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Michigan Survey of Cognitive Impairment & Dementia

Michigan Survey of Cognitive Impairment & Dementia Hector M. González, 1 Micki Horst, Ann Rafferty, Peter Lichtenberg 1 Acknowledgements Denise Cyzman, Michigan Department of Community Health Kim Curyto, Pine Rest Christian Mental Health Services Sara Duris, Michigan Council

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Michigan Survey of Cognitive Impairment & Dementia

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  1. Michigan Survey of Cognitive Impairment & Dementia Hector M. González,1 Micki Horst, Ann Rafferty, Peter Lichtenberg1

  2. Acknowledgements • Denise Cyzman, Michigan Department of Community Health • Kim Curyto, Pine Rest Christian Mental Health Services • Sara Duris, Michigan Council • Kevin Foley, Advantage Health • Judith Heidebrink, Michigan Alzheimer's Disease Research Center • Micki Horst, Michigan Public Health Institute • Rochelle Hurst, Michigan Department of Community Health • Larry Lawhorne, Geriatric Education Center of Michigan • Peter Lichtenberg, Institute of Gerontology • Katie Maslow, Alzheimer's Association • Daniel Murman, Michigan State University • Suzanne Ogland-Hand, Pine Rest Christian Mental Health Services • Karen Petersmarck, Michigan Department of Community Health • Ann Rafferty, Michigan Department of Community Health • Rhonna Shatz, Henry Ford Hospital

  3. Objectives • Background • Aims • Brief methods • Results • Discussion • Conclusions • Q & A

  4. Background • CDC, Behavioral Risk Factor Surveillance System (BRFSS) • Michigan has used the BRFSS system to develop recommendations to the State Department of Public Health in developing, implementing, and evaluating statewide programs • In 2003, planning for a special survey began with the addition of diabetes and dementia questions • Data collection began in November 2004 and continued through September 2005. • This is Hot off the Press

  5. Prevalence Estimates of Dementia and Alzheimer’s Disease in North American by Age (Evans 1989)

  6. Survey Methods • Telephone survey • Random digit dialing in Michigan • English-speaking, • Non-institutionalized adults (age 18 & over) • Disproportionate stratified • Over-sampled African-Americans, Latinos and persons age 45 & older • 2,656 completed interviews

  7. What Respondents were Asked • “Is there any person in your household whose memory or thinking is worse than it was a year ago?” • How many persons are there whose memory or thinking is worse that it was a year ago? • Has a physician or other health care professional ever evaluated this person's memory change? • Person with most recent birthday if more than 1 person in household • “Does this person's memory change interfere with their everyday activities or work?” (For example, does it affect their ability to shop, drive, pay bills, take medications, or perform housework?) 5. “If someone were to ask you where to go for information about a problem with memory or thinking what would you suggest?”

  8. Objectives • P_______ (the P-word) of cognitive impairment/dementia in Michigan • At least get a sense • Estimate functional impairment of identified Michiganians • Inform interest groups of the state-of-the-State’s cognitively impaired/demented in Michigan

  9. 2004-2005 Michigan Diabetes, Arthritis, and Osteoporosis Survey (DAOS; w/ MDC Questions) • Sex • U.S. Census * DAOS** • Males 49.1% 48.4% • Females 50.9% 51.6% • Race/Ethnicity • U.S. CensusDAOS ** • Whites 80.0% 78.6% • Blacks 14.0% 12.8% • Latinos 3.6% 5.2% *2004 U.S. Census **Estimate Confidence Intervals Not Shown

  10. Census vs2004-05 Michigan Special Survey • Indications the 2004-05 Michigan Special Survey is a reasonable estimate of the population of Michigan • Note over-sampled groups would not be expected to be similar to the state population.

  11. Results Q1. “Is there any person in your household whose memory or thinking is worse than it was a year ago?” Q1a. How many persons are there whose memory or thinking is worse than it was a year ago? • 14.8% One person in Michigan households • More than one-quarter(26.5%) reported more than one person in the household with cognition problems

  12. Michigan Adults Who Live in Households with One or More Persons with Cognitive Problems by Annual Household Income*

  13. Michigan Adults Who Live in Households with One or More Persons with Cognitive Problems by Race/Ethnicity • Non-Latino Whites 13.6% • Latinos (English-speaking) 15.2% • Blacks 21.9%

  14. Other possibilities?

  15. Respondent/Caregiver General Health • Are cognitive problems associated with the General Health (i.e., Excellent-Very Good-Good vs Fair-Poor) of Respondent/Caregivers in Michigan? • Households with a person with cognitive problems was associated with a four-fold increase in respondents rating their general health as Fair or Poor (OR = 3.56, CI, 2.33-5.51)* *Age Adjusted Estimate

  16. Poor Physical Health Days? • Cognitive problems (of someone in the household) associated with increased numbers of “Poor Physical Health” days of Respondent/Caregivers in Michigan • t = 4.50, p < 0.0001* *Age-adjusted estimate

  17. Poor Mental Health Days? • Cognitive problems (of someone in the household) associated with increased numbers of “Poor Mental Health” days of Respondent/Caregivers in Michigan • t = 4.04, p = 0.0001* *Age-adjusted estimate

  18. Discussion • Representative sample of Michiganians • 15% of respondents reported having One or More persons with cognitive problems • About ¼ reported More than One…in the household • Disproportionately associated with… • Low income • Black ethnicity (13.6% vs 21.9%) • Somewhat Higher in English-speaking Latinos (15.2%)

  19. Discussion • Two-thirds of Michiganians reported they would recommend Physicians (64.4%)as a source for information about cognitive problems • Don’t Know - 13.3% • Internet – 11.1% … • Alzheimer’s Association – 1.5%

  20. Discussion • Overall, about 1/3 of Michigan adults (29.4%) with with cognitive problems have been evaluated • Increased (37.7%) if the cognitive problems interfered with daily activities

  21. Discussion • Cognitive problems of persons in the household are associated with • Decreased general health • Increased days of poor physical health • Increased days of poor mental health

  22. Conclusion • Cognitive problems affect many Michiganians • Particularly disadvantaged groups • Associated with poor physical & mental health of household members • Few are evaluated • Need for increased awareness of reliable information sources (e.g., Alzheimer’s Association)

  23. Congratulations to the MDC & colleagues!

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