Validation of the 10/66 Dementia Research Group diagnostic assessment for dementia in Arabic: a study in Lebanon.
OBJECTIVE
In the North Africa and Middle East region, the illiteracy rates among older people are high, posing a great challenge to cognitive assessment. Validated diagnostic instruments for dementia in Arabic are lacking, hampering the development of dementia research in the region. The study aimed at validating the Arabic version of the 10/66 Dementia Research Group (DRG) diagnostic assessment for dementia to determine whether it is suitable for case ascertainment in epidemiological research.


METHODS
A total of 244 participants older than 65 years were included, 100 with normal cognition and 144 with mild to moderate dementia. Dementia was diagnosed by clinicians according to Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Depression was diagnosed using the Geriatric Mental State. Trained interviewers blind to the cognitive status of the participants administered the 10/66 DRG diagnostic assessment to the participants and interviewed the caregivers. The discriminatory ability of the 10/66 DRG assessment and its subcomponents were evaluated against the clinical diagnoses.


RESULTS
Half of the participants had no formal education and 49% of them were depressed. The 10/66 DRG diagnostic assessment showed excellent sensitivity (92.0%), specificity (95.1%), positive predictive value (PPV, 92.9%), and low false-positive rates among controls with no formal education (8.1%) and depression (5.6%). Each subcomponent of the 10/66 DRG diagnostic assessment independently predicted dementia diagnosis. The predictive ability of the 10/66 DRG assessment was superior to that of its subcomponents.


CONCLUSIONS
The 10/66 DRG diagnostic assessment for dementia is well suited for case ascertainment in epidemiological studies among Arabic-speaking older population with high prevalence of illiteracy.
Department of Neurology, Danish Dementia Research Center, The Neuroscience Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark thien.phung@mail.mcgill.ca.
Kieu T T
KT
Phung
Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Monique
M
Chaaya
Department of Neurology, Danish Dementia Research Center, The Neuroscience Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Gunhild
G
Waldemar
Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
Samir
S
Atweh
Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Khalil
K
Asmar
Department of Geriatrics, American University of Beirut Medical Center, Beirut, Lebanon.
Husam
H
Ghusn
Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center; Institute for Development, Advocacy, and Applied Care (IDRAAC), Beirut, Lebanon.
Georges
G
Karam
Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
Raja
R
Sawaya
Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Rose Mary
RM
Khoury
Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
Ibrahim
I
Zeinaty
Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
Sandrine
S
Salman
Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
Salem
S
Hammoud
Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
Wael
W
Radwan
Department of Internal Medicine, St George Hospital University Medical Center, Beirut, Lebanon.
Nazem
N
Bassil
Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, United Kingdom.
Martin
M
Prince
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004522:Educational Status; D005260:Female; D006801:Humans; D007802:Language; D007861:Lebanon; D008297:Male; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014175:Translating
Arabic; cognitive testing; dementia; diagnostic accuracy; illiteracy; validation