[Consensus on the concepts of cortical, subcortical and frontal dementia. Research by national and international dementia experts].
The level of agreement concerning the concepts cortical, subcortical and frontal dementia. The level of agreement between experts in the field of dementia concerning cortical, subcortical and frontal dementia was established. Nowadays these syndromes are implemented in clinical practice; the discussion about the validity and reliability of these concepts however has diminished. Forty-one national and international dementia experts of four disciplines completed a questionnaire, based on the cognitive section of the CAMDEXR. For each syndrome they marked whether the cognitive function mentioned was impaired or unimpaired in cortical, subcortical and frontal dementia. The level of agreement between experts was determined by use of a derivative of the kappa-coefficient. Cortical dementia was characterised by high levels of agreement between the experts. With an observed level of agreement of 0.76, experts reached the highest consensus about this syndrome. Less agreement was observed in the judgements of subcortical and frontal dementia, with observed levels of agreement of 0.64 and 0.67 respectively. No differences were found in the assessments of national and international experts, as well as between the participating disciplines. Apparently, the application of these syndromes in clinical practice is difficult. Because of this confusion the practical meaning is limited, and one may wonder wether these concepts must still be used in clinical practice.
Korten
E C
EC
Instituut Hersenen & Gedrag, Academische Afdeling Neuropsychologie, PMS Vijverdal Maastricht.
Verhey
F R
FR
Derix
M M
MM
Klinkenberg
E L
EL
Jolles
J
J
D001921:Brain / Q000473:pathology*; D003704:Dementia / Q000145:classification* / Q000175:diagnosis / Q000473:pathology / Q000523:psychology*; D003937:Diagnosis, Differential; D006801:Humans; D009426:Netherlands; D011795:Surveys and Questionnaires; D013577:Syndrome