Improving Rural Community Dementia Knowledge, Screening Rates Using Telemedicine: James E. Galvin, MD, MPH

"The first step is raising awareness, raising health literacy, and making people understand something about the disease—and have it resonate with them as a personal issue. That requires understanding their knowledge of the disease, giving them the information, and doing some type of assessment so that we can decide who has a problem and who doesn’t. And then, what kinds of services that person may benefit from."

Not only do rural, ethnically diverse older adults faced an increased risk of Alzheimer disease (AD) and related dementias, they also experience disparities in dementia education, detection, and treatment. A study presented at the 2021 Alzheimer’s Association International Conference (AAIC), July 26-30, implemented the Montreal Cognitive Assessment telephone app, or MoCA-T, in a rural community of 89% African American, Hispanic, and Haitian Creole residents to see if the method is effective in increasing AD knowledge and detecting cognitive risk in a rural setting.

Faith-based health educators, trained using online Alzheimer’s Association resources, contacted church congregants who responded to announcements during virtual workshop services. Among a cohort of 90 individuals who participated, t-tests showed a significant increase in dementia knowledge (t[89] = –6.3; P <.001; paired samples pre/post: t[24] = –2.23; P <.004). Of the 60 who completed cognitive screening using the MoCA-T, 15 (25%) were found to be at risk for memory impairment. Of those, 80% (n = 12) followed up with their provider.

James E. Galvin, MD, MPH, was an investigator on the study and feels as though to begin to create change, the overall awareness of the disease needs to be elevated. Galvin, the director of the Comprehensive Center for Brain Health at University of Miami Miller School of Medicine, sat down with NeurologyLive to discuss the efforts being done to improve dementia knowledge from within rural communities. He stressed the advantages the MoCA-T app and other telemedicine may bring, especially as the pandemic continues.

REFERENCE

Wiese LA, Williams IC, Schoenberg NE, Galvin JE, Lingler JH. Employing the Moca-T (telephone) as a means of cognitive screening in rural, ethnically diverse population during COVID-19 restrictions. Presented at AAIC 2021; July 26-30.