Sensitivity and specificity of death certificate diagnoses for dementing illnesses, 1988-1990.
OBJECTIVE
To evaluate the extent to which mortality data, which is often used to track secular trends for specific diseases, underestimates the prevalence of dementia.


METHODS
Retrospective analysis of existing data.


METHODS
Department of Mental Health inpatient facilities in South Carolina.


METHODS
Inpatients at Department of Mental Health facilities who were listed in the South Carolina Statewide Alzheimer's Disease and Related Disorders Registry and who died between 1988 and 1990 (n = 450).


METHODS
Sensitivity and specificity of dementia diagnoses on death certificates compared to medical record diagnoses for inpatients with a pre-mortem dementia diagnosis.


RESULTS
Twenty-three percent of death certificates contained any dementia diagnosis (104/450). The sensitivity of death certificates varied by type of dementia (28 percent for Alzheimer's disease; 8 percent for multi-infarct dementia) as well as by race, sex, and age.


CONCLUSIONS
Mortality statistics substantially underestimate the prevalence of dementing illnesses and do not fully represent the public health burden of dementia.
Macera
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Department of Epidemiology & Biostatistics, School of Public Health, University of South Carolina, Columbia 29208.
Sun
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Yeager
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Brandes
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DA
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D003625:Data Collection; D003644:Death Certificates; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D044469:Racial Groups; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014481:United States / Q000453:epidemiology