Suggestions on the ideal method of conducting community screenings for older adults.

BACKGROUND/OBJECTIVES: Since dementia and frailty lead to a reduced quality of life and risk of needing long-term care in the older adults, we hypothesized that evaluations related to dementia and frailty would be useful and of high interest in screening for the older adults. Therefore, we conducted a community screening incorporating multiple simple evaluations related to dementia and frailty. In addition to various functional evaluations, we investigated interest in tests, thoughts on the disease, and the relationships between subjective (i.e., how one feels about oneself) and objective evaluations (i.e., the results of tests and rating scales). The purpose of this study was to examine the thoughts regarding tests and diseases and the functions that make it difficult to accurately perceive changes by oneself, and to obtain suggestions on the ideal method of community screening for the older adults. SUBJECTS/METHODS: The participants were 86 people aged 65 and over living in Kotoura Town who participated in the community screening, for which we obtained background information and body measurements. We also assessed physical, cognitive and olfactory function, evaluated nutritional status, and we administered a questionnaire (interest in tests, thoughts on dementia and frailty, and a subjective functional evaluation). RESULTS: Regarding interest in tests, the participants answers were highest for physical, cognitive and olfactory function, in that order (68.6%, 60.5%, and 50.0%, respectively). In the survey on thoughts on dementia and frailty, 47.6% of participants felt that people with dementia were viewed with prejudice, and 47.7% did not know about frailty. Regarding the relationship between subjective and objective evaluations, only the assessment of cognitive function did not show a correlation between both evaluations. CONCLUSIONS: From the viewpoint of the participants' degree of interest in and the need for accurate evaluations through objective examination, the findings suggest that the assessment of physical and cognitive function may be beneficial as a screening tool for older adults. Objective evaluation is essential, particularly for assessing cognitive function. However, approximately half the participants believed people with dementia were viewed with prejudice and did not know about frailty, which may lead to barriers to testing and low interest. The importance of increasing the participation rate in community screening through disease-related educational activities was suggested.

Validation of a novel computerized cognitive function test for the rapid detection of mild cognitive impairment.

BACKGROUND: In the present study, we examined the distinguishing ability of a mild cognitive impairment (MCI) assessment tool for rapid screening using a computer (MARC) for Alzheimer's disease dementia (ADD), MCI, and non-demented controls (NDC) with no cognitive impairment, as well as its validity and reliability, as part of a preliminary trial for the development of the tool. METHODS: A total of 64 participants (23 in the ADD group, 17 in the MCI group, and 24 in the NDC group) were analyzed. The participants were administered MARC and a pre-existing computerized Alzheimer's dementia screening test (MSP), and 31 participants (14 in the MCI group, 17 in the NDC group) were readministered MARC within 4 months from the first test. RESULTS: The median (interquartile range) test time for MARC was 401 (350-453) s. Total MARC scores were significantly worse in the MCI and ADD groups than in the NDC group (p < 0.05 and p < 0.01, respectively). In the receiver operating characteristic (ROC) analysis, the area under the ROC curve (AUC) when comparing the NDC and MCI groups was 0.866 (95% CI, 0.759-0.974), when comparing the NDC and AD groups was 0.989 (95% CI, 0.970-1.000), and when comparing the MCI and AD groups was 0.889 (95% CI, 0.790-0.988). Furthermore, there was a significant correlation with the results of the existing test, MSP (r = 0.839, p < 0.001). In addition, the intraclass correlation coefficient (ICC) (1,1) when the first and second MARC scores were compared was 0.740 (95% CI, 0.529-0.865; p < 0.001). CONCLUSIONS: MARC is considered capable of distinguishing MCI with high accuracy. The tool has good validity and reliability, and it can be administered in a short period of time without the need for a specialist.