Identifying memory impairment and early dementia in primary care

Ellen Grober, Dorothy Wakefield, Amy R. Ehrlich, Peter C. Mabie, Richard B. Lipton

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)188-195
Number of pages8
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Volume6
DOIs
StatePublished - 2017

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Dementia
Primary Health Care
Short-Term Memory
Cognitive Dysfunction

Keywords

  • Alzheimer's disease
  • Cognition
  • Free and Cued Selective Reminding Test
  • Informant Questionnaire for Cognitive Decline in the Elderly
  • Memory
  • Two-stage screening

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

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title = "Identifying memory impairment and early dementia in primary care",
abstract = "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.",
keywords = "Alzheimer's disease, Cognition, Free and Cued Selective Reminding Test, Informant Questionnaire for Cognitive Decline in the Elderly, Memory, Two-stage screening",
author = "Ellen Grober and Dorothy Wakefield and Ehrlich, {Amy R.} and Mabie, {Peter C.} and Lipton, {Richard B.}",
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T1 - Identifying memory impairment and early dementia in primary care

AU - Grober, Ellen

AU - Wakefield, Dorothy

AU - Ehrlich, Amy R.

AU - Mabie, Peter C.

AU - Lipton, Richard B.

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Alzheimer's disease

KW - Cognition

KW - Free and Cued Selective Reminding Test

KW - Informant Questionnaire for Cognitive Decline in the Elderly

KW - Memory

KW - Two-stage screening

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