P-134: Screening for dementia in the elderly community

Abstract

One of the challenges in elderly health care is prediction of cognitive decline. This study was aimed to screen community-dwelling, healthy elderly volunteers in Tel Aviv, the largest urban area in Israel, for cognitive impairment and to compare their cognitive performance with memory clinic subjects, complaining of memory impairment. 278 elderly subjects were recruited in 12 elderly clubs, 49 were recruited from the memory disorders clinic in the Sourasky medical center and 50 age-matched volunteers served as controls. All subjects were 55–89 years old, had good or corrected vision and hearing and could understand Hebrew, English or Russian. Each group consisted of approximately 75% computer naive subjects. The test procedure included preliminary and final interviews, MMSE and a self-administered computerized neuropsychological tests battery, NexAde. 359 of the 377 subjects completed all 7 subtests in the NexAde battery and reported a pleasant user experience in their closing interview. MMSE scores of 23 or lower were more prevalent among the memory clinic referred subjects than in the home dwelling subjects (16% and 7%, respectively). All those subjects had also the lowest NexAde scores. For subjects with MMSE score>23, the NexAde scores of those from the elderly clubs were significantly higher (p<0.005) than those of the memory clinic, although the MMSE scores did not yield a significant difference between the two populations. The club population's NexAde scores were distinctly divided to two clusters containing 22% who were similar to the memory clinic subjects and 78% who were significantly different from them. Computer skills did not affect NexAde scores. NexAde's self administered computerized neuropsychological tests enabled population screening efficiently and at low costs. Computer skill influence on the test performance was very slight and comparable to that of the MMSE, implying a bias related to education and socio-economic status. A considerable part of elderly club's population has similar cognitive decline to that of memory clinic subjects and should be screened at small intervals, since many studies indicate that the conversion to dementia among memory clinic subjects is 10%-15%. All subjects will be followed up to check this assumption.