image: Regenstrief Institute Investigator Malaz Boustani, M.D., MPH, is associate professor of medicine at Indiana University School of Medicine and associate director of the Indiana University Center for Aging Research. view more
Credit: Wishard Health Services
INDIANAPOLIS -- A new study shows that a practical clinical tool developed by researchers from the Regenstrief Institute and the Indiana University School of Medicine to measure severity of dementia symptoms is reliable and valid. The Healthy Aging Brain Care Monitor is simple, user-friendly and sensitive to change in symptoms.
"The HABC Monitor is a 'blood pressure cuff' for dementia," said Regenstrief Institute investigator Malaz Boustani, M.D., MPH, associate professor of medicine and associate director of the IU Center for Aging Research. A geriatrician, Dr. Boustani is the study's corresponding author and principal investigator. He is also medical director of the Healthy Aging Brain Center at Wishard Health Services, the public hospital where the study was conducted. "Much as doctors and nurses use a sphygmomanometer -- a blood pressure cuff -- to quickly and repeatedly determine changes in blood pressure, we have developed a 31-item questionnaire to easily measure and track dementia symptoms. The results provide information critical to the clinician's care of older adults as well as to caregiver's well-being."
Divided into clinically relevant domains -- cognitive, functional, and behavioral and psychological symptoms of the patient; and caregiver quality of life -- all questions on the HABC Monitor have the same response options, ranging from never to almost all days. It takes about six minutes for caregiver response.
In the study, 171 caregivers -- three-quarters of whom were female -- completed the HABC Monitor. Fifty-two percent of the caregivers were the children of the patients, 34 percent were spouses, 6 percent were siblings, and 4 percent were grandchildren. Caregivers had a mean age of 58 years. Ninety percent indicated that they knew the patient very well, while 10 percent indicated they knew the patient well.
"We found the HABC Monitor to be highly sensitive to changes in the patient, both declines and improvement," said Patrick Monahan, Ph.D., associate professor of biostatistics at the IU School of Medicine. He is a psychometrician and first author of the new study. "The HABC Monitor is also able to distinguish between groups of patients who differ in severity of impairment based on physician diagnoses and based on other questionnaires that have been validated for research but are too long and time-consuming for clinical practice.
"Depression and anxiety, both very common in older adults with dementia, but often missed during a busy office visit, are highlighted for the clinician. This study confirmed that the HABC Monitor is an accurate measure of dementia symptoms. We are seeking funding to study the impact of this new 'blood pressure cuff' on primary care, where most older adults receive their care."
"A Practical Clinical Tool to Monitor Dementia Symptoms: The HABC-Monitor" was published June 14 in Clinical Interventions in Aging, an international peer-reviewed open-access publication.
Co-authors in addition to Drs. Monahan and Boustani are Catherine Alder, MSW, of the Regenstrief Institute and the IU Center for Aging Research; James E. Galvin, M.D., MPH, of the New York University School of Medicine; Anthony J. Perkins, M.S., of the IU Center for Aging Research; Patrick Healey, M.D., of the St. Vincent Health; Azita Chehresa, M.D., Ph.D. of Community Health Network; Polly Shepard, Ph.D., and Corby Bubp, Ph.D., of the Memory Clinic of Indianapolis; Amie Frame, MPH, of the Regenstrief Institute and the IU Center for Aging Research; and Christopher Callahan, M.D., of the Regenstrief Institute, IU Center for Aging Research and IU School of Medicine. Alder and Drs. Boustani and Callahan see patients at the Healthy Aging Brain Center at Wishard.
This work was funded by grants from National Institute on Aging (P30AG024967), National Institute of Mental Health (R24MH080827) and Agency for Healthcare Research and Quality (R01 HS019818-01).
The HABC-Monitor is a copyrighted by Drs. Boustani, Galvin and Callahan and the IU School of Medicine. The HABC Monitor and scoring rules are available without charge online at http://www.indydiscoverynetwork.org/HealthyAgingBrainCareMonitor.html.