title: The need for a consensus in the use of assessment tools for Alzheimer's disease: the Feasibility Study (assessment tools for dementia in Alzheimer Centres across Europe), a European Alzheimer's Disease Consortium's (EADC) survey.
abstract: OBJECTIVE
  To ensure that all Alzheimer centres across Europe are capable of using a similar method of data collection. Information about the patient assessment tools used by each participating centre was obtained and normal clinical practice in each EADC centre was documented by collecting data from routine new patient consultation.
  
  
  METHODS
  Twenty new consecutive patients with objective memory impairment were recruited in each Alzheimer centre over 6 months. Each patient consultation was carried out according to routine clinical practice. Patient data were recorded using the anonymous patient protocol (demographic, diagnosis, MMSE score, patient assessment scales, and most prominent behavioural problem). Information about neuropsychological assessment tools used in each centre was take to account to harmonise research practice for future multicentre collaboration.
  
  
  RESULTS
  Seven hundred and four patients from 36 memory clinics in 13 countries across Europe participated in the study. [M:F ratio 0.67. Mean age 75.4 SD 9.3 (51-102) Mean MMSE 21 SD 6 (0-30)] Five hundred and fifty-five patients had a clinical diagnosis of dementia [Alzheimer's disease (68.5%), vascular dementia (10.3%), frontal lobe dementia (5.6%), Lewy body dementia (4.1%), mixed dementia (5.6%)]. Duration of symptoms: 0-6 months 6.5%; 6-12 months 16.1%; 1-2 years 30.5%; 2-5 years 46.9%. Assessment scales used: Clinical Dementia Rating (CDR) 48.9%, Reisberg's Global Deterioration Scale (GDS) 38.6%, ADL/IADL (Lawton and Brody, 1969) 37.5%, Neuropsychological Inventory (NPI) 28.6%, Geriatric Depression Scale 22%, ADL (Katz et al., 1963) 19.2%, ADAS-Cog 14.9%, Cornell Scale for Depression 12.9%, Grober and Bushke Selective Reminding Test 11.5%, ADCS/ADL 7.7%. 64.8% of the patients experienced behavioural symptoms: apathy 13.6%; anxiety 12.8%; dysphoria 9.9%; irritability 7.8%; agitation 5.5%; hallucinations 3.6%; delusions 3.6%, sleep disorder 2.4%; desinhibition 2%.
  
  
  CONCLUSIONS
  The most common type of cognitive decline was Alzheimer's disease followed by mild cognitive impairment and vascular dementia. CDR, GDS Reisberg, and ADL/IADL were used widely (40-50%). The NPI, geriatric depression scale and ADL (Katz, 1963) were only used in 20% of the centres. We verified large differences in the tools use in the EADC centres to evaluate patients with dementia across Europe. There is a need for a consensus in the use of assessment tools for dementia in Alzheimer's centres in Europe.
authors: Geriatric Service, Hospital Clinico San Carlos, Madrid, Spain. ramirezdiazsp@gmail.com
authors: Santiago
authors: S
authors: Paulino Ramirez Diaz
authors: Pedro
authors: P
authors: Gil Gregório
authors: Jose
authors: J
authors: Manuel Ribera Casado
authors: Emma
authors: E
authors: Reynish
authors: Pierre
authors: P
authors: Jean Ousset
authors: Bruno
authors: B
authors: Vellas
authors: Eric
authors: E
authors: Salmon
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D032921:Consensus; D003625:Data Collection / Q000379:methods*; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015140:Dementia, Vascular / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005060:Europe / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007391:International Cooperation; D020961:Lewy Body Disease / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D017678:Sex Distribution