Informant-based dementia screening in a population-based sample of African Americans

Theodore K. Malmstrom, Douglas K. Miller, Mary A. Coats, Pamela Jackson, J. Philip Miller, John C. Morris

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)117-123
Number of pages7
JournalAlzheimer disease and associated disorders
Volume23
Issue number2
DOIs
StatePublished - Apr 2009

Keywords

  • African Americans
  • Dementia
  • Screening

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