Brief cognitive battery in the diagnosis of mild Alzheimer's disease in subjects with medium and high levels of education

Abstract

There has been an increasing trend to utilize short cognitive batteries for the diagnosis of dementia. Most of these batteries have been designed in countries with high standards of education and are less suitable for populations with low levels of education.We developed a battery that has been previously shown to be highly accurate in the diagnosis of dementia in individuals with low levels of education. The accuracy of this battery for patients with higher levels of education is unknown.ObjectivesTo evaluate the accuracy of a brief cognitive battery in the diagnosis of Alzheimer’s disease (AD) in subjects with medium and high levels of schooling, and to develop a mathematical model that includes the most discriminative tests.MethodsSeventy-three mildly demented patients with probable AD and 94 control subjects were evaluated. Sixty patients and 60 controls were randomly selected to generate a mathematical model including the most discriminative tests of the battery using logistic regression. The model was back-tested for the remaining sample of patients and controls.ResultsDelayed recall, learning and category fluency tests were included in a mathematical model that obtained an area of 0.917 in the ROC curve in the back-testing. Inter-rater reliabilities of these tests were high (kappa>0.8).ConclusionsThis model showed a high accuracy for the diagnosis of mild AD in patients with medium and high educational levels. Future studies with more heterogeneously educated individuals are necessary to investigate whether the educational level (number of years at school) should also be included in the model.

Frailty and cognitive impairment among community-dwelling elderly

“…Cognitive function was assessed using a two-stage screening process (sequential testing) to increase the accuracy of the evaluation, thereby enhancing the specificity of the measurement 14,15 . The Mini Mental State Examination (MMSE) was first administered to all participants 16,17 .…”

“…The Mini Mental State Examination (MMSE) was first administered to all participants 16,17 . Those who tested positive for altered cognition then underwent the Brief Cognitive Screening Battery (BCSB) 14,15 . Only those participants who tested positive for altered cognition on both on tests were classified as having cognitive impairment 14,15 .…”

“…Those who tested positive for altered cognition then underwent the Brief Cognitive Screening Battery (BCSB) 14,15 . Only those participants who tested positive for altered cognition on both on tests were classified as having cognitive impairment 14,15 . The cutoff scores for MMSE were 17/18 for illiterate participants, 20/21 for those with one to four years of schooling, 23/24 for those with five to eight years and 25/26 for those with nine or more years of schooling 14,18 .…”

“…Only those participants who tested positive for altered cognition on both on tests were classified as having cognitive impairment 14,15 . The cutoff scores for MMSE were 17/18 for illiterate participants, 20/21 for those with one to four years of schooling, 23/24 for those with five to eight years and 25/26 for those with nine or more years of schooling 14,18 . On the BCSB, individuals with a score of 7 or less were considered positive for altered cognition 18 .…”

Adaptação para o português do Cambridge Cognitive Examination-Revised aplicado em um ambulatório público de geriatria

“…Vá-rios instrumentos padronizados para a avaliação cognitiva estão descritos na literatura 1,2,3,4,5 . Um destes é o Cambridge Cognitive Examination-Revised (CAMCOG-R), parte de um instrumento de avaliação mais abrangente chamado Cambridge Examination for Mental Disorders of the Elderly (CAMDEX-R) 6 .…”