The predictive validity of the 10/66 dementia diagnosis in Chennai, India: a 3-year follow-up study of cases identified at baseline.
The predictive validity of the 10/66 dementia diagnosis in Chennai, India: a 3-year follow-up study of cases identified at baseline.
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DOI：
10.1097/wad.0b013e3181d5e540
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发表时间：
2010-07
影响因子：
2.1
通讯作者：
Prince MJ
中科院分区：
文献类型：
--
作者：
Jotheeswaran AT;Williams JD;Prince MJ
根据《精神疾病诊断和统计手册》第四版的标准，在欠发达地区，痴呆症的发病率往往很低。10/66痴呆症研究小组的跨文化验证诊断返回一个相当高的患病率。评估10/66痴呆诊断的预测有效性将有助于建立估计痴呆人口负担的最佳标准。在印度钦奈的一项基于人群的研究中，我们的目标是在三年后随访75名患有10/66痴呆症的人和193名患有认知障碍但没有痴呆症（CIND）的人，重新评估诊断状态，临床严重程度，认知功能，残疾和护理需求。我们追踪了54名痴呆症患者，其中25人（46.3%）死亡，死亡率是CIND患者的两倍。在24名患有10/66痴呆症的人中，有22人接受了重新检查，仍然符合10/66痴呆症标准。有明确的证据表明临床进展和护理需求增加。只有一个“病例”明显改善。与CIND患者相比，认知功能恶化，残疾程度增加。10/66痴呆诊断的强预测有效性与DSM-IV标准对轻度至中度病例缺乏敏感性一致，这可能低估了欠发达地区的患病率。
Dementia prevalence 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. In a population-based study in Chennai, India, we aimed to follow up after three 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. 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 re-examined 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. The strong predictive validity of the 10/66 dementia diagnosis is consistent with a lack of sensitivity of the DSM-IV criterion to mild to moderate cases, which may underestimate prevalence in less developed regions.