Sensitivity and specificity of death certificate diagnoses for dementing illnesses, 1988-1990

J Am Geriatr Soc. 1992 May;40(5):479-81. doi: 10.1111/j.1532-5415.1992.tb02015.x.


Objective: To evaluate the extent to which mortality data, which is often used to track secular trends for specific diseases, underestimates the prevalence of dementia.

Design: Retrospective analysis of existing data.

Setting: Department of Mental Health inpatient facilities in South Carolina.

Subjects: Inpatients at Department of Mental Health facilities who were listed in the South Carolina Statewide Alzheimer's Disease and Related Disorders Registry and who died between 1988 and 1990 (n = 450).

Main outcome measures: Sensitivity and specificity of dementia diagnoses on death certificates compared to medical record diagnoses for inpatients with a pre-mortem dementia diagnosis.

Results: Twenty-three percent of death certificates contained any dementia diagnosis (104/450). The sensitivity of death certificates varied by type of dementia (28 percent for Alzheimer's disease; 8 percent for multi-infarct dementia) as well as by race, sex, and age.

Conclusions: Mortality statistics substantially underestimate the prevalence of dementing illnesses and do not fully represent the public health burden of dementia.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / epidemiology
  • Alzheimer Disease / mortality
  • Data Collection
  • Death Certificates*
  • Dementia / diagnosis*
  • Dementia / epidemiology
  • Dementia / mortality
  • Female
  • Humans
  • Male
  • Racial Groups
  • Retrospective Studies
  • Sensitivity and Specificity
  • Sex Factors
  • United States / epidemiology