Global Perspectives on Brief Cognitive Assessments for Dementia Diagnosis¹

Article type: Research Article

Authors: Tsoy, Elena^a | Sideman, Alissa Bernstein^{b; c; d; e} | Piña Escudero, Stefanie D.^{d; e} | Pintado-Caipa, Maritza^{d; e} | Kanjanapong, Suchanan^f | Al-Rousan, Tala^{d; e} | Mbakile-Mahlanza, Lingani^{d; e} | de Oliveira, Maira Okada^{d; e} | De la Cruz Puebla, Myriam^{d; e} | Zygouris, Stelios^{d; e} | Mohamed, Aya Ashour^{d; e} | Ibrahim, Hany^{d; e} | Goode, Collette A.^a | Miller, Bruce L.^{a; d; e} | Valcour, Victor^{a; d; e} | Possin, Katherine L.^{a; d; e; *}

Affiliations: [a] Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA | [b] Department of Humanities and Social Sciences, University of California, San Francisco, San Francisco, CA, USA | [c] Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA | [d] Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA | [e] Trinity College Dublin, Ireland | [f] Division of Geriatrics, Department of Preventive Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Correspondence: [*] Correspondence to: Katherine L. Possin, PhD, Associate Professor in Residence, Department of Neurology, Memory and Aging Center, University of California San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA 94158, USA. Tel.: +1 415 476 1889; E-mail: katherine.possin@ucsf.edu.

Note: [1] This article received a correction notice (Erratum) with the reference: 10.3233/JAD-229005, available at http://doi.org/10.3233/JAD-229005.

Abstract: Background:Timely diagnosis of dementia is a global healthcare priority, particularly in low to middle income countries where rapid increases in older adult populations are expected. Objective:To investigate global perspectives on the role of brief cognitive assessments (BCAs) in dementia diagnosis, strengths and limitations of existing measures, and future directions and needs. Methods:This is a qualitative study of 18 dementia experts from different areas of the world. Participants were selected using purposeful sampling based on the following criteria: 1) practicing in countries with projected growth of older adult population of over 100%by 2050; 2) expertise in dementia diagnosis and treatment; 3) involvement in clinical practice and training; and 4) recognition as a national dementia expert based on leadership positions within healthcare system, research, and/or policy work. Participants were individually interviewed in their language of choice over secure videoconference sessions. Interviews were analyzed by a multidisciplinary team using theme identification approach. Results:Four domains with subthemes emerged illustrating participants’ perspectives: 1) strengths of BCAs; 2) limitations of BCAs; 3) needs related to the use of BCAs; and 4) characteristics of an ideal BCA. While most experts agreed that BCAs were important and useful for dementia diagnosis, the themes emphasized the need for development and validation of novel measures that are sensitive, psychometrically sound, and culturally appropriate. Conclusion:BCAs are important for guiding diagnosis and care for dementia patients. Findings provide a roadmap for novel BCA development to assist in diagnostic decision making for clinicians serving a rapidly growing and diverse dementia population.

Keywords: Alzheimer’s disease, cultural diversity, dementia, mental status and dementia tests, mild cognitive impairment

DOI: 10.3233/JAD-201403

Journal: Journal of Alzheimer's Disease, vol. 82, no. 3, pp. 1001-1013, 2021