Factors associated with cognitive evaluations in the United States

被引:72
作者
Kotagal, Vikas [1 ]
Langa, Kenneth M. [2 ]
Plassman, Brenda L. [5 ]
Fisher, Gwenith G. [7 ]
Giordani, Bruno J. [1 ,3 ,4 ]
Wallace, Robert B. [8 ]
Burke, James R. [6 ]
Steffens, David C. [9 ]
Kabeto, Mohammed [2 ]
Albin, Roger L. [1 ]
Foster, Norman L. [10 ]
机构
[1] Univ Michigan, Dept Neurol, Ann Arbor, MI 48109 USA
[2] Univ Michigan, Dept Internal Med, Ann Arbor, MI 48109 USA
[3] Univ Michigan, Dept Psychiat, Ann Arbor, MI 48109 USA
[4] Univ Michigan, Dept Psychol, Ann Arbor, MI USA
[5] Duke Univ, Med Ctr, Dept Psychiat, Durham, NC 27710 USA
[6] Duke Univ, Med Ctr, Dept Neurol, Durham, NC USA
[7] Colorado State Univ, Dept Psychol, Ft Collins, CO 80523 USA
[8] Univ Iowa, Dept Epidemiol, Iowa City, IA USA
[9] Univ Connecticut, Ctr Hlth, Dept Psychiat, Farmington, CT 06032 USA
[10] Univ Utah, Dept Neurol, Salt Lake City, UT USA
关键词
ALZHEIMERS-DISEASE; DEMENTIA; CARE; IMPAIRMENT; DIAGNOSIS; INTERVENTION; DEMOGRAPHICS; PREVALENCE; DONEPEZIL; SEVERITY;
D O I
10.1212/WNL.0000000000001096
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: We aimed to explore factors associated with clinical evaluations for cognitive impairment among older residents of the United States. Methods: Two hundred ninety-seven of 845 subjects in the Aging, Demographics, and Memory Study (ADAMS), a nationally representative community-based cohort study, met criteria for dementia after a detailed in-person study examination. Informants for these subjects reported whether or not they had ever received a clinical cognitive evaluation outside of the context of ADAMS. Among subjects with dementia, we evaluated demographic, socioeconomic, and clinical factors associated with an informant-reported clinical cognitive evaluation using bivariate analyses and multivariable logistic regression. Results: Of the 297 participants with dementia in ADAMS, 55.2% (representing about 1.8 million elderly Americans in 2002) reported no history of a clinical cognitive evaluation by a physician. In a multivariable logistic regression model (n = 297) controlling for demographics, physical function measures, and dementia severity, marital status (odds ratio for currently married: 2.63 [95% confidence interval: 1.10-6.35]) was the only significant independent predictor of receiving a clinical cognitive evaluation among subjects with study-confirmed dementia. Conclusions: Many elderly individuals with dementia do not receive clinical cognitive evaluations. The likelihood of receiving a clinical cognitive evaluation in elderly individuals with dementia associates with certain patient-specific factors, particularly severity of cognitive impairment and current marital status.
引用
收藏
页码:64 / 71
页数:8
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