The contribution of CAMDEX to the diagnosis of mild dementia in community surveys.

Abstract

Distinguishing between cognitively intact and mildly demented elderly people poses particular difficulties. Now that modern criteria, such as those contained in the DSM-III-R, specify that cognitive deficits be sufficient to interfere with the pursuit of daily tasks, investigators must consider the relative effects of personality, physical illness and handicap, sensory deficits and functional psychiatric disorders since all of these factors contribute to loss of independence. Simple tests and questionnaires are inadequate to the task and are subject to demographic bias but structured assessments conducted by skilled clinicians using operational criteria have much to offer, notwithstanding the increased costs and time required. This paper discusses some of the issues involved and presents evidence concerning the use of CAMDEX in a recent British survey.