Informant-based Dementia Screening in a Population-based Sample of African Americans

Background: An informant-based screening tool for dementia may be useful in population-based studies of minority populations. Objective: investigate the feasibility of screening for very mild dementia in a community sample of African Americans using an informant-based screening tool (AD8). Design: Cohort study. Participants: One hundred forty-seven persons from the African American Health (AAH) project were screened for dementia; 61 of 93 who were invited had follow-up clinical assessments for dementia diagnosis. Measurements: The AD8, Mini-Mental State Examination, Short Blessed Test, Brief Instrument for Dementia Detection, and a neuropsychologic battery were administered at visit I. The Clinical Dementia Rating (CDR) was administered at visit 2 by clinicians blinded to visit 1 results; the presence of dementia was determined by a CDR greater than 0. Results: Four hundred sixty-five individuals from the AAH cohort were sent a letter describing the study and, among this group. 252 individuals were contacted by phone to request participation in this study. Six percent (14/252) of the participants contacted by phone were unable to identify an informant (required for the AD8). One hundred fifty individuals agreed by phone to participate of which 2% (n = 3) did not have an informant available at the time of participation. The AD8 alone was effective at discriminating between CDR 0 and CDR 0.5 (area under the curve = 0.847; P < 0.001; 95% confidence interval, 0.73-0.96). Conclusions: A brief informant-based instrument, the AD8, has high sensitivity and specificity for distinguishing CDR 0 from CDR 0.5 in the community. Informant availability may not be a barrier for using the AD8 in an African American community sample; however, further study in larger samples with a higher response rate, different community settings (eg, community clinics), and among older age groups (eg, age 75+) is warranted to confirm this.