DIFFERENTIAL-DIAGNOSIS OF DEMENTIA - A PROSPECTIVE EVALUATION OF THE DAT INVENTORY

被引:10
作者
COEN, RF
OMAHONEY, D
BRUCE, I
LAWLOR, BA
WALSH, JB
COAKLEY, D
机构
[1] ROYAL COLL SURGEONS IRELAND,DEPT PSYCHOL,DUBLIN 2,IRELAND
[2] ST JAMES HOSP,DEPT OLD AGE PSYCHIAT,DUBLIN 8,IRELAND
关键词
D O I
10.1111/j.1532-5415.1994.tb06067.x
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objective: To compare prospectively the concordance between the diagnosis of dementia based on clinical criteria and using the DAT Inventory. Design, Setting, and Participants: A prospective study of 81 consecutive patients referred to a Memory Clinic. Only patients for whom a definitive diagnosis of dementia was established after 8 to 20 months follow-up were retained in the study (n = 76). Measurements: The sensitivity, specificity, positive and negative predictive values, and overall diagnostic accuracy of the DAT Inventory were calculated. Kappa values were also computed. Results: Based on all patients (n = 76), sensitivity and specificity were 71% and 95%, respectively, with 98% positive prediction, 56% negative prediction, 78% overall accuracy, and kappa of 0.54. Of 21 cases not meeting NINCDS/ADRDA criteria for DAT, one patient with multi-infarct dementia was misclassified as DAT on the DAT Inventory. Of 55 DAT cases (NINCDS/ADRDA criteria), 16 patients, predominantly very mild or mixed cases, were classified as non-DAT on the DAT Inventory. When mixed, very mild, and borderline cases were excluded (screening n = 54), DAT Inventory sensitivity increased to 94%, and specificity remained unchanged at 95%, with 97% positive and 91% negative prediction, 94% overall accuracy, and kappa of 0.88. Conclusions: In general, scores above the designated cutoff point (>14/20) on the DAT Inventory are consistent with a dinical diagnosis of DAT (NINCDS/ADRDA criteria). Concordance is best in cases of mild to moderate dementia (Clinical Dementia Rating 1-2). The Inventory is less discriminating as a differential diagnostic instrument in cases of very mild dementia, atypical presentations of DAT, or in cases of mixed pathology.
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页码:16 / 20
页数:5
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