ABSTRACT
OBJECTIVE: We aimed to evaluate the psychometric properties of the IADL measure included in the Dementia Care Assessment Packet (DCAP-IADL) in dementia patients. METHODS: The study involved 112 dementia patients and 546 controls. The DCAP-IADL was scored in two ways: observed score (OS) and predicted score (PS). The reliability of the DCAP-IADL was evaluated by testing its internal consistency, inter-rater reliability and test-retest reliability. Discriminant validity was evaluated by comparing the mean OS and PS between dementia patients and controls by ANCOVA. Pearson or Spearman correlation analysis was performed with other instruments to assess concurrent validity. Receiver operating characteristics curve analysis was performed to examine diagnostic accuracy. RESULTS: Chronbach's alpha coefficients of the DCAP-IADL were above 0.7. The values in dementia patients were much higher (OS=0.917, PS=0.927), indicating excellent degrees of internal consistency. Inter-rater reliabilities and test-retest reliabilities were statistically significant (p<0.05). PS exhibited higher reliabilities than OS. The mean OS and PS of dementia patients were significantly higher than those of the non-demented group after controlling for age, sex and education level. The DCAP-IADL was significantly correlated with other IADL instruments and MMSE-KC (p<0.001). Areas under the curves of the DCAP-IADL were above 0.9. CONCLUSION: The DCAP-IADL is a reliable and valid instrument for evaluating instrumental ability of daily living for the elderly, and may also be useful for screening dementia. Moreover, administering PS may enable the DCAP-IADL to overcome the differences in gender, culture and life style that hinders accurate evaluation of the elderly in previous IADL instruments.
Subject(s)
Aged , Humans , Activities of Daily Living , Dementia , Life Style , Mass Screening , Psychometrics , ROC CurveABSTRACT
OBJECTIVES: This study aimed to present the normative information of the Mini-Mental State Examination-Dementia Screening (MMSE-DS) and its short form (SMMSE-DS) in the Korean elderly. METHODS: The MMSE-DS was administered in a standardized manner to 1,008 healthy volunteers aged 60 years or over recruited from participants in the Korean Longitudinal Study on Health and Aging or from volunteers in the National Dementia Screening and Registry Program. The SMMSE-DS was consisted of 13 items from the MMSE-DS based on the diagnostic accuracy of individual items for dementia. RESULTS: Age and educational level were found to have significant effect on the SMMSE-DS score, but sex was not. Based on this result, overlapping age normative table (60 to 74, 70 to 84, and 75 to 90 years of age) with 4 educational strata (0 to 3 years, 4 to 6 years, 7 to 12 years and 13 years and more) was developed for the SMMSE-DS. For resulting 12 normative units, 5 percentile, lower quartile, median, upper quartile, mean, standard deviation and -1.5standard deviation were calculated. CONCLUSION: The normative data from this study can be widely used as reference values to objectively interpret the MMSE-DS and SMMSE-DS scores of the Korean elderly.
Subject(s)
Aged , Humans , Aging , Dementia , Longitudinal Studies , Mass Screening , Cognitive Dysfunction , Reference ValuesABSTRACT
OBJECTIVES: This study aimed to present the normative information of the Mini-Mental State Examination-Dementia Screening (MMSE-DS) and its short form (SMMSE-DS) in the Korean elderly. METHODS: The MMSE-DS was administered in a standardized manner to 1,008 healthy volunteers aged 60 years or over recruited from participants in the Korean Longitudinal Study on Health and Aging or from volunteers in the National Dementia Screening and Registry Program. The SMMSE-DS was consisted of 13 items from the MMSE-DS based on the diagnostic accuracy of individual items for dementia. RESULTS: Age and educational level were found to have significant effect on the SMMSE-DS score, but sex was not. Based on this result, overlapping age normative table (60 to 74, 70 to 84, and 75 to 90 years of age) with 4 educational strata (0 to 3 years, 4 to 6 years, 7 to 12 years and 13 years and more) was developed for the SMMSE-DS. For resulting 12 normative units, 5 percentile, lower quartile, median, upper quartile, mean, standard deviation and -1.5standard deviation were calculated. CONCLUSION: The normative data from this study can be widely used as reference values to objectively interpret the MMSE-DS and SMMSE-DS scores of the Korean elderly.
