Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Asahigawaso Research Institute, Asahigawaso Medical Welfare Center, Okayama, Japan.
J Intellect Disabil Res. 2020 Dec;64(12):970-979. doi: 10.1111/jir.12788. Epub 2020 Oct 5.
Dementia in people with intellectual disabilities (IDs) is difficult to detect because of preexisting cognitive deficits. An effective screening method is required. The Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID) was developed as an observer rating tool to screen dementia in people with ID. The aim of this study was to verify the screening accuracy of the DSQIID for Japanese people with ID.
Four-hundred ninety-three subjects with ID participated in this study. Caregivers who had observed the participants for more than 2 years scored the Japanese version of the DSQIID (DSQIID-J) of the participants. Three doctors examined participants directly and diagnosed dementia using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. To identify the key screening items that predict dementia, the specificities of a single and pairs of items with 100% sensitivity were evaluated relative to the dementia diagnosis.
Of 493 participants, 34 were people with Down syndrome (DS), and 459 were people without DS. Seventeen participants were diagnosed with dementia. The suitable cut-off score of the DSQIID-J was 10/11 (sensitivity 100% and specificity 96.8%) for screening dementia. The inter-rater reliability, test-retest reliability and internal consistency of the DSQIID-J were excellent. Regarding key items, there was no single item with 100% sensitivity, and the best two-item combination was the pair of 'Cannot dress without help' and 'Walks slower' (sensitivity 100% and specificity 93.5%).
We identified several important question items of the DSQIID-J related to the diagnosis of dementia in people with ID. The DSQIID-J is a useful screening tool for dementia in adults with ID.
由于智力障碍(ID)患者存在先前的认知缺陷,因此难以发现痴呆症。需要一种有效的筛查方法。《智力障碍个体痴呆筛查问卷》(DSQIID)是一种观察性评定工具,用于筛查 ID 患者的痴呆症。本研究旨在验证 DSQIID 对日本 ID 患者的筛查准确性。
本研究纳入 493 名 ID 患者。观察患者超过 2 年的护理人员对患者的日本版 DSQIID(DSQIID-J)进行评分。三位医生直接检查患者,并根据《精神障碍诊断与统计手册》第五版标准诊断痴呆症。为了确定预测痴呆症的关键筛查项目,评估了具有 100%敏感性的单个和配对项目的特异性,以与痴呆症诊断相对照。
在 493 名参与者中,34 名为唐氏综合征(DS)患者,459 名为非 DS 患者。17 名患者被诊断为痴呆症。DSQIID-J 的合适截断值为 10/11(敏感性为 100%,特异性为 96.8%),用于筛查痴呆症。DSQIID-J 的组内信度、重测信度和内部一致性均很好。在关键项目方面,没有任何一个项目的敏感性达到 100%,最佳的两项组合是“无法在没有帮助的情况下穿衣”和“行走更慢”(敏感性为 100%,特异性为 93.5%)。
我们确定了与 ID 患者痴呆症诊断相关的 DSQIID-J 的几个重要问题项目。DSQIID-J 是 ID 成人痴呆症的有用筛查工具。