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Age and Ageing Advance Access originally published online on September 19, 2007
Age and Ageing 2007 36(5):549-554; doi:10.1093/ageing/afm108
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Copyright © The Author 2007. Published by Oxford University Press on behalf of the British Geriatrics Society.

Proxy screening tools improve the recognition of dementia in old-age homes: results of a validation study

Leonore Köhler, Siegfried Weyerer and Martina Schäufele

Centre: Psychogeriatric Research Unit, Central Institute of Mental Health, Mannheim, Germany

Address correspondence to: Dr. Martina Schäufele. Tel: (+49) 621 1703 6352; Fax: (+49) 621 1205. Email: martina.schaeufele{at}zi-mannheim.de

Background: Despite the high true prevalence of dementia, demential disorders of residents of old age homes may often be not recognized. There is a need for a standardised tool which includes observations of nursing staff.

Objective: To describe and validate the Dementia Screening Scale (DSS) for use by nursing staff in old-age homes.

Methods: All residents of 20 randomly selected old age homes in the city of Mannheim, Germany (n = 1, 922) were rated by nurses using the seven-item proxy dementia rating scale. Based on a subset of residents (n = 598) the DSS was validated against independent diagnostic assessments made by trained psychologists including the Mini-Mental-State-Examination (MMSE), the Dementia Scale of the Brief Assessment Schedule (BAS DEM), and the Washington University Clinical Dementia Rating (CDR).

Results: Using the CDR as a gold standard, the DSS correctly classified at a cut-off of 2/3, 85.8% of the mildly, moderately, or severely demented residents. The accuracy of the DSS was only a little worse than that of the MMSE and the BAS DEM.

Conclusion: The DSS is well-suited for the recognition of dementia in old age homes. It achieved a better validity than global diagnosis-related staff assessments and compared to performance-based instruments. It is easier to apply, more economic, and associated with a fewer rate of non-response.

Keywords: screening, dementia, validation study, nursing homes, proxy, elderly

Received 30 November 2006; accepted in revised form 24 April 2007.


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