Stewart M, McDowell I, Hill G, Aylesworth R
Department of Epidemiology & Community Medicine, University of Ottawa, Ontario, Canada.
Int Psychogeriatr. 2001;13 Supp 1:99-106. doi: 10.1017/s1041610202008037.
There was a five-year delay between the two waves of the Canadian Study of Health and Aging during which 2,982 participants died. Their cognitive status before death should be taken into account in estimating the incidence of dementia in the cohort. Information concerning antemortem cognitive status was available from death certificates and from an interview with a close relative of the decedent at the CSHA-2 follow-up. The interview included a direct question on whether the person had been diagnosed with dementia and questions covering cognitive signs and symptoms from which we formed an algorithm to predict probability of dementia. These sources of information were validated using a small sample of study participants who died within five months of undergoing the CSHA clinical examination. Sensitivity of the death certificate and the question regarding diagnosis of dementia was low (33% and 44%), although their specificity was very high. Accordingly, we combined these with the predictive algorithm to form an overall estimate of the probability of antemortem dementia. This raised the sensitivity to 82% (specificity 93%).
加拿大健康与老龄化研究的两波调查之间相隔五年，在此期间有2982名参与者死亡。在估计该队列中痴呆症的发病率时，应考虑他们死亡前的认知状态。有关死前认知状态的信息可从死亡证明以及在加拿大健康与老龄化研究第二轮随访时对死者近亲的访谈中获得。访谈包括一个关于该人是否被诊断患有痴呆症的直接问题，以及涵盖认知体征和症状的问题，我们据此形成了一个预测痴呆症概率的算法。这些信息来源通过对一小部分在接受加拿大健康与老龄化研究临床检查后五个月内死亡的研究参与者进行验证。死亡证明以及关于痴呆症诊断问题的敏感性较低（分别为33%和44%），尽管其特异性非常高。因此，我们将这些与预测算法相结合，以形成对死前痴呆症概率的总体估计。这将敏感性提高到了82%（特异性为93%）。
