Factors associated with cognitive evaluations in the United States.

TitleFactors associated with cognitive evaluations in the United States.
Publication TypeJournal Article
Year of Publication2015
AuthorsKotagal, V, Langa, KM, Plassman, BL, Fisher, GG, Giordani, BJ, Wallace, RB, Burke, JF, Steffens, DC, Kabeto, MU, Albin, RL, Foster, NL
Date Published2015 Jan 06
ISSN Number1526-632X
KeywordsAged, Aged, 80 and over, Cognition Disorders, Cohort Studies, Dementia, Female, Humans, Logistic Models, Male, Marital Status, Multivariate Analysis, Neuropsychological tests, Severity of Illness Index, United States

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.

User Guide Notes


Short TitleNeurology
Alternate JournalNeurology
Citation Key8660
PubMed ID25428689
PubMed Central IDPMC4336093
Grant ListP30 AG024824 / AG / NIA NIH HHS / United States
U01 AG009740 / AG / NIA NIH HHS / United States