title: Cross-cultural cognitive examination: validation of a dementia screening instrument for neuroepidemiological research.
abstract: OBJECTIVE
  Validation of a new instrument for screening dementia, the Cross Cultural Cognitive Examination (CCCE), is described.
  
  
  METHODS
  Criterion and concurrent validation and cross-cultural comparison of a new instrument.
  
  
  METHODS
  All individuals over the age of 40 in a village in southern Guam participated in a door-to-door survey. Alzheimer's and Parkinson's Disease patients and healthy controls aged 40-90 participated in the US mainland study.
  
  
  METHODS
  The CCCE was administered to all subjects. Effects of age, language, education, and gender on test performances and social-cultural differences were assessed. Concurrent validation of the test with respect to other well accepted screening instruments was determined.
  
  
  RESULTS
  High specificity (> 94%) and sensitivity (> 99%) for detecting dementia were found in Guam and US mainland samples, and these were not biased by differences in gender, linguistic preference, education, or cultural background. Sensitivity and specificity of the CCCE matched or exceeded that of already accepted dementia screening instruments.
  
  
  CONCLUSIONS
  These validation studies support the usefulness of the CCCE for identifying patients with generalized dementia, rather than focal types of cognitive impairment, quickly and reliably in cross-cultural neuroepidemiological research.
authors.affiliation: Department of Neurology, Boston University School of Medicine, Massachusetts.
authors.forename: G
authors.initials: G
authors.lastname: Glosser
authors.forename: N
authors.initials: N
authors.lastname: Wolfe
authors.forename: M L
authors.initials: ML
authors.lastname: Albert
authors.forename: L
authors.initials: L
authors.lastname: Lavine
authors.forename: J C
authors.initials: JC
authors.lastname: Steele
authors.forename: D B
authors.initials: DB
authors.lastname: Calne
authors.forename: B S
authors.initials: BS
authors.lastname: Schoenberg
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000145:classification / Q000175:diagnosis* / Q000208:ethnology* / Q000517:prevention & control; D015982:Bias; D016022:Case-Control Studies; D003144:Communication Barriers; D003431:Cross-Cultural Comparison; D003704:Dementia / Q000145:classification / Q000175:diagnosis* / Q000208:ethnology* / Q000517:prevention & control; D004812:Epidemiologic Methods; D005260:Female; D006141:Guam / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009462:Neurology; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000145:classification / Q000175:diagnosis* / Q000208:ethnology* / Q000517:prevention & control; D011897:Random Allocation; D015203:Reproducibility of Results; D012107:Research Design; D012680:Sensitivity and Specificity; D012737:Sex Factors; D014481:United States / Q000453:epidemiology