Development and validation of a dementia screening tool for primary care in Taiwan

Brain Health Test

Ping Huang Tsai, Jian Liang Liu, Ker Neng Lin, Chiung Chih Chang, Ming-Chyi Pai, Wen Fu Wang, Jen Ping Huang, Tzung Jeng Hwang, Pei Ning Wang

Research output: Contribution to journalArticle

Abstract

Objectives To develop a simple dementia screening tool to assist primary care physicians in identifying patients with cognitive impairment among subjects with memory complaints or at a high risk for dementia. Design The Brain Health Test (BHT) was developed by several experienced neurologists, psychiatrists, and clinical psychologists in the Taiwan Dementia Society. Validation of the BHT was conducted in the memory clinics of various levels of hospitals in Taiwan. Participants All dementia patients at the memory clinics who met the inclusion criteria of age greater or equal to 50 years were enrolled. Besides the BHT, the Mini-Mental State Examination and Clinical Dementia Rating were used to evaluate the cognition state of the patients and the severity of dementia. Results The BHT includes two parts: a risk evaluation and a cognitive test (BHT-cog). Self or informants reports of memory decline or needing help from others to manage money or medications were significantly associated with cognitive impairment. Among the risk factors evaluated in the BHT, a total risk score greater or equal to 8 was defined as a high risk for dementia. The total score for the finalized BHT-cog was 16. When the cutoff value for the BHT-cog was set to 10 for differentiating dementia and a normal mental state, the sensitivity was 91.5%, the specificity was 87.3%, the positive predictive value was 94.8%, and the negative predictive value was 80.1% The area under the receiver operating characteristic curve between dementia and healthy subjects was 0.958 (95% CI = 0.941–0.975). Conclusions The BHT is a simple tool that may be useful in primary care settings to identify high-risk patients to target for cognitive screening.

Original languageEnglish
Article numbere0196214
JournalPloS one
Volume13
Issue number4
DOIs
Publication statusPublished - 2018 Apr 1

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dementia
Taiwan
Dementia
Brain
Primary Health Care
Screening
Health
screening
brain
testing
Data storage equipment
Primary Care Physicians
ROC Curve
Cognition
physicians
Psychiatry
cognition
Healthy Volunteers
drug therapy
risk assessment

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Tsai, P. H., Liu, J. L., Lin, K. N., Chang, C. C., Pai, M-C., Wang, W. F., ... Wang, P. N. (2018). Development and validation of a dementia screening tool for primary care in Taiwan: Brain Health Test. PloS one, 13(4), [e0196214]. https://doi.org/10.1371/journal.pone.0196214
Tsai, Ping Huang ; Liu, Jian Liang ; Lin, Ker Neng ; Chang, Chiung Chih ; Pai, Ming-Chyi ; Wang, Wen Fu ; Huang, Jen Ping ; Hwang, Tzung Jeng ; Wang, Pei Ning. / Development and validation of a dementia screening tool for primary care in Taiwan : Brain Health Test. In: PloS one. 2018 ; Vol. 13, No. 4.
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abstract = "Objectives To develop a simple dementia screening tool to assist primary care physicians in identifying patients with cognitive impairment among subjects with memory complaints or at a high risk for dementia. Design The Brain Health Test (BHT) was developed by several experienced neurologists, psychiatrists, and clinical psychologists in the Taiwan Dementia Society. Validation of the BHT was conducted in the memory clinics of various levels of hospitals in Taiwan. Participants All dementia patients at the memory clinics who met the inclusion criteria of age greater or equal to 50 years were enrolled. Besides the BHT, the Mini-Mental State Examination and Clinical Dementia Rating were used to evaluate the cognition state of the patients and the severity of dementia. Results The BHT includes two parts: a risk evaluation and a cognitive test (BHT-cog). Self or informants reports of memory decline or needing help from others to manage money or medications were significantly associated with cognitive impairment. Among the risk factors evaluated in the BHT, a total risk score greater or equal to 8 was defined as a high risk for dementia. The total score for the finalized BHT-cog was 16. When the cutoff value for the BHT-cog was set to 10 for differentiating dementia and a normal mental state, the sensitivity was 91.5{\%}, the specificity was 87.3{\%}, the positive predictive value was 94.8{\%}, and the negative predictive value was 80.1{\%} The area under the receiver operating characteristic curve between dementia and healthy subjects was 0.958 (95{\%} CI = 0.941–0.975). Conclusions The BHT is a simple tool that may be useful in primary care settings to identify high-risk patients to target for cognitive screening.",
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Tsai, PH, Liu, JL, Lin, KN, Chang, CC, Pai, M-C, Wang, WF, Huang, JP, Hwang, TJ & Wang, PN 2018, 'Development and validation of a dementia screening tool for primary care in Taiwan: Brain Health Test', PloS one, vol. 13, no. 4, e0196214. https://doi.org/10.1371/journal.pone.0196214

Development and validation of a dementia screening tool for primary care in Taiwan : Brain Health Test. / Tsai, Ping Huang; Liu, Jian Liang; Lin, Ker Neng; Chang, Chiung Chih; Pai, Ming-Chyi; Wang, Wen Fu; Huang, Jen Ping; Hwang, Tzung Jeng; Wang, Pei Ning.

In: PloS one, Vol. 13, No. 4, e0196214, 01.04.2018.

Research output: Contribution to journalArticle

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AU - Pai, Ming-Chyi

AU - Wang, Wen Fu

AU - Huang, Jen Ping

AU - Hwang, Tzung Jeng

AU - Wang, Pei Ning

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