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The Gospel Oak Study stage II: the diagnosis of dementia in the community

Published online by Cambridge University Press:  09 July 2009

Gill Livingston ,
Karen Sax ,
Jo Willison ,
Bob Blizard  and
Anthony Mann
Gill Livingston*
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
Karen Sax
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
Jo Willison
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
Bob Blizard
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
Anthony Mann
Affiliation:
Academic Department of Psychiatry, Royal Free Hospital, London
*
1Address for correspondence: Dr Gill Livingston, Academic Department of Psychiatry, Royal Free Hospital, Pond Street, London NW3 2QG.
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Synopsis

An attempt was made to assess in detail subjects screened as suffering from dementia among a North London community sample of elderly people. Forty-eight (80 %) subjects were interviewed, 7 (12%) were found to have died and 5 (8%) either refused interview or were lost to follow-up. By clinicians' diagnosis of the 48 interviewed, 22 subjects (46%) had probable Alzheimer's disease, one had multi-infarct dementia, five had mixed dementia, five had secondary dementia, 10 had a dementia which could not be further classified and 5 were not demented. No subject had a reversible condition. The prevalence rate for clinical dementia was 6·1 %, and for Alzheimer's disease 3·1 %. According to AGECAT diagnosis the prevalence of organicity was 5·7%. The AGECAT diagnoses and psychiatrists' diagnoses were significantly associated (P < 0·003) and AGECAT was more likely to identify as organic those subjects with dementia diagnosed by psychiatrists as Alzheimer's disease, than those not so diagnosed (P < 0·04). A short psychometric battery, including the MMSE in two versions, was administered and its acceptability to a community sample evaluated. This detailed clinical investigation showed that the Dementia Diagnostic Scale of the Short-CARE was a specific predictor of clinical dementia or death at the time of follow-up, whereas the more inclusive Organic Brain Syndrome scale was a more satisfactory first phase screening instrument.

Type
Orginal Articles
Information
Psychological Medicine , Volume 20 , Issue 4 , November 1990 , pp. 881 - 891
Copyright
Copyright © Cambridge University Press 1990

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