title: Informant-based dementia screening in a population-based sample of African Americans.
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).
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Neurology & Psychiatry, School of Medicine, St Louis University, 1438 South Grand Boulevard, St Louis, MO 63104, USA. malmsttk@slu.edu
authors.forename: Theodore K
authors.initials: TK
authors.lastname: Malmstrom
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Miller
authors.forename: Mary A
authors.initials: MA
authors.lastname: Coats
authors.forename: Pamela
authors.initials: P
authors.lastname: Jackson
authors.forename: J Philip
authors.initials: JP
authors.lastname: Miller
authors.forename: John C
authors.initials: JC
authors.lastname: Morris
mesh_terms: D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D010290:Parents / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires