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From The CriticsReviewer: Christopher J Graver, PhD, ABPP-CN(Madigan Healthcare System)
Description: The CAMDEX-DS is a combination of the CAMDEX informant interview and the Cambridge Cognitive Examination (CAMCOG) designed to assist in the evaluation of dementia in individuals with pre-existing intellectual disability.
Purpose: The purpose is to provide the necessary neuropsychological instruments to measure cognitive changes and to facilitate the diagnosis of dementia in individuals with intellectual disabilities, especially those with Down's syndrome.
Audience: The authors do not indicate a particular audience, but it is clearly intended for trained clinicians, primarily neuropsychologists. It was developed by two graduate students as part of their PhD theses under the supervision of clinicians who have abundant experience working with adults with developmental disabilities.
Features: This set of instruments represents a standardized approach to the assessment of dementia in Down's syndrome. As such, it includes an informant interview and an assessment of the patient's abilities. The informant interview contains relevant questions regarding the patient's history, general baseline functioning, mental health, and specific questions regarding cognitive domains (e.g., orientation, memory, language, etc.). This provides useful, contrasting information to the later section, which directly assesses the patient's current abilities. Each question is scored on a 2- or 3-point scale with scoring guidance and follow-up questions, if necessary. The section on clinical diagnosis, while accurate, is a simplified cookbook of criteria, rather than an extensive guide in conceptualizing dementia. The section on post-diagnosis intervention, however, is more helpful and provides a useful environmental checklist.
Assessment: The CAMDEX-DS is a promising instrument in the assessment of dementia in patients with Down's syndrome and other intellectual disabilities. On the one hand, the standardized format is an advantage. On the other hand, the validity of the instrument is based on repeated assessments, but no information is provided regarding practice effects. In addition, the lack of normative data for a single administration is a major weakness. Nonetheless, this instrument provides a reasonable, structured approach for this specialized type of assessment and would be an asset to clinicians.