The predictive validity of the 10/66 dementia diagnosis in Chennai, India: a 3-year follow-up study of cases identified at baseline.
BACKGROUND
The prevalence of dementia according to DSM-IV criteria tends to be very low in less developed settings. The 10/66 Dementia Research Group's cross-culturally validated diagnosis returns a considerably higher prevalence. Assessing the predictive validity of the 10/66 dementia diagnosis will assist in establishing the best criterion for estimating the population burden of dementia.


METHODS
In a population-based study in Chennai, India, we aimed to follow-up after 3 years 75 people with 10/66 dementia and 193 with cognitive impairment but no dementia (CIND), reassessing diagnostic status, clinical severity, cognitive function, disability, and needs for care.


RESULTS
We traced 54 people with dementia of whom 25 (46.3%) had died, double the mortality rate among those with CIND. Twenty-two of the 24 people with 10/66 dementia that were reexamined still met 10/66 dementia criteria. There was clear evidence of clinical progression and increased needs for care. Only one "case" had unambiguously improved. Cognitive function had deteriorated and disability increased to a much greater extent than among those with CIND.


CONCLUSIONS
The strong predictive validity of the 10/66 dementia diagnosis is consistent with a lack of sensitivity of the DSM-IV criteria to mild-to-moderate cases, which may underestimate prevalence in less developed regions.
Jotheeswaran
A T
AT
Institute of Community Health, Voluntary Health Services, Chennai, India.
Williams
Joseph D
JD
Prince
Martin J
MJ
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D011159:Population Surveillance; D011237:Predictive Value of Tests; D011581:Psychological Tests
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