ADAS-cog (Alzheimer's Disease Assessment Scale-cognitive subscale)--validation of the Slovak version.

BACKGROUND: ADAS was designed to measure the severity of the most important symptoms of Alzheimer's disease (AD). Its subscale ADAS-cog is the most popular cognitive testing instrument used in clinical trials of nootropics. It consists of 11 tasks measuring the disturbances of memory, language, praxis, attention and other cognitive abilities which are often referred to as the core symptoms of AD. AIM: The aim of the study is to verify the Slovak adaptation of ADAS-cog and its ability to distinguish patients with AD from those with depressive disorders (DD). SUBJECTS AND METHODS: The study sample consists of 29 psychiatric inpatients divided into 2 groups: the AD group of 14 patients (4 males, 10 females, mean age 73.9 +/- 7.3 yrs) fulfilling NINCDS-ADRDA criteria of probable AD and the DD group of 15 subjects (6 males, 9 females, mean age 74.3 +/- 6.5 yrs) without any cognitive impairment. In all patients the ADAS-cog and SMMSE were administered. We compared the group in: total scores in both scales, task scores in the ADAS-cog and the scores of 3 ADAS-cog factors--memory, language and praxis. RESULTS: Both methods distinguished the patients with the AD from DD (p < 0.001 for both scales). Also other variables (task and factor scores of ADAS-cog) reflect the worse results of the AD group. The most evident differences between the diagnostic groups were found in the orientation and constructive praxis. The education level did not affect the scores of the ADAS-cog in the AD patients but it did in SMMSE scores in the DD group (p < 0.05). CONCLUSIONS: The Slovak version of ADAS-cog has distinguished the patients with the AD from those with DD. The most evident differences between the groups were found in orientation and visuo-constructive praxis. In DD patients, the risk of false positive findings in subjects with lower education is higher than in the AD patients. In comparison with the SMMSE, ADAS-cog seems to be more helpful in early diagnostics of AD. (Tab. 6, Fig. 3, Ref. 14.)

[Use of behavioral scales in the diagnosis of dementia in the aged]. / Pouzitie behaviorálnych skál v diagnostike demencií vo vyssom veku.

The authors present their own experience with the use of the behavioural scale elaborated by Blessed, Tomlinson and Roth usually called Blessed Dementia Scale-BS. They examined 76 patients (59 dementia, 17 with major depression, aged 57 - 87 years (mean age 70.3 +/- 7.2 years). The results obtained by BS were compared with WAIS-R, Wechsler's memory scale (WMS) and the MSE cognitive scale (Knopman et al., 1985). They found that BS differentiates satisfactorily patients with dementia and major depression (dementia X = 8.16 +/- 5.4, depression X = 4.41 +/- 2.41, t = 4.07, p < 0,001). The results of examinations by means of BS correlate significantly inversely with the results of examinations of cognitive functions. The closest correlation is between the total BS score and MSE (r = -0.705, p < 0,001). It was confirmed that BS can be used in the diagnosis of dementia for the differential diagnosis of dementia and depressions. Evaluation of partial BS scores (associated with instrumental ADL, basic ADL and personality changes, drives and interests) provides information important for evaluation of the functional capacity of the patient and for the procedure after termination of in-patient treatment. It is important that the total BS score and the partial BS score is not influenced by the patients' age.

[Use of the MSE scale in geriatric psychiatry]. / Pouzitie skály MSE u gerontopsychiatrických pacientov.

In preliminary research the authors tested the congruent validity of MSE by comparison with results of the MMSE scale which previously proved useful. In 155 probands of senior age they used MSE, WAIS-R. They found a close correlation of the MSE score and the results. of psychomotor examination of the intellect and memory. As regards different factors of the intellect the MSE performance correlated most closely with the social intelligence and practical instructive solution of problems. The scale has a satisfactory sensitivity but low specificity. The score is influenced by the promorbid intelligence, education and age. MSE differentiates clinically demented and not demented patients and patients with endogenous depression from dementia. The differences between groups of dementia with a different aetiology--multiinfarction and dementia of Alzheimer's type--were not statistically significant.