Combined instruments for the screening of dementia in older people with low education.
OBJECTIVE
To determine which combination of cognitive tests and informant reports can improve the diagnostic accuracy of dementia screening in low educated older people.


METHODS
Patients with mild to moderate dementia (n=34) according to ICD-10 and DSM-III-R criteria and 59 older controls were assessed with the Mini-Mental State Examination (MMSE) and the Fuld Object Memory Evaluation (FOME). Informants were assessed using the Informant Questionnaire on Cognitive Decline in the Elderly and the Bayer-Activities of Daily Living Scale.


RESULTS
The 4 instruments combined with the mixed rule correctly classified 100% and the logistic regression (weighted sum) classified 95.7% of subjects. The weighted sum had a significantly larger ROC area compared to MMSE (p=0.008) and FOME (p=0.023). The specificity of the tested combinations was superior to the MMSE alone (p=0.002).


CONCLUSIONS
Cognitive tests combined with informant reports can improve the screening of mild to moderate dementia in low educated older people.
Bottino
Cássio M C
CM
Instituto e Departamento de Psiquiatria, Universidade de São Paulo, SP, Brazil. cbottino@usp.br
Zevallos-Bustamante
Sonia E
SE
Lopes
Marcos A
MA
Azevedo
Dionisio
D
Hototian
Sérgio R
SR
Jacob-Filho
Wilson
W
Litvoc
Julio
J
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003704:Dementia / Q000175:diagnosis*; D004522:Educational Status; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires