In conjunction with the Baltimore site of the Epidemiologic Catchment Area Survey of NIMH, NINCDS funded a detailed dementia workup on those persons in the elderly sample identified with dementing illness, by comprehensive psychiatric examination. The detailed dementia workup included a neurologic examination and comprehensive laboratory studies which included thyroid function tests, electrolytes, BUN and glucose, B12 and folate levels, calcium and phosphorous levels, syphilis serology, urinalysis, chest X-ray, EKG, EEG, and CT scan. The foci of this investigation were (1) to explore the limitations of the Mini-Mental-State- Examination (MMSE) as a screening instrument, (2) to explore which components of the comprehensive dementia workup provide the highest specificity when used as a dementia screening test, (3) to develop a screening model for dementia with a sensitivity and specificity improved beyond that of the MMSE, and (4) to examine the usefulness of this model in other elderly populations. In addition, for the confirmed cases of dementia, additional information was gathered to assess the social and economic impact upon the caregivers. A review of the data indicated that only 36 confirmed cases of dementia were identified and available for further analysis. The sample size was not adequate to address the four areas of interest and to develop a model for dementia screening beyond the MMSE. After review of the information on social and economic impact, it was determined that the study of the burden on care-givers was also not feasible. A report of the detailed dementia workup of the 36 cases is in progress and will be completed in FY 1989.
