A screening instrument for a Sicilian neuroepidemiological survey in the elderly.
We evaluated the sensitivity and specificity of a screening instrument developed for use in a two-phase neuroepidemiological survey in Sicily. The Sicilian Epidemiological Dementia Study (SEDES) project will evaluate the prevalence and incidence of dementia, parkinsonisms and essential tremor in four Sicilian municipalities. It is a two-phase door-to-door survey. To identify subjects with possible neurological disorders, in this study, we developed a screening instrument including a symptoms questionnaire and simple physical tasks for parkinsonisms and essential tremor. The Mini-Mental State Examination (MMSE) was chosen for screening dementia. The symptoms questionnaire and simple tasks developed to identify possible patients with parkinsonism and essential tremor, was tested in a hospital setting. To evaluate sensitivity, we selected 20 patients with essential tremor and 40 with Parkinson's disease (20 with Stages I-II and 20 with Stages III-V) [Neurology 17 (1967) 427]. To evaluate specificity we also selected 20 healthy subjects. The screening instrument was administered in a hospital setting by trained interviewers. Sensitivity of the screening instrument (questionnaire plus simple tasks) was 100% for essential tremor and parkinsonisms regardless of the stage. Specificity of the instrument was 90% (95% CI 66.9-98.2); the predictive positive value was 90.9%, while the negative predictive value was 100%. Even if validity was assessed in a hospital setting, the high sensitivity and specificity obtained suggest that the instrument could be an appropriate screening tool for parkinsonisms and essential tremor in a two-phase neuroepidemiological survey.
Department of Neuroscinces, University of Catania, Via S. Sofia No. 78, Catania 95125, Italy. anicol@dimtel.nti.it
Alessandra
A
Nicoletti
Giuseppe
G
Salemi
Letterio
L
Morgante
Francesco
F
Le Pira
Antonio
A
Epifanio
Arturo
A
Reggio
Giorgio
G
Basile
Giovanni
G
Savettieri
D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000453:epidemiology*; D004812:Epidemiologic Methods; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D008297:Male; D010300:Parkinson Disease / Q000453:epidemiology*; D015995:Prevalence; D012680:Sensitivity and Specificity; D012802:Sicily / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014202:Tremor / Q000453:epidemiology*