OBJECTIVE: To compare a family informant's report of memory loss in an older family member to standardized clinical diagnoses of cognitive impairment. SETTING: Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE), a 10-year longitudinal study of community dwellers aged 65 and greater in five counties of North Carolina. PARTICIPANTS: A stratified random sample of potentially demented participants was selected from the second wave of the Duke EPESE using responses to a brief cognitive screen. A neuropsychological battery was administered to these participants, and their family informants were asked whether they recognized memory loss in the participant. One hundred fifty-seven participants completed the full evaluation and also had an available family informant. MAIN OUTCOME MEASURES: Family informant's report of memory loss (yes, no, sometimes) compared to expert consensus diagnosis of cognitive impairment or dementia. RESULTS: There was poor concordance between the clinical diagnoses of cognitive impairment or dementia and the family informant's recognition of memory loss (kappa=-0.05; P=.74). When informants reported memory loss, 30% of participants were found not to have a cognitive loss. Among participants in whom family informants reported no memory loss, 75% were diagnosed with dementia or cognitive impairment (sensitivity, 0.70, 95% confidence interval [CI], 0.61 to 0.78; specificity, 0.24, 95% CI, 0.13 to 0.40; positive predictive value, 70%; negative predictive value, 25%). CONCLUSIONS: Asking family members about memory loss in a patient may be an unreliable strategy to detect dementia.
OBJECTIVE: To compare a family informant's report of memory loss in an older family member to standardized clinical diagnoses of cognitive impairment. SETTING: Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE), a 10-year longitudinal study of community dwellers aged 65 and greater in five counties of North Carolina. PARTICIPANTS: A stratified random sample of potentially demented participants was selected from the second wave of the Duke EPESE using responses to a brief cognitive screen. A neuropsychological battery was administered to these participants, and their family informants were asked whether they recognized memory loss in the participant. One hundred fifty-seven participants completed the full evaluation and also had an available family informant. MAIN OUTCOME MEASURES: Family informant's report of memory loss (yes, no, sometimes) compared to expert consensus diagnosis of cognitive impairment or dementia. RESULTS: There was poor concordance between the clinical diagnoses of cognitive impairment or dementia and the family informant's recognition of memory loss (kappa=-0.05; P=.74). When informants reported memory loss, 30% of participants were found not to have a cognitive loss. Among participants in whom family informants reported no memory loss, 75% were diagnosed with dementia or cognitive impairment (sensitivity, 0.70, 95% confidence interval [CI], 0.61 to 0.78; specificity, 0.24, 95% CI, 0.13 to 0.40; positive predictive value, 70%; negative predictive value, 25%). CONCLUSIONS: Asking family members about memory loss in a patient may be an unreliable strategy to detect dementia.
Authors: G W Small; P V Rabins; P P Barry; N S Buckholtz; S T DeKosky; S H Ferris; S I Finkel; L P Gwyther; Z S Khachaturian; B D Lebowitz; T D McRae; J C Morris; F Oakley; L S Schneider; J E Streim; T Sunderland; L A Teri; L E Tune Journal: JAMA Date: 1997 Oct 22-29 Impact factor: 56.272
Authors: Adolfo Jiménez-Huete; Antonio Del Barrio; Elena Riva; Pablo Campo; Rafael Toledano; Oriol Franch Journal: J Clin Neurol Date: 2017-07 Impact factor: 3.077