Is the Cambridge Cognitive Examination - Revised a good tool for detection of dementia in illiterate Brazilian older adults?

Paradela, Emylucy Martins Paiva; Lourenço, Roberto Alves

doi:10.1111/ggi.12161

Cited by 8 publications

(10 citation statements)

References 37 publications

(71 reference statements)

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“…Complaints were evaluated in detail by the geriatricians in order to define the presence or absence of major depression or dysthymia. Assessment of cognitive level was carried out with the MMSE (Folstein et al, 1975;Lourenço and Veras, 2006) and with the Informant Questionnaire on Cognitive Decline in the Elderly (Roth et al, 1998;Paradela and Lourenço, 2014). The diagnosis of dementia syndrome was conducted by consensus among geriatricians and neuropsychologists according to the criteria of Diagnostic and Statistical Manual of Mental Disorder-Fourth Edition.…”

Section: Participants and Settingmentioning

confidence: 99%

The impact of dementia, depression and awareness on activities of daily living in a sample from a middle-income country

Mograbi

Morris

Fichman

et al. 2017

Int J Geriatr Psychiatry

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The findings highlight the importance of developing interventions and compensatory strategies to prevent loss of ADL in dementia, also suggesting that early intervention in older adults with depression should focus on advanced ADL to prevent social isolation and withdrawal. Finally, the findings indicate that self-information about ADL may be compromised in dementia, so clinicians exploring disability should consider fully different aspects of ADL in this group. Copyright © 2017 John Wiley & Sons, Ltd.

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“…Aprahamian et al described sensitivities/specificities of 88.1%/83.5%, and 84.6%/96% in subjects with 1‐4 y/5‐8 y of education, respectively, as regarding the accuracy of the original CAMCog in discriminating controls from patients with Alzheimer disease. Paradela and Lourenço reported these sensitivities and specificities to be 83%/85% for low (1‐4 y) educational level and 90%/76% for middle (5‐8 y) educational level when using the CAMCog‐R. The study by Aprahamian et al reported a sensitivity and specificity of 70.8% and 90% for controls/AD discrimination in highly educated (≥9 y) subjects.…”

Section: Discussionmentioning

confidence: 53%

Sensitivity and specificity of a briefer version of the Cambridge Cognitive Examination (CAMCog-Short) in the detection of cognitive decline in the elderly: An exploratory study

Radanovic

Facco

Forlenza

2018

Int J Geriatr Psychiatry

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“…In addition, scores may still depend on the years of education, as evidenced by the high rates of errors in the items involving reading and writing abilities, in the Cambridge Cognition Examination 20 . Consequently, the proposed adaptations may not be entirely suitable for the illiterate population 3,45,46,47 .…”

Section: Discussionmentioning

confidence: 99%

“…Overall, the reviewed studies highlight that social and cultural factors should be taken into account when interpreting cognitive screening results, and that screening approaches should overcome the impact of educational and sociocultural heterogeneity on cognition 21,41,45,58 , either by the adjustment of cut-off scores or appropriate test construction or adaptation 59,60 .…”

Section: Discussionmentioning

confidence: 99%

Screening for Alzheimer's disease in low-educated or illiterate older adults in Brazil: a systematic review

Ortega

Aprahamian

Borges

et al. 2019

Arq. Neuro-Psiquiatr.

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Cognitive screening instruments are influenced by education and/or culture. In Brazil, as illiteracy and low education rates are high, it is necessary to identify the screening tools with the highest diagnostic accuracy for Alzheimer's disease (AD). Objective: To identify the cognitive screening instruments applied in the Brazilian population with greater accuracy, to detect AD in individuals with a low educational level or who are illiterate. Methods: Systematic search in SciELO, PubMed and LILACS databases of studies that used cognitive screening tests to detect AD in older Brazilian adults with low or no education. Results: We found 328 articles and nine met the inclusion criteria. The identified instruments showed adequate or high diagnostic accuracy. Conclusion: For valid cognitive screening it is important to consider sociocultural and educational factors in the interpretation of results. The construction of specific instruments for the low educated or illiterate elderly should better reflect the difficulties of the Brazilian elderly in different regions of the country.

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“…Even the proper utilization of internationally accepted methods of diagnosis is not sufficient to avoid outcome bias; cultural and educational issues remain important challenges for accuracy [ 18 ]. Although some Brazilian studies utilized a version of CAMDEX translated and adapted to Portuguese [ 26 ], it was only in 2013 that a revised version, extensively cross-culturally adapted, became available [ 27 ]. These authors proved that the test is too difficult for illiterate individuals that comprised 51%, 17%, and 10% of the samples from Magalhães, Bottino, and Lopes.…”

Section: Discussionmentioning

confidence: 99%

Reliability of Nationwide Prevalence Estimates of Dementia: A Critical Appraisal Based on Brazilian Surveys

Chaimowicz

Burdorf

2015

PLoS ONE

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BackgroundThe nationwide dementia prevalence is usually calculated by applying the results of local surveys to countries’ populations. To evaluate the reliability of such estimations in developing countries, we chose Brazil as an example. We carried out a systematic review of dementia surveys, ascertained their risk of bias, and present the best estimate of occurrence of dementia in Brazil.Methods and FindingsWe carried out an electronic search of PubMed, Latin-American databases, and a Brazilian thesis database for surveys focusing on dementia prevalence in Brazil. The systematic review was registered at PROSPERO (CRD42014008815). Among the 35 studies found, 15 analyzed population-based random samples. However, most of them utilized inadequate criteria for diagnostics. Six studies without these limitations were further analyzed to assess the risk of selection, attrition, outcome and population bias as well as several statistical issues. All the studies presented moderate or high risk of bias in at least two domains due to the following features: high non-response, inaccurate cut-offs, and doubtful accuracy of the examiners. Two studies had limited external validity due to high rates of illiteracy or low income. The three studies with adequate generalizability and the lowest risk of bias presented a prevalence of dementia between 7.1% and 8.3% among subjects aged 65 years and older. However, after adjustment for accuracy of screening, the best available evidence points towards a figure between 15.2% and 16.3%.ConclusionsThe risk of bias may strongly limit the generalizability of dementia prevalence estimates in developing countries. Extrapolations that have already been made for Brazil and Latin America were based on a prevalence that should have been adjusted for screening accuracy or not used at all due to severe bias. Similar evaluations regarding other developing countries are needed in order to verify the scope of these limitations.

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Is the Cambridge Cognitive Examination - Revised a good tool for detection of dementia in illiterate Brazilian older adults?

Abstract: The Br-CAMCOG-R was useful for identifying cases of dementia among older adults with middle and low levels of literacy, but inadequate for the illiterate individuals.

Cited by 8 publications

References 37 publications

The impact of dementia, depression and awareness on activities of daily living in a sample from a middle-income country

Sensitivity and specificity of a briefer version of the Cambridge Cognitive Examination (CAMCog-Short) in the detection of cognitive decline in the elderly: An exploratory study

Screening for Alzheimer's disease in low-educated or illiterate older adults in Brazil: a systematic review

Reliability of Nationwide Prevalence Estimates of Dementia: A Critical Appraisal Based on Brazilian Surveys

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