Inter-rater reliability of primitive signs in dementia

Abstract

Objectives: The aim of the present study is to explore inter-rater reliability of primitive signs in a group of patients assessed for dementia.

Patients and methods: 97 patients admitted to our University Hospital for cognitive impairment were enrolled in the study. The mean age was 73.04 ± 8.68 (53 females and 44 males). All patients were examined by two cognitive neurologists in a blind fashion. The grasp reflex, the snout reflex, the glabella tap reflex and the palmomental reflex were elicited according to the current literature. Moreover, we add a stretch reflexes (the masseter reflex) to our battery.

Results: The most frequent primitive reflex was the palmomental reflex followed by the glabella tap, snout, and grasp. The inter-rater reliability was measured for each primitive reflex: grasp reflex (0.884) have a strong correspondence; the glabella tap (0.556), the palmomental (0.516) and the snout reflex (0.445) have otherwise a weak correspondence. The masseter reflex reaches a moderate agreement (0.662). All the measurements reached statistical significance (p < 0.005).

Conclusion: The results of the study show weak to substantial agreement for primitive signs and the masseter reflex as expressed by the low-to-high kappa values.

Keywords: Dementia; Primitive signs.