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The efficiency of CAMDEX in the diagnosis of dementia and its sub-types.

AIMS
To determine the ability of the Cambridge Mental Disorders of the Elderly Examination (CAMDEX) to differentiate between healthy patients and those suffering from dementia or depression. To validate its efficiency in the diagnosis of different dementia sub-types. To determine inter-examiner reliability.


MATERIAL AND METHOD
A neurologist and a psychiatrist used DSM-III-R and ICD-10 criteria to independently select 13 patients suffering from Alzheimer-type primary degenerative dementia, 9 patients with multi-infarct dementia, 10 with secondary dementia, 14 with serious depression and 18 who were free of any type of dementia or depression to be used as controls. All these individuals were interviewed by a clinical psychologist using CAMDEX. The interviews of 41 were carried out by 3 teams of psychologists with CAMDEX experience. While 1 psychologist directed the interview, another acted as an observer who independently recorded answers.


RESULTS
The overall agreement levels between clinical and CAMDEX diagnoses was kappa = 0.825. The ability of CAMDEX to differentiate between patients with dementia and those who were depressed or controls was perfect (kappa = 1). On the other hand, the diagnostic agreement for the different dementia sub-types was kappa = 0.733. There was a very high level of agreement between the interviewer and observer for the various scales that make up the CAMDEX (p < 0.001). There was complete agreement on diagnoses (Phi = 1).


CONCLUSIONS
CAMDEX is an excellent instrument for the diagnosis of dementia and its sub-types, offering excellent inter-examiner reliability.