Bayley Peter J, Kong Jennifer Y, Mendiondo Marta, Lazzeroni Laura C, Borson Soo, Buschke Herman, Dean Margaret, Fillit Howard, Frank Lori, Schmitt Frederick A, Peschin Susan, Finkel Sanford, Austen Melissa, Steinberg Carol, Ashford John Wesson
War Related Illness and Injury Study Center, Veteran Affairs Palo Alto Health Care System, Palo Alto, California; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
J Am Geriatr Soc. 2015 Feb;63(2):309-14. doi: 10.1111/jgs.13234. Epub 2015 Jan 30.
To report experience with a large, nation-wide public memory screening program.
Descriptive study of community-dwelling elderly adults.
Local community sites (48 sites agreed to provide data) throughout the United States participating in National Memory Screening Day in November 2010.
Of 4,369 reported participants, 3,064 had complete data records and are included in this report.
Participants completed a questionnaire that included basic demographic information and a question about subjective memory concerns. Each site selected one of seven validated cognitive screening tests: Mini-Cog, General Practitioner assessment of Cognition, Memory Impairment Screen, Kokmen Short Test of Mental Status, Mini-Mental State Examination, Montreal Cognitive Assessment, Saint Louis University Mental Status Examination.
Overall, 11.7% failed one of the seven screening tests. As expected, failure rates were higher in older and less-educated participants (P's < .05). Subjective memory concerns were associated with a 40% greater failure rate for persons of similar age and education but no memory concerns (odds ratio = 1.4, 95% confidence interval = 1.07-1.78), although only 11.9% of those who reported memory concerns (75% of all participants) had detectible memory problems.
Screening for cognitive impairment in community settings yielded results consistent with expected effects of age and education. The event attracted a large proportion of individuals with memory concerns; 88.1% were told that they did not have memory problems detectible with the tests used. Further studies are needed to assess how participants respond to and use screening information, whether this information ultimately influences decision-making or outcomes, and whether memory screening programs outside healthcare settings have public health value.
报告一项大规模全国性公众记忆筛查项目的经验。
对社区居住的老年人进行描述性研究。
2010年11月在美国各地参与全国记忆筛查日活动的当地社区场所(48个场所同意提供数据)。
在报告的4369名参与者中,3064人有完整的数据记录并纳入本报告。
参与者完成一份问卷,其中包括基本人口统计学信息以及一个关于主观记忆问题的询问。每个场所从七种经过验证的认知筛查测试中选择一种:简易认知评估量表(Mini-Cog)、全科医生认知评估、记忆损害筛查、科克曼简易精神状态测验、简易精神状态检查表、蒙特利尔认知评估量表、圣路易斯大学精神状态检查表。
总体而言,11.7%的人在七种筛查测试中的一项未通过。正如预期的那样,年龄较大和受教育程度较低的参与者未通过率更高(P值<0.05)。主观记忆问题与年龄和教育程度相似但无记忆问题的人相比,未通过率高出40%(优势比=1.4,95%置信区间=1.07-1.78),尽管报告有记忆问题的人(占所有参与者的75%)中只有11.9%存在可检测到的记忆问题。
在社区环境中进行认知障碍筛查的结果与年龄和教育程度的预期影响一致。该活动吸引了很大一部分有记忆问题的人;88.1%的人被告知他们没有该测试可检测到的记忆问题。需要进一步研究来评估参与者如何回应和使用筛查信息,该信息是否最终影响决策或结果,以及医疗保健环境之外的记忆筛查项目是否具有公共卫生价值。