Psychological Medicine

Original Articles

The Psychogeriatric Assessment Scales: a multidimensional alternative to categorical diagnoses of dementia and depression in the elderly

A. F. Jorma1 c1, A. J. Mackinnona1, A. S. Hendersona1, R. Scotta1, H. Christensena1, A. E. Kortena1, J. S. Cullena1 and R. Mulligana1

a1 NH & MRC Social Psychiatry Research Unit, The Australian National University, Canberra and the Department of Geriatric Medicine, Repatriation General Hospital Concord, Sydney, Australia; Institutions Universitaires de Gériatrie de Genève, Geneva, Switzerland.

SYNOPSIS

The Psychogeriatric Assessment Scales (PAS) provide an assessment of the clinical changes seen in dementia and depression. Principal components analysis and latent trait analysis were used to develop a set of scales to summarize these clinical changes. There are three scales derived from an interview with the subject (Cognitive Impairment, Depression, Stroke) and three from an interview with an informant (Cognitive Decline, Behaviour Change, Stroke). Results are reported on the reliability and validity of these scales using data from clinical samples in Sydney and Geneva and a population sample from Canberra. The scales were found to have excellent validity when judged against clinical diagnoses of dementia and depression and could distinguish Alzheimer's from vascular dementia. Cut-off points were developed to indicate correspondence between scale scores and clinical diagnoses. Percentile rank norms were developed from the Canberra population sample. The PAS is easy to administer and score and can be used by lay interviewers after training. It is intended for application both in research and in services for the elderly.

Correspondence:

c1 Address for correspondence: Dr A. F. Jorm, NH&MRC Social Psychiatry Research Unit, The Australian National University, Canberra, ACT 0200, Australia.

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