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The 10/66 Dementia Research Group's fully operationalised DSM-IV dementia computerized diagnostic algorithm, compared
Martin J Prince1, Juan Llibre de Rodriguez, L Noriega
1Section of Epidemiology, Health Services Research, King's College London, De Crespigny Park, London SE5 8AF, UK. m.prince@iop.kcl.ac.uk
BMC Public Health
|June 26, 2008
Summary
The DSM-IV dementia criterion is specific but misses milder cases. The 10/66 dementia diagnosis is broader and more sensitive for population studies.
Area of Science:
- Neurology
- Psychiatry
- Epidemiology
Background:
- The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criterion for dementia lacks full operationalization for research.
- The 10/66 Dementia Research Group aimed to operationalize the DSM-IV criterion and validate it in a Cuban population.
Purpose of the Study:
- To operationalize the DSM-IV dementia criterion using a computerized algorithm.
- To validate this algorithm against local clinician diagnoses and the 10/66 dementia diagnosis in Cuba.
Main Methods:
- Developed a computerized algorithm based on 10/66 cognitive tests, clinical interviews, and informant reports.
- Validated the algorithm against DSM-IV diagnoses by local clinicians and the 10/66 dementia diagnosis in a Cuban population-based study.
Main Results:
- The DSM-IV algorithm showed plausible distribution of criteria in diagnosed cases and controls.
- Clinician diagnoses aligned better with the 10/66 dementia diagnosis than the computerized DSM-IV algorithm.
- The DSM-IV algorithm tended to miss less severe dementia cases; these cases still exhibited significant impairment.
Conclusions:
- Strict application of the DSM-IV criterion identifies unambiguous dementia but may lack sensitivity for milder, clinically relevant cases.
- The 10/66 dementia diagnosis offers a broader, more sensitive approach, potentially capturing more genuine cases relevant to population burden estimation.
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