The Rural Older Adult Memory (ROAM) Study: A Practice-based Intervention to Improve Dementia Screening and Diagnosis

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Figure 1.
Implementation of Rural Older Adult Memory (ROAM) Study in 6 participating rural practices: intervention protocol. dx, diagnosis; mci, mild cognitive impairment.
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Appendix.
ROAM, Rural Older Adult Memory; MMSE, mini-mental state examination; ADL, activities of daily living; IADL, instrumental activities of daily living; GDS, Geriatric Depression Scale; TSH, thyroid-stimulating hormone; CBC, complete blood count; MRI/CT, magnetic resonance imaging/computed tomography.

Table 1.

Practice-Level Data for Intervention Protocol

Practice Identifier	(1) Participating Clinicians (n)	(2) Patients Older than 75 Years^* (%)	(3) Patients ≥75 Years of Age Seen During Intervention Period (n)	(4) Screen Forms Initiated^† (n [%])	(5) Patient Screens Completed^‡ (n [%])	(6) Positive Screens^§ (n [%])	(7) Patients Scheduled for Work-up^‖ (n [%])	(8) Patients Evaluated^¶ (n [%])	(9) Patients Diagnosed with Dementia^# (n [%])
A	3	13	156	134 (86)	108 (81)	68 (63)	29 (43)	28 (97)	7 (10)
B	2	20	152	96 (63)	82 (84)	33 (40)	5 (15)	3 (60)	2 (6)
C	2	9	96	87 (91)	77 (88)	40 (52)	8 (20)	7 (88)	2 (5)
D	3	25	88	83 (94)	77 (93)	30 (39)	15 (50)	12 (80)	6 (20)
E	2	10	73	50 (68)	43 (86)	12 (28)	10 (83)	9 (90)	3 (25)
F	6	6	138	45 (33)	40 (89)	15 (38)	6 (40)	2 (33)	0 (0)
Total (n = 18)	18	N/A	703	495 (70)	427 (86)	198 (46)	73 (37)	61 (83)	19 (9.6)

* Percent of patients older than 75 for practice overall. Data is from an Oregon Rural Practice-based Research Network survey conducted in 2005, except for practice 2, which provided this information for this project separately.
† Screen forms initiated refers to screen forms that were partially or fully completed, including those from patients who refused screening or who were excluded from screening for other reasons.
‡ Percent with completed screens of patients who had screen forms initiated.
§ Percent is patients for whom screen forms were completed.
‖ Patients who had “work-up scheduled” written on screen form. Percent is patients with positive screen.
¶ Percent is for patients with “work-up scheduled” written on screen form who received a dementia work-up.
# Percent is positive screens.