Questionnaires Used in the MRC Cognitive Function and Ageing Study (CFAS)
Dementia and cognitive decline are difficult to study in populations as there are a large number of underlying diseases that may be present and there are no simple biological tests. Population studies of dementia can use a variety of interviews to make a diagnosis. It is important to standardise these interviews as differences shown by different studies may reflect different levels of illness, but may also reflect different definitions used by researchers.
The CFAS study uses a variety of standardised interviews in order to make the diagnoses of mental disorders. Trained personnel administer the interviews which are computerised in a programme known as ‘AGECAT’ (The Automated Geriatric Examination for Computer Assisted Taxonomy). Thus the diagnostic measure used in CFAS is not clinician based (i.e. made by a doctor), but is clinically based in its content.
Questions used at the initial screening interviews (1991/2)
- Questions about sociodemographic variables including main occupation, marital status and type of accommodation.
- Mini-Mental state examination - a commonly used test of memory and cognitive function.
- The ‘Organicity’ scale from The Geriatric Mental State (GMS) examination.These questions produce a score between 0 and 5 on an ‘organicity’ scale, with scores of O3 and above being equivalent to dementia. No clinical subtyping of cases is carried out, so the diagnosis is ‘dementia’, rather than a more specific term.
- Basic screening questions for depression.
- Essential activities of daily living (ADL).
Questions used at the more detailed interviews
- A version of the Geriatric Mental State examination (GMS B3) that enables organic mental disorders (dementia and depression) to be diagnosed according to ICD 10 and DSM IV criteria.
- The History and Aetiology Schedule (HAS) is an interview intended for use with an informant (for example the main carer). The schedule looks at such things as the speed of onset of illness, symptom fluctuation and other aspects of personal and family history.
- The cognitive subscales of the Cambridge Examination of Mental Disorders (CAMCOG). These questions assess a wide range of cognitive function and can detect mild degrees of cognitive impairment.
- Other questions are included to allow calculation of the Hachinski Ischaemia score (a score used to assess whether dementia is a primary degenerative type, such as Alzheimer’s disease, or has a vascular component) and also the Blessed Dementia Rating Scale, an assessment tool for differentiating elderly subjects with little or no decline from those with cognitive deterioration.
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