TY - JOUR
T1 - Informant-based dementia screening in a population-based sample of African Americans
AU - Malmstrom, Theodore K.
AU - Miller, Douglas K.
AU - Coats, Mary A.
AU - Jackson, Pamela
AU - Miller, J. Philip
AU - Morris, John C.
PY - 2009/4
Y1 - 2009/4
N2 - BACKGROUND: An informant-based screening tool for dementia may be useful in population-based studies of minority populations. OBJECTIVE: Investigate the feasibility of screening for very mild dementia in a community sample of African Americans using an informant-based screening tool (AD8). DESIGN: Cohort study. PARTICIPANTS: One hundred forty-seven persons from the African American Health (AAH) project were screened for dementia; 61 of 93 who were invited had follow-up clinical assessments for dementia diagnosis. MEASUREMENTS: The AD8, Mini-Mental State Examination, Short Blessed Test, Brief Instrument for Dementia Detection, and a neuropsychologic battery were administered at visit 1. The Clinical Dementia Rating (CDR) was administered at visit 2 by clinicians blinded to visit 1 results; the presence of dementia was determined by a CDR greater than 0. RESULTS: Four hundred sixty-five individuals from the AAH cohort were sent a letter describing the study and, among this group, 252 individuals were contacted by phone to request participation in this study. Six percent (14/252) of the participants contacted by phone were unable to identify an informant (required for the AD8). One hundred fifty individuals agreed by phone to participate of which 2% (n=3) did not have an informant available at the time of participation. The AD8 alone was effective at discriminating between CDR 0 and CDR 0.5 (area under the curve=0.847; P<0.001; 95% confidence interval, 0.73-0.96). CONCLUSIONS: A brief informant-based instrument, the AD8, has high sensitivity and specificity for distinguishing CDR 0 from CDR 0.5 in the community. Informant availability may not be a barrier for using the AD8 in an African American community sample; however, further study in larger samples with a higher response rate, different community settings (eg, community clinics), and among older age groups (eg, age 75+) is warranted to confirm this.
AB - BACKGROUND: An informant-based screening tool for dementia may be useful in population-based studies of minority populations. OBJECTIVE: Investigate the feasibility of screening for very mild dementia in a community sample of African Americans using an informant-based screening tool (AD8). DESIGN: Cohort study. PARTICIPANTS: One hundred forty-seven persons from the African American Health (AAH) project were screened for dementia; 61 of 93 who were invited had follow-up clinical assessments for dementia diagnosis. MEASUREMENTS: The AD8, Mini-Mental State Examination, Short Blessed Test, Brief Instrument for Dementia Detection, and a neuropsychologic battery were administered at visit 1. The Clinical Dementia Rating (CDR) was administered at visit 2 by clinicians blinded to visit 1 results; the presence of dementia was determined by a CDR greater than 0. RESULTS: Four hundred sixty-five individuals from the AAH cohort were sent a letter describing the study and, among this group, 252 individuals were contacted by phone to request participation in this study. Six percent (14/252) of the participants contacted by phone were unable to identify an informant (required for the AD8). One hundred fifty individuals agreed by phone to participate of which 2% (n=3) did not have an informant available at the time of participation. The AD8 alone was effective at discriminating between CDR 0 and CDR 0.5 (area under the curve=0.847; P<0.001; 95% confidence interval, 0.73-0.96). CONCLUSIONS: A brief informant-based instrument, the AD8, has high sensitivity and specificity for distinguishing CDR 0 from CDR 0.5 in the community. Informant availability may not be a barrier for using the AD8 in an African American community sample; however, further study in larger samples with a higher response rate, different community settings (eg, community clinics), and among older age groups (eg, age 75+) is warranted to confirm this.
KW - African Americans
KW - Dementia
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=67651015435&partnerID=8YFLogxK
U2 - 10.1097/WAD.0b013e318190a709
DO - 10.1097/WAD.0b013e318190a709
M3 - Article
C2 - 19484913
AN - SCOPUS:67651015435
SN - 0893-0341
VL - 23
SP - 117
EP - 123
JO - Alzheimer disease and associated disorders
JF - Alzheimer disease and associated disorders
IS - 2
ER -