Georgia Alzheimer's disease & related dementia report, 2016

GEORGIA ALZHEIMER'S DISEASE & Related Dementia Report, 2016
Georgia Department of Public Health / 1
PERCEIVED COGNITIVE IMPAIRMENT (PCI) AMONG GEORGIA RESIDENTS: ANALYSIS OF THE GEORGIA BRFSS 2011-2015

GEORGIA ALZHEIMER'S DISEASE & Related Dementia Report, 2016

Perceived Cognitive Impairment (PCI) Among Georgia Residents: Analysis of the Georgia BRFSS 2011-2015

CONTENTS

Executive Summary 2 ..................................................................................................................................................



Background.................................................................................................................................................................................2 Benefits of a State Alzheimer's and Related Dementias Registry................................................3 Goals for the ADRD Registry in Georgia..............................................................................................................3 Sources of Data for the Registry...............................................................................................................................3

2016 Georgia Alzheimer's and Related Dementias (GARD)

Highlights and Updates 4 ......................................................................................................................................



Work Group Updates...........................................................................................................................................................4 Workforce Development...................................................................................................................................................4 Service Delivery.......................................................................................................................................................................5 Public Safety..............................................................................................................................................................................5 Outreach and Partnerships............................................................................................................................................6 Policy.................................................................................................................................................................................................6 Healthcare, Research, and Data Collection...................................................................................................... 7

Prevalence of Perceived Cognitive Impairment (PCI) Among Georgia Adults 8 .........................................................................................................................................

Highlights ....................................................................................................................................................................................9

Introduction ............................................................................................................................................................................ 12

Prevalence of PCI................................................................................................................................................................ 12

Prevalence by Sex .............................................................................................................................................................. 12

Prevalence by Race/Ethnicity ................................................................................................................................. 12

Prevalence by Age ............................................................................................................................................................. 12

Prevalence by Educational Level ........................................................................................................................... 13

Prevalence by Employment Status ..................................................................................................................... 13

Prevalence by Health Insurance Status .......................................................................................................... 13

Prevalence by General Health Status ............................................................................................................... 13

Prevalence by Number of Diagnosed Chronic Conditions............................................................... 14

Prevalence by Sex and Race...................................................................................................................................... 14

Prevalence by Sex and Age......................................................................................................................................... 14

Prevalence by Race and Age...................................................................................................................................... 14

Discussed PCI with a Health Care Professional (HCP)



and Received Treatment/Therapy.................................................................................................................. 16

Inability to Perform Household Activities / Chores Due to PCI................................................... 18

Social Context and PCI Prevalence...................................................................................................................... 19

Prevalence of PCI by Public Health District................................................................................................. 20

Prevalence of PCI by Georgia Area Agencies

on Aging Planning and Service Areas........................................................................................................ 21

Summary....................................................................................................................................................................................22

Appendix 24 ..............................................................................................................................................................................
Georgia Department of Public Health / 5

EXECUTIVE SUMMARY

DPH HAS PARTNERED WITH THE DIVISION OF AGING SERVICES WITHIN THE GEORGIA DEPARTMENT OF HUMAN SERVICES AND THE ASSOCIATION OF STATE AND TERRITORIAL HEALTH OFFICIALS (ASTHO) TO CONVENE STAKEHOLDER MEETINGS INCLUDING MORE THAN 40 INTERNAL AND EXTERNAL PARTNERS:
Georgia Department of Human Services,
Division of Aging
Georgia Alzheimer's Association
Georgia Hospital Association
Medical Association of Georgia
State Legislators
Georgia Department of Community Health (Medicaid, State Health
Benefit Plan)

Background
DURING THE 2013 GEORGIA LEGISLATIVE SESSION, the Georgia General Assembly created the Georgia Alzheimer's and Related Dementias State Plan Task Force (GARD) to meet during the following summer. The task force was charged with creating a state Alzheimer's disease plan, including recommendations to collect statewide data to inform the evaluation and care infrastructure. All four legislative healthcare committee chairs and state health agency commissioners served on the task force and chaired issue-specific subcommittees.
Georgia Department of Public Health Commissioner, Brenda Fitzgerald, M.D., chaired the Healthcare Research and Data Collection Subcommittee which included clinical and state agency stakeholders. One of the goals for the subcommittee was to identify and make recommendations about using surveillance data to enhance Alzheimer's awareness and action in public health programming and state planning [1]. The subcommittee found that there was a paucity of data about Alzheimer's disease and related dementias in Georgia and that no central repository for these data existed. Furthermore, this has created a barrier to estimating accurate Alzheimer's disease and related dementias prevalence rates in Georgia to inform planning, research and reporting efforts. One key recommendation made was to establish a statewide Alzheimer's Disease and Related Dementias (ADRD) Registry that will provide accurate and current data to address these urgent needs.
During the 2014 Georgia Legislative Session, legislation (HB 966) regarding the establishment of an ADRD registry within the Georgia Department of Public Health (DPH) was introduced and subsequently passed (O.C.G.A 31-2a-17) [2]. As a major proprietor of health data in Georgia, DPH is uniquely situated to house such a registry. And given its existing footprint in the areas of health policy and promotion, DPH was identified as a prime coordinator of stakeholders and partners in the registry planning and development effort.

West Virginia and South Carolina Alzheimer's and
Related Dementias Registry Staff

Carl Vinson Institute, University of Georgia

University of Georgia, College of Public Health

Emory University, Rollins School of Public Health

Members of the healthcare provider community

2 / GARD REPORT / Georgia 2016

Benefits of a State Alzheimer's and Related Dementias Registry
- Provide legislators, state planners and administrators, and members of the private sector with accurate data that will enable informed planning for current and future healthcare and social service needs (e.g. nursing home beds, adult day care, etc.).
- Provide a resource for Georgia researchers to secure National Institute of Health (NIH) funding and establish an environment that will attract clinical trial and biotechnology investments, and create new jobs.
- Serve the people of the state of Georgia by guiding efforts to educate the public on ADRD and serve as an information clearing house on ADRD for patients and caregivers.
- To further serve Georgians by supporting cutting edge clinical research that will offer more effective treatments for dementing diseases
Goals for the ADRD Registry in Georgia
- Collect and disseminate usable data to inform programs and services for the aging population.
- Determine the burden of ADRD among Georgians
- Identify epidemiologic trends.
- Bring awareness at the state level to issues of ADRD and increase the potential for positive statewide health outcomes and influence the management of associated healthcare costs.
- Inform stakeholders for planning and for future registry needs.
Data Sources for the ADRD Registry
Georgia DPH currently collects and consolidates data from various sources including Medicare, Medicaid, Vital Records, Hospital Discharge Records, Emergency Room Visits Records, Physicians Reporting Portal (https://sendss.state.ga.us/ sendss/!alzheim.alzheim_login), the State Health Benefits Plan, Nursing Home Data, and Georgia Regents Health Plan.
The Georgia Behavioral Risk Factor Surveillance System (BRFSS) also serves as a primary source of information on the prevalence of perceived cognitive impairment (PCI), other chronic health conditions, health risk behaviors, and the use of clinical preventive services among adult Georgia residents [3]. Additionally, it provides information on the challenges facing caregivers of individuals with ADRD, and other long-term illnesses or disabilities. The analysis in this annual report is based on data collected in the Georgia BRFSS during calendar years 2011, 2012, 2013, and 2015.
Georgia Department of Public Health / 3

HIGHLIGHTS & UPDATES

2016 GEORGIA ALZHEIMER'S AND RELATED DEMENTIAS (GARD)
.........................................................................................................................................................................................

