Factors associated with cognitive evaluations in the United States. (6th January 2015)

• Record Type: Journal Article
• Authors: Kotagal, Vikas; Langa, Kenneth M.; Plassman, Brenda L.; Fisher, Gwenith G.; Giordani, Bruno J.; Wallace, Robert B.; Burke, James R.; Steffens, David C.; Kabeto, Mohammed; Albin, Roger L.; Foster, Norman L.
• Is Part Of: Neurology. Volume 84:Number 1(2015)
• Publication Date: 2015-01-06
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000001096
• Languages: English
• ISSNs: 0028-3878

Abstract

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.