The validity of informant reports in assessing the severity ofdementia: Evidence from the CAMDEX interview
M. Neri
Bok Engelsk 1998
| Utgitt | 1998
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| Omfang | Side 56- 62
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| Opplysninger | The evaluation of a patient's mental state, overall clinical profileand behavioural disturbance in the process of diagnosing dementiarequires at least two sources of information: the patient and theinformant. Since the severity of the dementia may interfere with thesubjective perception of these disorders, it is important to evaluatethe consistency between these two sources of information and theclinical and psychometric evaluation made by the physician.Accordingly, in this study five behavioural areas, derived from thesemi-structured interview schedule provided by the CambridgeExamination for Mental Disorders of the Elderly (CAMDEX, i.e., Sleep,Depressed Mood, Everyday Activity, Memory and Global MentalFunctioning) have been tested on the patient and his/her informant.Eighty dementia patients (mean age = 74 years) and their informantsparticipated in the study. The dementia group was subdivided into twolevels of severity according to DSM-IIIR criteria: 41 with milddementia and 39 with moderate dementia, respectively, matched for ageand schooling. The rating of impairment was found to increase alongwith the severity of dementia in all the above-mentioned areas,except for sleep. However, the source of information pel sesignificantly influenced the evaluation of memory functioning.Moreover, the significant interaction between the two factorsconsidered indicates that memory functioning is evaluated quitedifferently by the patients and the informants, as only in theassessment made by the latter group did the impairment increase inparallel with severity of dementia. Finally, whereas none of thesubjective measures recorded in the patients were significantlycorrelated with their test scores, the correlations between theinformant memory appraisals and patient test results proved to besignificant. The present findings confirm the validity of informantreports in assessing cognitive and memory disorders in early-stagedementia, as well as in distinguishing patients with mild from thosewith moderate dementia.
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