Early Detection

Even if we could get rid of all dementia risk factors in our society, many people would still develop symptoms of Alzheimer’s or dementia in their lifetimes. It’s important to identify symptoms as early as possible. New dementia medications work best when they are given early. And there are many things people can do to live well with dementia. The BHIL has developed several tools to support early detection and diagnosis of dementia.

BDSI

The BDSI (Brief Dementia Screening Indicator) was developed to help primary care doctors decide whether or not to screen an older patient for dementia. It uses a point score that includes older age, <12 years of education, being underweight, having a history of diabetes or stroke, needing assistance with money or medications, and current depression. 

BDSI (Brief Dementia Screening Indicator)    

The BDSI (Brief Dementia Screening Indicator) was developed to help primary care doctors decide whether or not to screen an older patient for dementia. It uses a point score that includes older age, <12 years of education, being underweight, having a history of diabetes or stroke, needing assistance with money or medications, and current depression. 

 

Brief Dementia Screening Indicator

 

If your patient is aged 80 years or older, or you suspect cognitive impairment based on your observations or concerns of the patient, family, or others, proceed with cognitive screening. Otherwise, answer the questions below to help decide whether or not the patient should be screened.  

Points

  1. How old is your patient? ___ years

 

If aged 65 to 79 years, assign 1 point per year after the age of 65. For example, age 65 years receives 0 points; age 72 years receives 7 points. 

 
  1. Does your patient have fewer than 12 years of education?1

No (0)

Yes (9)

 
  1. Is your patient underweight (BMI < 18.5 kg/m2)?2

No (0)

Yes (8)

 
  1. Does your patient have a history of type 2 diabetes?

No (0)

Yes (3)

 
  1. Has your patient ever had a stroke?

No (0)

Yes (6)

 
  1. Does your patient need help from others to manage money or medications?3

No (0)

Yes (10)

 
  1. Does your patient currently take anti-depressant medications OR report that “everything was an effort” ≥3 days per week over the past week?4

No (0)

Yes (6)

 

Total point score: If ≥22, your patient should be screened for cognitive impairment.

 

1Did not graduate from high school or pass a General Educational Development (GED) Test

2https://www.nhlbi.nih.gov/calculate-your-bmi

3Ask your patient and/or family member if present: Do you need help from others to manage money or medication?

4Ask your patient: In the past week, how many days did you feel that everything was an effort? 

If the answer is either “moderate” or “most,” then item 7 in the Brief Dementia Screening Indicator receives a score of 6 points.