Validez Clínica de la Dementia Rating Scale -2 en una muestra de pacientes con Deterioro Cognitivo Leve y Enfermedad de Alzheimer

[EN] Increasing numbers of the elderly suffer from dementia (of which Alzheimer’s Disease – AD – is the most common form). There are many different neuropsychological tests used to assess dementia. The Dementia Rating Scale 2 (DRS- 2) has been used successfully to identify healthy patients versus patients with decreased cognitive capability. Objectives: To obtain clinical data for the DRS-2 for the Spanish population aged 60 plus and to analyse the influence of age, gender and education within the distinct subscales of the test and analyse the validity of the test to differentiate between Alzheimer Disease (AD), Mild Cognitive Impairment (MCI) and the normal elderly population (CG). Method: The clinical trial of the DRS-2 was conducted on patients with dementia or Alzheimer’s taken from a pool of 422 subjects (aged between 60 and 89 years old) selected from the Association of Relatives of Alzheimer’s Sufferers of Salamanca (AFA) of which 168 were males and 254 were females. The participants were further divided into three groups based on the number of years of education they had received: 28 had received less than 7 years of education, 326 had received between 8 and 10 years of education and 68 had received more than 10 years of education. The participants were divided into three groups: 93 patients with Mild Cognitive Impairment (MCI – diagnosed in accordance with the criterion proposed by Peterson et al., 1999), 169 patients with Alzheimer’s Disease incipient (AD – diagnosed in accordance with the NINCDS- ADRDA criterion, McKhann, Drachman, Folstein, Katzman, Price y Stadlan, 1984) and a Control Group (CG) with 160 subjects with no cognitive deterioration. The protocol followed in this study consisted of two parts. The first part consisted of the tests: A Test, WAIS-R Digit Symbol Coding Test, WAIS-R Sequential and Nonsequential digit Span Test, Hopkin’s Revised Verbal Learning test, Semantic Fluency Test (animals), Token Test, Trail Making Test A, Stroop test, WAIS Similarity Test, WAIS Comprehension Test, FAS, Test Rey Complex Figure Test. The second part consisted of the tests: Mini Mental State Examination (MMSE), the Clock Drawing Test (CDT), DRS-2, Yesavage Depression Scale (GDS) and the Interview for Deterioration of Daily living in Dementia (IDDD). Results: The study shows a correlation between age and all of the subscales of the DRS-2 test as well as between age and the overall score of the DRS-2 test. In addition, there is also a correlation between years of education received and all of the subscales of the DRS-2 test. There is no significant correlation between gender and any of the variables. A ROC curve was produced using the DRS-2 scores (adjusted and unadjusted) MMSE and CDT and the CG and MCI group with the aim of finding the cut-off score (optimum relationship between sensitivity and specificity) and the DRS-2 adjusted was the best test at distinguishing between participants with MCI from the CG, with an ABC of .981 (Cut-off = 129, S = 93%, SP = 96%). A ROC curve was also produced using the results from the tests and the participants AD and CG, with an ABC of ABC of .998 (Cut-off = 121, S = 92%, SP =91%). From the results obtained it is clear that the adjusted DRS-2 has the highest sensitivity and specificity. As a result, DRS-2 adjusted permits a reliable diagnosis for patients of MCI and AD. Conclusion: The DRS-2 is an extremely useful test for neuropsychological assessment which facilitates the assessment of patients with dementia or suspected of having dementia. In addition, it allows the measurement of the degree of neuropsychological affect caused by the pathology in the patient, bearing in mind their age and educational background. Thus, this test can distinguish subjects without cognitive decline of subjects with cognitive impairment, and also allows to distinguish between patients with MCI and AD patients.

Author

• Alves, Cândida Helena Lopes

• Tesis y disertaciones académicas
• Universidad de Salamanca (España)
• Tesis Doctoral
• Academic dissertations
• Enfermedad de Alzheimer
• Alzheimer's disease
• Demencia
• Dementia

Identifier

hdl:10366/110756

OAI identifier oai:identifier

oai:gredos.usal.es:10366/110756