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Assessing cognitive abilities and dementia in a predominantly illiterate population of older individuals in Kinmen

Published online by Cambridge University Press:  09 July 2009

H. C. Liu ,
P. Chou ,
K. N. Lin ,
S. J. Wang ,
J. L. Fuh ,
H. C. Lin ,
C. Y. Liu ,
G. S. Wu ,
E. B. Larson  and
L. R. White
...Show all authors
H. C. Liu*
Affiliation:
Neurological Institute, Veterans General Hospital-Taipei, Institute of Public Health, National Yang-Ming Medical College and Department of Psychiatry, Chang-Gung Memorial Hospital, Taipei, Taiwan: Bureau of Public Health and Environment Protection, Kinmen, ROC; Department of Medicine, Epidemiology and Health Services, University of Washington and Battelle Seattle Research Center, Seattle, Washington; Honolulu-Asia Aging Study, National Institute on Aging, Honolulu; Department of Neurology, University of Southern California School of Medicine, Los Angeles, USA
P. Chou
Affiliation:
Neurological Institute, Veterans General Hospital-Taipei, Institute of Public Health, National Yang-Ming Medical College and Department of Psychiatry, Chang-Gung Memorial Hospital, Taipei, Taiwan: Bureau of Public Health and Environment Protection, Kinmen, ROC; Department of Medicine, Epidemiology and Health Services, University of Washington and Battelle Seattle Research Center, Seattle, Washington; Honolulu-Asia Aging Study, National Institute on Aging, Honolulu; Department of Neurology, University of Southern California School of Medicine, Los Angeles, USA
K. N. Lin
Affiliation:
Neurological Institute, Veterans General Hospital-Taipei, Institute of Public Health, National Yang-Ming Medical College and Department of Psychiatry, Chang-Gung Memorial Hospital, Taipei, Taiwan: Bureau of Public Health and Environment Protection, Kinmen, ROC; Department of Medicine, Epidemiology and Health Services, University of Washington and Battelle Seattle Research Center, Seattle, Washington; Honolulu-Asia Aging Study, National Institute on Aging, Honolulu; Department of Neurology, University of Southern California School of Medicine, Los Angeles, USA
S. J. Wang
Affiliation:
Neurological Institute, Veterans General Hospital-Taipei, Institute of Public Health, National Yang-Ming Medical College and Department of Psychiatry, Chang-Gung Memorial Hospital, Taipei, Taiwan: Bureau of Public Health and Environment Protection, Kinmen, ROC; Department of Medicine, Epidemiology and Health Services, University of Washington and Battelle Seattle Research Center, Seattle, Washington; Honolulu-Asia Aging Study, National Institute on Aging, Honolulu; Department of Neurology, University of Southern California School of Medicine, Los Angeles, USA
J. L. Fuh
Affiliation:
Neurological Institute, Veterans General Hospital-Taipei, Institute of Public Health, National Yang-Ming Medical College and Department of Psychiatry, Chang-Gung Memorial Hospital, Taipei, Taiwan: Bureau of Public Health and Environment Protection, Kinmen, ROC; Department of Medicine, Epidemiology and Health Services, University of Washington and Battelle Seattle Research Center, Seattle, Washington; Honolulu-Asia Aging Study, National Institute on Aging, Honolulu; Department of Neurology, University of Southern California School of Medicine, Los Angeles, USA
H. C. Lin
Affiliation:
Neurological Institute, Veterans General Hospital-Taipei, Institute of Public Health, National Yang-Ming Medical College and Department of Psychiatry, Chang-Gung Memorial Hospital, Taipei, Taiwan: Bureau of Public Health and Environment Protection, Kinmen, ROC; Department of Medicine, Epidemiology and Health Services, University of Washington and Battelle Seattle Research Center, Seattle, Washington; Honolulu-Asia Aging Study, National Institute on Aging, Honolulu; Department of Neurology, University of Southern California School of Medicine, Los Angeles, USA
C. Y. Liu
Affiliation:
Neurological Institute, Veterans General Hospital-Taipei, Institute of Public Health, National Yang-Ming Medical College and Department of Psychiatry, Chang-Gung Memorial Hospital, Taipei, Taiwan: Bureau of Public Health and Environment Protection, Kinmen, ROC; Department of Medicine, Epidemiology and Health Services, University of Washington and Battelle Seattle Research Center, Seattle, Washington; Honolulu-Asia Aging Study, National Institute on Aging, Honolulu; Department of Neurology, University of Southern California School of Medicine, Los Angeles, USA
G. S. Wu
Affiliation:
Neurological Institute, Veterans General Hospital-Taipei, Institute of Public Health, National Yang-Ming Medical College and Department of Psychiatry, Chang-Gung Memorial Hospital, Taipei, Taiwan: Bureau of Public Health and Environment Protection, Kinmen, ROC; Department of Medicine, Epidemiology and Health Services, University of Washington and Battelle Seattle Research Center, Seattle, Washington; Honolulu-Asia Aging Study, National Institute on Aging, Honolulu; Department of Neurology, University of Southern California School of Medicine, Los Angeles, USA
E. B. Larson
Affiliation:
Neurological Institute, Veterans General Hospital-Taipei, Institute of Public Health, National Yang-Ming Medical College and Department of Psychiatry, Chang-Gung Memorial Hospital, Taipei, Taiwan: Bureau of Public Health and Environment Protection, Kinmen, ROC; Department of Medicine, Epidemiology and Health Services, University of Washington and Battelle Seattle Research Center, Seattle, Washington; Honolulu-Asia Aging Study, National Institute on Aging, Honolulu; Department of Neurology, University of Southern California School of Medicine, Los Angeles, USA
L. R. White
Affiliation:
Neurological Institute, Veterans General Hospital-Taipei, Institute of Public Health, National Yang-Ming Medical College and Department of Psychiatry, Chang-Gung Memorial Hospital, Taipei, Taiwan: Bureau of Public Health and Environment Protection, Kinmen, ROC; Department of Medicine, Epidemiology and Health Services, University of Washington and Battelle Seattle Research Center, Seattle, Washington; Honolulu-Asia Aging Study, National Institute on Aging, Honolulu; Department of Neurology, University of Southern California School of Medicine, Los Angeles, USA
A. B. Graves
Affiliation:
Neurological Institute, Veterans General Hospital-Taipei, Institute of Public Health, National Yang-Ming Medical College and Department of Psychiatry, Chang-Gung Memorial Hospital, Taipei, Taiwan: Bureau of Public Health and Environment Protection, Kinmen, ROC; Department of Medicine, Epidemiology and Health Services, University of Washington and Battelle Seattle Research Center, Seattle, Washington; Honolulu-Asia Aging Study, National Institute on Aging, Honolulu; Department of Neurology, University of Southern California School of Medicine, Los Angeles, USA
E. L. Teng
Affiliation:
Neurological Institute, Veterans General Hospital-Taipei, Institute of Public Health, National Yang-Ming Medical College and Department of Psychiatry, Chang-Gung Memorial Hospital, Taipei, Taiwan: Bureau of Public Health and Environment Protection, Kinmen, ROC; Department of Medicine, Epidemiology and Health Services, University of Washington and Battelle Seattle Research Center, Seattle, Washington; Honolulu-Asia Aging Study, National Institute on Aging, Honolulu; Department of Neurology, University of Southern California School of Medicine, Los Angeles, USA
*
1Address for correspondence: Dr Hsiu-Chih Liu. The Neurological Institute, Veterans General Hospital-Taipei, Taipei, Taiwan, ROC
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Synopsis

