A patient self-reporting tool for tracking symptoms of multiple chronic conditions, including dementia and Alzheimer’s, has been found to be both reliable and valid, according to a new Regenstrief Institute and Indiana University Center for Aging Research study. Caregivers can also use this tool to report patient symptoms.
The patient self-reporting version of the Healthy Aging Brain Care Monitor (HABC Monitor), likened to a blood pressure cuff, is sensitive to symptom change. And setting it apart from other self-reporting tools is that it is broad, covering psychological, functional and cognitive problems, senior study author Patrick Monahan, Ph.D., associate professor of biostatistics at the IU School of Medicine, tells SHN.
Similar to the way the blood pressure cuff measures blood pressure levels during and between heart beats, the Healthy Aging Brain Center Monitor measures 27 items on a four-point scale to assess cognitive, functional, and psychological symptoms.
“The primary purpose of the tool is to track the symptoms of patients across time so that providers can use the improvement or worsening of the symptom scores as evidence, along with their clinical judgment, to decide how to adjust the treatment care plan,” he says. “Although our tool could be used to diagnose people with dementia or Alzheimer’s in earlier stages, there are existing lengthier tools that already do this very well. The purpose of our tool is for monitoring symptoms.”
The HABC Monitor records self-reported cognitive measurements that include the ability to identify correct month and year, ability to memorize, and ability to handle complex financial affairs. The HABC Monitor was developed by researchers from the Regenstrief Institute and the IU Center for Aging Research.
Functional measurements include the ability to learn to use a tool, appliance or gadget; planning and preparing meals; and ability to conduct activities of daily living such as bathing, shopping and performing household chores. Psychological measurements include individual scores on depression, anxiety, irritability and appetite.
The patient reported information yields an accurate assessment of the patient’s cognitive, functional and psychological well-being, he says.
“However, if a patient self-reports a perfect cognitive score, further performance testing or clinical examination or caregiver-reported HABC Monitor information is recommended to rule out the possibility that the patient is unaware of cognitive symptoms,” he says.
The study included 291 patients with a mean age of 72. Fifty-six percent of study participants were African American and 76% were female. All were patients age 65 or older seen at Eskenazi Healthprimary-care clinics.
“For many symptoms, such as pain, depression, anxiety, sleep, fatigue, it is precisely the patient perspective and the caregiver perspective, not lab values, that provide the most valuable information regarding the patient’s symptoms, health and wellbeing,” he says about the value of self-reporting tools. “And if properly built, the scores are quite reliable. The take home message for patients and caregivers is that this tool is reliable and valid for capturing their impressions about the symptoms of the patient. And the tool gives them the opportunity to share their perceptions with the doctors and nurses.”
Access the study here.
Written by Cassandra Dowell