Validation of the short version of the 10/66 dementia diagnosis in multiethnic Asian older adults in Singapore

Background: To validate the short version of the 10/66 dementia diagnosis against the standard version of the 10/66 dementia diagnosis and clinical diagnosis and examine concurrent validity with the World Health Organisation Disability Assessment schedule and care needs in a multiethnic Asian older adult population in Singapore. Methods: Data from the Well-being of the Singapore Elderly study, a nationally representative survey of the older Singapore Resident population aged 60 years and above was used. The validity of the short version of the 10/66 dementia diagnostic criteria derived from the Community Screening Instrument for Dementia, the modified Consortium to Establish a Registry of Alzheimer's Disease 10-word list delayed recall and the EURO-D depression screen were examined against the standard version of the 10/66 dementia diagnosis and clinician diagnosis as a gold standard. Concurrent validity was tested by examining the relationships between the short version 10/66 dementia diagnosis, disability and care needs. Results: A total of 2373 respondents who had completed data on the short version diagnosis were included in this study. The majority (82.63%) of respondents were of Chinese descent, 9.86% were Malays, 6.12% were of Indian descent and 1.39% belonged to other ethnic group. We found the short version 10/66 dementia diagnosis showed almost perfect agreement with the standard version 10/66 dementia diagnosis (kappa = 0.90, AUC = 0.96) and substantial agreement with clinical diagnosis (kappa = 0.70, AUC = 0.87). The weighted prevalence of dementia in the population was slightly higher based on the short version diagnosis than the standard version diagnosis (10.74% vs. 10.04%). We also found that those with the short version 10/66 dementia were significantly associated with higher disability (beta = 28.90, 95% CI = 23.62, 9.62) and needed care occasionally (OR = 35.21, 95% CI = 18.08, 68.59) or much of the time (OR = 9.02, 95% CI = 5.21, 15.61). Conclusions: The study found that the short version 10/66 dementia diagnosis has excellent validity to diagnose dementia in a multiethnic Asian population in Singapore. Further research is required to determine the usefulness of this diagnosis in clinical practice or institutional settings to aid early detection and intervention for dementia.