The Alzheimer's Disease and Related Dementias (ADRD) State Plan Coordinator began working

June 1, 2016 in the Department of Human Services, Division of Aging Services on

.

.........................................................................................................................................................................................

July 2016 GARD Advisors and Advisory Council met

and revitalized six existing work groups.

.........................................................................................................................................................................................

190 people are included in GARD email distribution and are updated on progress.

.........................................................................................................................................................................................

70 people are engaged in six active work groups.

.........................................................................................................................................................................................

Over 45 June 2016 new members were added to GARD email distribution since

,

with many now engaged in work groups. .........................................................................................................................................................................................
6 There are active work groups.
.........................................................................................................................................................................................

GARD WORK GROUP UPDATES
Workforce Development
Chairs: Kathy Simpson (Alzheimer's Association, Georgia Chapter) and Dr. Jennifer Craft Morgan (Georgia State University, Gerontology Institute)
Established State Plan Goals: Assess the current workforce in Georgia, improve/increase dementia capability of workforce, develop education and training curricula, and improve workforce retention.
2016 Update: Produced a one-year report about an online dementia education module for physicians, which showed that 77 healthcare professionals completed the training and that the education proves to be impactful. Participants demonstrated a strong understanding of the basics of Alzheimer's disease and the Annual Medicare Wellness Visit after completing the modules.
Collaborated with the Culture Change Network of Georgia and convened a group of providers to develop standard competencies for professionals who support people living with dementia.
The workgroup is comprised of three subcommittees: Healthcare Provider Education, Direct Care Worker Competencies, and Data Collection & Analysis.
4 / GARD REPORT / Georgia 2016

2017 Vision and Goals: Creation of a second web-based dementia training module for physicians Complete a dementia education competency guide for the direct care workforce Expand data collection on dementia competency and training of long-term care workforce
Service Delivery
Chair: Eve Anthony (Athens Community Council on Aging) Established State Plan Goals: Assess the regional capacity of our state including
rural versus urban access to services, train workforce in person-centered care, promote use of person-centered care models in long-term care, improve access to services and information, improve care transitions, and ensure high-quality services and quality care measurement in dementia services. 2016 Update: Established a chairwoman, reconvened membership, and reviewed the established
goals of service delivery. Communicated with work groups to determine collaboration opportunities 2017 Vision and Goals: Work toward the established goals in the state plan Collaborate with Workforce Development work group on common goals
and strategies
Public Safety
Chair: This work group did not have a chair in 2016. Established State Plan Goals: Ensure safety of persons with dementia who are
at-risk for abuse, neglect, or exploitation and reduce rates of injury among people living with dementia. 2016 Update: Reconvened and decided to continue to support the Abuse, Neglect, and
Exploitation initiatives that were established. Explored the current policies in the state of Georgia around the determination
of decision-making capacity in someone living with dementia. 2017 Vision and Goals:
Determine next steps in the creation or revision of a decision-making capacity toolkit for professionals including physicians, mental health professionals and judges
Revisit the goals established in the state plan and determine next steps Expand work group membership to include first-responders
Georgia Department of Public Health / 5

HIGHLIGHTS & UPDATES
Outreach and Partnerships
Chairs: Natalie Zellner, JD (Emory University, Alzheimer's Disease Research Center) and Ginny Helms (Alzheimer's Association, Georgia Chapter)
Established State Plan Goals: Raise public awareness about dementia, educate the public about "dementia-friendliness," expand state's capacity to address the needs of persons living with dementia through partnerships and leveraging resources.
2016 Update: Determined a plan to bring awareness of the importance of early detection and diagnosis, which includes education about using the Medicare Annual Wellness Visit as a means to conduct cognitive screenings.
Focused attention on partnership and connectivity to the faith community as a way to educate people on the topic of early detection.
2017 Vision and Goals: Use media outlets to disseminate information about the importance of early detection and diagnosis to the public
Attend and participate in professional conferences for healthcare professionals as a means to communicate the importance of early detection and diagnosis
Collaborate with faith communities on educational programming
Policy
Chairs: Sheila Humberstone, Principal (Stone Bridge Consulting Group)
Established State Plan Goals: The policy workgroup serves to assess the statutory, regulatory, and state funding environment as it relates to Alzheimer's disease and make necessary recommendations. The group serves to vet and move forward as appropriate any policy changes requested by other workgroups as well as independently consider policy changes which would assist individuals with dementia and their families.
2016 Update: Worked with GARD members on priorities during the 2016 Legislative Session, including: Increase in Home and Community Based Services (HCBS) funding
Allocation of funding for Georgia Bureau of Investigation (GBI) to hire additional staff for abuse, neglect and exploitation of vulnerable adults.
Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act
2017 Vision and Goals: Work with the other GARD workgroups to develop a strong policy platform for 2018
Pursue budgetary, legislative, and regulatory actions as advised by the GARD workgroups
6 / GARD REPORT / Georgia 2016

Healthcare, Research, & Data Collection
Chair: This workgroup did not have a chair in 2016.
Established State Plan Goals: Ensure early and accurate diagnosis of dementia, use surveillance data to enhance awareness for state planning, recognize Alzheimer's . as chronic disease, and improve the care and healthoutcomes of people living with dementia and their families.
2016 Update: Reconvened in order to establish direction.
Began work on a data set catalogue to assess existing data on dementia in the state of Georgia.
Welcomed the new full-time staff person leading the ADRD registry efforts to the work group.
2017 Vision and Goals: Complete data set catalogue and determine next steps
Use multiple data sets to analyze the accessibility challenges and health disparities . that exist in our state for people living with dementia
Continue to support the improvement of the ADRD registry efforts of Department of Public Health Georgia Department of Public Health / 7

Prevalence Of Perceived Cognitive Impairment (PCI) Among Georgia Adults
Although Alzheimer's Disease and Related Dementia is not a normal part of aging, increasing age is the greatest known risk factor. The majority of people with ADRD are 65 years and older but there are those who have early onset of ADRD, beginning as early as age 40.
8 / GARD REPORT / Georgia 2016

HIGHLIGHTS

More than 2.8 million Georgia adults are 45 years and older.
.........................................................................................................................................................................................

Approximately 385,500 (13 percent) self-reported PCI.

The prevalence of PCI was relatively consistent among races and ethnicities.

.........................................................................................................................................................................................

75 Georgians aged

years and older reported a higher prevalence of PCI

(Weighted Frequency (WF)* = 61,550; 17 percent) than those less than 65 years.
.........................................................................................................................................................................................

