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The validation of the Italian version of the GPCOG (GPCOG-It): a contribution to cross-national implementation of a screening test for dementia in general practice

Published online by Cambridge University Press:  06 November 2009

Alessandro Pirani ,
Henry Brodaty ,
Emilio Martini ,
Davide Zaccherini ,
Francesca Neviani  and
Mirco Neri
Alessandro Pirani*
Affiliation:
Interdisciplinary Geriatric Research Group, Dementia Assessment Unit, Cento, Italy
Henry Brodaty
Affiliation:
Primary Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
Emilio Martini
Affiliation:
University of Modena and Reggio Emilia, Modena, Italy
Davide Zaccherini
Affiliation:
Interdisciplinary Geriatric Research Group, Dementia Assessment Unit, Cento, Italy
Francesca Neviani
Affiliation:
University of Modena and Reggio Emilia, Modena, Italy
Mirco Neri
Affiliation:
University of Modena and Reggio Emilia, Modena, Italy
*
Correspondence should be addressed to: Dr. Alessandro Pirani, Centro Delegato Alzheimer – Distretto Ovest – AUSL Ferrara, Via Vicini 5, 44042, Cento, (FE), Italy. Phone: +39–051-901664; Fax: +39–051-6831162. Email: piranibosi@alice.it.
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Abstract

Background: The General Practitioner Cognitive Assessment of Cognition (GPCOG), a brief, efficient dementia-screening instrument for use by general practitioners (GPs), consists of cognitive test items and historical questions asked of an informant. The validity of instruments across different cultures and languages requires confirmation and so the aim of this study was to validate the Italian version of GPCOG (GPCOG-It).

Methods: The validity of the GPCOG-It was assessed against standard criteria for diagnosis of dementia (Diagnostic and Statistical Manual of Mental Disorders – 4th edition) as well as the Clinical Dementia Rating scale. The participants comprised 200 community-dwelling patients aged at least 55 years with (patient group) or without memory complaints (control group). Seven general practitioners were involved. Measurements used were the Cambridge Cognitive Assessment, Mini-mental State Examination with standard (24/25) and Italian cut-off (26/27), Alzheimer's Disease Assessment Scale-Cognitive scale and Geriatric Depression Scale.

Results: The GPCOG-It, total score and two-stage method, were at least equivalent in detecting dementia to the MMSE using the standard 24/25 or the Italian 26/27 cut-offs. The two-stage method of administering the GPCOG-It (cognitive testing followed by informant questions if necessary) had a sensitivity of 82%, a specificity of 92%, a misclassification rate of 17.4% and positive predictive value of 95%. Patient interviews took less than 4 minutes to administer and informant interviews less than 2 minutes, half the time needed for MMSE administration.

Conclusions: GPCOG-It maintains the same psychometric features and time efficiency as the original English version. Despite methodological limitations (i.e. use of defined samples), the GPCOG-It performed well in detecting clear cut and borderline cognitively impaired patients and can be introduced in the daily practice of Italian GPs.

Keywords

dementia screeninggeneral practicebrief psychometric testmild cognitive impairment
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 1 , February 2010 , pp. 82 - 90
Copyright
Copyright © International Psychogeriatric Association 2009

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