TYM is a useful screening test in the cognitive function clinic setting, with patients who fall below the designated cutoff requiring further investigation to ascertain a cause for their cognitive impairment. Self-administered tests such as TYM may be of particular value in situations where clinician time is limited.

In a memory clinic based population, the IQCODE proved sensitive for the diagnosis of dementia but overall diagnostic accuracy was suboptimal. Combining the IQCODE in series with the ACE-R or MMSE greatly improved diagnostic utility.

Background/Aims: Since widely accepted definitions of dementia encompass impairments in social and occupational, as well as cognitive, function, we investigated the diagnostic accuracy of Lawton and Brody’s Instrumental Activities of Daily Living (IADL) Scale as an independent test for the diagnosis of dementia. Methods: The IADL Scale was administered to consecutive referrals to 2 memory clinics over a 2-year period, independent of other tests (interview, neuropsychology, imaging) which were used to establish diagnoses according to standard diagnostic criteria, and the results were compared. Results: In a cohort of 296 patients, 52% adjudged to have dementia, IADL Scale scores and subscores showed low sensitivity, specificity, and positive and negative predictive values for the diagnosis of dementia. The likelihood ratios, a measure of diagnostic gain, were generally small to unimportant, and diagnostic accuracy as measured by area under the receiver operating characteristic curve was no better than 0.75. Conclusion: IADL Scale scores are not very helpful in making a diagnosis of dementia. More sensitive scales may be required to detect dementia-related functional decline, although it is also possible that dementia syndromes may be present in the absence of functional decline, challenging accepted definitions of dementia.

SUMMARY The parents of 106 children who had had Reye's syndrome and those of 185 comparison children who had febrile illnesses were interviewed in order to compare preadmission medication exposure rates in the two groups. Although comparable proportions of case and comparison patients had taken antipyretics in the three weeks before admission, a significant excess of cases (59% compared with 26% in the comparisons) had been given aspirin, whereas significantly more comparison children (49% compared with 25% in the cases) had taken paracetamol. There was an excess exposure to aspirin in children under 5 years of age; the excess observed in older patients just failed to reach significance. Separate analyses within Northern Ireland and England also showed a case-comparison difference. A significant correlation was shown between aspirin (but not paracetamol) exposure and the closeness with which cases

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