Clinical issues relating to the diagnosis of mild dementia in a British community survey
D. W. O'Connor, P. A. Pollitt, J. B. Hyde, N. D. Miller and J. L. Fellowes
Hughes Hall, Cambridge, United Kingdom.
Many epidemiologists base their diagnoses of dementia on scores on brief
cognitive tests, but the border between normal aging and mild dementia is
so poorly understood that simple demarcations cannot adequately encapsulate
the wealth of clinical material that needs to be taken into account in
assigning diagnostic labels. Data from a British study of the prevalence
and natural history of dementia, in which diagnoses of dementia were made
by clinicians using a new, standardized interview schedule, are presented
to demonstrate the effects of physical disability, psychiatric illness, and
other factors on memory impairment and performance in everyday life. Our
purpose is not to insist that clinicians are always correct but rather to
highlight the complexities involved and the need for investigators to be
more open about the way in which they distinguish between physical,
psychiatric, and cognitive infirmities.
