The Galicia study of mental health of the Elderly II: the use of the Galician DIS

Abstract

Reports of epidemiological surveys do not always provide adequate careful descriptions of the methodology used and the sociocultural context involved. Galicia, a natural region in south-west Europe, possesses certain characteristics that differ from those in other communities within the Spanish state. Galician is a Romance language, which is, in fact, closer to Portuguese than it is to Spanish. The population (2.7 million inhabitants) is widely dispersed, with two-thirds of them living in the countryside. More than 18% are older than 65, and the educational level of this elderly population is low. A total of 681 persons over 60 years of age were interviewed in their homes using the DIS-III as the main diagnostic instrument during the second phase of the Galicia Study of Mental Health of the Elderly. This paper analyses some methodological implications of this epidemiological study, focusing on the translation of the DIS into Galician and its performance and acceptability in thiscommunity. The possible cultural bias that can affect the rates of prevalence in some specific disorders, the limitations of lifetime prevalence and the advantages of using six-month prevalence rates is discussed. Besides some interesting anecdotes, which are described in the article, the main result is the very high acceptance of DIS-III in this elderly population.

Comparative analysis between the MMSE and the RUDAS for dementia screening in low educated people in a Spanish psychogeriatric clinic

“…In other words, our study made the screening instruments subject to a more challenging test, which interestingly the RUDAS has successfully passed, yielding good to very good psychometric parameters. Indeed, we found a smaller difference in our sample between the median of the scores on the MMSE in demented (13, Q1: 9-Q3: 16) and in non-demented (20,(17)(18)(19)(20)(21)(22)(23)(24) patients than in previous studies. This was also observed for the RUDAS (17, 10-19 vs. 23, 21-25) 15,16 .…”

“…The MMSE version sued in this study had been validated in the Galician population 22 as part of the diagnoses protocol of the Psychogeriatric Unit, which was an adaptation of the Portuguese validated version 23 . This was decided due to the excessive literality of most of the Spanish versions and the bilingualism of Galician population, in which Spanish and the native language, which is rather similar to Portuguese, are equally used .…”

The Galicia study of mental health of the Elderly I: general description of methodology

“…In the first phase no particularly relevant incident occurred; the high acceptance of DIS and some anecdotes of anthropological interest that occurred during the second phase are discussed elsewhere (Mateos et al, 2000).…”

“…For this reason the interviewers noted all the difficulties encountered. This material was treated quantitatively and qualitatively (discussion groups on difficulties and anecdotes) and it has been used in the additional methodological report on the DIS interview (Mateos et al, 2000). These procedures guarantee the validity of the information collected to a reasonable extent.…”

“…With this report we begin such a task, and to do so we combine an indispensable amount of objective sociodemographic information about the community under study with a partial description of the epidemiological procedures used (sampling, fieldwork, weighting of the prevalence rates, and other statistical procedures). In an additional publication (Mateos et al, 2000), there is an analysis of the preparation and use of the Galician version of the Diagnostic Interview Schedule (DIS), the main diagnostic instrument used.…”