The Validity and Reliability of a Persian Version of the Brief Community Screening Instrument for Dementia in the Elderly Patients with Dementia in Iran

Abstract

Background: The brief version of community screening instrument for dementia (CSI-D) is a neuropsychological tool, which can be used even by non-specialists in primary care settings following a short training. The CSI-D evaluates the cognitive and functional domains of the subjects and includes an informant interview. However, it should be adapted based on literacy level and sociocultural profile of population in each country. Objectives: The current study examined the validity and reliability of the Persian version of the brief CSI-D in elderly patients of Iran. Methods: The current descriptive, cross sectional study was conducted on people 60 and over from 16 provinces of Iran with seven different ethnicities and various levels of education (0 - 13 to ≥ 13 years). The participants consisted of subjects with normal cognition, subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and different types of dementia. Cognitive impairment was diagnosed by a neurologist with expertise in dementia. The psychometric properties were assessed by comparing Persian version of brief CSI-D with the gold standard. Area under ROC curve, optimal cutoff point, and sensitivity and specificity were also calculated. Results: Data were collected from 262 participants. Of all the participants, 112 were diagnosed with dementia, 64 with MCI, 32 with SCI, and 53 with normal cognition. The best cutoff point for the test- regardless of gender and level of education- was 8.5 compared with 8 - 9 in the original version of CSI-D and also the cutoff point for patient with dementia was 5.5, while it was 4 in the original version. Conclusions: The Persian version of CSI-D seems to be an accurate and sensitive tool to screen dementia and MCI in primary care setting, especially among low-educated and illiterate people.