title: The predictive validity of the 10/66 dementia diagnosis in Chennai, India: a 3-year follow-up study of cases identified at baseline.
abstract: 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.
authors.affiliation: Institute of Community Health, Voluntary Health Services, Chennai, India.
authors.forename: A T
authors.initials: AT
authors.lastname: Jotheeswaran
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Williams
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Prince
mesh_terms: 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
references.citation: Psychol Med. 1986 Feb;16(1):89-99
references.pmid: 3515380
references.citation: BMC Public Health. 2008 Jun 24;8:219
references.pmid: 18577205
references.citation: Age Ageing. 2003 Mar;32(2):200-4
references.pmid: 12615565
references.citation: Lancet. 2008 Aug 9;372(9637):464-74
references.pmid: 18657855
references.citation: Neurology. 2001 Sep 25;57(6):985-9
references.pmid: 11571321
references.citation: Am J Psychiatry. 1995 Oct;152(10):1485-92
references.pmid: 7573588
references.citation: BMC Public Health. 2007 Jul 20;7:165
references.pmid: 17659078
references.citation: N Engl J Med. 1997 Dec 4;337(23):1667-74
references.pmid: 9385127
references.citation: Int J Geriatr Psychiatry. 2001 Aug;16(8):751-61
references.pmid: 11536341
references.citation: Lancet. 2001 Jan 20;357(9251):169-75
references.pmid: 11213093
references.citation: Int Psychogeriatr. 1996 Winter;8(4):507-24
references.pmid: 9147167
references.citation: Lancet. 2003 Mar 15;361(9361):909-17
references.pmid: 12648969
references.citation: Neurology. 1998 Oct;51(4):1000-8
references.pmid: 9781520
references.citation: Psychol Med. 2009 Dec;39(12):2001-12
references.pmid: 19796426
references.citation: Lancet. 2005 Dec 17;366(9503):2112-7
references.pmid: 16360788
references.citation: Alzheimer Dis Assoc Disord. 2002 Oct-Dec;16(4):239-47
references.pmid: 12468898
references.citation: Neurology. 1993 Nov;43(11):2412-4
references.pmid: 8232972
references.citation: Ann Neurol. 1988 May;23(5):477-84
references.pmid: 3389756