The UCSF Brain Health Assessment for the Detection of Cognitive Impairment Among Diverse Populations in Primary Care

加州大学旧金山分校大脑健康评估，用于检测初级保健中不同人群的认知障碍

• 批准号: 9766416
• 负责人: Katherine Laurel Possin
• 金额: $ 155.04万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-25 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9766416
• 关键词: Address; Affect; Aging; Alzheimer' s Disease; American; Award; Behavior; California; Chinese American; Clinical; Cognitive; Computer software; Data; Data Collection; Data Storage and Retrieval; Delirium; Dementia; Detection; Development; Diagnosis; Diagnostic; Differential Diagnosis; Early Diagnosis; Economics; Education; Educational Background; Educational Materials; Elderly; Evaluation; Family; Feedback; Focus Groups; Frequencies; Funding; Goals; Impaired cognition; Individual; International; Language; Latino; Measures; Medical; Memory; Neurocognitive; Neurocognitive Deficit; Neuropsychological Tests; Neuropsychology; Paste substance; Patients; Persons; Physicians; Population Heterogeneity; Primary Health Care; Process; Provider; Public Health; Reporting; Research; Research Personnel; Sampling; San Francisco; Secure; Sensitivity and Specificity; Signal Transduction; Specificity; Speed; Surveys; Tablet Computer; Tablets; Testing; United States; Universities; Validation; Visuospatial; Work; brain health; clinical research site; cognitive testing; cohort; community setting; design; ethnic diversity; executive function; follow-up; health assessment; health disparity; implementation science; implementation strategy; improved; informant; medical specialties; neurocognitive disorder; performance tests; skills; stability testing; user-friendly; validation studies

Efficient and user-friendly neurocognitive screens are needed that are sensitive to the variety of neurocognitive disorder presentations to primary care. The UCSF Brain Health Assessment was developed to efficiently measure the cognitive domains that can be affected in the earliest stages of neurocognitive decline, including memory, executive functions / speed, visuospatial skills, language, behavior, and function. Four subtests and an optional informant survey are administered via an appealing tablet interface and with automated scoring and provider feedback. Preliminary validation studies indicate excellent combined sensitivity and specificity to cognitive impairment among English-speaking older adults with moderate to high levels of education. The primary goals of the proposed work are to optimize and validate the BHA for older adults who are diverse in terms of education and language spoken, to perform cross-validation studies of other paradigms funded by this award, and to evaluate and address barriers to detecting cognitive impairment in primary care. Education and English as a second language each impact cognitive test performance and are barriers to accurate detection of cognitive impairment. This project will address these health disparities by including persons with diverse levels of education and persons whose primary language is Spanish, Mandarin, or Cantonese in both validation and implementation studies. In Aim 1, we will evaluate the validity of the BHA for the detection of cognitive impairment in well-characterized and expertly diagnosed English-speaking older adults with low, moderate, or high education. In Aim 2, we will evaluate the validity of the BHA for the detection of cognitive impairment in well-characterized and expertly diagnosed Spanish-, Cantonese-, or Mandarin-speaking older adults. In Aim 3, we will identify and address implementation challenges in primary care practices that serve patients diverse in terms of education and language spoken. If successful, this project will lead to increased detection of cognitive impairment in everyday community settings, which is essential to enable differential diagnosis and to improve medical management for people with cognitive impairment, including dementia, in the United States.

需要有效且用户友好的神经认知屏幕，对神经认知敏感 对初级保健的疾病表现。 UCSF大脑健康评估是有效的 衡量在神经认知下降的最早阶段可能受到影响的认知领域，包括 记忆，执行功能 /速度，视觉空间技能，语言，行为和功能。四个子测验和 可选的线人调查是通过吸引人的平板电脑接口和自动评分进行的 和提供者的反馈。初步验证研究表明，对 具有中度至高水平教育的英语老年人的认知障碍。这 拟议工作的主要目标是对多样化的老年人进行优化和验证BHA 所说的教育和语言条款，对由此资助的其他范式进行交叉验证研究 奖励并评估和解决检测初级保健认知障碍的障碍。教育和 英语作为第二语言，每种影响认知测试表现，是准确检测的障碍 认知障碍。该项目将通过包括不同级别的人来解决这些健康差异 教育和主要语言是西班牙语，普通话或广东话的人 实施研究。在AIM 1中，我们将评估BHA检测认知的有效性 特征良好且熟练诊断的英语老年人的损害低，中度或中度或 高等教育。在AIM 2中，我们将评估BHA检测认知障碍的有效性 特征和专业诊断的西班牙语，粤语或普通话的老年人。在AIM 3中， 我们将确定并应对为多元化患者提供的初级保健实践中的实施挑战 教育条款和语言。如果成功，该项目将导致认知的发现增加 日常社区环境的损害，这对于能够进行鉴别诊断并改善至关重要 在美国，包括痴呆在内的认知障碍者的医疗管理。