Background: In a systematic review of the evidence for dementia screening in the primary care setting to support recommendations from the U.S. Preventive Services Task Force, we found insufficient evidence to estimate the potential harms of dementia screening. An accounting of potential harm is a fundamental requirement before one can assess the value of a routine screening maneuver. In the absence of such information, the balance between the benefit of dementia screening and its possible harms can't be evaluated. Evidence from preliminary studies suggests that older adults may refuse screening for dementia due to perceived harms, the magnitude and source of these fears is undocumented. Thus, one of the areas of research suggested by the US Preventive Services Task Force is documentation of the potential harms of dementia screening. As a first step to fill this gap in the literature, we are seeking support for a study that will capture older adults' sentiments about dementia screening and evaluate the impact of such attitudes on their acceptance of dementia screening. Study design: A cross-sectional study that will randomly select 1200 individuals aged 55 and older attending primary care clinics in Indianapolis. Participants will not have a diagnosis of dementia. Each participant will complete the PRISM-PC instrument and the 5-item MOS social support instrument delivered by a research assistant in a face-to-face interview. The PRISM-PC instrument consists of 38 Likert scale type questions that measure the patients' acceptability of dementia screening and their perceived benefits and harms of such a screening. The PRISM-PC instrument also include 12 Yes-No questions that collect demographic data. Following the completion of the PRISM-PC and the MOS instruments, the participants will be asked to undergo a dementia screening using the Community Screening Instrument for Dementia (CSI-D). Participants with screened positive results on the CSI-D will be offered to have a confirmatory diagnostic assessment at a local memory clinic. Primary Outcome: Patients' perceived benefits and harms of dementia as measured by the PRISM-PC. Secondary Outcomes: Patients' acceptability of dementia screening (PRISM-PC), their acceptance of dementia screening, and their acceptance of dementia diagnosis following positive screening results. Future directions: We anticipate that participants' responses could guide the design of specific counseling and educational interventions to overcome a patients' reluctance to accept dementia screening. ? ? ?
| Fowler, Nicole R; Frame, Amie; Perkins, Anthony J et al. (2015) Traits of patients who screen positive for dementia and refuse diagnostic assessment. Alzheimers Dement (Amst) 1:236-241 |
| Fowler, Nicole R; Perkins, Anthony J; Turchan, Hilary A et al. (2015) Older primary care patients' attitudes and willingness to screen for dementia. J Aging Res 2015:423265 |
| Salsman, John M; Butt, Zeeshan; Pilkonis, Paul A et al. (2013) Emotion assessment using the NIH Toolbox. Neurology 80:S76-86 |
| Boustani, Malaz (2013) Dementia screening in primary care: not too fast! J Am Geriatr Soc 61:1205-7 |
| Gershon, Richard C; Wagster, Molly V; Hendrie, Hugh C et al. (2013) NIH toolbox for assessment of neurological and behavioral function. Neurology 80:S2-6 |
| Victorson, David; Manly, Jennifer; Wallner-Allen, Kathleen et al. (2013) Using the NIH Toolbox in special populations: considerations for assessment of pediatric, geriatric, culturally diverse, non-English-speaking, and disabled individuals. Neurology 80:S13-9 |
| Fowler, Nicole R; Boustani, Malaz A; Frame, Amie et al. (2012) Effect of patient perceptions on dementia screening in primary care. J Am Geriatr Soc 60:1037-43 |
| Boustani, Malaz A; Justiss, Michael D; Frame, Amie et al. (2011) Caregiver and noncaregiver attitudes toward dementia screening. J Am Geriatr Soc 59:681-6 |
| Boustani, Malaz A; Sachs, Greg A; Alder, Catherine A et al. (2011) Implementing innovative models of dementia care: The Healthy Aging Brain Center. Aging Ment Health 15:13-22 |
| Boustani, Malaz A; Munger, Stephanie; Gulati, Rajesh et al. (2010) Selecting a change and evaluating its impact on the performance of a complex adaptive health care delivery system. Clin Interv Aging 5:141-8 |
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