Utility Of Chinese Version Of AD8as A Self-Rating Tool In Population Undergoing Health Check-up

Background:Dementia is a syndrom which affects memory, thinking, behavior and activities of daily lives. At present, the number of patients with dementia has reached to35.6million worldwide, and that will be up to two times in2030. Not only is painful to the patients, dementia is a heavy burden to the hole family and caretakers. To tackle the serious public health issue, it is necessary to find an efficient and simple tool to screen the population at high risk of dementia. In the meanwhile, as people pay more attention to the condition of their health, regular check-up is becoming a main trend, especially for old people. They could know their physical condition and get assessment for the risk of disease. If there was an easy, applicable way to estimate whether cognitive functions are impaired in the process of checkup, particularly the process of dementia has set out and some mild clinic symptoms have existed. It could help to find patients of dementia in the early stage, which makes physicians alert. As soon as they confront the condition, they can tell patients to go to the right and specific department(e.g. psychiatry, neurology) to seek for help. At the same time, treatment in time can postpone the progress of dementia. The Chinese version of AD8is a simple and less time consuming scale based on informants. Some researches have conformed that AD8is efficient in screening patients of dementia. In the process of physical examination, some older people come to hospital without reliable informants, especially, who preserves normal abilities of daily lives and only have mild cognitive impairment. Consequently, it has obvious significance to estimate the utility of Chinese version of AD8as a self-rating scale in check-up population.objective:To check out whether the Chinese version of AD8is suitable for domestic check-up population and the efficiency as a self-rating scale. The research will testify the hypothesis that the Chinese version of AD8can be used to screen dementia patients in physical examination population. When without a informant, participants can use it as a self-rating tool to discriminate older adults without dementia from those with even the mildest forms of dementia.Methods:The subjects comprised114participants who underwent physical examination in the second affiliated hospital, Zhejiang university school of medicine. These older participants were all more than60years old and divided into3groups:normal, mild cognitive impairment, dementia. Experienced clinicians conducted independent interviews with the older participant and a knowledgable informant to rate the Chinese version of AD8. Other psychiatrists assessed the scores of mini-mental state examination(MMSE) and activity of daily living scale(ADL) for participants. The clinical dementia rating(CDR) was used to quantify dementia severity of patients through interviewing with informants. Dementia was diagnosed referring to related diagnostic criteria. CDR was used as a gold standards in this study. Descriptive analysis, correlation analysis, receiver operator characteristic curves analysis were used for data analysis with software SPSS20.0for Windows.Result:1.63men and51women were selected as subjects, including normal control group(58participants), mild cognitive impairment group(43participants), mild or more sever dementia group (13participants). The mean age for participants was68years (range:60-85years) with a men educational attainment of6.9years(range:3-15years).2. Agreement between the patient and the caregiver was measured with intraclass correlation coefficients. The intraclass correlation coefficients was0.76,95%confidence interval was0.68-0.83. In the meanwhile, AD8scores had adequate agreement with CDR scores and MMSE scores.3. Receiver operator characteristic curves analysis showed the effectiveness of AD8in classifying no dementia vs dementia. Using a cutoff of2or greater on the participant to predict dementia yield the most desirable combination of sensitivity (85.7%) and specificity (77.6%),95%confidence interval was0.82-0.94.Conclusion:The Chinese version of AD8, as an informant rating tool, could discriminate older adults without dementia from those even the mildest forms of dementia. In the absence of an informant, especially the patients with little cognitive impairment and who are still able to function independently, AD8could be used as a self-rating tool to offer useful information about the patients’cognitive status with good sensitivity and specificity. It has great potential to apply in community and physical examination center due to its less time consuming and simplicity and convenience. Because of its effectiveness as a self-rating tool, at the same time, AD8may help clinician to discover the dementia symptom in early stage and find out the cause of dementia before it’s too late. Taking appropriate measures may improve the effect of treatment and make the lives of patients and their caregivers much better.