BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: Cambridge Mental Disorders of the Elderly Examination (CAMDEX) Year: 1986, 1998 Domain: Psychological Assessment Tool Category: Dementia/Alzheimer’s Variations/Translations: An abbreviated version (Short-CAMDEX) is available. This version includes 106 of the 340 items and requires 30 minutes to complete. There is also a Spanish and Italian version. Setting: Clinical setting Method of Delivery: Administered by a psychiatrist. Description: The CAMDEX includes three components: clinical interview, set of cognitive tests, and interview with patient’s relative to obtain independent information on the patient’s past and present state. The cognitive tests include the MMSE, Blessed Dementia Score and Hachinski’s Ischemia Scale. The three components of the CAMDEX can be divided into eight sections, A to I. Scoring/Interpretation: After the clinical interview, the psychiatrist makes a diagnosis based on operational criteria that are described in the manual. Eleven diagnosis categories are specified: four dementia categories, two of clouding or delirium and other psychiatric states (e.g., depression). The severity of dementia and depression is graded on a five-point scale. Scores can be derived to indicate organicity, 14 from relative interview, and two from interview observations. Time to Administer: Interview with patient takes about 60 minutes. The informant interview takes about 20 minutes. Availability: Available in source article (Roth, et al. 1986). Software: N/A Website: N/A Quantitative/Qualitative: Quantitative Validity (Quantitative): A Dutch study found that the DSM-III-R criteria both identified more people as having dementia than the CAMDEX (5.1% verses 2.6%). A kappa coefficient of 0.83 has been reported between reported between the CAMDEX and clinical diagnosis. Sensitivity was 90% and specificity was 76% in a small dementia study. A Spanish study found that CAMDEX diagnoses agreed closely with neurologists’ diagnoses of dementia, depression or normal based on the DSM-III-R: Kappa=0.95. Reliability (Quantitative): Inter-rater reliability among four psychiatrists who interviewed 40 patients, showed median agreement phi coefficients of 0.94 for section A, 0.90 for B, 0.83 for C, and 0.91 for section H. In a Spanish study, CAMDEX interviews were observed and the agreement between interviewers and observers was almost perfect (W index of concordance=0.99). References: McDowell, I. (2006). Measuring Health: A guide to rating scales and questionnaires 3rd Ed. New York: Oxford University Press. Roth, M., Tym, E., Mountjoy, C.Q., et al. (1986). CAMDEX: a standardized instrument for the diagnosis of mental disorder in the elderly with special reference to the elderly detection of dementia. British Journal of Psychiatry; 149, 698- 709. Comments: The CAMDEX is generally applied following an initial screening test, because of its length and the need for a psychiatrist to lead the interview.