Identifying memory impairment and early dementia in primary care

Area of Science:

• Gerontology
• Neurology
• Public Health

Background:

• Memory impairment and dementia are significant health concerns in aging populations.
• Early identification is crucial for timely intervention and management.
• Existing screening methods may have limitations in primary care settings.

Purpose of the Study:

• To evaluate the operating characteristics of a two-stage case-finding strategy.
• To assess the effectiveness of this strategy in identifying memory impairment and very mild dementia.
• To determine the sensitivity and specificity of the screening process.

Main Methods:

• A two-stage testing approach was implemented in primary care patients.
• Stage one involved screening for subjective cognitive decline using the Informant Questionnaire on Cognitive Decline in the Elderly.
• Stage two involved memory testing with the Free and Cued Selective Reminding Test with Immediate Recall for positive screens.

Main Results:

• The study identified 117 patients (21%) with dementia and 68 (12%) with memory impairment but not dementia.
• The two-stage screening achieved a combined sensitivity of 72% and specificity of 90% in the pooled sample.
• Classification accuracy was not significantly affected by ethnicity, education, or age.

Conclusions:

• Two-stage screening is an efficient method for identifying older adults with memory impairment or dementia.
• This approach can facilitate early detection and intervention in primary care.
• The screening method demonstrates robust performance across diverse demographic groups.