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Post-Mortem diagnosis of dementia by informant interview

Diagnóstico postmortem de demência mediante entrevista com informante

Abstract

The diagnosis of normal cognition or dementia in the Brazilian Brain Bank of the Aging Brain Study Group (BBBABSG) has relied on postmortem interview with an informant.

Objectives:

To ascertain the sensitivity and specificity of postmortem diagnosis based on informant interview compared against the diagnosis established at a memory clinic.

Methods:

A prospective study was conducted at the BBBABSG and at the Reference Center for Cognitive Disorders (RCCD), a specialized memory clinic of the Hospital das Clínicas, University of São Paulo Medical School. Control subjects and cognitively impaired subjects were referred from the Hospital das Clínicas to the RCCD where subjects and their informants were assessed. The same informant was then interviewed at the BBBABSG. Specialists' panel consensus, in each group, determined the final diagnosis of the case, blind to other center's diagnosis. Data was compared for frequency of diagnostic equivalence. For this study, the diagnosis established at the RCCD was accepted as the gold standard. Sensitivity and specificity were computed.

Results:

Ninety individuals were included, 45 with dementia and 45 without dementia (26 cognitively normal and 19 cognitively impaired but non-demented). The informant interview at the BBBABSG had a sensitivity of 86.6% and specificity of 84.4% for the diagnosis of dementia, and a sensitivity of 65.3% and specificity of 93.7% for the diagnosis of normal cognition.

Conclusions:

The informant interview used at the BBBABSG has a high specificity and sensitivity for the diagnosis of dementia as well as a high specificity for the diagnosis of normal cognition.

Key words:
brain bank; postmortem diagnosis; dementia; aging; informant-interview.

Resumo

Os diagnósticos de cognição normal ou de demência dos casos do Banco de Encéfalos do Grupo Brasileiro de Estudos de Envelhecimento Cerebral tem se baseado em entrevista realizada com informante.

Objetivos:

Verificar a sensibilidade e especificidade do diagnóstico postmortem baseado em entrevista com informante quando comparado com o diagnóstico estabelecido em clínica de memória.

Métodos:

Um estudo prospectivo foi conduzido no Banco de Encéfalos e no Centro de Referência em Distúrbios Cognitivos (CEREDIC), uma clínica especializada do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Indivíduos controle e cognitivamente comprometidos foram encaminhados pelo Hospital das Clínicas ao CEREDIC onde os indivíduos foram avaliados e os informantes entrevistados. O mesmo informante foi então entrevistado pela equipe do Banco de Encéfalos. Consenso em painel de especialistas, em cada centro, estabeleceu o diagnóstico final em cada caso, sem conhecimento do diagnóstico do outro centro. Os diagnósticos foram comparados, admitindo-se o diagnóstico estabelecido no CEREDIC como padrão-ouro. Sensibilidade e especificidade foram calculadas.

Resultados:

90 indivíduos foram incluídos, 45 com demência e 45 não-dementes (26 cognitivamente normais e 19 com comprometimento cognitivo sem demência). A entrevista realizada no Banco de Encéfalos teve sensibilidade de 86,6% e especificidade de 84,4% para o diagnóstico de demência e sensibilidade de 65,3% e especificidade de 93,7% para o diagnóstico de cognição normal.

Conclusões:

A entrevista com informante realizada no Banco de Encéfalos do Grupo Brasileiro de Estudos de Envelhecimento Cerebral tem altas sensibilidade e especificidade para o diagnóstico de demência e alta especificidade para o diagnóstico de cognição normal.

Palavras-chave:
banco de encéfalos; diagnóstico postmortem; demência; envelhecimento; entrevista com informante.

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Publication Dates

  • Publication in this collection
    Apr-Jun 2010

History

  • Received
    13 Jan 2009
  • Accepted
    20 Mar 2010
Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento R. Vergueiro, 1353 sl.1404 - Ed. Top Towers Offices, Torre Norte, São Paulo, SP, Brazil, CEP 04101-000, Tel.: +55 11 5084-9463 | +55 11 5083-3876 - São Paulo - SP - Brazil
E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br