Hostname: page-component-7c8c6479df-nwzlb Total loading time: 0 Render date: 2024-03-29T00:38:01.177Z Has data issue: false hasContentIssue false

The Diagnosis of Dementia in the Elderly a Comparison of CAMCOG (the Cognitive Section of CAMDEX), the AGECAT Program, DSM–III, the Mini-Mental State Examination and Some Short Rating Scales

Published online by Cambridge University Press:  02 January 2018

G. Blessed*
Affiliation:
MRC Neurochemical Pathology Unit, Newcastle General Hospital, Newcastle upon Tyne NE4 6BE
S. E. Black
Affiliation:
Brighton Clinic, Newcastle General Hospital
T. Butler
Affiliation:
Division of Primary Health Care, Medical School, University of Newcastle upon Tyne
D. W. K. Kay
Affiliation:
MRC Neurochemical Pathology Unit, Newcastle General Hospital
*
Correspondence

Abstract

The performance of CAMCOG, the cognitive section of the CAMDEX, is compared in a non-random sample of 222 elderly people with diagnoses based on agecat and on DSM–III criteria, and with the MMSE and some short rating scales. With a cut-off point of 69/70 and agecat organic syndrome as the criterion, the sensitivity of CAMCOG was 97% and the specificity 91%. However, 21% of DSM–III diagnoses of dementia scored above this cut-off; these were mostly mild cases. The correlation between CAMCOG and MMSE scores was 0.87, and the advantage of CAMCOG may be more apparent in longitudinal studies. Multivariate analyses showed that CAMCOG scores are affected by age, sociocultural factors and hearing and visual deficits in addition to dementia, but not by depression. There was a suggestion that individual subsections are differentially affected.

Type
Papers
Copyright
Copyright © 1991 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Blessed, G., Tomlinson, B. E. & Roth, M. (1968) The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 114, 797811.CrossRefGoogle ScholarPubMed
Brayne, C. & Calloway, P. (1989) An epidemiological study of dementia in a rural population of elderly women. British Journal of Psychiatry, 155, 214219.CrossRefGoogle Scholar
Copeland, J. R. M., Dewey, M. E. & Griffiths-Jones, H. M. (1986) A computerised psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT. Psychological Medicine, 16, 8999.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Dewey, M. E., Henderson, A. S., et al (1988) The Geriatric Mental State (GMS) used in the community: replication studies of the computerised diagnosis AGECAT. Psychological Medicine, 18, 219223.Google Scholar
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Grimes, A. M., Grady, C. L., Foster, N. L., et at (1985) Central auditory function in Alzheimer's disease. Neurology, 35, 352358.Google Scholar
Henderson, A. S. (1990) The co-occurrence of affective and cognitive symptoms: the epidemiological evidence. Dementia, 1, 119123.Google Scholar
Herbst, K. G. & Humphrey, C. (1980) Hearing impairment and mental state in the elderly living at home. British Medical Journal, 281, 903.Google Scholar
Hodkinson, H. M. (1972) Evaluation of a mental test score for assessment of mental impairment in the elderly. Age and Ageing, 1, 233238.CrossRefGoogle ScholarPubMed
Jachuck, S., Stobo, S. A. & Sahgal, A. (1984) Evaluation of the mental function of the elderly in a general practice. Journal of the Royal College of General Practitioners, 36, 123124.Google Scholar
Kay, D. W. K., Black, S. E., Blessed, G., et al (1990) The prevalence of dementia in a general practice sample: upward revision of reported rate after follow-up and reassessment. International Journal of Geriatric Psychiatry, 5, 179186.Google Scholar
O'Connor, D. W., Pollitt, P. A., Treasure, F. P., et al (1989) The influence of education, social class and sex on Mini-mental State scores. Psychological Medicine, 19, 771776.Google Scholar
O'Connor, D. W., Pollitt, P. A., Treasure, F. P., et al (1991) The influence of education and social class on the diagnosis of dementia in a community population. Psychological Medicine, 21, 219224.Google Scholar
Office of Population Censuses and Surveys (1980) Classification of Occupation. London: HMSO.Google Scholar
Pattie, A. H. & Gilleard, C. J. (1976) The Clifton Assessment Schedule – further validation of a psychiatric assessment schedule. British Journal of Psychiatry, 129, 6872.CrossRefGoogle Scholar
Rabbit, P. (1986) Memory impairment in the elderly. In Psychiatric Disorders in the Elderly (eds Bebbington, P. E. & Jacoby, R.), pp. 101119. London: Mental Health Foundation.Google Scholar
Roth, M., Tym, E., Mountjoy, C. Q., et al (1986) CAMDEX: a standardised instrument for the diagnosis of mental disorders in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry, 149, 698709.CrossRefGoogle Scholar
Roth, M., Huppert, F., Tym, E., et al (1988) CAMDEX: the Cambridge Examination for Mental Disorders in the Elderly. Cambridge: Cambridge University Press.Google Scholar
Statistical Package for the Social Sciences (1986) SPSS (10th edn). Chicago: SPSS.Google Scholar
Uhlmann, R. F., Teri, L., Rees, T. S., et al (1989) Impact of mild to moderate hearing loss on mental status testing. Journal of the American Geriatrics Society, 37, 223228.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.