Screening for dementia: family caregiver questionnaires reliably predict dementia

INTRODUCTION: Because of increasing numbers of patients with diseases that cause dementia, primary care physicians must use efficient assessment procedures in their clinics. Important advantages of screening for dementia include determination of the patient's cognitive capacity to participate competently in his/her own medical care and early diagnosis, which enables administration of medications that preserve some cognitive functions. METHODS: A study was conducted to determine whether questionnaires completed by a family caregiver about a patient could differentiate between those with dementia and those with other neurological disorders that do not cause dementia. Clinical and demographic information gleaned from more than 330 consecutive multidisciplinary outpatient dementia clinic assessments were entered into an Institutional Review Board-approved database and analyzed post hoc to answer several research questions. RESULTS: Three questionnaires completed by family caregivers about patients were able to differentiate reliably between patients with dementia with a variety of degenerative disorders and patients without dementia with other neurological disorders that often are mistaken for dementia. When these questionnaires are combined with a patient test (Mini-Mental State Examination), an accurate prediction of which patients suffer from a true degenerative disease that causes dementia was robust (effect size of R2 = 0.81, P <.0001 for the multiple logistic regression analysis). DISCUSSION: These instruments assist the primary care physician to determine which patients seem to suffer from a disease that causes dementia and need further assessment by the physician or at a specialized dementia clinic. The ultimate goal is to assure that patients receive appropriate medical management as early in the disease process as possible.