Epidemiological dementia index: A screening instrument forAlzheimer's disease and other types of dementia suitable for use inpopulations with low education level
K.N. Fountoulakis
Bok Engelsk 1998
| Utgitt | 1998
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| Omfang | Side 329- 338
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| Opplysninger | Introduction: MMSE and CAMCOG are neuropsychological scales developedfor use in everyday clinical practice and epidemiological surveys.Material and Methods: These two instruments were used as part of theassessment during an epidemiological survey in the municipality ofPylaia, Greece. The project was based on the World HealthOrganization Program for Research on Aging and Age-AssociatedDementias (1992). It had two phases. During phase I, nursing studentscollected demographic data, risk factors, personal and family historydata and they applied MMSE, CAMCOG and scales of everyday lifefunctioning. During phase II, 4 physicians examined all subjects thatmanifested possible cognitive deterioration (MMSE<27), in order toreach a final diagnosis. The final diagnosis was made according toDSM-IV and NINCDS-ADRDA criteria. MMSE and CAMCOG were not taken intoconsideration in the diagnostic process. Three hundred and eightysubjects were initially screened. All were aged over 70 years. Afterthe exclusion of subjects who were illiterate, blind, etc., theresults of 277 subjects were finally analyzed. Subjects with 6 yearsof education or less accounted for 92.42% of the total study sample.Twelve of them (5.33%) suffered from Alzheimer's disease, 7 fromvascular dementia (2.52%) and I suffered from secondary dementia(0.36%). Results: MMSE exceeded 90% sensitivity at the level 22/23and specificity at 14/15. The levels for CAMCOG were 56/57 and 43/44,respectively. This low performance of both tests is to a large extentdue to the functional illiteracy of elderly individuals in Greece, topossible coexistence of mood disorders or simply to lack ofcooperation. The analysis of data led to the development of anEpidemiological Dementia Index (EDI), with a scale ranging from 0 to7. Nondemented subjects had a mean EDI of 5.12 (SD = 1.67) anddemented patients had a mean EDI of 1.6 (SD = 1.92). At the level 4/5sensitivity was 93.33. Specificity was 93.56 at the level 2/3.
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| Emner |