A community survey of dementia was conducted on a Chinese islet. A total of 221 men and 234 women in the age range of 50–92 were assessed. The Cognitive Abilities Screening Instrument (CASI), a 100-point cognitive test designed for cross-cultural studies and adapted in Chinese for individuals with little or no formal education, was administered twice by trained field workers with a retest interval of 3 to 4 weeks. In addition, all participants were assessed by physicians who did not know the CASI scores. The physicians' assessment included a complete neurological examination, plus semi-structured tests and interviews covering cognitive abilities, daily activities, depression, cerebrovascular disease, and Parkinson's disease. Dementia was diagnosed by consensus among the physicians according to the DSM-III-R criteria. Among the 455 participants, 16 cases of dementia were identified, including 13 with probable Alzheimer's disease and 1 each with vascular dementia, Parkinson's disease, and alcoholism. The rates of dementia were 0, 3·9 and 11·5% for the age groups of 50–69, 70–79 and 80–92; and 4·4, 2·0 and 0% for the education groups of 0–1, 2–6 and 7–15 years of schooling. No sex difference was found after controlling for education. The Chinese version of the CASI had an intraclass retest reliability of 0·90. Using a cut-off score of ≤ 50 for dementia, the sensitivity was 0·88 and the specificity was 0·94. The preliminary study suggests that the CASI can be used in Chinese populations with generally low education levels and that Alzheimer's disease was the most common type of dementia in this population.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 3 , August 1994 , pp. 763 - 770
Copyright
Copyright © Cambridge University Press 1994

