title: Dementia diagnoses from clinical and neuropsychological data compared: the Cache County study.
abstract: OBJECTIVE
  To validate a neuropsychological algorithm for dementia diagnosis.
  
  
  METHODS
  We developed a neuropsychological algorithm in a sample of 1,023 elderly residents of Cache County, UT. We compared algorithmic and clinical dementia diagnoses both based on DSM-III-R criteria. The algorithm diagnosed dementia when there was impairment in memory and at least one other cognitive domain. We also tested a variant of the algorithm that incorporated functional measures that were based on structured informant reports.
  
  
  RESULTS
  Of 1,023 participants, 87% could be classified by the basic algorithm, 94% when functional measures were considered. There was good concordance between basic psychometric and clinical diagnoses (79% agreement, kappa = 0.57). This improved after incorporating functional measures (90% agreement, kappa = 0.76).
  
  
  CONCLUSIONS
  Neuropsychological algorithms may reasonably classify individuals on dementia status across a range of severity levels and ages and may provide a useful adjunct to clinical diagnoses in population studies.
authors.affiliation: Department of Psychology, College of Family Life, Utah State University, Logan 84322-4440, USA. joannt@cc.usu.edu
authors.forename: J T
authors.initials: JT
authors.lastname: Tschanz
authors.forename: K A
authors.initials: KA
authors.lastname: Welsh-Bohmer
authors.forename: I
authors.initials: I
authors.lastname: Skoog
authors.forename: N
authors.initials: N
authors.lastname: West
authors.forename: M C
authors.initials: MC
authors.lastname: Norton
authors.forename: B W
authors.initials: BW
authors.lastname: Wyse
authors.forename: R
authors.initials: R
authors.lastname: Nickles
authors.forename: J C
authors.initials: JC
authors.lastname: Breitner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity; D014589:Utah