STANDARDIZATION OF THE DIAGNOSIS OF DEMENTIA IN THE CANADIAN STUDY OF HEALTH AND AGING

摘要: Standardization of diagnostic procedures for cognitive impairment in large epidemiologic surveys remains difficult. This paper reports results standardization a subsample 2,914 elderly (age 65 years+) Canadians from the Canadian Study Health and Aging (CSHA; n = 10,263). The objectives were to measure consistency CSHA diagnosis as test validity; assess inter-rater reliability, impact neuropsychological data on dementia. clinical assessment included nurse's examination, Modified Mini-Mental Status (3MS) exam Cambridge Mental Disorders Examination, tests, medical history laboratory investigations. A final was reached consensus conference which incorporated preliminary diagnoses both physicians neuropsychologists. Computer algorithms, developed check between observations diagnosis, demonstrated 98% concordance with DSM-III-R criteria dementia 92% NINCDS-ADRADA (National Institute Neurological Communicative Stroke Alzheimer's Disease Related Association) probable disease. Inter-rater agreement high: kappa 0.81 dementia/no dementia; 0.74 normal/cognitive impairment, not dementia/ Comparisons raters by specialty revealed few systematic differences. input physician's most marked borderline cases categories.