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References

American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn – Revised. APA: Washington. DC.Google Scholar
Blessed, G., Tomlinson, B. E. & Roth, M. (1968). The association between quantitative measure of dementia and of senile changes in the cerebral grey matter of elderly subjects. British Journal of Psychiatry 114, 797–811.CrossRefGoogle ScholarPubMed
Brayne, C. (1993). Research and Alzheimer's disease: an epidemiological perspective. Psychological Medicine 23, 287–296.CrossRefGoogle ScholarPubMed
DeKosky, S. T. & Scheff, S. W. (1990). Synapse loss in frontal cortex biopsies in Alzheimer's disease: correlation with cognitive severity. Annals of Neurology 27, 457–464.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975).‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189–198.CrossRefGoogle Scholar
Graves, A. B., Larson, E. B., Kukull, W. A., White, L. R. & Teng, E. L. (1993). Screening for dementia in the community in cross-national studies: comparison between the cognitive abilities screening instrument and the mini-mental state examination. In Alzheimer's Disease: Advances in Clinical and Basic Research (ed. Corain, B., Iqbal, K., Nicolini, M., Winblad, B., Wisniewski, H. and Zatta, P.), pp. 113–119. John Wiley & Sons: Chichester.Google Scholar
Hamos, J. E., DeGennaro, L. J. & Drachman, D. A. (1989). Synaptic loss in Alzheimer's disease and other dementias. Neurology 39, 355–361.CrossRefGoogle ScholarPubMed
Hasegawa, K. (1983). The clinical assessment of dementia in the aged: a dementia screening scale for psychogeriatric patients. In Aging in the Eighties and Beyond (ed. Bergerner, M., Lehr, U., Lang, E. and Schmitz-Scherzer, R.), pp. 207–218. Springer Publishing Company: New York.Google Scholar
Hill, L. R., Klauber, M. R., Salmon, D. P., Yu, E. S. H., Liu, W. T., Zhang, M. & Katzman, R. (1993). Functional status, education, and the diagnosis of dementia in the Shanghai survey. Neurology 43, 138–145.CrossRefGoogle ScholarPubMed
Hughes, C. P., Berg, L., Danziger, W. L., Coben, L. A. & Martin, R. L. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry 140, 566–572.CrossRefGoogle ScholarPubMed
Jorm, A. F. & Jacomb, P. A. (1989). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms. Psychological Medicine 19, 1015–1022.CrossRefGoogle ScholarPubMed
Katzman, R. (1993). Education and the prevalence of dementia and Alzheimer's disease. Neurology 43, 13–20.CrossRefGoogle ScholarPubMed
Liu, H. C., Tsou, H. K., Lin, K. N., Yan, S. H., Guo, N. W., Wang, C. L. & Chiang, B. N. (1991). Evaluation of 110 consecutive patients with dementias: a prospective study. Acta Neurologica Scandinavica 84, 421–425.CrossRefGoogle ScholarPubMed
Mortimer, J. A. (1988). Do psychosocial risk factors contribute to Alzheimer's disease? In Etiology of Dementia of Alzheimer's Type (ed. Henderson, A. S. and Henderson, J. H.), pp. 39–52. John Wiley and Sons: New York.Google Scholar
Myers, J. K. & Weissman, M. M. (1980). Use of a self-report symptom scale to detect depression in a community sample. American Journal of Psychiatry 137, 1081–1084.Google Scholar
Radloff, L. S. (1977). The CES-D scale: a self-report symptom scale to detect depression in the general population. Applied Psychological Measurement 1, 385–401.CrossRefGoogle Scholar
Rosenzweig, M. R., Krech, D., Bennett, E. L. & Diamond, M. C. (1962). Effects of environmental complexity and training on brain chemistry and anatomy: a replication and extension. Journal of Comparative Physiology and Psychology 55, 429–437.CrossRefGoogle ScholarPubMed
Stern, Y., Alexander, G. E., Prohovnik, I. & Mayeux, R. (1992). Inverse relationship between education and parietotemporal perfusion deficit in Alzheimer's disease. Annals of Neurology 32, 371–375.CrossRefGoogle ScholarPubMed
Teng, E. L. (1990). The 3RT test: three reaction time tasks for IBM PC computers. Behavior Research Methods, Instrument and Computers 22, 389–392.CrossRefGoogle Scholar
Teng, E. L. & Chui, H. C. (1987). The Modified Mini-Mental State (3MS) Examination. Journal of Clinical Psychiatry 48, 314–317.Google ScholarPubMed
Teng, E. L., Hasegawa, K., Homma, A., Imai, Y., Larson, E., Sasaki, H. & White, L. R. (1992). A practical test for cross-cultural epidemiological studies of dementia: the Cognitive Abilities Screening Instrument (CASI). In New Horizons in Aging Science (ed. Orimo, H., Fukuchi, Y., Kuramoto, K. and Iriki, M.), pp. 325–327. University of Tokyo Press: Tokyo.Google Scholar
Teng, E. L., Hasegawa, K., Homma, A., Imai, Y., Larson, E., Graves, A., Sugimoto, K., Yamaguchi, T., Sasaki, H., Chiu, D. & White, L. R. (1994). The cognitive abilities screening instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia. International Psychogeriatrics 6, 45–56.CrossRefGoogle Scholar
White, L. R. (1992). The Ni-Hon-Sea demented project: description and progress report. In New Horizons in Aging Science (ed. Orimo, H., Fukuchi, Y., Kuramoto, K. and Iriki, M.), pp. 324–325. University of Tokyo Press: Tokyo.Google Scholar
Zhang, M., Katzman, R., Salmon, D., Jin, H., Cai, G., Wang, Z., Qu, G., Grant, I., Levy, P., Klauber, M. & Liu, W. T. (1990). The prevalence of dementia and Alzheimer's disease (AD) in Shanghai, China: impact of age, gender and education. Annals of Neurology 27, 428–437.CrossRefGoogle ScholarPubMed