Abstract Details

Title Implementing Cognitive Behavior Screening in a Hispanic Cohort with Amyotrophic Lateral Sclerosis

Topic Practice, Policy, and Ethics

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-068

Objective To report the experience with implementing Cognitive Behavior Screening (CBS) in a Hispanic cohort with Amyotrophic Lateral Sclerosis (ALS).

Background Cognitive dysfunction in ALS is seen in 20–50% with 3–5% developing frontotemporal dementia (FTD). A fuller characterization of the extent of cognitive and behavioral dysfunction in ALS has relevance to effective communication, legal issues and end-of-life decision making. The ALS-CBS is specific to ALS, validated with 100% accuracy to detect FTD, and 85% sensitivity to detect any cognitive impairment.

Design/Methods As part of our quality improvement (QI) project, we aimed at increasing the frequency of CBS in ALS clinic comprising of Hispanic patients. The ALS-CBS is a brief assessment tool developed by Forbes Norris ALS Center which is composed of two sections. The cognitive section consists of five domains specific to frontal lobe function. It includes commonly used elements of standard testing battery consisting of 8 tasks. The behavioral section is composed of caregiver-directed questions intended to detect changes since disease onset sensitive to organic brain damage. It consists of a set of questions that compare changes in personality and behavior since the onset as well as yes/no questions about mood, pseudo-bulbar affect and mood and fatigue. ALS-CBS is intended to use in longitudinal assessment of cognitive and behavioral impairments in ALS.

Results Preliminary data analysis revealed that we accomplished our primary goal of increasing ALS-CBS being performed in ALS clinics by over 75%. The ease of using ALS-CBS allowed us to detect cognitive impairment sooner. Overall, the study demonstrated that performing ALS-CBS in a clinic setting was feasible.

Conclusions This QI project met the goal of increasing documentation of ALS-CBS in ALS clinic. This facilitated earlier recognition and referral to appropriate services. We obtained cognitive data in a predominantly Hispanic population which has previously not been studied.

Authors/Disclosures
Bhavesh Trikamji, MD (University of California Los Angeles) PRESENTER	Dr. Trikamji has nothing to disclose.
Margaret Adler, MD (Harbor UCLA Department of Neurology)	Dr. Adler has nothing to disclose.

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