Effect of patient perceptions on dementia screening in primary care

Abstract

Objectives: To determine individuals' perceptions concerning dementia screening and to evaluate the possibility of an association between their perceptions and their willingness to undergo screening.

Design: Cross-sectional study of primary care patients aged 65 and older.

Setting: Urban primary care clinics in Indianapolis, Indiana, in 2008 to 2009.

Participants: Five hundred fifty-four primary care patients without a documented diagnosis of dementia.

Measurements: The Perceptions Regarding Investigational Screening for Memory in Primary Care Questionnaire (PRISM-PC) and agreement or refusal to undergo dementia screening.

Results: Of the 554 study participants who completed the PRISM-PC, 65.5% were aged 70 and older, 70.0% were female, and 56.5% were African American; 57 (10.3%) refused screening for dementia. Of the 497 (89.7%) who agreed to screening, 63 (12.7%) screened positive. After adjusting for age, perception of depression screening, perception of colon cancer screening, and belief that no treatment is currently available for Alzheimer's disease, the odds of refusing screening were significantly lower in participants who had higher PRISM-PC domain scores for benefits of dementia screening (odds ratio (OR) = 0.85, 95% confidence interval (CI) = 0.75-0.97; P = .02). In the same regression model, the odds of refusing screening were significantly higher in participants aged 70 to 74 (OR = 5.65, 95% CI = 2.27-14.09; P < .001) and those aged 75 to 79 (OR = 3.63, 95% CI = 1.32-9.99; P = .01) than in the reference group of patients aged 65 to 69.

Conclusion: Age and perceived benefit of screening are associated with acceptance of dementia screening in primary care.