Cognitive screening in Asia: recognizing the role of the patient-family unit.
OBJECTIVE
Cognitive screening programmes may improve awareness and help at-risk subjects receive earlier medical attention. Cognitive profiles of subjects who attend cognitive screening by personal choice (self-referred) compared to those where the referral was initiated by family members (family-referred) were compared.


METHODS
A cross-sectional survey of community subjects attending a cognitive screening initiative. Performance on the MMSE, Frontal Assessment Battery (FAB), Elderly Cognitive Assessment Questionnaire (ECAQ) and Even Briefer Assessment Scale for Depression was evaluated.


RESULTS
A total of 342 subjects with a mean age of 59.2 +/- 9.0 years were screened. Overrepresentation of Chinese and Indian subjects and underrepresentation of Malay subjects was noted. The prevalence of cognitive impairment ranged from 7.0 to 9.6% depending on the screening instrument used. Of the 342 subjects, 267 were self-referred, while 75 subjects were family-referred. Family-referred subjects had lower MMSE (p < 0.001), lower ECAQ (p < 0.001) and lower FAB (p < 0.001) scores but were not more depressed compared to self-referred subjects (p = 0.904). Only the difference in ECAQ scores remained significant after adjustment for baseline differences in age and education. The prevalence of hypertension, diabetes mellitus and hypercholesterolaemia was not statistically different between the 2 groups.


CONCLUSIONS
Family members play a crucial role in the diagnosis of cognitive impairment, especially in older subjects with fewer years of education.
Ng
A
A
Department of Neurology, National Neuroscience Institute, Singapore.
Earnest
A
A
Yeo
D
D
Kandiah
N
N
D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D010054:Brief Psychiatric Rating Scale; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010361:Patients; D015995:Prevalence; D012380:Role; D012720:Severity of Illness Index; D012846:Singapore / Q000453:epidemiology