Assessing the 10/66 dementia classification algorithm for international comparative analyses with the United States.

Cross-national comparisons of dementia prevalence are essential for identifying unique determinants and cultural-specific risk factors, but methodological differences in dementia classification across countries hinder global comparisons. This study maps the 10/66 algorithm for dementia classificatio...

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Publicado en:American Journal of Epidemiology Vol. 194; no. 11; pp. 3117 - 3126
Autores principales: Guerra, Jorge J Llibre, Weiss, Jordan, Li, Jing, Soria, Chris, Rodriguez-Salgado, Ana, Rodriguez, Juan Jesús Llibre, Velázquez, Ivonne Z Jiménez, Acosta, Daisy, Liu, Mao-Mei, Dow, William H
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA Nov2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2025
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      pub: Oxford University Press / USA
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        atl: Assessing the 10/66 dementia classification algorithm for international comparative analyses with the United States.
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        au:
          Guerra, Jorge J Llibre
          Weiss, Jordan
          Li, Jing
          Soria, Chris
          Rodriguez-Salgado, Ana
          Rodriguez, Juan Jesús Llibre
          Velázquez, Ivonne Z Jiménez
          Acosta, Daisy
          Liu, Mao-Mei
          Dow, William H
        affil: Department of Neurology, Washington University in St. Louis, St. Louis, MO, United States
      sug:
        subj:
          Dementia Classification
          Algorithms
          Aging
          Low and Middle Income Countries
          Instrument Validation
          Funding Source
          United States
          Human
          Male
          Female
          Aged
          Aged, 80 and Over
          Validation Studies
          Comparative Studies
          Random Sample
          Logistic Regression
          ROC Curve
          Data Analysis Software
          Descriptive Statistics
          Sensitivity and Specificity
          Alzheimer's Disease
          Scales
          Interview Guides
          Psychological Tests
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Cross-national comparisons of dementia prevalence are essential for identifying unique determinants and cultural-specific risk factors, but methodological differences in dementia classification across countries hinder global comparisons. This study maps the 10/66 algorithm for dementia classification, widely used and validated in low- and middle-income countries (LMICs), to the US Aging, Demographics, and Memory Study (ADAMS), the dementia sub-study of the Health and Retirement Study, and assesses its performance in ADAMS. We identified the subset of 10/66 algorithm items comparably measured in ADAMS, then used these items to retrain the 10/66 algorithm against the ADAMS clinical dementia diagnosis, using k-fold cross-validation to assess performance. We compared the modified 10/66 algorithm to 4 other dementia classification algorithms previously validated in ADAMS, both for overall dementia estimation as well as for estimating education gradients. The modified 10/66 algorithm had higher sensitivity (87%) and specificity (93%) than the comparison algorithms. All the algorithms overestimated the education gradient in dementia, although the modest ADAMS sample size precludes precise comparisons of education gradient accuracy. Overall, we found that the modified 10/66 algorithm performs well in classifying dementia status in the United States. Our results support the validity of risk factor comparisons between US and 10/66 LMIC dementia data sets. This article is part of a Special Collection on Cross-National Gerontology.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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