Biomedical subjects

Daisy Acosta

Publications and source records attributed to Daisy Acosta.

3 recordsLinked to original sources

PubMed2004

Alzheimer Disease International's 10/66 Dementia Research Group - one model for action research in developing countries.

BACKGROUND: The 10/66 Dementia Research Group (10/66) founded in 1998, is a network of over 100 researchers from mainly developing countries. 10/66 is committed to encourage more good quality research in those regions, where an estimated two-thirds of all those with dementia live. It represents a collaboration of academics, clinicians, and an international non-governmental organization, Alzheimer's Disease International (ADI). METHOD: 10/66 pilot studies in 26 centres in Latin America, India, Africa and China and SE Asia suggest that education and culture-fair diagnosis is an attainable aim. Despite extended family care networks, these studies also identified high levels of practical, psychological and economic strain upon caregivers. Population-based studies in six centres will now estimate prevalence, describe impact and seek to identify genetic and environmental risk factors in novel settings. At a practical level, 10/66 has studied ways to circumvent the lack of help-seeking in developing countries, and has developed a low-level intervention to educate and train caregivers. CONCLUSION: The links with ADI and its international networks, and the volunteerism of ADIs members have fostered the rapid growth of 10/66. The partnership facilitates both the raising of awareness and influence upon policy, as 10/66 research evidence can be used by ADI and national Alzheimer's Associations to direct and support advocacy.

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PubMed2004

Effects of education and culture on the validity of the Geriatric Mental State and its AGECAT algorithm.

BACKGROUND: The Geriatric Mental State (GMS) is the most widely used psychiatric research assessment for older persons. Evidence for validity comes from the developed world. AIMS: To assess the validity of GMS/AGECAT organicity and depression diagnoses in 26 centres in India, China, Latin America and Africa. METHOD: We studied 2941 persons aged 60 years and over: 742 people with dementia and three groups free of dementia (697 with depression, 719 with high and 783 with low levels of education). Local clinicians diagnosed dementia (DSM-IV) and depression (Montgomery-Asberg Depression Rating Scale score >/=18). RESULTS: For dementia diagnosis GMS/AGECAT performed well in many centres but educational bias was evident. Specificity was poor in India and sensitivity sub-optimal in Latin America. A predictive algorithm excluding certain orientation items but including interviewer judgements improved upon the AGECAT algorithm. For depression, sensitivity was high. The EURO-D depression scale, derived from GMS items using European data, has a similar factor structure in Latin America, India and, to a lesser extent, China. CONCLUSIONS: Valid, comprehensive mental status assessment across cultures seems achievable in principle.

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PubMed2003

Dementia diagnosis in developing countries: a cross-cultural validation study.

BACKGROUND: Research into dementia is needed in developing countries. Assessment of variations in disease frequency between regions might enhance our understanding of the disease, but methodological difficulties need to be addressed. We aimed to develop and test a culturally and educationally unbiased diagnostic instrument for dementia. METHODS: In a multicentre study, the 10/66 Dementia Research Group interviewed 2885 people aged 60 years and older in 25 centres, most in Universities, in India, China and southeast Asia, Latin America and the Caribbean, and Africa. 729 had dementia and three groups were free of dementia: 702 had depression, 694 had high education (as defined by each centre), and 760 had low education (as defined by each centre). Local clinicians diagnosed dementia and depression. An interviewer, masked to dementia diagnosis, administered the geriatric mental state, the community screening instrument for dementia, and the modified Consortium to Establish a Registry of Alzheimer's Disease (CERAD) ten-word list-learning task. FINDINGS: Each measure independently predicted a diagnosis of dementia. In an analysis of half the sample, an algorithm derived from all three measures gave better results than any individual measure. Applied to the other half of the sample, this algorithm identified 94% of dementia cases with false-positive rates of 15%, 3%, and 6% in the depression, high education, and low education groups, respectively. INTERPRETATION: Our algorithm is a sound basis for culturally and educationally sensitive dementia diagnosis in clinical and population-based research, supported by translations of its constituent measures into most languages used in the developing world.

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