Background: There is a need for more research into dementia in developing countries. Exploring variations in disease frequency in international collaborations may enhance our understanding of aetiology. Culture- and education-fair diagnostic procedures need first to be developed.
Methods: The 10/66 Dementia Research Group interviewed 2885 persons aged 60 and over in 25 centres in India, China and South East Asia, Latin America and the Caribbean and Africa; 729 people with dementia, and three groups free of dementia; 702 with depression, 694 with high education and 760 with low education. Experienced local clinicians diagnosed dementia (DSM IV dementia and Clinical Dementia Rating mild or moderate) and depression (Montgomery Asberg Depression Rating Scale 18 or over). The Geriatric Mental State, the Community Screening Instrument for Dementia and the modified CERAD 10 word list-learning task were administered by an interviewer, masked to case status.
Results: Each measure independently predicted dementia diagnosis. In a split half procedure, an algorithm derived from all three performed better than any of them individually; applied to the other half of the sample it identified 94% of dementia cases with false positive rates of 15%, 3% and 6% in the depression, high education and low education groups.
Conclusion: The 10/66 algorithm provides a sound basis for culture and education-fair dementia diagnosis in clinical and population-based research, supported by translations of its constituent measures into many languages, covering the majority of the peoples of the developing world.
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