And since your doctor should be testing for your dementia risk, you need to be concerned about this. I hit all the right categories; higher education, white, young, not in nursing home. When I went to a psychiatrist I analyzed the questions she was giving me, I would do the same for any dementia test. A doctor once gave me the Neuropsychological Assessment Battery® Digits Forward/Digits Backward Test while in the hospital. He mentioned that I was the only patient he had that had ever gotten thru the whole test. I asked if that meant I was normal. He said no.
Study Finds Biases in Widely Used Dementia Identification Tests
Brief
cognitive assessments used in primary care settings to identify whether
people are likely to have dementia may often be wrong, according to a
study published in Neurology.
The 3 tests examined in the study were the Mini-Mental State Examination, the Memory Impairment Screen, and Animal Naming.
“Our study found that all 3 tests often give incorrect results that may wrongly conclude that a person does or does not have dementia,” said David Llewellyn, PhD, University of Exeter Medical School, Exeter, United Kingdom. “Each test has a different pattern of biases, so people are more likely to be misclassified by one test than another depending on factors such as their age, education and ethnicity.”
For the study, 824 people in the United States with an average age of 82 years were given full dementia assessments that included a physical exam, genetic testing for the APOE gene, psychological testing, and comprehensive memory and thinking tests. The researchers divided participants into 2 groups based on the comprehensive dementia diagnosis. Of the participants, 35% had dementia and 65% did not.
Participants took each of the 3 quick tests and researchers found that 36% of participants were wrongly classified by at least 1 of the tests, but only 2% were misclassified by all 3 tests. Overall rates of misclassification by these tests individually ranged from 14% to 21%, including both false-positive and false-negative results.
Researchers also found that different tests had different biases. One test had an education bias, in that those with higher education were more likely to be misclassified as not having dementia and those with lower education were more likely to be misclassified as having dementia. Older age, having an ethnic background other than white, and living in a nursing home also led to misclassification. Across all tests, a lack of information on whether a family member or friend rated the participant’s memory to be poor resulted in an increased risk of misclassification.
“Failing to detect dementia can delay access to treatment and support, whereas false alarms lead to unnecessary investigations, causing pressure on health care systems,” said Dr. Llewellyn. “Identifying people with dementia in a timely fashion is important, particularly as new methods of treatment come on-stream. Our findings show that we desperately need more accurate and less biased ways of detecting dementia swiftly in clinic.”
A limitation of the study was that other brief cognitive assessments in clinical use were not examined.
Reference: http://cp.neurology.org/lookup/doi/10.1212/CPJ.0000000000000566
SOURCE: American Academy of Neurology
The 3 tests examined in the study were the Mini-Mental State Examination, the Memory Impairment Screen, and Animal Naming.
“Our study found that all 3 tests often give incorrect results that may wrongly conclude that a person does or does not have dementia,” said David Llewellyn, PhD, University of Exeter Medical School, Exeter, United Kingdom. “Each test has a different pattern of biases, so people are more likely to be misclassified by one test than another depending on factors such as their age, education and ethnicity.”
For the study, 824 people in the United States with an average age of 82 years were given full dementia assessments that included a physical exam, genetic testing for the APOE gene, psychological testing, and comprehensive memory and thinking tests. The researchers divided participants into 2 groups based on the comprehensive dementia diagnosis. Of the participants, 35% had dementia and 65% did not.
Participants took each of the 3 quick tests and researchers found that 36% of participants were wrongly classified by at least 1 of the tests, but only 2% were misclassified by all 3 tests. Overall rates of misclassification by these tests individually ranged from 14% to 21%, including both false-positive and false-negative results.
Researchers also found that different tests had different biases. One test had an education bias, in that those with higher education were more likely to be misclassified as not having dementia and those with lower education were more likely to be misclassified as having dementia. Older age, having an ethnic background other than white, and living in a nursing home also led to misclassification. Across all tests, a lack of information on whether a family member or friend rated the participant’s memory to be poor resulted in an increased risk of misclassification.
“Failing to detect dementia can delay access to treatment and support, whereas false alarms lead to unnecessary investigations, causing pressure on health care systems,” said Dr. Llewellyn. “Identifying people with dementia in a timely fashion is important, particularly as new methods of treatment come on-stream. Our findings show that we desperately need more accurate and less biased ways of detecting dementia swiftly in clinic.”
A limitation of the study was that other brief cognitive assessments in clinical use were not examined.
Reference: http://cp.neurology.org/lookup/doi/10.1212/CPJ.0000000000000566
SOURCE: American Academy of Neurology
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