Feasibility and Validity of Dementia Assessment by Trained Community Health Workers Based on Clinical Dementia Rating. Issue 7 (3rd June 2013)

• Record Type: Journal Article
• Authors: Han, Hae‐Ra; Park, So‐Youn; Song, Heejung; Kim, Miyong; Kim, Kim B.; Lee, Hochang Ben
• Is Part Of: Journal of the American Geriatrics Society. Volume 61:Issue 7(2013:Jul.)
• Page Start: 1141
• Page End: 1145
• Publication Date: 2013-06-03
• Subjects: Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.12309
• Languages: English
• ISSNs: 0002-8614

Abstract

<abstract abstract-type="main" id="jgs12309-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jgs12309-sec-0001" sec-type="section"> <title>Objectives</title> <p>To determine the level of agreement between dementia rating by trained community health workers (CHWs) based on the Clinical Dementia Rating (CDR) and the criterion standard: physician diagnosis.</p> </sec> <sec id="jgs12309-sec-0002" sec-type="section"> <title>Design</title> <p>Cross‐sectional validation study.</p> </sec> <sec id="jgs12309-sec-0003" sec-type="section"> <title>Setting</title> <p>Community gathering places such as ethnic churches, senior centers, low‐income elderly apartments, and ethnic groceries in the Baltimore–Washington metropolitan area.</p> </sec> <sec id="jgs12309-sec-0004" sec-type="section"> <title>Participants</title> <p>Ninety community‐dwelling Korean‐American individuals aged 60 and older.</p> </sec> <sec id="jgs12309-sec-0005" sec-type="section"> <title>Measurements</title> <p>The CDR is a standardized clinical dementia staging instrument used to assess cognitive and functional performance using a semistructured interview protocol. Six CHWs trained and certified as CDR raters interviewed and rated study participants. A bilingual geriatric psychiatrist evaluated participants independently for dementia status.</p> </sec> <sec id="jgs12309-sec-0006" sec-type="section"> <title>Results</title> <p>CHWs rated 61.1% of the participants as having mild cognitive impairment (MCI; CDR = 0.5) or dementia (CDR≥1), versus 56.7% diagnosed by the clinician. A receiver operating characteristic (ROC) curve analysis demonstrated good predictive ability of CDR rating by trained CHWs (area under the ROC curve = 0.86, 95% confidence interval = 0.78–0.93, sensitivity = 85.5%, specificity = 88.6%) in detecting MCI and dementia.</p> </sec> <sec id="jgs12309-sec-0007" sec-type="section"> <title>Conclusion</title> <p>The findings provide preliminary evidence that trained CHWs can effectively identify community‐dwelling elderly Korean adults with MCI and dementia for early follow‐up assessment and care in a community with scarce bilingual caregivers and programs.</p> </sec> </abstract>