Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-10-31T22:20:40.869Z Has data issue: false hasContentIssue false

The applicability of the cognitive abilities screening instrument–short (CASI-S) in primary care in Brazil

Published online by Cambridge University Press:  29 April 2015

Glaucia Martins de Oliveira
Affiliation:
School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
Juliana Emy Yokomizo
Affiliation:
Old Age Research Group (PROTER), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Laís dos Santos Vinholi e Silva
Affiliation:
School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
Laura Ferreira Saran
Affiliation:
Old Age Research Group (PROTER), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Cássio M. C. Bottino
Affiliation:
Old Age Research Group (PROTER), Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Mônica Sanches Yassuda*
Affiliation:
School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
*
Correspondence should be addressed to: Dra. Mônica Sanches Yassuda, Av. Arlindo Bettio, 1000, Prédio I-1, sala 322-J. Ermelino Matarazzo, São Paulo, SP, 03828-000, Brazil. Phone: 551130911027. Email: yassuda@usp.br.

Abstract

Background:

The Cognitive Abilities Screening Instrument – Short (CASI-S) is a brief cognitive screening test. However, there is limited information regarding its applicability in primary care.

Objectives:

To ascertain whether the CASI-S differentiates between dementia patients and normal controls in primary care; to examine its correlation with other cognitive instruments, to analyze its internal consistency, test-retest stability, and diagnostic accuracy.

Methods:

In a case-control study, carried out at two Primary Care Units (PCUs) in the eastern region of the city of São Paulo, 47 older adults were diagnosed with dementia according to DSM-IV criteria (mean age = 76.81 ± 7.03 years), and 55 were classified as normal controls (mean age = 72.78 ± 7.37 years), by a multidisciplinary panel which had access to results from a comprehensive cognitive battery and the patients’ health data. The present analyses included results from the Mini-Mental State Examination (MMSE). The CASI-S was not used to determine diagnostic status.

Results:

The CASI-S was easily applied in the primary care setting. There was a significant performance difference (p < 0.001) between dementia patients (15.57 ± 7.40) and normal controls (26.67 ± 3.52) on the CASI-S. CASI-S scores correlated with age (ρ = −0.410, p < 0.001), educational level (ρ = 0.373, p < 0.001), and MMSE score (ρ = 0.793, p < 0.001). The internal consistency of the CASI-S was high (α = 0.848) and the correlation between test and retest was 0.688, suggesting adequate temporal stability. In the ROC curve analyses, scores of 22/23 generated an area under the curve of 0.907, with sensitivity of 93% and specificity of 81%.

Conclusions:

