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Smell identification test as an indicator for cognitive impairment in Alzheimer's disease
- Authors:
- SUZYKI Y., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 19(8), August 2004, pp.727-733.
- Publisher:
- Wiley
The aim of the present study was to assess olfactory dysfunction in patients with Alzheimer's disease (AD) and to compare utility of the olfactory tests as possible clinical markers. Two olfactory identification tests (The Cross-Cultural Smell Identification Test [CC-SIT] and the Picture-based Smell Identification Test [P-SIT]) and the Mini Mental State Examination (MMSE) were administered to patients with AD and age-matched controls. Apolipoprotein E (Apo E) genotypes of patients with AD were identified. Patients with AD had significantly lower olfactory identification scores than age-matched non-demented elderly subjects in both olfactory assessments. In the AD group, the coefficient of correlation between the MMSE scores and the P-SIT scores was higher than that between the MMSE scores and the CC-SIT scores. Receiver operating curve (ROC) analyses for both tests indicated that the P-SIT discriminated AD patients from controls more reliably than did the CC-SIT. Within AD patients, those who were carrying one or two ApoE 4 alleles had a higher coefficient of correlation between the MMSE scores and the P-SIT scores than patients without the ApoE 4 allele. The results suggest that a short and simple non-lexical olfactory identification test can be useful as a clinical marker of AD appropriate for Japanese elderly population
Screening for late life depression: cut-off scores for the Geriatric Depression Scale and the Cornell Scale for Depression in Dementia among Japanese subjects
- Authors:
- SCHREINER Andrea S., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(6), June 2003, pp.498-505.
- Publisher:
- Wiley
Proper screening of depression among older adults depends on accurate cut-off scores. Recent articles have recommended the Geriatric Depression Scale (GDS) and the Cornell Scale for Depression in Dementia (CSDD) for this screening. However, there has been no investigation of the sensitivity and specificity of either scale using Japanese subjects. The purpose of the present study was to identify appropriate GDS and CSDD cut-offs for Japanese older adults. The GDS and the CSDD were interview-administered to nondepressed Japanese older adults (n = 74) and to Japanese older adults with a SCID-IV diagnosis of major or minor depression (n = 37). Depressed subjects were also administered the Hamilton Depression Rating Scale (HDRS). Data were also collected on demographic variables, mental status, health status, and medication use. ROC curve analysis identified a cut-off score of 6 for the GDS which had a sensitivity of 0.973, a specificity of 0.959, a False Positive Rate (FPR) of 0.894, and a False Negative Rate (FNR) of 0. A cutoff score of 5 for the CSDD yielded a sensitivity of 1, a specificity of 0.919, a FPR of 0.942, and a FNR of 0. Comparisons indicate current HDRS cut-offs may overlook subthreshold depression. The GDS cut-off score identified among Japanese subjects was the same as that reported for Western subjects. Due to the substantial prevalence of psychiatric disorders found in false-negative subjects, the above cut-off scores were chosen to optimize the potential for true positives. These scores are recommended for alerting physicians and other caregivers as to when more intensive depression evaluation is needed.
Delusions of Japanese patients with Alzheimer's disease
- Authors:
- IKEDA Manabu, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(6), June 2003, pp.527-532.
- Publisher:
- Wiley
Delusions constitute one of the most prominent psychiatric complications in Alzheimer's disease (AD). However, there is little consensus of the prevalence and associated factors for delusions in AD. 112 consecutive patients with AD were recruited over a one year period and administered the Neuropsychiatric Inventory (NPI). Delusions were present in 53 patients (47.3%). Delusions of theft were the most common type of delusion (75.5% of patients with delusions), followed by misidentification delusions and delusions of suspicion. More hallucination, agitation, and female gender were found in the delusions group. The authors found a high frequency of delusions, particularly of delusions of theft and suggested that gender was associated with the expression of delusions in Japanese patients with AD.