Skip navigation
Skip navigation

Evaluation of a research diagnostic algorithm for DSM-5 neurocognitive disorders in a population-based cohort of older adults

Eramudugolla, Ranmalee; Mortby, Moyra; Sachdev, Perminder Singh; Meslin, Chantal; Kumar, Rajeev; Anstey, Kaarin

Description

There is little information on the application and impact of revised criteria for diagnosing dementia and mild cognitive impairment (MCI), now termed major and mild neurocognitive disorders (NCDs) in the DSM-5. We evaluate a psychometric algorithm for diagnosing DSM-5 NCDs in a community-dwelling sample, and characterize the neuropsychological and functional profile of expert-diagnosed DSM-5 NCDs relative to DSM-IV dementia and International Working Group criteria for MCI.Methods A...[Show more]

dc.contributor.authorEramudugolla, Ranmalee
dc.contributor.authorMortby, Moyra
dc.contributor.authorSachdev, Perminder Singh
dc.contributor.authorMeslin, Chantal
dc.contributor.authorKumar, Rajeev
dc.contributor.authorAnstey, Kaarin
dc.date.accessioned2021-06-16T23:24:27Z
dc.date.available2021-06-16T23:24:27Z
dc.identifier.issn1758-9193
dc.identifier.urihttp://hdl.handle.net/1885/237750
dc.description.abstractThere is little information on the application and impact of revised criteria for diagnosing dementia and mild cognitive impairment (MCI), now termed major and mild neurocognitive disorders (NCDs) in the DSM-5. We evaluate a psychometric algorithm for diagnosing DSM-5 NCDs in a community-dwelling sample, and characterize the neuropsychological and functional profile of expert-diagnosed DSM-5 NCDs relative to DSM-IV dementia and International Working Group criteria for MCI.Methods A population-based sample of 1644 adults aged 72–78 years was assessed. Algorithmic diagnostic criteria used detailed neuropsychological data, medical history, longitudinal cognitive performance, and informant interview. Those meeting all criteria for at least one diagnosis had data reviewed by a neurologist (expert diagnosis) who achieved consensus with a psychiatrist for complex cases. Results The algorithm accurately classified DSM-5 major NCD (area under the curve (AUC) = 0.95, 95% confidence interval (CI) 0.92–0.97), DSM-IV dementia (AUC = 0.91, 95% CI 0.85–0.97), DSM-5 mild NCD (AUC = 0.75, 95% CI 0.70–0.80), and MCI (AUC = 0.76, 95% CI 0.72–0.81) when compared to expert diagnosis. Expert diagnosis of dementia using DSM-5 criteria overlapped with 90% of DSM-IV dementia cases, but resulted in a 127% increase in diagnosis relative to DSM-IV. Additional cases had less severe memory, language impairment, and instrumental activities of daily living (IADL) impairments compared to cases meeting DSM-IV criteria for dementia. DSM-5 mild NCD overlapped with 83% of MCI cases and resulted in a 19% increase in diagnosis. These additional cases had a subtly different neurocognitive profile to MCI cases, including poorer social cognition. Conclusion DSM-5 NCD criteria can be operationalized in a psychometric algorithm in a population setting. Expert diagnosis using DSM-5 NCD criteria captured most cases with DSM-IV dementia and MCI in our sample, but included many additional cases suggesting that DSM-5 criteria are broader in their categorization.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherBioMed Central
dc.rights© 2017 The Authors
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceAlzheimer's Research and Therapy
dc.source.urihttps://alzres.biomedcentral.com/articles/10.1186/s13195-017-0246-x
dc.subjectNeurocognitive disorders
dc.subjectdementia
dc.subjectMild cognitive impairment
dc.subjectDiagnostic algorithm
dc.subjectLongitudinal
dc.subjectCognitive aging
dc.subjectDSM-5
dc.titleEvaluation of a research diagnostic algorithm for DSM-5 neurocognitive disorders in a population-based cohort of older adults
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume9
dc.date.issued2017
local.identifier.absfor170199 - Psychology not elsewhere classified
local.identifier.ariespublicationa383154xPUB5331
local.publisher.urlhttps://alzres.biomedcentral.com
local.type.statusPublished Version
local.contributor.affiliationEramudugolla, Ranmalee, College of Health and Medicine, ANU
local.contributor.affiliationMortby, Moyra, College of Health and Medicine, ANU
local.contributor.affiliationSachdev, Perminder Singh, University of New South Wales (Prince of Wales Hospital)
local.contributor.affiliationMeslin, Chantal, College of Health and Medicine, ANU
local.contributor.affiliationKumar, Rajeev, College of Health and Medicine, ANU
local.contributor.affiliationAnstey, Kaarin, College of Health and Medicine, ANU
dc.relationhttp://purl.org/au-research/grants/nhmrc/1002160
dc.relationhttp://purl.org/au-research/grants/nhmrc/1102028
dc.relationhttp://purl.org/au-research/grants/nhmrc/1002560
local.bibliographicCitation.issue15
local.identifier.doi10.1186/s13195-017-0246-x
local.identifier.absseo970117 - Expanding Knowledge in Psychology and Cognitive Sciences
dc.date.updated2020-11-23T10:30:14Z
local.identifier.scopusID2-s2.0-85014504660
local.identifier.thomsonID000396066200002
dcterms.accessRightsOpen Access
dc.provenanceThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated
dc.rights.licenseCreative Commons Attribution licence
CollectionsANU Research Publications

Download

File Description SizeFormat Image
01_Eramudugolla_Evaluation_of_a_research_2017.pdf919.02 kBAdobe PDFThumbnail


This item is licensed under a Creative Commons License Creative Commons

Updated:  17 November 2022/ Responsible Officer:  University Librarian/ Page Contact:  Library Systems & Web Coordinator