Brazilian version of the European Cross-Cultural Neuropsychological Test Battery (CNTB-BR): diagnostic accuracy across schooling levels

Abstract

Objective: To translate, establish the diagnostic accuracy, and standardize the Brazilian Portuguese version of the European Cross-Cultural Neuropsychological Test Battery (CNTB) considering schooling level. Methods: We first completed an English-Brazilian Portuguese translation and back-translation of the CNTB. A total of 135 subjects aged over 60 years-65 cognitively healthy (mean 72.83, SD = 7.71; mean education 9.42, SD = 7.69; illiterate = 25.8%) and 70 with Alzheimer's disease (AD) (mean 78.87, SD = 7.09; mean education 7.62, SD = 5.13; illiterate = 10%)-completed an interview and were screened for depression. The receiver operating characteristic (ROC) analysis was used to verify the accuracy of each CNTB test to separate AD from healthy controls in participants with low levels of education (p 4 years of schooling) and high levels of education (X 8 years of schooling). The optimal cutoff score was determined for each test. Results: The Recall of Pictures Test (RPT)-delayed recall and the Enhanced Cued Recall (ECR) had the highest power to separate AD from controls. The tests with the least impact from schooling were the Rowland Universal Dementia Assessment Scale (RUDAS), supermarket fluency, RPT naming, delayed recall and recognition, and ECR. Conclusions: The Brazilian Portuguese version of the CNTB was well comprehended by the participants. The cognitive tests that best discriminated patients with AD from controls in lower and higher schooling participants were RPT delayed recall and ECR, both of which evaluate memory.

The Figure Memory Test: diagnosis of memory impairment in populations with heterogeneous educational background

“…At the end of 2020, Araujo et al 68 published the translation and diagnostic accuracy of the Brazilian version of the European Cross-Cultural Neuropsychological Test Battery (CNTB). This battery, which was designed for diagnosing dementia in immigrants or low-educated individuals living in European countries, consists of single tests.…”

“…69 Among them, the test with the highest accuracy in differentiating patients with AD from cognitively healthy controls is the Recall of Pictures Test (RPT), particularly the delayed recall subtest.68,69 According to Araujo et al, this test is "similar to a test from the Brief Cognitive Screening Battery (BCSB), except that color pictures are used." 68 The figures in the FMT and the RPT are identical (except for the bucket, which was replaced by a trash can). The testing procedure is the same, and in both FMT and RPT, the semantic Verbal Fluency (animals in one minute) and the CDT are included as interference tests between Learning (encoding) and Delayed Recall.…”

The memory test of the Brief Cognitive Screening Battery is the same as the Recall of Pictures Test of the European Cross-Cultural Neuropsychological Test Battery

“…We read with interest the paper by Araujo et al 1 on the translation and diagnostic accuracy of the Brazilian version of the European Cross-Cultural Neuropsychological Test Battery (CNTB). This battery consists of simple tests for diagnosing dementia in immigrants or low-educated individuals living in European countries.…”

“… 2 The test that differentiated patients with Alzheimer’s disease from cognitively healthy controls with the highest accuracy was the Recall of Pictures Test (RPT), particularly the delayed recall task. 1 , 2 According to Araujo et al, 1 this test is “similar to a test from the Brief Cognitive Screening Battery (BCSB), 3 except that color pictures are used.” The reason given for using color pictures instead of black and white line drawings was that color information “can improve the recognition of pictures in illiterate and less schooled individuals.” 2 …”

Recall of Pictures Test included in the European Cross-Cultural Neuropsychological Test Battery

“…In response our recent paper titled “Brazilian version of the European Cross-Cultural Neuropsychological Test Battery,” 1 Nitrini et al argue that the Recall of Pictures Test (RPT) is “the color version of the Brief Cognitive Screening Battery (BCSB) memory test” 2 and claim that Nielsen et al 3 have not given due credit to the original authors of the BSCB memory test.…”