Neuropsychological strategies for detecting early dementia.
As new and more effective treatments for Alzheimer's disease (AD) emerge, the development of efficient screening strategies in educationally and racially diverse primary care settings has increased in importance. A set of candidate screening tests and an independent diagnostic assessment were administered to a sample of 318 patients treated at a geriatric primary care center. Fifty-six subjects met criteria for dementia. Exploratory analysis led to the development of three two-stage screening strategies that differed in the composition of the first stage or Rapid Dementia Screen, which is applied to all patients over the age of 65. The second stage, applied to those patients who screen positively for dementia, is accomplished with the Free and Cued Selective Reminding Test to detect memory impairment. Using clinical diagnosis as a gold standard, the strategies had high sensitivity and specificity for identifying dementia and performed better for identifying AD than non-AD dementias. Sensitivity and specificity did not differ by race or education. The strategies provide an efficient approach to screening for early dementia.
Grober
Ellen
E
Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA. egrober@montefiore.org
Hall
Charles
C
McGinn
Maryanne
M
Nicholls
Toni
T
Stanford
Stephanie
S
Ehrlich
Amy
A
Jacobs
Laurie G
LG
Kennedy
Gary
G
Sanders
Amy
A
Lipton
Richard B
RB
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000209:etiology; D003704:Dementia / Q000175:diagnosis* / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies