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Brar M, Mc Ardle R, Hagan A, Al-Oraibi A, Hanjari M, Stephan B, Brayne C, Lafortune L, Bains M, Qureshi N, Robinson L. Attitudes and Preferences Towards Screening for Dementia with a Focus on Ethnic Minority and Low Socio-Economic Groups: A Systematic Review of Research Studies Written in the English Language. J Alzheimers Dis 2024:JAD240315. [PMID: 39031361 DOI: 10.3233/jad-240315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
Background Increased understanding of dementia risk-reduction and early detection of Alzheimer's disease and related disorders has spurred interest in the identification of risks for dementia, underlying putative biologies, or dementia itself. Implementation of such approaches require acceptability to the public. Research prior to 2012 indicated limited acceptability for population dementia screening. The changing landscape of dementia prevention research may influence recent perceptions. Additionally, perspectives from underserved populations, such as ethnic minorities and low socio-economic groups, are lacking. Objective In this systematic review, we sought published studies since 2012 on attitudes and preferences of people with dementia, carers and the general public from ethnic minorities and low socio-economic groups regarding dementia screening. Methods This review was preregistered on PROSPERO (CRD42023384115) and followed PRISMA guidelines. Key search terms were entered into five databases. Articles were included if they focused on population or risk screening for dementia via primary/community care-based assessments, and which included majority ethnic minority or low socio-economic groups or discretely considered these groups in data analysis. Data were synthesized narratively. Results Seven studies reported perspectives of ethnic minorities regarding dementia screening; one study included people from low socio-economic groups. Results indicated that participants from ethnic minorities were willing to undergo dementia screening. Predictors of willingness included belief in benefits, desire to boost diversity, and to implement lifestyle changes. Unwillingness was associated with anxiety regarding results. Conclusions Although there seems to be high acceptability for screening in the studied groups, more research is necessary to explore the practical considerations for screening such as cultural and economic barriers, trust, and post-screening actions.
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Affiliation(s)
- Manjot Brar
- Population Health Sciences Institute, Newcastle University, UK
| | - Ríona Mc Ardle
- Translational and Clinical Research Institute, Newcastle University, UK
| | - Alexander Hagan
- Population Health Sciences Institute, Newcastle University, UK
| | - Amani Al-Oraibi
- PRISM Research Group, Lifespan and Population Health, School of Medicine, University of Nottingham, UK
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Development Centre for Population Health, University of Leicester, Leicester, UK
| | - Matilda Hanjari
- PRISM Research Group, Lifespan and Population Health, School of Medicine, University of Nottingham, UK
- Faculty of Health and Life Sciences, Institute for Allied Health Sciences Research, De Montfort University, Leicester, UK
| | - Blossom Stephan
- Dementia Centre of Excellence, enAble Institute, Curtin University, Bentley, Western Australia
- Institute of Mental Health, University of Nottingham, UK
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, UK
| | - Louise Lafortune
- Cambridge Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, UK
| | - Manpreet Bains
- PRISM Research Group, Lifespan and Population Health, School of Medicine, University of Nottingham, UK
| | - Nadeem Qureshi
- PRISM Research Group, Lifespan and Population Health, School of Medicine, University of Nottingham, UK
| | - Louise Robinson
- Population Health Sciences Institute, Newcastle University, UK
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Paladino J, Ritchie C. Meeting the Communication and Care Planning Needs of Patients and Caregivers Affected by Dementia from the Time of Diagnosis. J Palliat Med 2024; 27:716-719. [PMID: 38770630 DOI: 10.1089/jpm.2024.0144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Affiliation(s)
- Joanna Paladino
- Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Christine Ritchie
- Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Dublin S, Greenwood-Hickman MA, Karliner L, Hsu C, Coley RY, Colemon L, Carrasco A, King D, Grace A, Lee SJ, Walsh JME, Barrett T, Broussard J, Singh U, Idu A, Yaffe K, Boustani M, Barnes DE. The electronic health record Risk of Alzheimer's and Dementia Assessment Rule (eRADAR) Brain Health Trial: Protocol for an embedded, pragmatic clinical trial of a low-cost dementia detection algorithm. Contemp Clin Trials 2023; 135:107356. [PMID: 37858616 PMCID: PMC11244615 DOI: 10.1016/j.cct.2023.107356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 09/26/2023] [Accepted: 10/15/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND About half of people living with dementia have not received a diagnosis, delaying access to treatment, education, and support. We previously developed a tool, eRADAR, which uses information in the electronic health record (EHR) to identify patients who may have undiagnosed dementia. This paper provides the protocol for an embedded, pragmatic clinical trial (ePCT) implementing eRADAR in two healthcare systems to determine whether an intervention using eRADAR increases dementia diagnosis rates and to examine the benefits and harms experienced by patients and other stakeholders. METHODS We will conduct an ePCT within an integrated healthcare system and replicate it in an urban academic medical center. At primary care clinics serving about 27,000 patients age 65 and above, we will randomize primary care providers (PCPs) to have their patients with high eRADAR scores receive targeted outreach (intervention) or usual care. Intervention patients will be offered a "brain health" assessment visit with a clinical research interventionist mirroring existing roles within the healthcare systems. The interventionist will make follow-up recommendations to PCPs and offer support to newly-diagnosed patients. Patients with high eRADAR scores in both study arms will be followed to identify new diagnoses of dementia in the EHR (primary outcome). Secondary outcomes include healthcare utilization from the EHR and patient, family member and clinician satisfaction assessed through surveys and interviews. CONCLUSION If this pragmatic trial is successful, the eRADAR tool and intervention could be adopted by other healthcare systems, potentially improving dementia detection, patient care and quality of life.
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Affiliation(s)
- Sascha Dublin
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA; Kaiser Permanente Bernard Tyson School of Medicine, Pasadena, CA, USA.
| | | | - Leah Karliner
- University of California, San Francisco, San Francisco, CA, USA
| | - Clarissa Hsu
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - R Yates Coley
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA; Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Leonardo Colemon
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Anna Carrasco
- University of California, San Francisco, San Francisco, CA, USA
| | - Deborah King
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Sei J Lee
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Tyler Barrett
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Jia Broussard
- University of California, San Francisco, San Francisco, CA, USA
| | - Umesh Singh
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Abisola Idu
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Kristine Yaffe
- University of California, San Francisco, San Francisco, CA, USA
| | - Malaz Boustani
- Indiana University School of Medicine, Indianapolis, IN, USA
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Keegan A, Strahley A, Taylor SP, Wilson TM, Shah MD, Williamson J, Palakshappa JA. Older Adults' Perspectives on Screening for Cognitive Impairment Following Critical Illness: Pre-Implementation Qualitative Study. Crit Care Explor 2023; 5:e0920. [PMID: 37197588 PMCID: PMC10184981 DOI: 10.1097/cce.0000000000000920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
Screening for cognitive impairment following ICU discharge is recommended but not part of routine care. We sought to understand older adults' perspectives on screening for cognitive impairment following an ICU admission to inform the design and delivery of a cognitive screening intervention. DESIGN Qualitative study using semi-structured interviews. SUBJECTS Adults 60 years and older within 3 months of discharge from an ICU in an academic health system. INTERVENTIONS Interviews were conducted via telephone, audio recorded and transcribed verbatim. All transcripts were coded in duplicate. Discrepancies were resolved by consensus. Codes were organized into themes and subthemes inductively. MEASUREMENTS AND MAIN RESULTS We completed 22 interviews. The mean age of participants was 71 ± 6 years, 14 (63.6%) were men, 16 (72.7%) were White, and 6 (27.3%) were Black. Thematic analysis was organized around four themes: 1) receptivity to screening, 2) communication preferences, 3) information needs, and 4) provider involvement. Most participants were receptive to cognitive screening; this was influenced by trust in their providers and prior experience with cognitive screening and impairment. Participants preferred simple, direct, compassionate communication. They wanted to understand the screening procedure, the rationale for screening, and expectations for recovery. Participants desired input from their primary care provider to have their cognitive screening results placed in the context of their overall health, because they had a trusted relationship, and for convenience. CONCLUSIONS Participants demonstrated limited understanding of and exposure to cognitive screening but see it as potentially beneficial following an ICU stay. Providers should use simple, straightforward language and place emphasis on expectations. Resources may be needed to assist primary care providers with capacity to provide cognitive screening and interpret results for ICU survivors. Implementation strategies can include educational materials for clinicians and patients on rationale for screening and recovery expectations.
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Affiliation(s)
- Alek Keegan
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Ashley Strahley
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Stephanie P Taylor
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
- Carolinas Medical Center, Atrium Health, Charlotte, NC
| | - Taniya M Wilson
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Meehir D Shah
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Jeff Williamson
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Jessica A Palakshappa
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
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Crossnohere NL, Childerhose JE, Bose-Brill S. Increasing the Patient-Centeredness of Predictive Analytics Tools. THE PATIENT 2022; 15:615-617. [PMID: 36053486 DOI: 10.1007/s40271-022-00595-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Norah L Crossnohere
- Department of Biomedical Informatics, The Ohio State University, College of Medicine, 1800 Cannon Drive, Columbus, OH, 43210, USA.
- Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University, College of Medicine, Columbus, OH, USA.
| | - Janet E Childerhose
- Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University, College of Medicine, Columbus, OH, USA
- Division of Bioethics, Department of Anatomy and Biomedical Education, The Ohio State University, College of Medicine, Columbus, OH, USA
| | - Seuli Bose-Brill
- Division of General Internal Medicine, Department of Internal Medicine, The Ohio State University, College of Medicine, Columbus, OH, USA
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Jiao Y, Liu C, Chang J, Zhou S, Ji Y. Self-management preferences in patients with mild cognitive impairment: A qualitative study. Front Psychol 2022; 13:955960. [DOI: 10.3389/fpsyg.2022.955960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
PurposePatients with mild cognitive impairment (MCI) require self-management, yet current self-management compliance is low. Taking patients’ preferences into account can improve the self-management situation. The purpose of this study is to look into MCI patients’ preferences for self-management in China.MethodsA qualitative research was conducted using semi-structured in-depth interviews with 21 patients recently diagnosed with MCI who were chosen by purposive sampling. These interviews were analyzed through thematic analysis and identified emerging themes.ResultsFive themes of self-management preference were identified: (1) Preference for acquiring disease knowledge; (2) Preference for participating in drug therapy; (3) Preference for participating in exercise; (4) Preference for applying memory compensation strategy; (5) Preferences for emotional expression and response.ConclusionOur study identified the specific preferences of MCI patients in China for the main self-management items. The findings are valuable insights for knowing MCI patients’ self-management content and preferences and provide better guidance for health practitioners to improve self-management compliance.
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