Poster Presentations

Session Title: Alzheimer's Disease (AD) including Non-Cognitive Aspects
Presentation Date: Friday, March 14 – Saturday, March 15, 2009

COMMUNITY SCREENING FOR EARLY SIGNS OF DEMENTIA

D. Darby1, J. Fredrickson2, A. Fredrickson2, L. Moore3, J. Sach3, M. Woodward4, P. Maruff2
1University of Melbourne, Centre for Neuroscience, Melbourne, Australia, 2CogState Ltd, Melbourne, Australia, 3Alzheimer Australia Vic, Hawthorn, Australia, 4Heidelberg Repatriation Hospital, Austin Health, Heidelberg, Australia


Background: Cognitive decline is associated with increased risk of PET-PIB amyloid accumulation. We used a computerised battery, CogHealth, already shown sensitive to subtle decline in the community to determine whether concerned but healthy persons:

  1. tolerate 3M screening over a year, and
  2. show impairment or serial decline.
Methods: Community volunteers (≥50Y) willing to undergo 3M testing over 12M. Participants with impairment (failure to pass integrity checks or >1.65 standard deviations below population mean) or serial decline using linear regression were offered full medical assessment. Participants' doctors interest was surveyed.
Results: 301 volunteers without existing cognitive impairment recruited from a total of 394 screened by telephone. Mean age 61.8 ± 7.2 years (212F). The proportion of participants who failed integrity checks or timed out at each time point was: baseline 13% (n=301); 3M 6% (n=271); 6M 3% (n=253), 9M 3% (n=258) and 12M 3% (n=263). 87% participants completed 12M testing. Overall, 20% failed one or more integrity check over the study. Only 11% of doctors returned surveys. Serial decline occurred in 27 (10%), 6 agreed to assessment, with 3 “worried well” and 3 showing early episodic memory loss, normal routine studies but positive amyloid imaging in both scanned so far.
Conclusions: Community concern about early AD appears high at study entry, and motivation to complete serial screening, but practitioner interest low. Serial monitoring in the community with brief computerized test batteries appears feasible and acceptable. Serial decline detected 1% with very early AD.


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