Dementia Care Research and Psychosocial Factors

Area of Science:

• Gerontology
• Public Health
• Clinical Informatics

Background:

• Alzheimer's disease (AD) disproportionately affects Black and Hispanic/Latino individuals.
• Existing dementia screening tools lack efficiency, accessibility, and cultural sensitivity.
• Underdiagnosis of AD is prevalent, especially in minority populations.

Purpose of the Study:

• To implement a brief dementia screening tool (DST) integrated into electronic health records (EHR).
• To evaluate the DST's impact on dementia diagnosis, workup, and treatment in a diverse primary care setting.
• To address health disparities in dementia care through improved screening and diagnosis.

Main Methods:

• A brief (<5 min) DST with patient and informant components was culturally adapted and translated.
• The DST was integrated into EHR for patients aged 60+ before annual wellness visits.
• A pre-post intervention study design compared outcomes before and after DST implementation.

Main Results:

• Screening 996 patients over 10 months led to 35 referrals and 15 new dementia diagnoses.
• New dementia diagnoses increased significantly post-DST implementation (4.17% to 4.80%).
• Dementia medication prescriptions, specialty referrals, and use of diagnostic labs/imaging all significantly increased post-DST.

Conclusions:

• Integrating a brief, culturally sensitive DST into primary care enhances dementia diagnosis, workup, and treatment.
• The DST shows potential for broad implementation to improve dementia care and reduce health disparities.
• Culturally adapted screening tools are crucial for equitable dementia care in diverse patient populations.