PT  - JOURNAL ARTICLE
AU  - Vikas Kotagal
AU  - Kenneth M. Langa
AU  - Brenda L. Plassman
AU  - Gwenith G. Fisher
AU  - Bruno J. Giordani
AU  - Robert B. Wallace
AU  - James R. Burke
AU  - David C. Steffens
AU  - Mohammed Kabeto
AU  - Roger L. Albin
AU  - Norman L. Foster
TI  - Factors associated with cognitive evaluations in the United States
AID  - 10.1212/WNL.0000000000001096
DP  - 2015 Jan 06
TA  - Neurology
PG  - 64--71
VI  - 84
IP  - 1
4099  - http://n.neurology.org/content/84/1/64.short
4100  - http://n.neurology.org/content/84/1/64.full
SO  - Neurology2015 Jan 06; 84
AB  - Objective: We aimed to explore factors associated with clinical evaluations for cognitive impairment among older residents of the United States.Methods: Two hundred ninety-seven of 845 subjects in the Aging, Demographics, and Memory Study (ADAMS), a nationally representative community-based cohort study, met criteria for dementia after a detailed in-person study examination. Informants for these subjects reported whether or not they had ever received a clinical cognitive evaluation outside of the context of ADAMS. Among subjects with dementia, we evaluated demographic, socioeconomic, and clinical factors associated with an informant-reported clinical cognitive evaluation using bivariate analyses and multivariable logistic regression.Results: Of the 297 participants with dementia in ADAMS, 55.2% (representing about 1.8 million elderly Americans in 2002) reported no history of a clinical cognitive evaluation by a physician. In a multivariable logistic regression model (n = 297) controlling for demographics, physical function measures, and dementia severity, marital status (odds ratio for currently married: 2.63 [95% confidence interval: 1.10–6.35]) was the only significant independent predictor of receiving a clinical cognitive evaluation among subjects with study-confirmed dementia.Conclusions: Many elderly individuals with dementia do not receive clinical cognitive evaluations. The likelihood of receiving a clinical cognitive evaluation in elderly individuals with dementia associates with certain patient-specific factors, particularly severity of cognitive impairment and current marital status.ADAMS=Aging, Demographics, and Memory Study; CCE=clinical cognitive evaluation; CDR=Clinical Dementia Rating; CI=confidence interval; CIND=cognitive impairment not dementia; DSM-III-R=Diagnostic and Statistical Manual of Mental Disorders (Third Edition Revised); DSM-IV=Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition); DSRS=Dementia Severity Rating Scale; HRS=Health and Retirement Study; MMSE=Mini-Mental State Examination