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Ageing in Brazil
- Author:
- RAMOS Luiz R.
- Journal article citation:
- Ageing International, 25(4), Spring 2000, pp.58-64.
- Publisher:
- Springer
- Place of publication:
- New York
Brazil is experiencing a rapid and intense demographic transition. The industrialisation that started in the 1940's brought on fast urbanisation. The country is characterised by considerable socioeconomic inequalities and significant regional variations in the demographics of ageing. The pre-eminent role of the family as caregiver is in jeopardy even as more people are living to older ages seeking family care. Health and social services are grossly inadequate. The Ministry of Health launched the first National Health Policy for the elderly with functional capacity as a keyword. Manpower training in the area of gerontology is very little. All these necessitate an urgent focus on the needs of the fast growing elderly population.
A population based study on the intra and inter-rater reliability of the clock drawing test in Brazil: the Bambuí Health and Ageing Study
- Authors:
- FUZIKAWA Cintia, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(5), May 2003, pp.450-456.
- Publisher:
- Wiley
Reliability should be considered when selecting a scoring system since it influences validity. CDT reliability has rarely been assessed in population based studies and in developing countries. The aim of the present study was to determine intra and inter-rater reliabilities of the CDT scored by the Shulman method, in elderly with very low formal educational level from Brazil. CDTs performed by a random sample of 202 subjects of a population-based cohort of elderly were scored on two occasions by the same rater and by two independent raters. Reliability was measured using the kappa statistic, weighted kappa and the intraclass correlation coefficient. Data were stratified according to gender, age and schooling level. Intra and inter-rater reliabilities were excellent when CDTs were classified as normal (scores 4 or 5) or abnormal (scores 0 to 3) (kappa = 0.99 and 0.94, respectively) and were in the good to excellent range when scored from 0 to 5 (kappa = 0.88 and 0.74, respectively). Difficulties in distinguishing between scores 4 and 5, and a low proportion of score 1 tests were found. The CDT scored by the Shulman method appears to have good to excellent reliability in an elderly population with very low formal educational level. However, difficulties in distinguishing between scores 4 and 5, and a low proportion of score 1 tests suggest these scores may not be totally adequate for this population. Further studies are necessary to determine the consistency of our results in similar populations.