The epidemiology of dementia: GMS-AGECAT studies of prevalence and incidence, including studies in progress

SummaryThe paper reviews the main studies using the AGECAT computerised diagnostic system for the diagnosis of dementia in community studies of prevalence and incidence. It is suggested that variations in reported rates may be due to the use of unstandardised methods, and the paper reviews the oldest established standardised interview: the Geriatric Mental State. The AGECAT system is outlined, and the studies of its diagnostic validity indicated. Arguments are presented against the inclusion of cognitive tests in such instruments, and for the critical evaluation of the concepts of mild dementia. The use of AGECAT in the US/UK Diagnostic Project, and in the Liverpool study of Continuing Health in the Community is described. In addition, preliminary information is given on the Liverpool ALPHA study, the MRC UK multi-centre study, studies organised by the Pan American Health Organisation (Argentina, Chile, Cuba), the Eurodem concerted action (based in Rotterdam) and the WHO multi-site studies. Individual studies in Spain and Portugal are also discussed.

[1]  C. Brayne,et al.  An Epidemiological Study of Dementia in a Rural Population of Elderly Women , 1989, British Journal of Psychiatry.

[2]  Michael E. Dewey,et al.  Computerized psychiatric diagnosis in the elderly: AGECAT , 1986 .

[3]  J. Lindesay,et al.  The Guy's/Age Concern Survey , 1989, British Journal of Psychiatry.

[4]  G. Bråne,et al.  A new rating scale for dementia syndromes. , 1982, Archives of gerontology and geriatrics.

[5]  S. Benbow.  The Role of Electroconvulsive Therapy in the Treatment of Depressive Illness in Old Age , 1989, British Journal of Psychiatry.

[6]  C. Berr.  [Epidemiology of Alzheimer's disease]. , 1999, Servir.

[7]  M. Dewey,et al.  The relationship between mortality and mental disorder: Evidence from the Liverpool longitudinal study , 1988 .

[8]  J. Copeland,et al.  Is There More Dementia, Depression and Neurosis in New York? , 1987, British Journal of Psychiatry.

[9]  J. Copeland,et al.  Dementia and depression in elderly persons: Agecat compared with dsm III and pervasive illness , 1990 .

[10]  J. Fleiss,et al.  The psychiatric status schedule. A technique for evaluating psychopathology and impairment in role functioning. , 1970, Archives of general psychiatry.

[11]  P. Duncan-Jones,et al.  The reliability of the Geriatric Mental State Examination , 1983, Acta psychiatrica Scandinavica.

[12]  J. Copeland,et al.  Is there more dementia, depression and neurosis in New York? A comparative study of the elderly in New York and London using the computer diagonosis AGECAT , 1988 .

[13]  G. Livingston,et al.  The Gospel Oak Study: prevalence rates of dementia, depression and activity limitation among elderly residents in Inner London , 1990, Psychological Medicine.

[14]  J. Copeland,et al.  A standardized interview for the elderly (GMS): Reliability studies comparing the Dutch language version with the original , 1991 .

[15]  J. Copeland,et al.  Range of Mental Illness Among the Elderly in the Community , 1987, British Journal of Psychiatry.

[16]  J. Copeland,et al.  Range of Mental Illness Among the Elderly in the Community , 1987, British Journal of Psychiatry.

[17]  F. Huppert,et al.  CAMDEX: A Standardised Instrument for the Diagnosis of Mental Disorder in the Elderly with Special Reference to the Early Detection of Dementia , 1986, British Journal of Psychiatry.

[18]  J. Copeland,et al.  A computerized psychiatric diagnostic system and case nomenclature for elderly subjects: GMS and AGECAT , 1986, Psychological Medicine.

[19]  D. Kay,et al.  Prevalence rates of dementia in an ageing population: are low rates due to the use of insensitive instruments? , 1990, Age and ageing.

[20]  B. Gurland.  The Mind and mood of aging : mental health problems of the community elderly in New York and London , 1984 .

[21]  K. Morgan,et al.  Mental Health and Psychological Well-being Among the Old and the Very Old Living at Home , 1987, British Journal of Psychiatry.

[22]  R. Lévy,et al.  Comparison of the Sensitivity of Three Instruments for the Detection of Cognitive Decline in Elderly Living at Home , 1987, British Journal of Psychiatry.

[23]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[24]  M J Kelleher,et al.  A semi-structured clinical interview for the assessment of diagnosis and mental state in the elderly: the Geriatric Mental State Schedule: I. Development and reliability , 1976, Psychological Medicine.

[25]  M. Folstein,et al.  Clinical diagnosis of Alzheimer's disease , 1984, Neurology.

[26]  B. Reiss,et al.  The prevalence of dementia as measured by the Cambridge Mental Disorders of the Elderly Examination , 1989, Acta psychiatrica Scandinavica.

[27]  M. Clarke,et al.  Cognitive impairment in the elderly--a community survey. , 1986, Age and ageing.

[28]  J. Copeland,et al.  The Geriatric Mental State (GMS) used in the community: replication studies of the computerized diagnosis AGECAT , 1988, Psychological Medicine.