OBJECTIVES: 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. DESIGN: Cross-sectional validation study. SETTING: Community gathering places such as ethnic churches, senior centers, low-income elderly apartments, and ethnic groceries in the Baltimore-Washington metropolitan area. PARTICIPANTS: Ninety community-dwelling Korean-American individuals aged 60 and older. MEASUREMENTS: 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. RESULTS: 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. CONCLUSION: 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.
OBJECTIVES: 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. DESIGN: Cross-sectional validation study. SETTING: Community gathering places such as ethnic churches, senior centers, low-income elderly apartments, and ethnic groceries in the Baltimore-Washington metropolitan area. PARTICIPANTS: Ninety community-dwelling Korean-American individuals aged 60 and older. MEASUREMENTS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: Ana Teresa A Ramos-Cerqueira; Albina R Torres; André L Crepaldi; Nair I L Oliveira; Márcia Scazufca; Paulo R Menezes; Martin Prince Journal: J Am Geriatr Soc Date: 2005-10 Impact factor: 5.562
Authors: Paula V Nunes; Breno S Diniz; Marcia Radanovic; Izabella D Abreu; Danilo T Borelli; Monica S Yassuda; Orestes V Forlenza Journal: Int J Geriatr Psychiatry Date: 2008-11 Impact factor: 3.485
Authors: Kim B Kim; Miyong T Kim; Hochang B Lee; Tam Nguyen; Lee R Bone; David Levine Journal: Am J Public Health Date: 2016-03-17 Impact factor: 9.308
Authors: F Aragón; M A Zea-Sevilla; J Montero; P Sancho; R Corral; C Tejedor; B Frades-Payo; V Paredes-Gallardo; A Albaladejo Journal: Clin Oral Investig Date: 2018-02-23 Impact factor: 3.573
Authors: Inge Petersen; Sara Evans-Lacko; Maya Semrau; Margaret M Barry; Dan Chisholm; Petra Gronholm; Catherine O Egbe; Graham Thornicroft Journal: Int J Ment Health Syst Date: 2016-04-11