Subject(s)
Aged , Humans , Aging , Dementia , Longitudinal Studies , Mass Screening , Cognitive Dysfunction , Reference ValuesABSTRACT
OBJECTIVE: We developed a Korean version of Mini-Mental Status Examination (MMSE) optimized for screening dementia (MMSE-DS) and its' short form (SMMSE-DS). METHODS: We constructed the MMSE-DS using the items of the two current Korean versions of MMSE and then construct the SMMSE-DS consisted of 13 items from the MMSE-DS based on the diagnostic accuracy of individual items for dementia. We investigated reliability and validity of MMSE-DS and SMMSE-DS on 1,555 subjects (1,222 nondemented controls, 333 dementia patients). We compared the diagnostic accuracy of the SMMSE-DS with that of the three full Korean versions of MMSE, and examined its' age- and education-specific optimal cutoff scores for dementia. RESULTS: The internal consistency obtained by Cronbach's coefficient alpha was 0.826. The inter-rater reliability and test-retest reliability were 0.968 (p<0.001) and 0.825 (p<0.001), respectively. It showed significant correlation with the Clinical Dementia Rating (CDR) (r=-0.698, p<0.05) and the three full Korean versions of MMSE (r=0.839-0.938, p<0.001). The area under the receiver operator curve for dementia of the SMMSE-DS was larger than those of the three full Korean versions of MMSE (p<0.001). Age, education and gender explained 19.4% of the total variance of SMMSE-DS scores. The optimal cutoff scores for dementia of the SMMSE-DS were estimated differently by age and educational attainment of the subjects. CONCLUSION: The SMMSE-DS was found to be accurate, brief and portable instrument for screening dementia in Korean elders, and may be particularly useful for screening dementia in elderly populations with wide variation in educational levels.
Subject(s)
Aged , Humans , Dementia , Mass Screening , Reproducibility of ResultsABSTRACT
OBJECTIVES: This study aimed to develop an informant report questionnaire for dementia screening and to verify its reliability and validity. METHODS: A preliminary questionnaire with 30 items was administered to a reliable informant for each of 81 dementia patients and 166 normal controls. Through item analyses, the 15-item Seoul Informant Report Questionnaire for Dementia (SIRQD) was clraum up. Internal consistency and inter-informant correlation were analyzed. Factor analysis and ROC curve analysis were also performed. RESULTS: SIRQD was found to have high internal consistency and inter-informant reliability. Optimal cut-off score of SIRQD was 9/10, and the sensitivity and specificity at that score were .850 and .873, respectively. SIRQD was composed of four major factors (remote memory, recent memory, language, and activity of daily living). SIRQD was closely equivalent to MMSE-KC in terms of overall dementia screening ability, and it appeared efficient in discriminating very mild dementia from normal. SIRQD showed low false positive and negative rates, irrespective of levels of education, age, and sex. CONCLUSION: SIRQD possess good psychometrical properties and is probably very useful to screen dementia, especially for the Korean elderly with a very wide range of educational background.
Subject(s)
Aged , Humans , Dementia , Education , Mass Screening , Memory , Surveys and Questionnaires , Reproducibility of Results , ROC Curve , Sensitivity and Specificity , SeoulABSTRACT
From Nov. 1983 through Jan. 1986, 43 patients with nonsmall cell lung cancer were treated by radiation therapy at Inje Medical College Paik Hospital. 38 patients were available for the analysis of this study. 33 patients received definite irradiation with curative intent, while 5 patients received postoperative irradion. Chemotherapy was added in 12 patients before, during and after radio-therapy. 28 patients were squamous cell carcinoma and 10 patients were adenocarcinoma. There were 29 men and 9 women (median age, 58 years; range 34 to 74 years). Stage 1 was 1 patients, Stage 11, 7 patient, and Stage 111, 30 patients. Among 33 patients who received radiotherapy with curative intent, follow up radiological study revealed complete response in 12 patients (36%), partial response, in 9 patients (27%), and minimal response, in 5 patients (15%), while 7 patients (21%) were nonresponders. Median survival for all patients was 6.9 months; squamous cell carcinoma, 7.3 months, adenocarcinoma, 5.9 months. Responders survived median 7 months, while nonresponders survived median 1.9 months. Improved complete response rate and survival were shown in high radiation dose group. As prognostic factors, age, initial performance status, sex, histology and tumor location were evaluated.
Subject(s)
Female , Humans , Male , Adenocarcinoma , Age Factors , Carcinoma, Non-Small-Cell Lung , Carcinoma, Squamous Cell , Drug Therapy , Follow-Up Studies , RadiotherapyABSTRACT
From Nov. 1983 through Feb. 1986, 35 patients of uterine cervical cancer were treated by external radiation therapy and intracavitary radiation therapy using Fletcher-Sult-Delclos applicator. Age of the patients ranged from 32 to 70 years (median age:53 years). All patients had follow up from 9 to 34 months and median follow up of 20 months. 4 patients were in stage I, 25 were in stage II, 5 were in stage III and I was in stage IV. Overall regression rate was 80% and uncorrected actuarial 2 year survival rate was 88%. The incindence of rectal complications were analyzed. There was no rectal complication in the patients who received less than 7000 rad maximal rectal dose, but 2 out of 17 patients who received more than 7000rad developed moderate degree (grade 2) of rectal complication. In viewing of our results, Fletcher-Suit-Delclos applicator (3M) seemed to be an appropriate instrument for intracavitary radiation therapy in the patients of uterine cervical cancer.