The CASI-S can be useful for dementia screening in primary care in Brazil.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aprahamian, I., Martinelli, J. E., Neri, A. L. and Yassuda, M. S. (2010). The accuracy of the clock drawing test compared to that of standard screening tests for Alzheimer's disease: results from a study of Brazilian elderly with heterogeneous educational backgrounds. Internacional Psychogeriatrics, 1, 6471. doi: 10.1017/S1041610209991141.CrossRefGoogle Scholar
Associação Brasileira dos Institutos de Pesquisa de Mercado (2008). Abipeme. Critério de classificação socioeconômica – Brasil (CCSEB).Google Scholar
Bottino, C. M. C., Almeida, O. P., Tamai, S., Forlenza, O. V., Scalco, M. Z. and Carvalho, I. A. M. (1999). Entrevista estruturada para diagnóstico de transtornos mentais em idosos – CAMDEX (translated and adapted on behalf of the editors). São Paulo: Cambridge University Press.Google Scholar
Brucki, S. M. D., Nitrini, R., Caramelli, P., Bertolucci, P. H. F. and Okamoto, I. H. (2003). Suggestions for the use of the Mini -Mental State Exam in Brazil. Arquivos de Neuro-Psiquiatria, 61, 777781. doi: 10.1590/S0004-282×2003000500014.CrossRefGoogle Scholar
Chaves, M. L. F. et al. (2011). Alzheimer's disease: cognitive, behavioral and funtional assessment. Dementia & Neuropsychologia, 5, 2133.Google Scholar
Damasceno, A. et al. (2005). Validation of the Brazilain version of the mini-test CASI-S. Arquivos Neuro-Psiquiatria, 63, 416421. doi: 10.1590/S0004-282×2005000300010.Google Scholar
Folquitto, J. C. et al. (2007). The bayer: activities of daily living scale (B-ADL) in the differentiation between mild to moderate dementia and normal aging. Revista Brasileira de Psiquiatria, 29, 350353. doi: 10.1590/S1516-44462006005000037.CrossRefGoogle ScholarPubMed
Frota, N. A. F. et al. (2011). Group recommendations in Alzheimer's disease and vascular dementia of Brazilian academy of neurology. Criteria for the diagnosis of Alzheimer's disease. Dementia & Neuropsychologia, 5, 146152.Google Scholar
Gibbons, L. E. et al. (2009). Japanese–English language equivalence of the cognitive abilities screening instrument among Japanese–Americans. Internacional Psychogeriatrics, 21, 129137.CrossRefGoogle ScholarPubMed
Graves, A. B., Larson, E. B., Kukull, W. A., White, L. R. and Teng, E. L. (1993). Screening for dementia in the community in cross-national studies: comparison between the cognitive abilities screening instrument and the Mini-Mental State Examination. In Corain, B., Iqbal, K., Nicolini, M., Winblad, B., Wisniewski, H. and Zatta, P. (eds.), Alzheimer's Disease: Advances in Clinical and Basic Research (pp. 113119). New York: Wiley.Google Scholar
Jacinto, A. F., Nitrini, R., Brucki, S. M., Porto, C. S., de Mello Franco, F. G. and de Albuquerque Citero, V. (2013). The pros and cons of early diagnosis of dementia. The British Journal of General Practice, 63, 463. doi: 10.3399/bjgp13×671551.Google Scholar
Jorm, A. F., Masaki, K. H., Petrovitch, H., Ross, G. W. and White, L. R. (2005). Cognitive deficits 3 to 6 years before dementia onset in a population sample: the Honolulu–Asia aging study. Journal of the American Geriatrics Society, 53, 452455.Google Scholar
Lin, K., Wang, P., Liu, H. and Teng, E. (2012). Cognitive abilities screening instrument, Chinese version 2.0 (CASI C-2.0): administration and clinical application. Actua Neurologia Taiwanica, 21, 180189.Google Scholar
Liu, H.-C.a. et al. (2002). Performance on the cognitive abilities screening instrument at different stages of Alzheimer's disease. Dementia Geriatrics Cognitive Disordes, 13, 244248.Google Scholar
McCurry, S. M. et al. (1999). The cognitive abilities screening instrument (CASI): data from a cohort of 2524 cognitively intact elderly. International Journal of Geriatric Psychiatry, 14, 882888.3.0.CO;2-D>CrossRefGoogle ScholarPubMed
McKhann, G. M. et al. (2011). The diagnosis of dementia due to Alzheimer's disease: recommendations from the national institute on aging-Alzheimer's association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dementia, 7, 263269. doi: 10.1016/j.jalz.2011.03.005.Google Scholar
Rezende, G. P., Cecato, J. and Martinelli, J. E. (2013). Cognitive abilities screening instrument-short form, Mini-Mental State Examination and functional activities questionnaire in the illiterate elderly. Dementia & Neuropsychologia, 7, 410415.CrossRefGoogle ScholarPubMed
Sanchez, M. A. dos S. and Lourenço, R. A. (2009). Informant questionnaire on cognitive decline in the elderly (IQCODE): adaptação transcultural para uso no Brasil. Cadernos de Saúde Pública, 25, 14551465. doi: 10.1590/S0102-311×2009000700003.Google Scholar
Teng, E. L. et al. (1994). The cognitive abilities screening instrument (CASI): a practical test for cross-cultural epidemiological studies of dementia. Internacional Psychogeriatrics, 6, 4558.Google Scholar