Age Corrections and Dementia Classification Accuracy

In contrast to expectations, demographic corrections to reduce biases against those of advanced age or few years of education does not universally improve diagnostic classification accuracy. Age corrections may be particularly problematic because age is also a risk factor for a dementia diagnosis. W...

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Bibliographic Details
Published in:Archives of clinical neuropsychology 2010-03, Vol.25 (2), p.126-138
Main Authors: O'Connell, Megan E., Tuokko, Holly
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Age Factors
Aged
Aged, 80 and over
Aging - psychology
Area analyses
Biological and medical sciences
Classification
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Dementia
Dementia - classification
Dementia - diagnosis
Dementia - epidemiology
Demography
Female
Humans
Male
Medical sciences
Middle Aged
Neurology
Neuropsychological Tests
Neuropsychology
Nosology. Terminology. Diagnostic criteria
Organic mental disorders. Neuropsychology
Psychology. Psychoanalysis. Psychiatry
Psychometrics
Psychopathology. Psychiatry
Reproducibility of Results
Risk Factors
Sensitivity and Specificity
Techniques and methods
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Summary:In contrast to expectations, demographic corrections to reduce biases against those of advanced age or few years of education does not universally improve diagnostic classification accuracy. Age corrections may be particularly problematic because age is also a risk factor for a dementia diagnosis. We found that simulating increased risk for dementia based on demographic variables, such as age, reduced the overall classification accuracy for demographically corrected simulated scores relative to the raw, uncorrected test scores. In clinical data with a small magnitude of association between age and dementia diagnosis, we found equivalent overall classification accuracy for demographically corrected and raw test scores. Regardless of the overall classification accuracy results, cutoff comparisons (16th and 9th percentiles) in clinical and simulated data demonstrated that for the most part, the sensitivity of raw scores was higher than the sensitivity of demographically corrected scores, but the specificity of scores corrected with normative data was superior.
ISSN:0887-6177
1873-5843
DOI:10.1093/arclin/acp111