Dementia and geriatric cognitive disorders
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Dement Geriatr Cogn Disord · Jan 2003
Comparative StudyValidity and applicability of the Chinese version of community screening instrument for dementia.
The development of an educationally independent screening instrument for dementia is most valuable for epidemiological studies. The Community Screening Instrument for Dementia (CSI-D) was applied to 120 subjects, with 30 matched for age in each of the four groups of mild to moderately demented, depressed, low-education and high-education normal control subjects. The internal consistency and interrater reliability of CSI-D were satisfactory. ⋯ CSI-D could differentiate the demented from nondemented subjects, but not the high- from the low-education control group. Receiver operating characteristic analysis showed good test performance of CSI-D. In conclusion, the Chinese version of CSI-D is a valid, reliable and educationally independent screening instrument for dementia sensitive to detect early stage of the disease.
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Dement Geriatr Cogn Disord · Jan 2003
The impact of different diagnostic criteria on prevalence rates for delirium.
A cross-sectional study was performed to evaluate the concordance of the present criteria of delirium among elderly (>70 years) geriatric hospital patients (n = 230) and nursing home residents (n = 195). Different subjects were diagnosed as having delirium when operationalized criteria according to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III, DSM-III-R, DSM-IV) and the World Health Organization's International Classification of Diseases (ICD-10) were used. ⋯ The DSM-IV and ICD-10 had the largest number of patients not overlapping with any other diagnostic group. The newest DSM-IV classification found more cases of delirium especially among acutely ill, hospitalized patients.
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To obtain prevalence estimates of dementia in China, an analysis of 17 studies published in Chinese from 1990-1999 was carried out. The prevalence rates for the population aged 60 years and older were 1.26% for Alzheimer's disease (AD) and 0.74% for vascular dementia (VD). The prevalence of AD was 2.10% in women and 0.76% in men, while the prevalence of VD was 0.71 and 0.69%, respectively. ⋯ The difference between the prevalence of VD in urban (0.67%) and in rural areas (1.13%) was not significant either. The prevalence of AD increased with age, and gender was found to be associated with Alzheimer's disease. The prevalence of VD also increased with age, but there was no association between VD and gender.
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Dement Geriatr Cogn Disord · Jan 2003
The validity and reliability of 6 sets of clinical criteria to classify Alzheimer's disease and vascular dementia in cases confirmed post-mortem: added value of a decision tree approach.
Data from 204 participants from the Oxford Project to Investigate Memory and Ageing, who were diagnosed post-mortem using the histopathological criteria of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), were used to assess the validity of the clinical criteria for Alzheimer's disease (AD) of the 'National Institute of Neurological and Communicative Disorders and Stroke/the Alzheimer's Disease and Related Disorders Association' (NINCDS/ADRDA). Cases who had been diagnosed as NINCDS/ADRDA 'probable AD' in life were usually confirmed at autopsy, but half of the NINCDS/ADRDA 'negative' cases were not (low specificity). It was hypothesized that the overall clinical impression may have taken precedence over the use of the actual criteria. ⋯ The ADDTC and VCI criteria for VaD had good specificity (88%) and sensitivity (75%), but only for one rater. The DSM-IV and NINCDS-AIREN criteria for VaD showed poor validity and inter-rater reliability. We conclude that the forced use of decision trees through a computerized system enhances the accuracy of the clinical diagnoses of dementia.
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Dement Geriatr Cogn Disord · Jan 2003
Comparative StudyNeuropsychological profile of patients with Parkinson's disease without dementia.
Cognitive deficits are often associated with Parkinson's disease (PD), although their prevalence in PD patients without dementia is still unknown. In order to describe the neuropsychological profile of PD patients without dementia, a sample of 103 PD patients was compared with a control group consisting of 38 healthy elderly subjects. Psychometric assessment consisted of the Mini Mental State Examination, the Dementia Rating Scale and a battery of neuropsychological tests. ⋯ Among non-demented subjects, 34 (45%) had no cognitive impairment and 42 (55%) had a mild cognitive impairment. Subjects with mild cognitive impairment were older, had a later onset of the disease, and more severe motor symptoms than cognitively intact subjects. Identification of mild cognitive impairment is important, since these symptoms are important for patient management and may also facilitate to determine prognosis.