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) |
|---|---|
| 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 |
Fingerprint
Keywords
- clinical dementia rating
- community health worker
- dementia
- elderly adults
- Korean
ASJC Scopus subject areas
- Geriatrics and Gerontology
Cite this
Feasibility and validity of dementia assessment by trained community health workers based on clinical dementia rating. / Han, Hae Ra; Park, So Youn; Song, Heejung; Kim, Miyong; Kim, Kim B.; Lee, Hochang Ben.
In: Journal of the American Geriatrics Society, Vol. 61, No. 7, 07.2013, p. 1141-1145.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Feasibility and validity of dementia assessment by trained community health workers based on clinical dementia rating
AU - Han, Hae Ra
AU - Park, So Youn
AU - Song, Heejung
AU - Kim, Miyong
AU - Kim, Kim B.
AU - Lee, Hochang Ben
PY - 2013/7
Y1 - 2013/7
N2 - 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.
AB - 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.
KW - clinical dementia rating
KW - community health worker
KW - dementia
KW - elderly adults
KW - Korean
UR - http://www.scopus.com/inward/record.url?scp=84880273142&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84880273142&partnerID=8YFLogxK
U2 - 10.1111/jgs.12309
DO - 10.1111/jgs.12309
M3 - Article
C2 - 23730928
AN - SCOPUS:84880273142
VL - 61
SP - 1141
EP - 1145
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
SN - 0002-8614
IS - 7
ER -