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Clinical Epidemiology of Dementia in Primary Care - Steel Valley Seniors Survey (SVSS)

This study, conducted by the University of Pittsburgh School of Medicine, aims to examine the prevalence and progression of dementia in primary care settings in small town areas of southwestern Pennsylvania. The survey includes clinical evaluations, home visits, and follow-up assessments to gather comprehensive data on cognitive impairment among older adults.

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Clinical Epidemiology of Dementia in Primary Care - Steel Valley Seniors Survey (SVSS)

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  1. Clinical Epidemiology of Dementia in Primary Care(grant # AG16705 from NIA) Aka STEEL VALLEY SENIORS SURVEY (SVSS) Home

  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; Home

  3. Materials and MethodsRecruitment / 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. Home

  4. Total Screened Cohort • 1107 participants recruited during office visits to primary care physicians; • Age: Mean (sd) 76.3 (6.6), • Range: 64.9 – 100.1 years ; • Sex:63.9 % women • Race:95.2% White • Education ( > 12 years) : 23.1% Home

  5. Mini-Mental State Examination (n=1107) Mean (sd) = 25.5 (3.1) Median=26.0 Range 9 - 30 “Cognitive Impairment” MMSE <25 Home

  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. Home

  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; Home

  8. Clinical Evaluations (2) • Subjective memory report; • Social support; • Health service utilization; • Clinical Dementia Rating (Hughes et al 1982) • CDR 0 = No dementia • CDR 0.5 = Possible/questionable dementia • CDR 1 = Mild dementia • CDR 2 = Moderate dementia • CDR 3 = Severe dementia Home

  9. Clinically Evaluated Cohort • 358 participants underwent home visits. • Mean (SD) age: 77.6 (6.7) • CDR = 0 n= 80 (22.4%) • CDR= 0.5 n= 228 (63.7%) • CDR > 1 n= 50 (13.9%) Home

  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. Home

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