Dementia, including Alzheimer's disease (AD), is a common and devastating neurodegenerative disorder of the elderly. Most older individuals receive their health care solely within the general practice/primary care setting. Dementia, and complications related to dementia, will impose growing demands on the general practice sector as the US population ages. Few data exist on the occurrence, characteristics, and outcomes of dementia in the U.S. general practice setting. Such data cannot be obtained or extrapolated either from specialty clinics/case-control studies or from community surveys. Using a clinical epidemiological approach, we propose to examine the prevalence, outcomes, and prognostic factors in Alzheimer's and other dementias in an elderly general practice (internal medicine/family practice) patient population drawn from a stable, biracial, economically depressed community in Southwestern Pennsylvania. Screening all patients aged 65+ seen over one year (anticipated N=6,240) within five participating practices, we will evaluate them for the presence of AD/dementia and related variables. We will estimate their prevalence and describe their characteristics. We will then follow them for four years to assess outcomes of interest (mortality, institutionalization, and complications of dementia) and to identify prognostic factors for the outcomes. Prognostic (risk and protective) variables to be examined will include subjects' demographic, clinical, and relevant social characteristics, as well as selected medical interventions. Results will shed important new light on the prevalence, type, and severity of dementia in general practice, as well as its impact on long-term outcomes. Such clinical epidemiological data are needed to determine the risks associated with dementia in primary care patients. They will also assist in formulating appropriate policies and guidelines for early diagnosis, treatment, and prevention of excess disability.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
1R01AG016705-01
Application #
2832414
Study Section
Epidemiology and Disease Control Subcommittee 2 (EDC)
Program Officer
Anderson, Dallas
Project Start
1999-04-01
Project End
2004-03-31
Budget Start
1999-04-01
Budget End
2000-03-31
Support Year
1
Fiscal Year
1999
Total Cost
Indirect Cost
Name
University of Pittsburgh
Department
Psychiatry
Type
Schools of Medicine
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Snitz, Beth E; Yu, Lan; Crane, Paul K et al. (2012) Subjective cognitive complaints of older adults at the population level: an item response theory analysis. Alzheimer Dis Assoc Disord 26:344-51
Stoehr, Gary P; Lu, Shu-Ya; Lavery, Laurie et al. (2008) Factors associated with adherence to medication regimens in older primary care patients: the Steel Valley Seniors Survey. Am J Geriatr Pharmacother 6:255-63
McMichael, Kathryn A; Vander Bilt, Joni; Lavery, Laurie et al. (2008) Simple balance and mobility tests can assess falls risk when cognition is impaired. Geriatr Nurs 29:311-23
Lavery, Laurie L; Lu, Shu-ya; Chang, Chung-Chou H et al. (2007) Cognitive assessment of older primary care patients with and without memory complaints. J Gen Intern Med 22:949-54
Ganguli, Mary; Du, Yangchun; Rodriguez, Eric G et al. (2006) Discrepancies in information provided to primary care physicians by patients with and without dementia: the Steel Valley Seniors Survey. Am J Geriatr Psychiatry 14:446-55
Steffens, David C; Otey, Emeline; Alexopoulos, George S et al. (2006) Perspectives on depression, mild cognitive impairment, and cognitive decline. Arch Gen Psychiatry 63:130-8
Ganguli, Mary; Rodriguez, Eric; Mulsant, Benoit et al. (2004) Detection and management of cognitive impairment in primary care: The Steel Valley Seniors Survey. J Am Geriatr Soc 52:1668-75