Development and validation of a brief dementia screening indicator for primary care

Deborah E Barnes, Alexa S Beiser, Anne Lee, Kenneth M Langa, Alain Koyama, Sarah R Preis, John Neuhaus, Ryan J McCammon, Kristine Yaffe, Sudha Seshadri, Mary N Haan, David R Weir

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Background: Detection of “any cognitive impairment” is mandated as part of the Medicare annual wellness visit, but screening all patients may result in excessive false positives.

Methods: We developed and validated a brief Dementia Screening Indicator using data from four large, ongoing cohort studies (the Cardiovascular Health Study [CHS]; the Framingham Heart Study [FHS]; the Health and Retirement Study [HRS]; the Sacramento Area Latino Study on Aging [SALSA]) to help clinicians identify a subgroup of high-risk patients to target for cognitive screening.

Results: The final Dementia Screening Indicator included age (1 point/year; ages, 65–79 years), less than 12 years of education (9 points), stroke (6 points), diabetes mellitus (3 points), body mass index less than 18.5 kg/m 2 (8 points), requiring assistance with money or medications (10 points), and depressive symptoms (6 points). Accuracy was good across the cohorts (Harrell's C statistic: CHS, 0.68; FHS, 0.77; HRS, 0.76; SALSA, 0.78).

Conclusions: The Dementia Screening Indicator is a simple tool that may be useful in primary care settings to identify high-risk patients to target for cognitive screening.
Original languageEnglish
Pages (from-to)656-665
Number of pages10
JournalAlzheimer's and Dementia
Volume10
Issue number6
DOIs
Publication statusPublished - 2014
Externally publishedYes

Keywords

  • dementia
  • screening
  • risk prediction modeling
  • primary care

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