The modified CAMDEX informant interview is a valid and reliable tool for use in the diagnosis of dementia in adults with Down's syndrome
The modified CAMDEX informant interview is a valid and reliable tool for use in the diagnosis of dementia in adults with Down's syndrome
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DOI：
10.1111/j.1365-2788.2004.00630.x
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发表时间：
2004-09-01
影响因子：
3.6
通讯作者：
Hon, J
中科院分区：
文献类型：
--
作者：
Ball, SL;Holland, AJ;Hon, J
背景 阿尔茨海默病 (AD) 引起的痴呆通常影响患有唐氏综合症 (DS) 的老年人。当痴呆症因先前存在的智力障碍（ID）而变得复杂时，需要具有既定的并发有效性和预测有效性的方法来促进痴呆症的诊断评估。我们报告了剑桥老年人精神障碍考试 (CAMDEX) 知情者访谈的修改版本的可靠性和有效性，该版本用于评估疑似患有痴呆症的 DS 患者。 方法 作为先前针对患有 DS 的老年人的流行病学研究的一部分，CAMDEX 知情者访谈被用来确定痴呆症的患病率。当时（时间 1）的 74 名 DS 患者还完成了剑桥认知考试 (CAMCOG)，即 CAMDEX 时间表中的神经心理学评估。 6 年后（时间 2）再次评估了 56 例。根据 CAMDEX 线人访谈，时间 1 的 74 人中的 9 人以及时间 2 的 56 人中的 11 人被发现符合 AD 的临床标准。 41 人在第一时间的 CAMCOG 得分高于地板，并被纳入认知能力下降的分析中。通过将时间 2 的诊断与自时间 1 以来认知任务客观下降的独立证据进行比较，建立了同时有效性。预测有效性是通过检查时间 1 的诊断预测认知衰退和未来诊断的准确程度来建立的。通过比较两个评估者之间的一致性水平来确定评估者间的可靠性。结果显示，基于 CAMDEX 的 AD 诊断与客观观察到的认知衰退一致（良好的并发有效性），并且是未来诊断的良好预测指标。尽管数字很小，但也为诊断预测认知能力下降的准确性提供了一些支持。评估者间的信度良好，91% 的项目 Kappa > 0.8，所有项目 > 0.6。结论 使用改进的 CAMDEX 知情访谈可以结构化收集诊断信息，从而可以使用既定的诊断标准对已有 ID 的患者做出有效且可靠的痴呆症诊断。
Background Dementia because of Alzheimer's disease (AD) commonly affects older adults with Down's syndrome (DS). Methods are needed, with established concurrent and predictive validity, to facilitate the diagnostic assessment of dementia, when it is complicated by pre-existing intellectual disabilities (ID). We report on the reliability and validity of a modified version of the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) informant interview, for use when assessing people with DS suspected as having dementia.Methods As part of a previous epidemiological study of older people with DS, the CAMDEX informant interview was used to determine the prevalence of dementia. The 74 people with DS included at that time (Time 1) had also completed the Cambridge Cognitive Examination (CAMCOG), the neuropsychological assessment from the CAMDEX schedule. Fifty-six were assessed again 6 years later (Time 2). Based on the CAMDEX informant interview, nine of the 74 at Time 1, and 11 of the 56 at Time 2, were found to meet clinical criteria for AD. Forty-one scored above floor on the CAMCOG at Time 1 and were included in the analysis of cognitive decline. Concurrent validity was established by comparing diagnosis at Time 2 with independent evidence of objective decline on cognitive tasks since Time 1. Predictive validity was established by examining how accurately diagnosis at Time 1 predicted both cognitive decline and future diagnosis. Inter-rater reliability was determined by comparing the level of agreement between two raters.Results CAMDEX-based diagnosis of AD was shown to be consistent with objectively observed cognitive decline (good concurrent validity) and to be a good predictor of future diagnosis. Although numbers are small, some support is also provided for the accuracy with which diagnosis predicts cognitive decline. Inter-rater reliability was good with Kappa > 0.8 for 91% of items and > 0.6 for all items.Conclusions The use of the modified CAMDEX informant interview enables the structured collection of diagnostic information, so that a valid and a reliable diagnosis of dementia can be made in those with pre-existing ID, using established diagnostic criteria.