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P1‐062: Detection of cognitive impairment in the elderly by general practitioners in Brazil
Author(s) -
Jacinto Alessandro F.,
Nitrini Ricardo,
Brucki Sonia M.D.,
Porto Claudia S.
Publication year - 2009
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2009.04.066
Subject(s) - dementia , medicine , anamnesis , cognitive impairment , clinical dementia rating , cognition , verbal fluency test , neuropsychology , physical therapy , psychiatry , disease
Background: There is a need for novel assessment methods in the determination of clinically meaningful change in Alzheimer Disease (AD). The Clinical Meaningfulness in Alzheimer Disease Treatment (CLIMAT) scale is a newly developed instrument that targets two constructs: severity, defined as the magnitude of AD symptoms, and social impact, defined as the importance patients and caregivers attribute to AD symptoms. If social impact can be established as a construct distinct from disease severity, it could aid in weighting treatment benefit in AD. This cross-sectional study investigated the relationship between CLIMAT severity and social impact ratings. Methods: The CLIMAT covers social, functional, cognitive and behavioral items in separate patient and informant interviews. In the patient interview, items were rated for severity and impact on self (I-Pat-self). In the informant interview items were rated for severity, impact on patient reported by informant (I-Inf-Pat) and impact on self reported by informant (IInf-self). Domain and total scores were computed for all ratings. Pearson correlation coefficients were used to assess the relation between severity and impact ratings. Collinearity was defined as r>.70. Results: Participants were n1⁄423 community-dwelling ‘probable’ AD subjects (MMSE M1⁄419.9, SD1⁄47.3, range 11-28), with spousal informants. For patient ratings, the correlation between total severity and total I-Pat-self ratings was r1⁄4.54. Correlations between domain severity and domain I-Pat-self ratings were r<.50 for the social, functional and cognitive, r1⁄4.74 for the behavioral domain. For informant ratings, the correlation between total severity and total I-Inf-Pat was r1⁄4.50, and correlations between domain ratings r<.50 for social, functional and cognitive, r1⁄4.72 for the behavioral domain. The correlation between total severity and I-Inf-self was r1⁄4.78, with all correlations between domain ratings r>.70. Conclusions: Disease severity and social impact were hypothesized as two distinct constructs in AD symptom assessment. CLIMAT data largely support this hypothesis. The determination of the social impact on patients appears to add a valid dimension in the assessment of social, functional and cognitive symptoms, and in turn hold promise in the measurement of clinically meaningful response to treatment. The overlap between severity and social impact in the behavioral domain warrants further study.