TY - JOUR T1 - Factors associated with cognitive evaluations in the United States. JF - Neurology Y1 - 2015 A1 - Vikas Kotagal A1 - Kenneth M. Langa A1 - Brenda L Plassman A1 - Gwenith G Fisher A1 - Bruno J Giordani A1 - Robert B Wallace A1 - James F. Burke A1 - David C Steffens A1 - Mohammed U Kabeto A1 - Roger L. Albin A1 - Norman L Foster KW - Aged KW - Aged, 80 and over KW - Cognition Disorders KW - Cohort Studies KW - Dementia KW - Female KW - Humans KW - Logistic Models KW - Male KW - Marital Status KW - Multivariate Analysis KW - Neuropsychological tests KW - Severity of Illness Index KW - United States AB -
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.
VL - 84 UR - http://www.neurology.org/cgi/doi/10.1212/WNL.0000000000001096 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25428689?dopt=Abstract JO - Neurology ER -