A quantitative rating system was developed based on 18 quality criteria relevant to the clinical assessment of dementia. This system allowed to compare the performance of similar scales, and to identify areas of strength and weakness. The criteria included a combination of the scale’s psychometric performance (13 criteria), adoption in dementia guidelines (1 criterion), user-friendliness (2 criteria), and cost (2 criteria). Psychometric criteria included separate ratings for different kinds of reliability (inter-rater, test-retest, internal consistency), validity (concurrent, discriminant, sensitivity, specificity, responsiveness) and generalisability (to different: dementia types, clinical settings and countries/languages).
Criteria for user-friendliness included ease of administration and scoring, or for informant scales, the cognitive burden on the respondent completing the scale. Criteria regarding cost included costs of purchasing or using the scale itself, costs of training to use the scale (when applicable), and the level of clinical qualifications required to administer the scale.
Based on a literature review of peer-reviewed publications for each scale, each criterion was scored as 0, 1 or 2 with a higher score reflecting a greater degree of support for that criterion. In most cases the criteria were quantified or where qualitative in nature were defined objectively. For example, for the diagnostic sensitivity of the scale the scales were scored as follows:
score 0: sensitivity < 0.70
score 1: sensitivity from 0.70 to 0.84
score 2: sensitivity ≥ 0.85
An overall score was derived by multiplying the score on each criterion by the weighting of that criterion, summing the totals and scaling to a total score out of 100. Full details of the entire set of rating criteria and the complete scale scores will be accessible from the domain pages (under construction).
65–79: Very good
First, test results are not necessarily easy to interpret. There are many other conditions which can mimic the symptoms of memory loss or dementia. Only trained medical staff can request further medical investigations which are necessary to establish and confirm a diagnosis.
Secondly, cognitive testing can be confronting and distressing for the person who is tested and psychological attention and counselling may be required. It is best to let a professional health-care worker handle this rather than putting yourself under the stress of dealing with a distressed loved one.
Last but not least, cognitive tests are susceptible to training effects, i.e. the more often you do the same test the better you perform. So chances are that if you administer the test to your family member at home, they might score negative (i.e., show no impairment) when assessed subsequently by a doctor due to training effects. This may delay the process of receiving a proper diagnosis and getting access to available support services. We ask you to refer to a doctor or other health care professional if you seek testing rather than administer any of these tests yourself.
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