Confusion or Memory Loss Behavioral Risk Factor Surveillance System (NYS BRFSS) New York State Department of Health Committee on the Public Health Dimensions of Cognitive Aging April 11, 2014 Patricia P. Lillquist
What is NYS BRFSS? NYS BRFSS is a population-based survey of adult, non-institutionalized New Yorkers Its purpose is to measure health indicators important to public health and disseminate this information to the public, planners and policy makers Part of the survey content is set by CDC with input from the states States can choose to add questions relevant to specific state needs
BRFSS Health Indicators BRFSS measures a wide number of health indicators: Access to health care Tobacco use Cancer screening utilization Weight status Number of poor physical health days per month Number of poor mental health days per month Chronic diseases such as asthma, heart disease
BRFSS Demographic Information Demographic information is collected to weight the data to reflect NYS s population and permit data analyses by subpopulations: Age Sex Race/ethnicity Education Income Marital status Disability status Veteran status Region (New York City/Rest of New York State)
How NYS BRFSS data are collected NYS BRFSS data are collected through telephone calls made to randomly selected non-institutionalized adult New Yorkers In recent years, approximately 6,000 to 8,000 respondents completed 20-minute-long telephone interviews Cell phone interviewing accounted for 25% of the interviews in 2011 Other methods of collection have been pilot tested in NYS
Strengths and Limitations of NYS BRFSS Strengths Representative of New York State population Rigorous data collection methods In operation since 1985 Limitations Not longitudinal Self-reported information
Confusion and Memory Loss Questions During the past 12 months, have you experienced confusion or memory loss that is happening more often or is getting worse? [If more than one adult in the household] not including yourself, how many adults in your household experienced confusion or memory loss that is happening more often or is getting worse during the past 12 months? If there is more than one adult with confusion or memory loss in the household, one adult is selected at random. The respondent answers subsequent questions about his or her own confusion or memory loss or answers on behalf of the other adult in the household.
Questions on Need Have household activities been given up due to confusion or memory loss? In which of the following four areas does you or the other person need the most assistance? Safety, transportation, household activities, personal care Has confusion or memory loss limited the ability to work, volunteer, or engage in social activities? How often has a family member of friend provided any care or assistance?
Questions on Health Care Has confusion or memory loss been discussed with a health care professional? Has treatment such as therapy or medications for confusion or memory loss been received? Has a health care professional ever identified this as Alzheimer s or some other form of dementia?
Confusion and Memory Loss by Age Group, NYS BRFSS, 2011 Percentage of Respondents with Confusion and Memory Loss 50 45 40 35 30 25 20 15 10 5 0 11.6 8.9 9.3 10.8 5.2 5.1 18-24 25-34 35-44 45-54 55-64 65+ Age group
Confusion and Memory Loss by Sex, NYS BRFSS, 2011 Percentage of Respondents with Confusion of Memory Loss 50 45 40 35 30 25 20 15 10 5 0 10.0 Men 7.6 Women Sex
Confusion and Memory Loss by Education, NYS BRFSS, 2011 Percentage of Respondents with Confusion or Memory Loss 50 45 40 35 30 25 20 15 10 5 0 15.9 Less than high school 9.4 8.9 5.0 High school Some college College graduate Education
Confusion and Memory Loss by Income, NYS BRFSS, 2011 Percentage of Respondents with Confusion or Memory Loss 50 45 40 35 30 25 20 15 10 5 0 17.0 Less than $15,000 12.9 $15,000 - $24,999 8.2 7.3 9.3 $25,000 - $35,000 - $34,999 $49,999 Income $50,000 - $74,999 4.9 More than $75,000
Confusion and Memory Loss by Disability Status, NYS BRFSS, 2011 Percentage of Respondents with Confusion or Memory Loss 50 45 40 35 30 25 20 15 10 5 0 19.7 Disabled Disability status 5.2 Not Disabled
Confusion and Memory Loss by Health Care Coverage, NYS BRFSS, 2011 Percentage of Respondents with Confusion or Memory Loss 50 45 40 35 30 25 20 15 10 5 0 7.8 11.7 Has insurance Does not have insurance Health care coverage
Confusion and Memory Loss by Employment Status, NYS BRFSS, 2011 Percentage of Respondents with Confusion or Memory Loss 50 45 40 35 30 25 20 15 10 5 0 6.9 11.9 10.5 Employed Unemployed Not in Labor Force Employment status
Confusion and Memory Loss by Mental Health, NYS BRFSS, 2011 Percentage of Respondents with Confusion or Memory Loss 50 45 40 35 30 25 20 15 10 5 0 33.3 Poor mental health 5.8 Good mental health Mental health
Confusion and Memory Loss by Leisure-time Activity, NYS BRFSS, 2011 Percentage of Respondents with Confusion or Memory Loss 50 45 40 35 30 25 20 15 10 5 0 15.0 6.5 Leisure-time activity No leisure-time activity Participation in Leisure-time activity
Has discussed confusion or memory loss with health care professional, NYS BRFSS, 2011 32.8% 67.2% Yes No
Has received treatment such as therapy or medication for confusion or memory loss, NYS BRFSS, 2011 47.1% 52.9% Yes No/not sure
Uses of NYS BRFSS NYS BRFSS data on confusion and memory loss have been used: To maintain funding for the NYS DOH Dementias Program when at risk of losing funding By the NY State Office for the Aging in obtaining a Systems Integration Grant from the U.S. Administration on Aging called Part B - Creating Dementia Capable, Sustainable Service Systems for Persons with Dementia and Their Family Caregivers. In background for state requests for proposals In a 2013 Report of the New York State Coordinating Council For Services Related to Alzheimer s Disease and Other Dementias to Governor Andrew M. Cuomo and the New York State Legislature In handouts and public meetings by the Alzheimer s Association
Dissemination of BRFSS data BRFSS reports are widely disseminated through: The NYSDOH public website Listservs to community partners BRFSS datasets and documentation are also available through the public website (open data concept)
Next steps in surveillance The length of the BRFSS limits the number of questions possible to each health indicator. Some programs have addressed this limitation by funding a call-back survey in which respondents with a particular health condition agree to be called back with a more extensive interview. This could permit more detailed information on both the respondent and the other household member with confusion and memory loss. This additional funding also supports part of a data analyst to work with the call-back information. Trend information will be available when the 2013 BRFSS data set is available. The set of questions are included in 2014 NYS BRFSS also.