Georgians who had less than a high school education reported the highest prevalence of PCI
(WF*=106,200; 22 percent) than those with higher levels of education.
.........................................................................................................................................................................................
Georgians who rated their general health as Fair or Poor (WF*=211,480; 30 percent)

were significantly more likely to report PCI than those who reported good or better general health
(WF*=173,830; 8 percent).
.........................................................................................................................................................................................

The prevalence of PCI is significantly higher among Georgians without any form of health care
coverage (WF*=61,720; 17 percent) than those who have some form of coverage (WF*= 322,788; 13 percent).
.........................................................................................................................................................................................
Approximately 80 percent (WF*=262,260) of Georgians who reported PCI had not

discussed their condition with a health care provider (HCP), and had therefore not received any treatment

8 percent ( 24,940) or therapy. Only

WF*=

had discussed their condition with a HCP

and received treatment. .........................................................................................................................................................................................

* The BRFSS employs a complex survey design to account for overrepresentation or underrepresentation of various population subgroups within the final sample of respondents. Responses to the survey are then weighted to adjust for the distribution of the sample data. The weighted frequency represents the estimated number of adult Georgians who responded to a particular question.

Georgia Department of Public Health / 9

INTRODUCTION
Like other chronic diseases, Alzheimers Disease and Related Dementia is not randomly distributed in the population. It is more common in certain demographics than others, such as older adults and women.
10 / GA R D RE P O RT / G e orgi a 20 16

More than 16 million U.S. residents are living with

cognitive impairment [4]. While cognitive impairment is not an

inevitable result of aging, age is the greatest risk factor. As the U.S.

population continues to age and the number of people ages 65 years and older increases, the prevalence of cognitive impairment

WHAT IS COGNITIVE I M PA I R M E N T ?

also is expected to increase. The number of Americans ages 65 years or older who are living with Alzheimer's disease is projected to increase from 5.1 million in 2000, to about 13.2 million in 2050 [5]. Cognitive decline may also be the result of other reversible conditions/diseases (e.g., depression, infections, medication side effects or nutritional deficiencies), which can be serious and should be treated by a health care provider as soon as possible [6].
Perceived cognitive impairment (PCI) is the self-
perceived impression of declining cognitive function that is not readily identifiable through neuropsychological testing, but which may be the first preclinical sign of Alzheimer's disease and other dementias . [7,8] Studies show that older adults with memory complaints have a greater risk than those without memory complaints for developing mild cognitive impairment (a potential precursor to Alzheimer's disease) [9]. While having cognitive decline and impairment does not necessarily mean a person will develop future dementia, current estimates indicate that 32 percent to 53 percent of individuals with mild cognitive impairment

Cognitive impairment is when a person has trouble remembering, concentrating, learning new things, or making decisions that affect their everyday life. Cognitive impairment ranges from mild to severe. With mild impairment, people may begin to notice changes in cognitive function, but may still be able to do their daily activities. Severe levels of impairment can lead to the inability to understand the meaning or importance of something and the ability to talk or write, resulting in the inability to live independently. Cognitive impairment may be the result of causes or diseases other than Alzheimer's disease . [10]

will experience some form of dementia later in life [10-12].

Geo rgia Depa rtmen t of Pu blic H ea lth / 11

PREVALENCE
Prevalence of PCI
Approximately 13% (385,500) of Georgians aged 45 years or older reported they had experienced PCI that was happening more often or was getting worse during the past 12 months.
Prevalence by Sex
Fourteen percent (14%; 177,500) of males and 13% (208,000) of females reported experiencing PCI over the past 12 months.

PERCENTAGE

Prevalence of PCI among Adults Aged 45 Years or Older, Georgia, 2011-2013, 2015

13

YES

NO
87

Prevalence of PCI among Adults Aged 45 Years Or Older, By Sex, Georgia, 2011-2013, 2015
50

40

30

20

14

13

10

0 MALE

FEMALE

Prevalence by Race/Ethnicity
Approximately 13% (251,500) of Non-Hispanic Whites, 13% (96,600) of Non-Hispanic Blacks, and 15% (13,900) of Hispanics reported experiencing PCI over the past 12 months.

PERCENTAGE

Prevalence of PCI among Adults Aged 45 years or Older, by Race/Ethnicity, Georgia, 2011-2013, 2015
50

40

30

20
13

13

15

10

0 NH WHITE

NH BLACK

HISPANIC

Prevalence by Age
Nearly 17% (61,550) of Georgians 75 years and older reported experiencing PCI that was happening more often or getting worse over the past 12 months. This was significantly higher than the prevalence among 45-54 and 65-74 year olds (12% each).
12 / GA R D R E P O RT / G e orgi a 20 16

PERCENTAGE

Prevalence of PCI among Adults Aged 45 years or Older, by Age Group, Georgia, 2011-2013, 2015
50

40

30

20
12

14

12

17

10

0

45-54

55-64

65-74

75+

AGE (YEARS)

PERCENTAGE

Prevalence of PCI among Adults Aged 45 years or Older, by Education Level, Georgia, 2011-2013, 2015

50

40

30

20

10

0 < HS

HS GRAD

SOME COLLEGE

EDUCATION LEVEL

COLLEGE GRAD

Prevalence by Education Level
A significantly higher percentage of Georgians 45 years and older with less than a high school education (22%; 106,200) reported having PCI than those with higher levels of education. Conversely, Georgians with at least a college degree had significantly lower PCI (8%; 57,800) than those with all other education levels.

PERCENTAGE

Prevalence of PCI among Adults Aged 45 years or Older, by Employment Status, Georgia, 2011-2013, 2015
50

40

30

20

10

0

EMPLOYED/

OUT OF WORK/UNABLE TO WORK

RETIRED

HOMEMAKER

STUDENT

EMPLOYMENT STATUS

Prevalence by Employment Status
The prevalence of PCI was higher among Georgians who were either out of work or unable to work (31%; 159,920) than those who were employed/homemakers/ students (7%; 107,370), or retired (13%; 117,420).

PERCENTAGE

Prevalence of PCI among Adults 45 years or older,
by Health Insurance Status, Georgia, 2011-2013, 2015
50

40

30

20

10

0 HAS INSURANCE

NO INSURANCE

HEALTH INSURANCE STATUS

Prevalence by Health Insurance Status
The prevalence of PCI was significantly higher among Georgians who did not have any form of health care coverage (17%; 61,720) than those who had some form of coverage (13%; 322,790).

Prevalence of PCI among Adults 45 years or Older, by General

50

Health Status, Georgia, 2011-2013, 2015

40

PERCENTAGE

30

20

10

0 EXCELLENT/VERY GOOD/GOOD

FAIR/POOR

HEALTH STATUS

Prevalence by General Health Status
The prevalence of PCI was significantly higher among Georgians who described their general health as fair/poor (30%; 211,480) than those who rated themselves as having at least good general health (8%; 178,830).

