Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-17T21:31:17.311Z Has data issue: false hasContentIssue false

Cognitive impairment and functional disability in the absence of psychiatric diagnosis

Published online by Cambridge University Press:  09 July 2009

Susan Spear Bassett*
Affiliation:
Department of Psychiatry and Behavioral Sciences, The Johns Hopkins Medical Institutions, Baltimore, USA
Marshal F. Folstein
Affiliation:
Department of Psychiatry and Behavioral Sciences, The Johns Hopkins Medical Institutions, Baltimore, USA
*
1Address for correspondence: Dr Susan Spear Bassett, Osler 320, The Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA.

Synopsis

Data from the 1981 East Baltimore Mental Health Survey were used to examine the relationship between cognitive impairment and psychiatric diagnosis in an adult population. The Mini-Mental State Examination was administered to 3841 household respondents and a subset of 810 received psychiatric evaluations. Of the 810, 23% were found to be cognitively impaired. Over one-third of those with cognitive impairment, however, did not meet DSM-III criteria for a psychiatric diagnosis. Education, geographical background, race and neurological status were predictive of cognitive performance. There was no linear effect of age on cognitive performance with disease status and education controlled. In addition to their cognitive impairment these individuals, who ranged in age from 19 to 89, were found to have significant functional disabilities. Cognitive performance itself, along with physical and emptional health, predicted total functional disability.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allen, R. M. & Cortazzo, A. D. (1970). Psychosocial and Educational Aspects and Problems of Mental Retardation, pp. 5767. Charles C. Thomas: Springfield.Google Scholar
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. revised. American Psychiatric Association: Washington, DC.Google Scholar
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. American Psychiatric Association: Washington, DC.Google Scholar
Ashurst, D. I. (1973). Social system and clinical model in school identification of the educable retarded. In Sociobehavioral Studies in Mental Retardation (ed. Tarjan, G., Eyman, R. K. and Meyers, C. E.), pp. 150163. American Association on Mental Deficiency: Los Angeles.Google Scholar
Fillenbaum, G. G., Hughes, D. C., Heyman, A., George, L. K. & Blazer, D. G. (1988). Relationship of health and demographic characteristics to Mini-Mental State Examination score among community residents. Psychological Medicine 18, 719726.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, 189198.Google Scholar
Folstein, M. F., Anthony, J. C., Parhad, I., Duffy, B. & Gruenberg, E. (1985 a). The meaning of cognitive impairment in the elderly. Journal of the American Geriatric Society 33, 228235.CrossRefGoogle ScholarPubMed
Folstein, M. F., Romanoski, A., Chahal, R., Anthony, J. C., von Korff, M., Nestadt, G., Merchant, A., Gruenberg, E. M. & Kramer, M. (1985 b). Eastern Baltimore mental health survey clinical reappraisal. In Epidemiologic Field Methods in Psychiatry, The National Institute of Mental Health Epidemiologic Catchment Area Program, (ed. Eaton, W. W. and Kessler, L. G.), pp. 253284. Academic Press: Orlando.CrossRefGoogle Scholar
Goldberg, D. P. (1978). The Manual of the General Health Questionnaire. NFER: Windsor.Google Scholar
Holzer, C. E., Tischler, G. L.Leaf, P. J. & Myers, J. K. (1984). An epidemiologic assessment of cognitive impairment in a community population. In Research in Community and Mental Health, 4 (ed. Greeley, J.), pp. 332. JAI Press: Greenwich.Google Scholar
Kramer, M., German, P. S., Anthony, J. C., von Korff, M. & Skinner, E. A. (1985). Patterns of mental disorders among the elderly residents of Eastern Baltimore. Journal of the American Geriatric Society 33, 236245.Google Scholar
Kuriansky, J. B., Gurland, B. J. & Fleiss, J. L. (1976). The assessment of self-care capacity in geriatric psychiatric patients by objective and subjective methods. Journal of Clinical Psychology 32, 95102.Google Scholar
Mercer, J. R. (1973). Labelling the Mentally Retarded: Clinical and Social System Perspectives on Mental Retardation. University of California Press: Berkeley.CrossRefGoogle Scholar
Perlin, S. & Butter, R. N. (1963). Psychiatric aspects of adaptation to the aging experience. In Human Aging: A Biological and Behavioral Study (ed. Birren, J. E., Butter, R. N., Greenhouse, S. W., Sokoloff, L. and Yarrow, M. R.), pp. 157213. Us Department of Health, Education and Welfare. Public Health Service, National Institutes of Health, Government Printing Office: Washington, DC.Google Scholar
Pierce, R. C. (1967). Intellectual status compared. In Aging and Mental Disorder in San Francisco: A Social Psychiatric Study (ed. Lowenthal, M. F. and Berkman, P. L.), pp. 112119. Jossey-Bass: San Francisco.Google Scholar
Willerman, L. (1979). The Psychology of Individual and Group Differences. W. H. Freeman: San Francisco.Google Scholar
World Health Organization (1989). International Classification of Diseases-10, ch. V, Mental and Behavioral Disorders (draft). World Health Organization: Geneva.Google Scholar