The validation of an informant screening test for irreversible cognitive decline in the elderly: performance characteristics within a general population sample
✍ Scribed by Karen Ritchie; Rebecca Fuhrer
- Publisher
- John Wiley and Sons
- Year
- 1996
- Tongue
- English
- Weight
- 687 KB
- Volume
- 11
- Category
- Article
- ISSN
- 0885-6230
No coin nor oath required. For personal study only.
✦ Synopsis
The performance characteristics of an informant screening test for senile dementia were evaluated within a community-dwelling sample of 583 elderly persons in the Bordeaux region of France. Receiver operating characteristics analysis indicated that although the test performs less well within this context than within a previous case-control study, it nonetheless retains high discriminability. A specificity of 90% and a sensitivity of 79% for the detection of diagnosed senile dementia were obtained with a cutoff point of 24/25. The discriminability of the test was not affected by level of education. The study demonstrates the necessity of adjusting the cutoff point of dementia screening instruments according to the estimated prevalence rate of dementia in the target population. The potential utility of the instrument as a method of detecting dementia by postal survey and in cross-cultural research is discussed.
KEY woms-senile dementia; screening: informant In public health terms the value of population screening of senile dementia is clearly debatable. Firstly, the screening instruments presently available have very imperfect discriminability due to the absence of a biological marker for senile dementia and subsequent reliance on non-specific behavioural indicators. Concern has been expressed in particular at the high false positive rates occurring in elderly persons with little education (Quereshi and Hodkinson, 1974; Folstein et d., 1975; Anthony et d., 1982). Secondly, health care providers question the value of general population screening for a non-infectious disease for which there presently exists only palliative care.
Despite these reservations, there are also strong arguments in favour of early diagnosis of dementia. While no specific treatment is available,