Of the 1065 individuals approached at the primary care clinics, 201 declined participation at that visit but agreed to be approached at a follow-up visit. Among the 864 patients who discussed participation in the study on the day that they were approached, 554 (64.0%) signed informed consent, 110 (13%) refused participation for any research study, and 200 (23%) refused participation in this study. The 310 nonparticipants did not vary significantly from the participants in terms of age (P=.07), sex (P=.19), or race/ethnicity (P=.62). Unfortunately, due to insufficient resources, we were not able to follow-up the 310 to assess their reasons for not wanting to participate.
Of the 554 participants, 363 (65.5%) were ≥70 years old, 388 (70.0%) were female, 313 (56.5%) were African American, 232 (42.1%) had less than a high school education, 360 (77.4%) had an annual income of less than $20,000, and 327 (59.0%) lived alone. When asked to undergo screening for dementia, 57 (10.3%) refused.
Of the 497 (89.7%) who underwent screening, 63 (12.7%) screened positive and were referred for a confirmatory diagnostic assessment.
A bivariate analysis of the participants’ sociodemographic characteristics and experience with Alzheimer’s disease () showed that the only significant difference between the participants who accepted screening and those who refused screening was in age (P<.001).
Bivariate Comparison of the Sociodemographic Characteristics and Experience with Alzheimer’s Disease of Study Participants Who Accepted and Refused Screening for Dementiaa
A bivariate comparison of the mean PRISM-PC scores of participants who accepted screening for dementia and participants who refused it () showed that there was a significant difference in the average domain score for benefits of dementia screening (73.0 vs. 67.3; P=.001), but not in the average domain scores for the stigma of dementia screening, the negative impact of dementia screening on independence, and the suffering related to dementia screening. There were also significant differences regarding the following individual items: agreement about planning for future health care as a benefit (4.0 vs. 3.8; P=.03), agreement with screening for colon cancer (3.5 vs. 3.1; P=.02), agreement with screening for depression (3.4 vs. 3.1; P=.008), and belief that a treatment for Alzheimer’s disease is not currently available (2.7 vs. 3.0; P=.02).
Bivariate Comparison of the Mean PRISM-PC Scores of Study Participants Who Accepted and Refused Screening for Dementia
The logistic regression model adjusted for items found to be significant in and . The results of regression analysis () indicated that the odds of refusing screening were significantly lower in participants who had higher domain scores for benefits of dementia screening (OR, 0.85; 95%CI, 0.75–0.97; P=.02). The odds of refusing screening were significantly higher in patients aged 70–74 years (OR, 5.65; 95%CI, 2.27–14.09; P<.001) and patients aged 75–79 years (OR, 3.63; 95%CI, 1.32–9.99; P=.01) than in the reference group of patients aged 65–69 years old. The odds of refusing screening among patients aged ≥80 years were higher (OR, 2.44; 95%CI, 0.78–7.66; P=.13) than in the reference group, but these results were not significant.
Logistic Regression Analysis of the Odds of Refusing to Undergo Screening for Dementiaa
A bivariate comparison of the mean PRISM-PC scores of participants who screened positive for dementia and those who screened negative for dementia () showed that participants in the positive result group had a significantly higher score on the stigma domain (39.8 vs. 32.1; P<.001) and on the item regarding agreement with screening for colon cancer (3.7 vs. 3.4; P=.03).
Bivariate Comparison of the Mean PRISM-PC Scores of Study Participants Who Screened Positive and Screened Negative for Dementia