Geo rgia Depa rtmen t of Pu blic H ea lth / 13

PREVALENCE
Prevalence by Number of Diagnosed Chronic Conditions
The prevalence of PCI significantly increased with every increase in the number of diagnosed comorbid chronic conditions from none (5%; 58,030), to one (11%; 93,700), two (21%; 84,570), and three or more (37%; 119,350).
Prevalence by Sex and Race
The prevalence of PCI was 14%, 13%, and 15% among Non-Hispanic White, Non-Hispanic Black, and Hispanic males, respectively (Table 1, Appendix). Similarly, the prevalence of PCI was 13%, 13%, and 14% among Non-Hispanic, Non-Hispanic Black, and Hispanic females, respectively (Table 1, Appendix).

Prevalence of PCI among Adults 45 years or Older, by Number of Comorbid Conditions, Georgia, 2011-2013, 2015
50

40

37

PERCENTAGE

30

20

10

5

21 11

0

NONE

1

2

3 or MORE

NUMBER OF DIAGNOSED DISEASES

PERCENTAGE

Prevalence of PCI among Adults 45 years or older, by Sex and Race, Georgia, 2011-2013, 2015
50

40

MALE

FEMALE

30

20

14 13

10

13 13

15 14

0 NH WHITE

NH BLACK

HISPANIC

Prevalence by Sex and Age
The prevalence of PCI was highest among males and females 75 years or older (18% and 16% respectively). However, the differences between sex-age groups were not significant. (Table 1, Appendix).

PERCENTAGE

Prevalence of PCI among Adults 45 years or older, by Sex and Age, Georgia, 2011-2013, 2015
50

40

MALE

FEMALE

30
20
12 12
10

15 14

12 12

18 16

0

45-54

75+

AGE (YEARS)

Prevalence by Race and Age
Among Non-Hispanic Blacks, a significantly higher percentage of Georgians 75 years or older (22%) reported PCI than those aged less than 65 years. (Table 1, Appendix).
14 / GA R D R E P O RT / G e orgi a 20 16

PERCENTAGE

Prevalence of PCI among Adults 45 years or older, by Race and Age, Georgia, 2011-2013, 2015

50

NH WHITE

NH BLACK

HISPANIC

40

30

20

12 11 14

10

18 15 12

12 13 8

22 15

0 45-54

55-64

65-74

75+

AGE (YEARS)

The prevalence of Perceived Cognitive Impairment was significantly higher among Georgians who described their general health as fair/poor than those who rated themselves as having at least good general health.
Geo rgia Depa rtmen t of Pu blic H ea lth / 15

DISCUSSING MEMORY ISSUES

Discussed PCI with a Health Care Professional (HCP) and Received Treatment/Therapy
Approximately 80% of Georgians with PCI had not discussed their memory issues with an HCP, and therefore had not received any form of treatment or therapy. Only 8% of Georgians with PCI had discussed their condition with a HCP and received some form of treatment or therapy.

Percentage of Adults Aged 45 Years or Older with PCI Who Have Discussed Condition with HCP and Received
Treatment, Georgia, 2011-2013, 2015

8%

13% 80%

DID NOT DISCUSS CONDITION
DISCUSSED CONDITION, RECEIVED TREATMENT DISCUSSED CONDITION, DID NOT RECEIVE TREATMENT

A similar proportion of males (7%) and females (8%) with PCI reported that they had discussed their condition with an HCP and had received some form of treatment or therapy.

PERCENTAGE

Percentage of Adults Aged 45 Years or Older with PCI Who Have Discussed Condition with HCP and Received
Treatment, By Sex, Georgia, 2011-2013, 2015
100

80

80

DISCUSSED CONDITION, RECEIVED TREATMENT

80

DISCUSSED CONDITION, DID NOT RECEIVE TREATMENT 60
DID NOT DISCUSS CONDITION

40

20

13

7

0 MALE

13 8
FEMALE

Approximately 78% of Non-Hispanic Whites, and 84% of Non-Hispanic Blacks with PCI had not discussed their condition with an HCP, and had therefore not received any treatment.
16 / GA R D R E P O RT / G e orgi a 20 16

Percentage of Adults with PCI Who Have Discussed Condition with HCP and Received Treatment, By Race/Ethnicity, Georgia, 2011-2013, 2015
100

DISCUSSED CONDITION,

84

80

75

RECEIVED TREATMENT

DISCUSSED CONDITION, DID NOT RECEIVE TREATMENT 60

DID NOT DISCUSS CONDITION

40

PERCENTAGE

20

16

9

7

9

0

MALE

FEMALE

RACE/ETHNICITY

Approximately 80% of Georgians with Perceived Cognitive Impairment had not discussed their memory issues with a health care provider, and therefore had not received any form of treatment or therapy.

Among Georgians 65 years and older, a higher percentage had not discussed their PCI with an HCP, and therefore had not received any treatment, than those less than 65 years. However, the differences were not significant.

PERCENTAGE

Percentage of Adults with PCI Who Have Discussed Condition with HCP and Received Treatment, By Age, Georgia, 2011-2013, 2015

DISCUSSED CONDITION,

100

RECEIVED TREATMENT

80

75

DISCUSSED CONDITION, DID NOT RECEIVE TREATMENT
78

DID NOT DISCUSS CONDITION

85

86

60

40

20

16

9

45-54

10

13

55-64

11 4

AGE (YEARS)

65-74

9 5
75+

Geo rgia Depa rtmen t of Pu blic H ea lth / 17

ACTIVITY & ABILITY

Inability to Perform Household Activities /Chores Due to PCI
Approximately 38% of Georgia adults with PCI reported that they sometimes, usually, or always gave up on performing household chores or activities during the past 12 months because their confusion or memory loss was happening more often or was getting worse.

Percentage of Adults Aged 45 Years or Older With PCI who Reported Difficulty in Performing Household Activities, Georgia, 2011-2013, 2015

38% 62%

RARELY OR NEVER SOMETIMES, USUALLY OR NEVER

A similar proportion of males (39%) and females (36%) with PCI reported that they sometimes, usually, or always gave up on performing household chores or activities during the past 12 months due to their worsening condition.

Percentage of Adults Aged 45 Years or Older with PCI who Reported Difficulty in Performing Household Activities, By Sex,
Georgia, 2011-2013, 2015

PERCENTAGE

100
80
60
39
40
20
0 MALE

36
FEMALE

A significantly lower percentage of Non-Hispanic Whites (33%) than Non-Hispanic Blacks (46%) with PCI reported that they sometimes, usually, or always gave up on performing household chores or activities during the past 12 months due to their worsening condition.
18 / GA R D R E P O RT / G e orgi a 20 16

PERCENTAGE

Percentage of Adults Aged 45 years or Older with PCI Who Reported Difficulty in Performing Household Activities, by Race/Ethnicity, Georgia, 2011-2013, 2015

100

80

60

40

33

20

0 MALE

46
FEMALE

PERCENTAGE

Percentage of Adults Aged 45 years or Older with PCI Who Reported Difficulty 100 in Performing Household Activities, by Age, Georgia, 2011-2013, 2015

80

60
45 40
40
29 25
20

0

45-54

55-64

65-74

75+

AGE (YEARS)

The percentage of Georgians with PCI who reported that they sometimes, usually, or always gave up on performing household chores or activities decreased with increasing age.

