A brief dementia screener suitable for use by non‐specialists in resource poor settings—the cross‐cultural derivation and validation of the brief Community Screening Instrument for Dementia

Abstract

ObjectiveBrief screening tools for dementia for use by non-specialists in primary care have yet to be validated in non-western settings where cultural factors and limited education may complicate the task. We aimed to derive a brief version of cognitive and informant scales from the Community Screening Instrument for Dementia (CSI-D) and to carry out initial assessments of their likely validity.MethodsWe applied Mokken analysis to CSI-D cognitive and informant scale data from 15 022 participants in representative population-based surveys in Latin America, India and China, to identify a subset of items from each that conformed optimally to item response theory scaling principles. The validity coefficients of the resulting brief scales (area under ROC curve, optimal cutpoint, sensitivity, specificity and Youden's index) were estimated from data collected in a previous cross-cultural validation of the full CSI-D.ResultsSeven cognitive items (Loevinger H coefficient 0.64) and six informant items (Loevinger H coefficient 0.69) were selected with excellent hierarchical scaling properties. For the brief cognitive scale, AUROC varied between 0.88 and 0.97, for the brief informant scale between 0.92 and 1.00, and for the combined algorithm between 0.94 and 1.00. Optimal cutpoints did not vary between regions. Youden's index for the combined algorithm varied between 0.78 and 1.00 by region.ConclusionA brief version of the full CSI-D appears to share the favourable culture- and education-fair screening properties of the full assessment, despite considerable abbreviation. The feasibility and validity of the brief version still needs to be established in routine primary care. Copyright © 2010 John Wiley & Sons, Ltd.

Cognition, Health, and Well-Being in a Rural Sub-Saharan African Population

“…While understanding this prevalence is important, this research overlooks the wide range of cognitive abilities in the older population, the social determinants of CH in SSA, and the implications of variability in CH for day-to-day activities and well-being among older individuals. Moreover, the survey instruments used in these studies are designed mainly to capture clinical dementia (Guerchet et al, 2014; Paddick et al, 2015; Prince et al, 2011), rather than population-level variability of CH. Dementia represents only a small subset of this population-level distribution of CH, and our measures of CH have therefore been designed to capture the full range of CH present among older individuals in a SSA LIC.…”

Translation and cultural adaptation for Portuguese Brazilian language of the Vellore instrument for screening cognitive

“…Um problema que poderia ser melhor conduzido com a disponibilidade de outros profissionais da área da saúde treinados para aplicar instrumentos para rastreio de declínio cognitivo. 12,13 A situação de vulnerabilidade da população idosa, que cada vez mais demanda atenção dos serviços de saúde, faz com que se torne necessário elaborar métodos para rastreio de doenças mentais, com baixo custo.…”

Development and Validation of the Identification and Intervention for Dementia in Elderly Africans (IDEA) Study Dementia Screening Instrument

“…12 Prince et al report much better performance generally and most notably in Nigeria. This is an area we intend to explore further during work in Nigeria and Tanzania, as part of the IDEA study.…”

“…The results are presented in Table 5, together with a comparison of the performance of the CSI-D cognitive section and the brief CSI-D developed by Prince et al 10,12 The 5-item instrument is preferred.…”

“…The model is very similar to that developed by Prince et al12 Question Split into Domains Identified by Factor Analysis.…”