AGREEMENT IN THE CLINICAL-DIAGNOSIS OF DEMENTIA - EVALUATION OF A CASE SERIES WITH MILD COGNITIVE IMPAIRMENT

Interobserver agreement in the clinical diagnosis of dementia among fo ur neurologists was evaluated. The physicians, masked to the original diagnoses, independently reviewed the clinical records of 50 outpatien ts consulting either the Ist University Neurology Department of Milan or the Neuropsychology Unit of the Medical Center of Veruno (Novara) f or suspected cognitive impairment, during a 6-month period. The record s contained patients' medical and neurological history, results of neu ropsychological testing, laboratory tests, cerebral computed tomograph y and other investigations. For each patient, the raters had to provid e both a diagnosis concerning the presence or absence of dementia and to assign an analytical diagnosis to all the dementia cases. The kappa statistic was used as a measure of interrater reliability. The level of agreement on the primary diagnosis of dementia was moderate (kappa = 0.49); with respect to the nosological diagnoses, the kappa values r anged from 0.16 for depression to 0.80 for multiinfarct dementia.