Percentage of Adults Aged 45 years or older with PCI,
By Self Reported Difficulty in Buying Food or Paying for Rent,
Georgia, 2011-2013, 2015
100

80

PERCENTAGE

60

40
22
20
0 SOMETIMES, USUALLY, ALWAYS

8
RARELY, NEVER

29
SOMETIMES, USUALLY, ALWAYS

8
RARELY, NEVER

ABILITY TO PAY RENT

ABILITY TO BUY FOOD

Social Context and PCI Prevalence
A higher percentage of Georgia adults who sometimes, usually, or always had difficulty paying rent (22%; 106,030), or buying food (29%; 104,090) reported PCI than those who rarely or never had difficulty paying rent (8%; 80,620) or buying food (8%; 96,800).

Geo rgia Depa rtmen t of Pu blic H ea lth / 19

Prevalence of PCI by Public Health District

Southeast, South, Northwest, North Central, and North Health Districts had the highest prevalence of PCI, but none was significantly higher than the state average (Appendix, Table 2).

PUBLIC HEALTH DISTRICTS
1-1 Northwest (Rome)
1-2 North Georgia (Dalton)

PCI PREVALENCE BY PH DISTRICT

DADE (1-1)

CATOOSA (1-1)

WALKER (1-1)

WHITFIELD (1-2)

FANNIN (1-2)
MURRAY 1-2 (1-2)
GILMER (1-2)

CHATTOOGA (1-1)
FLOYD (1-1)

GORDON (1-1)
1-1
BARTOW (1-1)

PICKENS (1-2)
CHEROKEE (1-2)

UNION (2)
LUMPKIN (2)
DAWSON (2)
FORSYTH (2)

TOWNS (2)

RABUN (2)

WHITE (2)
2
HALL (2)

HABERSHAM (2)
STEPHENS (2)

BANKS (2)

FRANKLIN (2)

HART (2)

JACKSON (10)

MADISON (10)

ELBERT (10)

8% <12% 12% <14% 14% 17%

2 North (Gainesville) 3-1 Cobb-Douglas 3-2 Fulton 3-3 Clayton (Jonesboro) 3-4 GNR (Lawrenceville) 3-5 DeKalb 4 District 4 5-1 South Central (Dublin) 5-2 North Central (Macon) 6 East Central (Augusta)

POLK (1-1)
HARALSON (1-1)
CARROLL (4)
HEARD (4)

COBB (3-1)

GWINNETT

BARROW (10)

PAULDING

(3-4)

(1-1)
3-1

3-5

3-4

WALTON (10)

DOUGLAS (3-1)

FULTON (3-2)

DEKALB
(3-5) ROCKDALE

3-2

CLAYTON (3-3)

(3-4) NEWTON

3-3

HENRY

(3-4)

FAYETTE

(4)

COWETA (4)

(4)
SPALDING (4)

BUTTS (4)

JASPER (5-2)

CLARKE (10)
OCONEE (10)
10
MORGAN (10)
PUTNAM (5-2)

OGELTHORPE (10)

WILKES (6)

LINCOLN (6)

GREENE (10)

TALIAFERRO
(6) McDUFFIE
(6) WARREN
(6)

COLUMBIA (6)
RICHMOND (6)

HANCOCK (5-2)

GLASCOCK

6

(6)

7 West Central (Columbus) 8-1 South (Valdosta) 8-2 Southwest (Albany) 9-1 Coastal (Savannah) 9-2 Southeast (Waycross) 10 Northeast (Athens)

TROUP (4)

4
MERIWETHER (4)

PIKE

LAMAR

(4)

(4)

UPSON (4)

MONROE (5-2)

HARRIS (7)

TALBOT (7)

CRAWFORD (5-2)

JONES (5-2)

BALDWIN (5-2)

BIBB (5-2)

5-2

WILKINSON (5-2)

TWIGGS (5-2)

WASHINGTON (5-2)

JEFFERSON (6)

JOHNSON (5-1)

EMANUEL (6)

BURKE (6)
JENKINS (6)

SCREVEN (6)

MUSCOGEE (7)
CHATTAHOOCHIE (7)

TAYLOR (7)

MARION (7)

7
SCHLEY (7)

MACON (7)

STEWART (7)

WEBSTER (7)

SUMTER (7)

PEACH (5-2)
HOUSTON (5-2)

BLECHLEY (5-1)

LAURENS (5-1)

TREUTLEN (5-1)

5-1

DOOLEY (7)

PULASKI (5-1)

DODGE (5-1)

MONTGOMERY (5-1)

WHEELER (5-1)

TOOMBS (9-2)

CRISP (7)

WILCOX (5-1)

TELFAIR (5-1)

CANDLER (9-2)

BULLOCH (9-2)

EVANS (9-2)
TATTNAIL (9-2)

EFFINGHAM (9-1)

BRYAN (9-1)
LIBERTY (9-1)

CHATHAM (9-1)

QUITMAN (7)

RANDOLPH (7)

TERRELL (8-2)

LEE (8-2)

CLAY (7)

CALHOUN (8-2)

DOUGHERTY (8-2)

EARLY (8-2)
MILLER (8-2)

BAKER (8-2)

8-2
MITCHELL (8-2)

SEMINOLE (8-2)

DECATUR (8-2)

GRADY (8-2)

TURNER (8-1)
WORTH (8-2)
TIFT (8-1)

COLQUIT (8-2)

COOK (8-1)

THOMAS (8-2)

BROOKS (8-1)

BEN HILL (8-1)
IRWIN (8-1)

JEFF DAVIS (9-2)
COFFEE (9-2)

BERRIEN (8-1)

ATKINSON (9-2)

LANIER (8-1)
8-1
LOWNDES (8-1)

CLINCH (9-2)

APPLING (9-2)

BACON (9-2)

WAYNE (9-2)

9-2

PIERCE (9-2)

WARE (9-2)

BRANTLEY (9-2)

CHARLETON (9-2)

LONG (9-1)

9-1
McINTOSH (9-1)

GLYNN (9-1)

CAMDEN (9-1)

ECHOLS (8-1)

20 / GA R D R E P O RT / G e orgi a 20 16

Prevalence of PCI by Georgia Area Agencies on Aging (AAA) Planning and Service Areas (PSAs)

Middle Georgia, Heart of Georgia Altamaha, and Southeast Georgia PSAs had the highest prevalence of PCI, but none was significantly higher than the state average (Appendix, Table 2).
PCI PREVALENCE BY AAA PSA

AAA PSA 1 Northwest Georgia 2 Georgia Mountains 3 Atlanta Region

DADE (1)

CATOOSA (1)

WALKER (1)

WHITFIELD (1)

MURRAY (1)

CHATTOOGA (1-1)
FLOYD (1)

GORDON (1)
1
BARTOW (1)

