The applicability of the cognitive abilities screening instrument-short (CASI-S) in primary care in Brazil.
BACKGROUND
The Cognitive Abilities Screening Instrument - Short (CASI-S) is a brief cognitive screening test. However, there is limited information regarding its applicability in primary care.


OBJECTIVE
To ascertain whether the CASI-S differentiates between dementia patients and normal controls in primary care; to examine its correlation with other cognitive instruments, to analyze its internal consistency, test-retest stability, and diagnostic accuracy.


METHODS
In a case-control study, carried out at two Primary Care Units (PCUs) in the eastern region of the city of São Paulo, 47 older adults were diagnosed with dementia according to DSM-IV criteria (mean age = 76.81 ± 7.03 years), and 55 were classified as normal controls (mean age = 72.78 ± 7.37 years), by a multidisciplinary panel which had access to results from a comprehensive cognitive battery and the patients' health data. The present analyses included results from the Mini-Mental State Examination (MMSE). The CASI-S was not used to determine diagnostic status.


RESULTS
The CASI-S was easily applied in the primary care setting. There was a significant performance difference (p < 0.001) between dementia patients (15.57 ± 7.40) and normal controls (26.67 ± 3.52) on the CASI-S. CASI-S scores correlated with age (ρ = -0.410, p < 0.001), educational level (ρ = 0.373, p < 0.001), and MMSE score (ρ = 0.793, p < 0.001). The internal consistency of the CASI-S was high (α = 0.848) and the correlation between test and retest was 0.688, suggesting adequate temporal stability. In the ROC curve analyses, scores of 22/23 generated an area under the curve of 0.907, with sensitivity of 93% and specificity of 81%.


CONCLUSIONS
The CASI-S can be useful for dementia screening in primary care in Brazil.
School of Arts,Sciences and Humanities,University of São Paulo,São Paulo,Brazil.
Glaucia Martins
GM
de Oliveira
Old Age Research Group (PROTER),Institute of Psychiatry,University of São Paulo School of Medicine,São Paulo,Brazil.
Juliana Emy
JE
Yokomizo
School of Arts,Sciences and Humanities,University of São Paulo,São Paulo,Brazil.
Laís dos Santos
Ldos S
Vinholi e Silva
Old Age Research Group (PROTER),Institute of Psychiatry,University of São Paulo School of Medicine,São Paulo,Brazil.
Laura Ferreira
LF
Saran
Old Age Research Group (PROTER),Institute of Psychiatry,University of São Paulo School of Medicine,São Paulo,Brazil.
Cássio M C
CM
Bottino
School of Arts,Sciences and Humanities,University of São Paulo,São Paulo,Brazil.
Mônica Sanches
MS
Yassuda
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001938:Brazil; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis*; D003704:Dementia / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D009483:Neuropsychological Tests; D011320:Primary Health Care; D012372:ROC Curve; D012680:Sensitivity and Specificity
CASI-S; aging; cognitive screening; dementia; elderly; primary care