Reducing case ascertainment costs in U.S. population studies of Alzheimer's disease, dementia, and cognitive impairment-Part 2.
Dementia of the Alzheimer's type (DAT) is a major public health threat in developed countries where longevity has been extended to the eighth decade of life. Estimates of prevalence and incidence of DAT vary with what is measured, be it change from a baseline cognitive state or a clinical diagnostic endpoint, such as Alzheimer's disease. Judgment of what is psychometrically "normal" at the age of 80 years implicitly condones a decline from what is normal at the age of 30. However, because cognitive aging is very heterogeneous, it is reasonable to ask "Is 'normal for age' good enough to screen for DAT or its earlier precursors of cognitive impairment?" Cost containment and accessibility of ascertainment methods are enhanced by well-validated and reliable methods such as screening for cognitive impairment by telephone interviews. However, focused assessment of episodic memory, the key symptom associated with DAT, might be more effective at distinguishing normal from abnormal cognitive aging trajectories. Alternatively, the futuristic "Smart Home," outfitted with unobtrusive sensors and data storage devices, permits the moment-to-moment recording of activities so that changes that constitute risk for DAT can be identified before the emergence of symptoms.
Rush Institute on Healthy Aging, Rush University Medical Center, Chicago, IL, USA. Denis_Evans@rush.edu
Denis A
DA
Evans
Francine
F
Grodstein
David
D
Loewenstein
Jeffrey
J
Kaye
Sandra
S
Weintraub
D000375:Aging; D000544:Alzheimer Disease / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D002986:Clinical Trials as Topic; D003072:Cognition Disorders / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D018672:Community Health Planning; D003362:Cost-Benefit Analysis; D003704:Dementia / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D006801:Humans; D009483:Neuropsychological Tests; D014481:United States / Q000453:epidemiology
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