FANNIN (1)
GILMER (1)
PICKENS (1)
CHEROKEE (3)

UNION (2)
LUMPKIN (2)
DAWSON (2)
FORSYTH (2)

TOWNS (2)

RABUN (2)

11% <13% 13% <15%

WHITE (2)
2
HALL (2)

HABERSHAM (2)
STEPHENS (2)

BANKS (2)

FRANKLIN (2)

HART (2)

15%17%

JACKSON (5)

MADISON (5)

ELBERT (5)

POLK (1)
HARALSON (1)
CARROLL (4)
HEARD (4)

PAULDING (1)
DOUGLAS (3)
COWETA (4)

COBB (3)

GWINNETT (3)

BARROW (5)

3

FULTON (3)

DEKALB (3)

CLAYTON (3)

WALTON (5)
ROCKDALE (3)
NEWTON (5)

FAYETTE (3)

HENRY (3)

SPALDING (4)

BUTTS (4)

JASPER (5)

CLARKE (5)
OCONEE (5)
5
MORGAN (5)
PUTNAM (7)

OGELTHORPE (5)

WILKES (8)

LINCOLN (8)

GREENE (5)

TALIAFERRO
(8) McDUFFIE
(8) WARREN
(8)

COLUMBIA (8)
RICHMOND (8)

HANCOCK (8)

GLASCOCK

8

(8)

TROUP (4)

4
MERIWETHER (4)

PIKE

LAMAR

(4)

(4)

UPSON (4)

MONROE (7)

HARRIS (6)

TALBOT (6)

CRAWFORD (7)

JONES (7)

BALDWIN (7)

7

BIBB (7)

WILKINSON (7)

TWIGGS (7)

WASHINGTON (8)

JEFFERSON (8)

JOHNSON (9)

EMANUEL (9)

BURKE (8)
JENKINS (8)

MUSCOGEE (6)

TAYLOR (6)

PEACH (7)
HOUSTON (7)

BLECHLEY (9)

LAURENS (9)

TREUTLEN (9)

CANDLER (9)

4 Southern Crescent 5 Northeast Georgia 6 Lower Chattachoochee 7 Middle Georgia 8 Central Savannah River 9 Heart of Georgia Altamaha 10 Southwest Georgia 11 Southeast Georgia 12 Coastal Georgia

SCREVEN (8)

BULLOCH (12)

EFFINGHAM (12)

CHATTAHOOCHIE (6)
6

MARION (6)

SCHLEY (6)

MACON (6)

STEWART (6)

WEBSTER (6)

SUMTER (6)

DOOLEY (6)
CRISP (6)

PULASKI (7)
WILCOX (9)

9
DODGE (9)

MONTGOMERY (9)

WHEELER (9)

TOOMBS (9)

TELFAIR (9)

EVANS (9)
TATTNAIL (9)

12
BRYAN (12)
LIBERTY (12)

QUITMAN

(6)

RANDOLPH (6)

TERRELL (10)

LEE (10)

CLAY (6)

CALHOUN (10)

DOUGHERTY (10)

TURNER (11)
WORTH (10) TIFT (11)

BEN HILL (11)
IRWIN (11)

JEFF DAVIS (9)
COFFEE (11)

EARLY

(10)

BAKER

10

(10)

BERRIEN (11)

ATKINSON (11)

MILLER (10)

SEMINOLE (10)

DECATUR (10)

MITCHELL (10)

COLQUIT (10)

COOK (11)

LANIER (11)

GRADY (10)

THOMAS (10)

BROOKS (11)

LOWNDES (11)

11
CLINCH (11)

APPLING (9)
BACON (11)

LONG (12)
WAYNE (9)

WARE (11)

PIERCE (11)
BRANTLEY (11)

McINTOSH (12)
GLYNN (12)

CHARLETON (11)

CAMDEN (12)

CHATHAM (12)

ECHOLS (11)

Geo rgia Depa rtmen t of Pu blic H ea lth / 21

SUMMARY
Approximately 92,000 (6.4 percent) of Medicare beneficiaries in Georgia
were living with Alzheimer's disease and related dementias (ADRD) in 2013 . [14] Our analysis showed that approximately 80 percent of Georgians who perceived themselves as having some form of cognitive impairment have not discussed their condition with their health care provider (HCP) and therefore have not received treatment. Additionally, a significant percentage of Georgians who discussed their condition with their HCP do not receive any treatment or therapy for their complaint. Considering that individuals with PCI may have a greater risk for developing cognitive impairment later in life, equitable access to care and early diagnosis are critical not only for maintaining quality of life and independence, but are important steps in reducing the potential economic burdens of cognitive impairment. There is the need for an education campaign to encourage Georgians who experience persistent confusion or memory loss to consult with their health care providers. Efforts should also be made to integrate memory screening into regular checkups for elderly Georgians who may be more at risk of developing ADRD. While there is currently no established treatment for mild cognitive impairment, consultation with an HCP will help identify and treat any contributing medical conditions such as depression, ADRD, and blood clots or tumors in the brain . [15] Increased physical activity, spending time with family and friends, and learning new skills have also been shown to help improve memory . [15]
22 / GA R D R E P O RT / G e orgi a 20 16

As the Georgia population continues to age, the proportion
of the population diagnosed with ADRD is projected to increase significantly. By analyzing data from the various data sources, the GA ADRD Registry provides a clearer picture of the burden of ADRD in Georgia. Plans for 2017 include merging data from the various resources available to the registry to produce a complete analytical dataset, and getting more physicians to sign on and submit information in the Physicians Reporting Portal (available at https://sendss.state.ga.us/ sendss/!alzheim.alzheim_login). Ongoing analysis of the Georgia BRFSS will also serve as a valuable surveillance tool for monitoring the prevalence of PCI and the challenges faced by caregivers of ADRD-affected Georgians.
Geo rgia Depa rtmen t of Pu blic H ea lth / 23

APPENDIX

TABLE 1.
Characteristics of Georgia Adults 45 Years and Older Who Reported Perceived Cognitive Impairment (PCI), Georgia BRFSS, 2011-2013, 2015

WEIGHTED FREQUENCY* N (%)

GENERAL SAMPLE

385492

2079 (13.44)

SEX

Male

177470

733 (13.53)

Female

208022

1346 (13.36)

RACE/ETHNICITY

Non-Hispanic White

251449

1449 (13.27)

Non-Hispanic Black

96628

466 (12.91)

Hispanic

13914

35 (14.62)

EDUCATION

Less than HS

106175

428 (21.88)

HS Grad

119895

673 (13.96)

Some College

100338

526 (12.55)

College Grad

57802

445 (8.04)

AGE GROUP (YEARS)

45 - 54

126714

463 (12.26)

55 - 64

126803

665 (14.41)

65 - 74

70429

484 (12.09)

75+

61546

467 (16.51)

EMPLOYMENT STATUS

Employed / Homemaker / Student

107368

512 (7.4)

Out Of Work / Unable To Work

159918

745 (30.97)

Retired

117421

816 (13.17)

