TY - JOUR
T1 - Diagnosing dementia. Univariate and multivariate analyses of the mental status examination
AU - Klein, L. E.
AU - Roca, R. P.
AU - McArthur, J.
AU - Vogelsang, G.
AU - Kirby, S. M.
AU - Folstein, M.
PY - 1985
Y1 - 1985
N2 - Investigators have reported poor recognition of dementia by primary physicians. For this reason, mental status examinations were performed on 72 demented and 144 nondemented medical inpatients to assess the sensitivity, specificity, and predictive value of components of this examination in the diagnosis of dementia. Sensitivity of individual level-of-orientation items was low (15.3 to 56.9%), though specificity was high (91.7 to 100%). Sensitivity of several nonorientation items was high (80.6 to 100%), though specificity was low. A multivariate discriminant equation using both orientation and nonorientation items achieved high sensitivity (89.6% test cases, 87.5% validation cases) and specificity (78.1% test cases, 87.5% validation cases). Adding the easily obtained patient characteristic of age to the equation further increased sensitivity (95.8%, 91.3%), while maintaining specificity (82.3%, 85.4%). From these results, it is concluded that the level-of-orientation screening examination used by clinicians to detect dementia is unacceptably insensitive. In contrast, a composite decision rule including nonorientation items achieves high sensitivity with relatively high specificity.
AB - Investigators have reported poor recognition of dementia by primary physicians. For this reason, mental status examinations were performed on 72 demented and 144 nondemented medical inpatients to assess the sensitivity, specificity, and predictive value of components of this examination in the diagnosis of dementia. Sensitivity of individual level-of-orientation items was low (15.3 to 56.9%), though specificity was high (91.7 to 100%). Sensitivity of several nonorientation items was high (80.6 to 100%), though specificity was low. A multivariate discriminant equation using both orientation and nonorientation items achieved high sensitivity (89.6% test cases, 87.5% validation cases) and specificity (78.1% test cases, 87.5% validation cases). Adding the easily obtained patient characteristic of age to the equation further increased sensitivity (95.8%, 91.3%), while maintaining specificity (82.3%, 85.4%). From these results, it is concluded that the level-of-orientation screening examination used by clinicians to detect dementia is unacceptably insensitive. In contrast, a composite decision rule including nonorientation items achieves high sensitivity with relatively high specificity.
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U2 - 10.1111/j.1532-5415.1985.tb05460.x
DO - 10.1111/j.1532-5415.1985.tb05460.x
M3 - Article
C2 - 4008847
AN - SCOPUS:0021794290
SN - 0002-8614
VL - 33
SP - 483
EP - 488
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 7
ER -