title: Identifying memory impairment and early dementia in primary care.
abstract: BACKGROUND
  This study examined the operating characteristics of two-stage case finding to identify memory impairment and very mild dementia.
  
  
  METHODS
  Primary care patients underwent two-stage testing and a subsequent diagnostic assessment to assess outcomes. Patients who screen positive for subjective cognitive decline on the Informant Questionnaire on Cognitive Decline in the Elderly undergo memory testing with the Free and Cued Selective Reminding Test with Immediate Recall. Outcomes were determined without access to these data. A split-half design with discovery and confirmatory samples was used.
  
  
  RESULTS
  One hundred seventeen of 563 (21%) patients had dementia and 68 (12%) had memory impairment but not dementia. Operating characteristics were similar in the discovery and confirmatory samples. In the pooled sample, combined, patients with memory impairment or dementia were identified with good sensitivity (72%) and high specificity (90%). Differences in ethnicity, educational level, or age (≤75, >75) did not affect classification accuracy.
  
  
  CONCLUSIONS
  Two-stage screening facilitates the efficient identification of older adults with memory impairment or dementia.
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Grober
authors.affiliation: Center on Aging, UConn Health, Farmington, CT, USA.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Wakefield
authors.affiliation: Division of Geriatrics, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Ehrlich
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Mabie
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Lipton
keywords: Alzheimer's disease; Cognition; Free and Cued Selective Reminding Test; Informant Questionnaire for Cognitive Decline in the Elderly; Memory; Two-stage screening