HEALTH COVERAGE STATUS

Has Insurance

322,788

1816 (12.88)

No Insurance

61722

256 (17.24)

HEALTH STATUS

Excellent / Very Good / Good

173826

957 (8.08)

Fair / Poor

211476

1121 (29.76)

HAD ANNUAL DR. VISIT WITHIN PAST 12 MONTHS

Yes

299418

1677 (13.09)

No

76558

347 (14.36)

BMI

Underweight / Normal

106544

592 (13.09)

Overweight

123726

683 (11.84)

Obese

142835

744 (15.84)

24 / GA R D R E P O RT / G e orgi a 20 16

95% CI 12.70 - 14.21
12.34 - 14.82 12.46 - 14.31
12.41 - 14.17 11.46 - 14.53 9.57 - 21.69
19.39 - 24.60 12.65 - 15.40 11.24 - 13.99 7.16 - 9.01
10.91 - 13.75 13.10 - 15.83 10.79 - 13.53 14.72 - 18.47
6.62 - 8.26 28.37 - 33.69 12.07 - 14.35
12.12 - 13.67 14.71 - 20.11
7.43 - 8.78 27.72 - 31.89
12.29 - 13.94 12.51 - 16.44
11.76 - 14.54 10.71 - 13.07 14.44 - 17.33

TABLE 1. (continued)
Characteristics of Georgia Adults 45 Years and Older Who Reported Perceived Cognitive Impairment (PCI), Georgia BRFSS, 2011-2013, 2015

NUMBER OF CHRONIC DISEASES None 1 2 3 or more STRESSED ABOUT BEING ABLE TO PAY RENT Sometimes, Usually, Always Rarely, Never STRESSED ABOUT BEING ABLE TO BUY FOOD Sometimes, Usually, Always Rarely, Never RACE/ETHNICITY AND SEX Male Non-Hispanic White Non-Hispanic Black Hispanic Female Non-Hispanic White Non-Hispanic Black Hispanic SEX AND AGE GROUP (YEARS) Male 45 - 54 55 - 64 65 - 74 75+ Female 45 - 54 55 - 64 65 - 74 75+ RACE/ETHNICITY, AND AGE GROUP (YEARS) Non-Hispanic White 45 - 54 55 - 64 65 - 74 75+

58031 93701 84571 119345
106026 80617
104086 96800
118740 40163 7255
132708 427946 6658
59237 61385 31592 25256
67477 65418 38837 36290
74179 83641 48312 45317

307 (4.79) 494 (11.3) 460 (20.55) 667 (37.18)
481 (22.32) 412 (7.81)
480 (29.16) 506 (7.95)

4.15 - 5.52 10.04 - 12.71 18.25 - 23.06 34.19 - 40.27
19.96 - 24.88 6.89 - 8.84
26.16 - 32.36 7.12 - 8.87

532 (13.62) 136 (12.54) 13 (15.18)
917 (12.97) 330 (13.19) 22 (14.05)

12.22 - 15.13 10.17 - 15.36 8.38 - 25.93
11.96 - 14.06 11.45 - 15.16 7.57 - 24.59

162 (12.20) 250 (14.64) 172 (11.93) 149 (17.81)
301 (12.31) 415 (14.19) 312 (12.23) 318 (15.71)

10.07 - 14.71 12.62 - 16.93 9.93 - 14.27 14.65 - 21.48
10.69 - 14.14 12.56 - 16.01 10.59 - 14.09 13.66 - 18.02

293 (11.87) 444 (14.55) 352 (12.05) 360 (15.38)

10.26 - 13.69 12.99 - 16.27 10.58 - 13.70 13.53 - 17.44

Geo rgia Depa rtmen t of Pu blic H ea lth / 25

TABLE 1. (continued)
Characteristics of Georgia Adults 45 Years and Older Who Reported Perceived Cognitive Impairment (PCI), Georgia BRFSS, 2011-2013, 2015

RACE/ETHNICITY, AND AGE GROUP (YEARS) Continued

Non-Hispanic Black

45 - 54

32977

55 - 64

32709

65 - 74

18391

75+

12553

Hispanic

45 - 54

7266

55 - 64

4390

65 - 74

888

75+ a

TALKED TO A HEALTH CARE PROVIDER ABOUT PCI

Yes

117753

No

262262

HAVE NOT DISCUSSED PCI WITH A HEALTH CARE PROVIDER (HCP)

By Age

45 - 54

83085

55 - 64

81103

65 - 74

50701

75+

47373

By Sex

Male

118598

Female

143664

By Race

Non-Hispanic White

166386

Non-Hispanic Black

70557

Hispanic a

114 (10.99) 175 (12.31) 98 (12.95) 79 (21.55)
10 (13.96) 14 (18.02) 7 (7.51)
555 (30.8) 1490 (69.2)
302 (66.89) 443 (64.58) 371 (72.85) 374 (79.45)
512 (68.2) 978 (70.04)
1038 (67.44) 347 (74.04)

8.74 - 13.74 10.84 - 15.98 9.99 - 16.62 16.21 - 28.05
7.00 - 25.91b 9.74 - 30.92 b 3.01 - 17.51
27.98 - 33.78 66.22 - 72.02
60.84 - 72.43 59.34 - 69.49b 66.73 - 78.22 73.44 - 84.39
63.22 - 72.80 66.45 - 73.40
63.85 70.83 67.87 79.39

26 / GA R D R E P O RT / G e orgi a 20 16

TABLE 1. (continued)
Characteristics of Georgia Adults 45 Years and Older Who Reported Perceived Cognitive Impairment (PCI), Georgia BRFSS, 2011-2013, 2015

RECEIVED TREATMENT AMONG GEORGIANS WHO DISCUSSED PCI WITH HCP

Yes

24938

168 (37.17)

No

42153

221 (62.83)

HAVE NOT RECEIVED TREATMENT AMONG GEORGIANS WHO DISCUSSED PCI WITH HCP

By Age Group (Years)

45 - 54

17752

76 (64.49)

55 - 64

13037

73 (56.31)

65 - 74

6430

42 (72.38)

75+

4933

30 (65.54)

By Sex

Male

19113

81 (63.27)

Female

23039

140 (62.47)

By Race

Non-Hispanic White

29362

158 (63.61)

Non-Hispanic Black

7746

40 (56.54)

Hispanic a

a Not available if the unweighted sample size for the denominator is less than 50 b Estimates with 95% Confidence Intervals greater than 20 are unreliable

31.19 - 56.43b 56.43 - 68.81
53.69 - 74.00b 45.07 - 66.93b 57.49 - 83.54b 49.16 - 78.90b
52.64 - 72.75b 54.58 - 69.75
56.09 70.53 41.63 70.36b

* The BRFSS employs a complex survey design to account for overrepresentation or underrepresentation of various population subgroups within the final sample of respondents. Responses to the survey are then weighted to adjust for the distribution of the sample data. The weighted frequency represents the estimated number of adult Georgians who responded to a particular question.

