ABSTRACT
BACKGROUND: Dementia screening in elderly people with low education can be difficult to implement. For these subjects, informant reports using the long (L) (26 items) and short (C) (16 items) versions of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) can be useful. The objective of the present study was to investigate the performance of Brazilian versions of the IQCODE L, S and a new short version (SBr) (15 items) in comparison with the Mini-mental State Examination (MMSE) for dementia screening in elderly people with low education. METHODS: Thirty-four patients with mild to moderate dementia, diagnosed according to ICD-10 criteria, and 57 controls were evaluated and divided into three groups based on their socioeconomic status and level of education. Patients were evaluated using the MMSE and the informants were interviewed using the IQCODE by interviewers blind to the clinical diagnosis. RESULTS: Education was correlated with MMSE results (r = 0.280, p = 0.031), but not with the versions of the IQCODE. The performance of the instruments, evaluated by the ROC curves, was very similar, with good internal consistency (Cronbach's alpha = 0.97). MMSE correctly classified 85.7% of the subjects while the three IQCODE versions (L, S and SBr) correctly classified 91.2% of the subjects. CONCLUSIONS: The long, short and the new short Brazilian IQCODE versions can be useful as a screening tool for mild and moderate patients with dementia in Brazil. The IQCODE is not biased by schooling, and it seems to be an adequate instrument for samples with low levels of education.
Subject(s)
Cognition Disorders/diagnosis , Dementia/diagnosis , Geriatric Assessment , Mass Screening/methods , Surveys and Questionnaires , Age Factors , Aged , Brazil , Case-Control Studies , Cognition Disorders/psychology , Dementia/psychology , Educational Status , Female , Humans , Male , Mental Status Schedule/statistics & numerical data , Middle Aged , Neuropsychological Tests/statistics & numerical data , Psychiatric Status Rating Scales/statistics & numerical data , Psychometrics , ROC Curve , Sex FactorsABSTRACT
OBJECTIVE: To determine if a functional scale combined with a cognitive test would improve the diagnostic accuracy of dementia. METHOD: Thirty patients with mild to moderate dementia, diagnosed according to ICD-10 and DSM-III-R criteria, and 46 elderly controls, divided into three groups according to their socioeconomic status and educational level (high, medium and low) were investigated. The subjects were assessed with the MMSE, and their informants were assessed with the scales IQCODE and B-ADL. RESULTS: On the logistic regression, the MMSE isolated classified correctly 86.8% of patients and controls (80% sensitivity and 91.3% specificity). The combination MMSE + IQCODE classified correctly 92.1% of the subjects (83.3% sensitivity and 97.8% specificity), and the combination MMSE + B-ADL classified correctly 92.1% of subjects (86.7% sensitivity and 95.7% specificity). CONCLUSION: The results suggest that the combination of a cognitive test with a functional scale can improve the detection of mild to moderate cases of dementia even on samples of a very heterogeneous population regarding its socioeconomic status and educational level, as the Brazilian.
Subject(s)
Dementia/diagnosis , Psychiatric Status Rating Scales/standards , Aged , Educational Status , Female , Humans , Logistic Models , Male , Middle Aged , Predictive Value of Tests , Sensitivity and Specificity , Socioeconomic FactorsABSTRACT
OBJETIVO: Investigar se a combinaçäo de uma escala de avaliaçäo funcional com um teste cognitivo poderia melhorar a precisäo do diagnóstico de demência. MÉTODO: Foram avaliados 30 pacientes com diagnóstico de demência leve a moderada, segundo critérios da CID-10 e DSM-III-R e 46 controles idosos, divididos em grupos segundo seu nível socioeconômico e educacional (alto, médio e baixo). Nos sujeitos foi aplicado o MMSE, e em seus informantes as escalas IQCODE e B-ADL. RESULTADOS: Pela regressäo logística, o MMSE isolado classificou corretamente 86,8 por cento dos pacientes e controles (sensibilidade 80 por cento e especificidade 91,3 por cento). A combinaçäo MMSE + IQCODE classificou corretamente 92,1 por cento dos sujeitos (sensibilidade 83,3 por cento e especificidade de 97,8 por cento), e a combinaçäo MMSE + B-ADL classificou corretamente 92,1 por cento dos sujeitos (sensibilidade 86,7 por cento e especificidade 95,7 por cento). CONCLUSÄO: Os resultados sugerem que a combinaçäo de um teste cognitivo a escalas funcionais pode melhorar a detecçäo de casos leves ou moderados de demência, mesmo em amostras de populaçäo heterogênea com relaçäo ao nível sócio-econômico e educacional como a brasileira