Adaptation and validation of CAMDEX-DS (Cambridge Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities) in Spanish population with intellectual disabilities
*Correspondencia: Dra. Susanna Esteba Castillo. Servicio Especializado en Salud Mental y Discapacidad Intelectual
(SESM-DI). Parc Hospitarlari Martí i Julià. Institut d’Assistència Sanitària. Doctor Castany, s/n. E-17190 Salt (Girona).
E-mail: susanna.esteba@ias.scs.es
INTRODUCTION Dementia caused by Alzheimer’s disease commonly affects the adult population with Down’s syndrome. This population presents two characteristic clinical features: a semiologic pattern that differs from the typical Alzheimer’s disease, and previous intellectual deficits that may confound the clinical diagnosis. There is a clear need to validate specific instruments adapted to Spanish population.
AIM To adapt and to validate CAMDEX-DS (Cambridge Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities) in Spanish population.
PATIENTS AND METHODS 146 patients with intellectual disability (mild to moderate) were recruited and assessed with CAMDEX-DS, K-BIT I and DMR tests. Test-retest reliability, inter-rater concordance and validity statistic were performed between CAMDEX-DS and clinical diagnosis. This is an observational, multicenter, cross-sectional and validation study.
RESULTS Test-retest and inter-rater reliability achieved kappa coefficient values of 0.92 and 0.91, respectively. Agreement (kappa index) for CAMDEX-DS on clinical diagnosis compared to other clinical criteria was high: CAMDEX-DS vs DSM-IV (kappa = 0.95; p < 0,001); CAMDEX-DS vs ICD-10 (kappa = 0.97; p < 0.001). All item-test correlations ranged between 0,31 and 0,69. Internal reliability-calculated using Chronbach’s alpha scored 0.93.
CONCLUSIONS The Spanish version of CAMDEX-DS is a valid instrument with high applicability for people with intellectual disability. It shows good psychometric properties. The Cambridge Cognitive Examination for Older Adults with Down’s Syndrome (CAMCOG-DS) can set two key points by the level of intellectual disability on the suspicion of cognitive impairment in people with Down’s syndrome.
Objetivo Adaptar y validar el Cambridge Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities (CAMDEX-DS) en población española.
Pacientes y métodos Se consideraron 146 pacientes con discapacidad intelectual (leve-moderada). Se realizó un estudio de validación de tipo observacional, transversal y multicéntrico. Se administraron los siguientes tests: CAMDEX-DS, test breve de inteligencia de Kaufman y Dementia Questionnaire for Persons with Mental Retardation. Se calculó la fiabilidad test-retest, la fiabilidad interjueces, la concordancia del CAMDEX-DS para el diagnóstico clínico y la validez.
Resultados La fiabilidad test-retest e interjueces obtuvo un coeficiente kappa de 0,92 y 0,91, respectivamente. El índice kappa del CAMDEX-DS para el diagnóstico clínico respecto al resto de los criterios clínicos utilizados fue alto: CAMDEX-DS frente a DSM-IV (kappa = 0,95; p < 0,001); CAMDEX-DS frente a Clasificación Internacional de Enfermedades, décima revisión (kappa = 0,97; p = 0,000). Todas las correlaciones ítem-test oscilaban entre 0,31 y 0,69. La fiabilidad interna calculada mediante el alfa de Cronbach fue de 0,93.
Conclusiones La versión española del CAMDEX-DS es un instrumento válido, de alta aplicabilidad a personas con discapacidad intelectual, que muestra buenas propiedades psicométricas. El Cambridge Cognitive Examination for Older Adults with Down’s Syndrome (CAMCOG-DS) permite establecer dos puntos de corte para la sospecha de deterioro cognitivo en el grupo de personas con síndrome de Down en función del nivel de discapacidad intelectual previo.
