of cognitive impairment, new dementia medication prescriptions, and specialist or social work referrals. The outcome events will be tracked using our electronic health record system. We will also conduct health care utilization and cost effectiveness analysis of the 5-Cog intervention in real-world settings. By the end of the UH3 phase, we will create a web registry to make 5-Cog test items and procedures available for download by health care professionals. The 5-Cog battery will overcome many of the implementation barriers of previous cognitive screens; it will be fast, low cost, easy to implement (requires only pen, paper and stopwatch), can be administered by non- clinicians after minimal training, not educationally or culturally biased, not confounded by depression and does not require informants.

在初级保健机构中，与痴呆症相关的认知障碍往往未得到充分诊断

项目成果

期刊论文数量（9）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Motoric Cognitive Risk Syndrome in Polypharmacy.

DOI：
10.1111/jgs.16380
发表时间：
2020-05
期刊：
Journal of the American Geriatrics Society
影响因子：
6.3
作者：
George CJ;Verghese J
通讯作者：
Verghese J

Cross-Cultural Comparisons of Subjective Cognitive Complaints in a Diverse Primary Care Population.

DOI：
10.3233/jad-201399
发表时间：
2021
期刊：
Journal of Alzheimer's disease : JAD
影响因子：
0
作者：
Rodríguez D;Ayers E;Weiss EF;Verghese J
通讯作者：
Verghese J

Is the Montreal cognitive assessment culturally valid in a diverse geriatric primary care setting? Lessons from the Bronx.

蒙特利尔认知评估在多元化的老年初级保健环境中在文化上有效吗？

DOI：
10.1111/jgs.18705
发表时间：
2024
期刊：
Journal of the American Geriatrics Society
影响因子：
6.3
作者：
Stimmel,MarninaB;Orkaby,ArielaR;Ayers,Emmeline;Verghese,Joe;Nsubayi,CelesteK;Weiss,EricaF
通讯作者：
Weiss,EricaF

Prodromal Motoric Cognitive Risk Syndrome and Everyday Function.