Suggested instruments for General Practitioners in countries with low schooling to screen for cognitive impairment in the elderly

Suggested instruments for General Practitioners in countries with low schooling to screen for cognitive impairment in the elderly

Author Jacinto, Alessandro Ferrari Autor UNIFESP Google Scholar
Dozzi Brucki, Sonia Maria Google Scholar
Porto, Claudia Sellitto Google Scholar
Martins, Milton de Arruda Google Scholar
Citero, Vanessa de Albuquerque Autor UNIFESP Google Scholar
Nitrini, Ricardo Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Abstract Background: General Practitioners (GPs) from underdeveloped countries apply cognitive impairment (CI) assessment tools translated and adapted to cultural setting from other idioms, mainly English. As schooling in elderly from underdeveloped countries tends to be relatively heterogeneous, it is necessary to establish normative and cut-off scores for these CI instruments that are based on studies conducted locally. Some CI screening instruments frequently used by Brazilian specialists in dementia were analyzed to determine which could be most useful to GPs in their working sets.Method: Two hundred forty-eight patients aged 65 years or older that had been assisted by GPs in a tertiary hospital in Brazil were evaluated. Based on the MMSE and/or Short-IQCODE scores, 52 probable cases were identified on the basis of clinical data, performances on the neuropsychological tests and questionnaires (Functional Assessment Questionnaire/FAQ, Category Verbal Fluency/CVF, Clock Drawing Test /CDT) and blood tests and brain CT.Results: the combination of a functional questionnaire with a cognitive instrument had higher sensitivity and specificity than using the instruments alone. A FAQ cut-off of 3 in conjunction with a CDT cut-off of 6 proved optimal (93% sensitivity and 92.5% specificity). A higher specificity (93.5%) was attained using a combination of the FAQ (cut-off of 3) with the CVF (cut-off of 10).Conclusions: for low schooling elderly, the combination of the FAQ and CVF represented a very simple method of increasing the chances of correct screening. for those with higher schooling, the combination of the FAQ and CDT was more suitable.
Keywords cognitive impairment
cognitive testing
developing country
Language English
Date 2014-07-01
Published in International Psychogeriatrics. New York: Cambridge Univ Press, v. 26, n. 7, p. 1121-1125, 2014.
ISSN 1041-6102 (Sherpa/Romeo, impact factor)
Publisher Cambridge Univ Press
Extent 1121-1125
Access rights Closed access
Type Article
Web of Science ID WOS:000337708600008

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