Dementia screening: can a second administration reduce the number of false positives?
OBJECTIVE
Early diagnosis of dementia is important for medical treatment and quality-of-life interventions. The authors examine whether administering a second cognitive screening after a poor initial score can improve the accuracy of diagnosis. Of particular interest is reducing false positives that may generate an unnecessary referral for a dementia work-up.


METHODS
A group of 389 Japanese men from the Honolulu-Asia Aging Study were administered the Cognitive Assessment Screening Instrument (CASI) twice within a 2-month period. A small sample received a follow-up CASI 3 years later.


RESULTS
Administration of a second CASI reduced the false-positive rate by 16.1% in the total sample and 20.2% in those suspected of having mild dementia. The negative predictive value for the second administration was 80% for the entire sample and 82.6% for those suspected of having mild dementia.


CONCLUSIONS
Administration of a second cognitive screening in patients initially scoring in the dementia range can significantly reduce the number of false positives for dementia. This technique may be useful to managed-care companies who aim to reduce unnecessary costs in medical care.
Fujii
Daryl
D
Hawaii State Hospital, Kaneohe, Hawaii 96744, USA. defujii@hsh.health.state.hi.su
Hishinuma
Earl
E
Masaki
Kamal
K
Petrovich
Helen
H
Ross
G Webster
GW
White
Lon
L
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D005189:False Positive Reactions; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires