Development of a brief assessment and algorithm for ascertaining dementia in low-income and middle-income countries: the 10/66 short dementia diagnostic schedule

Abstract

ObjectivesTo develop and evaluate a short version of the 10/66 dementia diagnostic schedule for use in low-income and middle-income countries.DesignSplit-half analysis for algorithm development and testing; cross-evaluation of short-schedule and standard-schedule algorithms in 12 community surveys.Settings(1) The 10/66 pilot sample data set of people aged 60 years and over in 25 international centres each recruiting the following samples: (a) dementia; (b) depression, no dementia; (c) no dementia, high education and (d) no dementia, low education. (2) Cross-sectional surveys of people aged 65 years or more from 12 urban and rural sites in 8 countries (Cuba, Dominican Republic, Peru, Mexico, Venezuela, India, China and Puerto Rico).ParticipantsIn the 10/66 pilot samples, the algorithm for the short schedule was developed in 1218 participants and tested in 1211 randomly selected participants; it was evaluated against the algorithm for the standard 10/66 schedule in 16 536 survey participants.Outcome measuresThe short diagnostic schedule was derived from the Community Screening Instrument for Dementia, the CERAD 10-word list recall task and the Euro-D depression screen; it was evaluated against clinically assigned groups in the pilot data and against the standard schedule (using the Geriatric Mental State (GMS) rather than Euro-D) in the surveys.ResultsIn the pilot test sample, the short-schedule algorithm ascertained dementia with 94.2% sensitivity. Specificities were 80.2% in depression, 96.6% in the high-education group and 92.7% in the low-education group. In survey samples, it coincided with standard algorithm dementia classifications with over 95% accuracy in most sites. Estimated dementia prevalences in the survey samples were not consistently higher or lower using the short compared to standard schedule.ConclusionsFor epidemiological studies of dementia in low-income and middle-income settings where the GMS interview (and/or interviewer training required) is not feasible, the short 10/66 schedule and algorithm provide an alternative with acceptable levels of performance.

Dementia prevalence in a population at high vascular risk: the Trinidad national survey of ageing and cognition

“…The 10/66 short schedule is identical to the original 10/66 schedule 22 in its inclusion of the Community Screening Instrument for Dementia and CERAD 10-word list recall task, but substitutes the Euro-D depression instrument for the longer Geriatric Mental State (of which the Euro-D is a subcomponent). As recently published 19 , the 10/66 short schedule retains high sensitivity and specificity for dementia ascertainment (on data from 25 international centres) and was comparable to the longer instrument in dementia prevalence estimation across previous 10/66 surveys (on data from 16 536 participants in 12 sites from eight countries). All components of the algorithm and the source instruments have been published in an open access source.…”

“…All components of the algorithm and the source instruments have been published in an open access source. 19 …”

“When someone becomes old then every part of the body too becomes old”: Experiences of living with dementia in Kintampo, rural Ghana

“…obtained using the original algorithm (Stewart et al, 2016). Given the established validity of this 97 approach, as we would expect, distribution of cognitive test scores between our qualitative sampling 98 frame and study participants without dementia were consistent with differences identified in studies 99 carried out elsewhere in sub-Saharan Africa (Guerchet et al, 2010).…”

Dementia research needs in Ghana: a perspective

“…Participants aged 70+ years were sampled from the Kintampo Health and Demographic Surveillance System's database. The 10/66 short dementia diagnostic schedule (comprising of a household questionnaire, Euro-D, a background sociodemographic and risk factor interview, a cognitive test battery, and an in-Dementia research needs in Ghana: a perspective formant interview) 16 , 17 was administered to participants in their homes. A total of 761 participants agreed to participate and were interviewed for the first part of the aim (quantitative component).…”