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: 10100827
• 负责人: Katherine Laurel Possin
• 金额: $ 7.28万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10100827
• 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

PROJECT SUMMARY / ABSTRACT 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.

项目概要/摘要 需要对各种神经认知敏感的高效且用户友好的神经认知屏幕 向初级保健机构介绍疾病。 UCSF 大脑健康评估的开发旨在有效地 测量在神经认知衰退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。四个子测试和 可选的知情人调查通过有吸引力的平板电脑界面和自动评分进行管理 和提供者的反馈。初步验证研究表明其具有出色的综合敏感性和特异性 具有中等到高教育水平的英语老年人的认知障碍。这 拟议工作的主要目标是优化和验证 BHA，以适应不同年龄的老年人 教育和语言方面，对本基金资助的其他范式进行交叉验证研究 奖项，并评估和解决初级保健中检测认知障碍的障碍。教育和 英语作为第二语言都会影响认知测试的表现，并成为准确检测的障碍 认知障碍。该项目将通过包括不同水平的人来解决这些健康差异 教育程度和主要语言为西班牙语、普通话或粤语的人在验证和 实施研究。在目标 1 中，我们将评估 BHA 用于检测认知能力的有效性 具有良好特征且经过专业诊断的英语老年人的低度、中度或 受过高等教育。在目标 2 中，我们将评估 BHA 用于检测认知障碍的有效性 特征明确且经过专业诊断的讲西班牙语、粤语或普通话的老年人。在目标 3 中， 我们将确定并解决初级保健实践中的实施挑战，为不同领域的患者提供服务 教育和语言方面。如果成功，该项目将导致认知能力检测的增加 日常社区环境中的损害，这对于实现鉴别诊断和改善 在美国，对认知障碍（包括痴呆症）患者进行医疗管理。