Abstract
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.
Original language | English (US) |
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Pages (from-to) | 1141-1145 |
Number of pages | 5 |
Journal | Journal of the American Geriatrics Society |
Volume | 61 |
Issue number | 7 |
DOIs | |
State | Published - Jul 2013 |
Keywords
- Korean
- clinical dementia rating
- community health worker
- dementia
- elderly adults
ASJC Scopus subject areas
- Geriatrics and Gerontology