Abstract Details

Title NIH Toolbox Screen for MCI and Dementia: Results of a 90-Day Pilot in Primary Care Practices

Topic Aging and Dementia

Presentation(s) P07 - (-)

Poster/Presentation
Number 151

Objective

Background BACKGROUND: Biomarker studies and clinical drug trials outcomes suggest that the optimal period to intervene with preventative or curative treatments for dementia is at preclinical or early MCI stages. Current office screens are insensitive to earliest cognitive declines. We studied the newly developed NIH Toolbox, a non-proprietary web-based smart technology cognitive tool administered by trained MAs, standardized for ages 5-85, in screening for MCI and dementia in primary care well/wellness visits.

Design/Methods DESIGN/METHODS: In 3,365 patient visits >/=70y among 18 primary care physicians over 18 weeks, 2/5 of visits fit well/wellness inclusion criteria for screening. NIH Toolbox with and without fluency tasks and delayed free and recognition RAVLT trials administered. Outcome measures included physician offer and patient acceptance rates and MCI and dementia detection rates as defined by MCI >/=1 domain 1SD below norm and dementia >/=2 domains 2SD below norm. Rates of MCI and dementia compared using Toolbox alone and with supplemental measures.

Results RESULTS: Physicians offered screens to 43% of eligible patients and significantly less in highest risk group,patients >80. Offer rates increased over time. 76% of patients offered screening accepted. In the 221 patients screened, MCI detection increased from 39-43% at age 70 to 63-74% at age 85. Dementia was diagnosed in 5%, increasing with age, but only with Toolbox + supplemental tests. possibly reflecting the need for delayed episodic memory measures.

Conclusions CONCLUSIONS: NIH Toolbox is practical as a cognitive screen in primary care, detects MCI well, but did not detect dementia without addition of delayed episodic memory tests. Physician education needed to improve screen offer rates. Patient acceptance high.

Authors/Disclosures
Rhonna S. Shatz, DO (University of Cincinnati) PRESENTER	Dr. Shatz has nothing to disclose.
Helmut Butzkueven, MD, MBBS	Dr. Butzkueven has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Oxford Health Policy Forum. The institution of Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biogen. The institution of Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Merck. The institution of Dr. Butzkueven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. The institution of Dr. Butzkueven has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Butzkueven has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for MSBase . The institution of Dr. Butzkueven has received research support from NHMRC. The institution of Dr. Butzkueven has received research support from Biogen. The institution of Dr. Butzkueven has received research support from Roche. The institution of Dr. Butzkueven has received research support from Novartis.
	No disclosure on file
	No disclosure on file
	No disclosure on file

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