Feasibility and outcomes of a national memory screening day at a community senior mental health clinic

Abstract

Early detection of Alzheimer's disease (AD) and other dementias is advantageous for treatment planning and preparation for future decision-making. Easily accessible community memory screening is one method for early AD detection; however, the feasibility and community desire for such screening is not well established. We present development, feasibility, and outcomes from a free clinic-based cognitive screening as part of National Memory Screening Day. Free memory screens were advertised via the local newspaper, word-of-mouth, and at regional events and organizations serving older adults. Screening occurred at a community senior mental health clinic. Assessments for the memory screening were chosen to favor test sensitivity over specificity in order to maximize detection of possible cognitive impairment. Tests were also selected to cover multiple domains of cognition including memory, processing and psychomotor speed, language, and global cognition within a 20-minute battery. Sensitivity and specificity estimates were used to derive likelihood ratios, which were subsequently combined to provide an estimate of risk of cognitive impairment based on an estimated base rate of 25%. Presence of self- and informant-reported memory concerns factored into the risk calculation. A total of 18 older adults ranging in age from 57 to 87 (M = 70.22, SD = 8.69) participated. The sample was highly educated (M = 16.28 years of education) and included equal numbers of male and female participants. Sixteen participants (89%) reported concerns about their own memory, while six participants (33%) reported that others had expressed concerns about their memory. Mean Montreal Cognitive Assessment (MoCA) score was 25.05 (SD = 3.47), and recommendations for neuropsychological follow-up were made for four participants (22% of the sample). This screening yielded clinically relevant information regarding potential risk for cognitive impairment using a brief, easily administered battery. The service identified just over one fifth of the sample as high risk of cognitive impairment, potentially increasing the likelihood of early detection of AD or other dementias for individuals whose risk may otherwise have gone unidentified until later in the disease course. Such a memory screening day represents a valuable public health outreach for older adults at risk of dementia.