Challenges to screening and evaluation of memory impairment among Hispanic elders in a primary care safety net facility

International Journal of Geriatric Psychiatry
Dorothy P HarrisBarbara G Vickrey

Abstract

Implement a memory impairment screening procedure for elderly Hispanic primary care patients, and analyze its yield and challenges to further triage and diagnostic evaluation. Three hundred twenty nine Hispanic patients aged ≥60 years or proxy informants were enrolled from outpatient primary care clinics at an urban safety-net medical center. Patients were screened for memory impairment using the WHO-UCLA AVLT; for those without consent capacity, proxies were given the IQCODE. Bilingual research assistants conducted in-person or telephone screening. Age, gender, education, comorbidities, acculturation, overall health, access to care, and memory concerns were assessed as potential predictors of memory impairment. Based on identified implementation challenges, a multi-disciplinary stakeholder committee proposed revised approaches to increase diagnostic evaluation and sustainability. Of 677 eligible patients approached, 329 (49%) were screened, and 77 (23%) met criteria for memory impairment using the WHO-UCLA AVLT (N=60) or the IQCODE (N=17). Only male gender and higher comorbidity uniquely predicted memory impairment (ps<0.05). Few screen-positive patients declined further triage and evaluation, but a substantial proportion coul...Continue Reading

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Citations

Aug 15, 2014·Journal of the International Neuropsychological Society : JINS·Ellen GroberRichard B Lipton
Feb 7, 2015·Journal of Aging and Health·Joshua ChodoshBarbara Grace Vickrey
Jun 14, 2012·Journal of the American Geriatrics Society·Nicole R FowlerHugh C Hendrie

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