Geo rgia Depa rtmen t of Pu blic H ea lth / 27

TABLE 2.
Prevalence of PCI among Adults Aged 45 years or more, by Health District, and Area Agencies of Aging (AAA) Planning and Service Areas (PSAs). Georgia BRFSS, 2011-2013, 2015

WEIGHTED FREQUENCY* N (%)

95% CI

BY HEALTH DISTRICT

Northwest (Rome)

31314

136 (16.07)

13.19 - 19.44

North Georgia (Dalton)

18213

103 (12.88)

9.95 - 16.52

North (Gainesville)

31427

133 (15.25)

12.36 - 18.67

Cobb-Douglas

21449

89 (11.73)

9.08 - 15.02

Fulton

22823

91 (11.17)

8.71 - 14.23

Clayton (Jonesboro)

3661

52 (8.05)

5.70 - 11.26

East Metro (Lawrenceville)

25147

87 (10.17)

7.80 - 13.15

DeKalb

20871

96 (12.56)

9.54 - 16.38

District 4 (LaGrange)

33087

136 (13.65)

11.09 - 16.69

South Central (Dublin)

8150

129 (14.82)

11.26 - 19.25

North Central (Macon)

27281

132 (15.61)

12.74 - 18.99

East Central (Augusta)

23201

115 (13.62)

10.71 - 17.17

West Central (Columbus)

15977

135 (14.05)

11.31 - 17.33

South (Valdosta)

14403

120 (16.22)

12.00 - 21.55

Southwest (Albany)

19274

123 (13.82)

10.89 - 17.39

Coastal (Savannah)

19099

94 (11.38)

8.80 - 14.60

Southeast (Waycross)

22387

151 (16.89)

13.84 - 20.46

Northeast (Athens)

20866

114 (14.35)

11.41 - 17.89

BY AREA AGENCIES OF AGING (AAA) PLANNING AND SERVICE AREAS (PSA)

Northwest Georgia

422250

198 (14.89)

12.60 17.52

Georgia Mountains

206090

133 (15.25)

12.36 18.67

Atlanta Region

107519

491 (11.29)

10.05 12.66

Southern Crescent

24140

91 (15.79)

12.26 20.10

Northeast Georgia

24780

130 (13.32)

10.74 16.42

Lower Chattahoochee

15980

135 (14.05)

11.31 17.33

Middle Georgia

25210

129 (16.21)

13.15 19.82

Central Savannah River

23220

113 (12.87)

10.12 16.22

Heart of Georgia Altamaha

18680

190 (16.88)

13.64 20.71

Southwest Georgia

19270

123 (13.82)

10.89 17.89

Southeast Georgia

23960

188 (16.15)

13.05 19.82

Coastal Georgia

22220

115 (11.70)

9.26 14.68

* The BRFSS employs a complex survey design to account for overrepresentation or underrepresentation of various population subgroups
within the final sample of respondents. Responses to the survey are then weighted to adjust for the distribution of the sample data. The weighted frequency represents the estimated number of adult Georgians who responded to a particular question.

28 / GA R D R E P O RT / G e orgi a 20 16

Table 3.
Percentage of Adults with PCI Stratified by Discussion with HCP and Treatment Status, Georgia BRFSS, 2011- 2013, 2015

DISCUSSED CONDITION, RECEIVED TREATMENT

DISCUSSED CONDITION, DID NOT RECEIVE TREATMENT

DID NOT DISCUSS CONDITION OR RECEIVE
TREATMENT

N

%

95% CI

N

%

95% CI

N

%

95% CI

GENERAL SAMPLE

168 7.57 6.21 - 9.20 221 12.80 10.85 - 15.03 1490 79.63 77.07 - 81.97

BY AGE GROUP (YEARS)

45 - 54

48

8.84 6.18 - 12.47 76

16.05 12.37 - 20.57 302 16.05 12.37 - 20.57

55 - 64

70

9.70 7.19 - 12.98 73

12.51 9.14 - 16.87 443 77.79 72.96 - 81.97

65 - 74

25

4.12 2.48 - 6.77 42

10.79 7.21 - 15.84 371 85.09 79.88 - 89.14

75+

25

4.73 2.89 - 7.62 30

8.99 5.74 - 13.80 374 86.29 81.23 - 90.15

BY SEX

Male

62

7.46 5.39 - 10.24 81

12.84 9.76 - 16.72 512 79.70 75.38 - 83.43

Female

106 7.67 6.01 - 9.74 140 12.76 10.44 - 15.51 978 79.57 79.41 - 82.40

BY RACE

Non-Hispanic White

111 7.90 6.25 - 9.95 158 13.81 11.43 - 16.60 1038 78.28 75.13 - 81.14

Non-Hispanic Black

38

7.07 4.52 - 10.87 40

9.19 6.24 - 13.34 347 83.74 78.72 - 87.76

Hispanic a

BY NUMBER OF DIAGNOSED CHRONIC CONDITIONS

None

9

2.96 1.30 - 6.58 35

11.07 7.63 - 15.80 246 85.97 80.70 - 89.97

One

25

5.30 3.15 - 8.80 42

10.33 6.94 - 15.10 397 84.37 79.09 - 88.51

Two

48 9.53 6.49 - 13.79 43 9.93 6.79 - 14.30 324 80.54 75.07 - 85.05

Three or More

74

11.16 8.37 - 14.72 81

16.26 12.36 - 21.09 417 72.58 67.33 - 77.27

a Not available if the unweighted sample size for the denominator is less than 50

b Estimates with 95% Confidence Intervals greater than 20 are unreliable

Geo rgia Depa rtmen t of Pu blic H ea lth / 29

TABLE 4.
Percentage of Adults with PCI Who Had Given Up On Household Activities/Chores, Georgia BRFSS, 2011-2013, 2015

SOMETIMES, USUALLY, ALWAYS

N

%

95% CI

General Sample

701

37.51

34.53 - 40.59

BY AGE GROUP (YEARS)

45 - 54

198

45.23

39.09 - 51.51

55 - 64

255

40.25

35.19 - 45.51

65 - 74

137

29.23

23.78 - 35.34

75+

111

25.47

20.53 - 31.13

By Sex

Male

249

39.12

34.28 - 44.19

Female

452

36.14

32.54 - 39.90

By Race

Non-Hispanic White

426

33.34

29.94 - 36.64

Non-Hispanic Black

202

45.50

39.26 - 51.89

Hispanic a

a Not available if the unweighted sample size for the denominator is less than 50

b Estimates with 95% Confidence Intervals greater than 20 are unreliable

N 1345
260 397 342 346
473 872
1003 256

RARELY, NEVER

%

95% CI

62.49

59.41 - 65.47

54.77 59.75 70.77 74.53

48.49 - 60.91 54.49 - 64.81b 64.66 - 76.22 68.87 - 79.47

60.88 63.86

55.81 - 65.72 60.10 - 67.46

66.66 54.50

63.08 - 70.06 48.11 - 60.74

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REFERENCES
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2 Peachtree Street, NW Atlanta, Georgia 30303-3142 dph.ga.gov/alzheimersdisease
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