Title | Factors associated with cognitive evaluations in the United States. |
Publication Type | Journal Article |
Year of Publication | 2015 |
Authors | Kotagal, V, Langa, KM, Plassman, BL, Fisher, GG, Giordani, BJ, Wallace, RB, Burke, JF, Steffens, DC, Kabeto, MU, Albin, RL, Foster, NL |
Journal | Neurology |
Volume | 84 |
Issue | 1 |
Pagination | 64-71 |
Date Published | 2015 Jan 06 |
ISSN Number | 1526-632X |
Keywords | Aged, 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 |
Abstract | 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. |
URL | http://www.neurology.org/cgi/doi/10.1212/WNL.0000000000001096 |
DOI | 10.1212/WNL.0000000000001096 |
User Guide Notes | |
Short Title | Neurology |
Alternate Journal | Neurology |
Citation Key | 8660 |
PubMed ID | 25428689 |
PubMed Central ID | PMC4336093 |
Grant List | P30 AG024824 / AG / NIA NIH HHS / United States U01 AG009740 / AG / NIA NIH HHS / United States |