1. Aka STEEL VALLEY SENIORS SURVEY (SVSS)
Clinical Epidemiology of Dementia in Primary Care (grant # AG16705 from NIA)
Aka
STEEL VALLEY SENIORS SURVEY
(SVSS)
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2. Steel Valley Seniors Survey (SVSS)
University of Pittsburgh School of Medicine, Department of Psychiatry;
7 primary care practices including 15 physicians;
Located in small town areas of McKeesport and White Oak in southwestern Pennsylvania;
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3. Materials and Methods Recruitment / Screening
Patients 65+ years approached during office visit to primary care physician;
Informed consent obtained;
Demographic information
MMSE (Folstein et al 1975)
Permission to review medical records;
Permission to call at home.
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4. Total Screened Cohort
1107 participants recruited during office visits to primary care physicians;
Age: Mean (sd) 76.3 (6.6),
Range: 64.9 – years ;
Sex: % women
Race: 95.2% White
Education ( > 12 years) : 23.1%
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5. Mini-Mental State Examination (n=1107)
Mean (sd) = 25.5 (3.1)
Median=26.0
Range
“Cognitive Impairment”
MMSE <25
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6. Clinical Evaluations (home visits)
Groups selected for home visit for clinical evaluation:
- all “cognitively impaired” participants with MMSE <25;
- matched “unimpaired” controls with MMSE > 25;
Clinical evaluators blind to MMSE score.
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7. Clinical Evaluations (1)
Neuropsychological assessment;
Depression screening;
Functional status (ADL and IADL);
Prescription and over-the-counter drugs;
Health history (systems review);
Focused general physical examination;
Focused neurological examination;
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8. Clinical Evaluations (2)
Subjective memory report;
Social support;
Health service utilization;
Clinical Dementia Rating (Hughes et al 1982)
CDR = No dementia
CDR 0.5 = Possible/questionable dementia
CDR = Mild dementia
CDR = Moderate dementia
CDR = Severe dementia
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9. Clinically Evaluated Cohort
358 participants underwent home visits.
Mean (SD) age: 77.6 (6.7)
CDR = 0 n= (22.4%)
CDR= n= (63.7%)
CDR > 1 n= (13.9%)
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10. Follow-up
After initial home visit, participants receive a brief telephone interview every 3 months;
Charts are reviewed in the primary care physicians’ offices every 3 months;
A follow-up home visit and clinical assessment takes place every year.
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