Common use of Dementia Clause in Contracts

Dementia. Across the developing-country centres included in this study, the GMS was highly effective at discriminating between de- mentia cases and high-education controls, therefore the data presented here are entirely consistent with earlier reports of the satisfactory validity of GMS/AGECAT when used in well-educated developed- country populations (▇▇▇▇▇▇▇▇▇▇ et al, 1990; ▇▇▇▇▇▇▇▇▇▇ et al, 1993). It was in this context that the GMS was first developed and the AGECAT algorithm calibrated. In the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS; 1998) the age-specific prevalence of GMS/ AGECAT organicity was very similar to that consistently reported from other major European and North American population- based surveys. In developing countries the GMS is a useful adjunct to dementia diagnosis. Our earlier analyses have demonstrated that it adds to the discriminating power of an algorithm, including informant report of decline in cognitive and functional ability (from the CSI–D) and cognitive testing (from the CSI–D and the CERAD ten-word list learning test) (▇▇▇▇▇▇ et al, 2003). More detailed findings presented here underline a tendency for the GMS to overdiagnose 4 3 2 VA L ID I T Y OF THE G M S Table 2 Discriminability by region of the Geriatric Mental State (GMS) organicity items dementia in low-education groups in some but not all centres, and for a relative insen- Item Dementia Depression High education Low education sitivity to the presence of dementia in others. Given that the items contributing Date of birth incorrect India 54 36 7 41 LAC 47 5 1 2 Age incorrect India 45 14 2 15 LAC 47 5 1 2 Discrepancy between date of birth and age LAC 49 8 1 4 One or more of above India 64 54 8 50 China 61 6 0 3 LAC 61 11 1 6 Day of week incorrect India 8 2 0 1 China 41 1 0 0 LAC 30 5 1 1 Month incorrect India 35 6 1 4 China 43 2 0 0 LAC 49 6 1 1 Year incorrect India 40 11 1 9 China 52 5 1 9 LAC 54 8 1 4 Address incorrect India 44 11 1 5 China 28 1 0 1 LAC 49 5 2 6 Claimed to have seen interviewer before LAC 30 2 1 3 Did not recall interviewer’s name India 81 31 6 12 China 79 29 8 39 LAC 67 28 7 19 Did not recall country’s leader India 85 39 12 32 LAC 54 18 5 12 Did not recall country’s past leader India 90 50 15 41 LAC 65 38 18 27 Interviewer’s opinion Participant has difficulty with memory