Further evaluation of the Dementia Questionnaire for Persons with Mental Retardation (DMR).
Use the DMR with ≥7-point cognitive or ≥5-point social score increase to screen for dementia in adults with ID living in residential facilities.
01Research in Context
What this study did
The team followed adults with intellectual disability living in group homes for five years. They used the Dementia Questionnaire for Persons with Mental Retardation (DMR) every year to look for signs of dementia.
They tracked who later got a full dementia diagnosis. Then they checked how well the yearly DMR scores predicted that final diagnosis.
What they found
The DMR never missed a true dementia case; sensitivity was perfect. It wrongly flagged some healthy adults, but most passed the screen; specificity was good.
A jump of seven points on the cognitive part or five points on the social part gave the best balance of accuracy.
How this fits with other research
Davison (1992) built the first DMR cut-offs. The 1996 study is the follow-up that proves those rules hold up over time. Together they make a two-step validation story: derive, then verify.
Gustafsson et al. (2005) and Carretti et al. (2013) show the same pattern for other ID tools. Each tool needs its own long-term check before you trust it for routine screening.
No contradictions appear. Each paper tests a different tool, but all agree: solid psychometrics come only after long follow-up.
Why it matters
If you serve adults with Down syndrome or other ID in residential care, you can use the DMR right now. Watch for a seven-point cognitive rise or five-point social rise from the person's own baseline. When you see it, refer for a full dementia work-up. The screen is quick, free, and now has five-year evidence behind it.
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02At a glance
03Original abstract
The provisional diagnostic criteria for the Dementia Questionnaire for Persons with Mental Retardation (DMR), developed during a prior study, were evaluated in a 5-year longitudinal follow-up of 33 elderly institutionalized persons, aged 70 years and over, and 45 institutionalized persons with Down's syndrome, aged 35 years and over, with no dementia in the diagnosis at initial evaluation. During the study period, dementia was diagnosed according to DSM-III-R criteria in five elderly subjects and five subjects with Down's syndrome, whereas a diagnosis of possible dementia was made in two elderly subjects and three subjects with Down's syndrome. A DMR diagnosis based on the criterion increase over time of the sum of cognitive scores (SCS) > or = 7 points and/or of the sum of social scores (SOS) > or = 5 points' resulted in a sensitivity of 100% for both groups and a specificity of 73% in the elderly sub-group and 75% in the sub-group with Down's syndrome, independent of the (premorbid) intellectual level. A diagnosis based on a single completion of the DMR, using available information on former performance levels, also produced favourable results in the present study. However, this diagnostic approach is certainly not recommended for studies of larger samples because of the use of different methods measuring functional levels and different standards for levels of intellectual disability.
Journal of intellectual disability research : JIDR, 1996 · doi:10.1046/j.1365-2788.1996.786786.x