Memory Alteration Test to Detect Amnestic Mild Cognitive Impairment and Early Alzheimer’s Dementia in Population with Low Educational Level

Abstract

Background/Aims: Short tests to early detection of the cognitive impairment are necessary in primary care setting, particularly in populations with low educational level. The aim of this study was to assess the performance of Memory Alteration Test (M@T) to discriminate controls, patients with amnestic Mild Cognitive Impairment (aMCI) and patients with early Alzheimer’s Dementia (AD) in a sample of individuals with low level of education.Methods: Cross-sectional study to assess the performance of the M@T (study test), compared to the neuropsychological evaluation (gold standard test) scores in 247 elderly subjects with low education level from Lima-Peru. The cognitive evaluation included three sequential stages: (1) screening (to detect cases with cognitive impairment); (2) nosological diagnosis (to determinate specific disease); and (3) classification (to differentiate disease subtypes). The subjects with negative results for all stages were considered as cognitively normal (controls). The test performance was assessed by means of area under the receiver operating characteristic (ROC) curve. We calculated validity measures (sensitivity, specificity and correctly classified percentage), the internal consistency (Cronbach’s alpha coefficient), and concurrent validity (Pearson’s ratio coefficient between the M@T and Clinical Dementia Rating (CDR) scores).Results: The Cronbach’s alpha coefficient was 0.79 and Pearson’s ratio coefficient was 0.79 (p < 0.01). The AUC of M@T to discriminate between early AD and aMCI was 99.60% (sensitivity = 100.00%, specificity = 97.53% and correctly classified = 98.41%) and to discriminate between aMCI and controls was 99.56% (sensitivity = 99.17%, specificity = 91.11%, and correctly classified = 96.99%).Conclusions: The M@T is a short test with a good performance to discriminate controls, aMCI and early AD in individuals with low level of education from urban settings.

Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America

“…Administration is not standardized; the cultural and socioeconomic characteristics of the patient may bias scores, and the tool can detect dementia only in individuals with at least 5 years of education; the tool does not measure executive function; finally, the MMSE can only detect moderate or advanced dementia, and is not sensitive to early-stage Alzheimer's disease dementia (ADD) or non-Alzheimer's dementias (Dubois et al, 2000 ). Recently, other BCSs have been proposed as substitutes, such as the Montreal cognitive assessment (MoCA) (Gómez et al, 2013 ; Pereira-Manrique and Reyes, 2013 ; Gil et al, 2014 ; Pedraza et al, 2016 ; Aguilar-Navarro et al, 2017 ; Delgado et al, 2017 ), Addenbrooke's cognitive examination (ACE) (Sarasola et al, 2005 ; Custodio et al, 2012 ; Herrera-Pérez et al, 2013 ), ACE-III (Bruno et al, 2017 ), and Addenbrooke's cognitive examination-revised (ACE-R) (Torralva et al, 2011 ; Muñoz-Neira et al, 2012a ; Ospina, 2015 ), as well as complimentary tools designed to measure specific domains such as the memory alteration test (M@T) (Custodio et al, 2014 , 2017a ), INECO frontal screening (IFS) (Torralva et al, 2009 ; Ihnen Jory et al, 2013 ; Custodio et al, 2016 ), and frontal assessment battery (FAB; Dubois et al, 2000 ).…”

Cognitive Assessment Tools for Screening Older Adults With Low Levels of Education: A Critical Review

“…However, detailed information was not available in all studies. Adults with AD had 1.69 (51) to 7.6 years (29) of schooling and those with MCI had 2.53 (38) to 10.93 years (33) of schooling. The proportion of illiterate adults ranged from 1.8% (35) to 32.1% (23).…”

“…The SIS showed low sensitivity for screening MCI in this population (sensitivity = 34.3%; specificity = 90.1%). The Memory Alteration Test (MAT) was used in a single study (38) for discriminating MCI and AD from healthy individuals. The AUC of MAT to discriminate between early AD and amnestic mild cognitive impairment (aMCI) was 99.60% (sensitivity = 100.00%; specificity = 97.53%) and to discriminate between aMCI and controls was 99.56% (sensitivity = 99.17%; specificity = 91.11%).…”

“…The mean score was 17. 54 In this review, six studies ( Table 2) assessed cutoff scores of the MMSE for adults with 4 years of education or less (25,36,38,40,45,48). MCI cutoff scores (SD) ranged from 17.8 (1.9) to 21.36 (0.98), but there was great variation in sensitivity and specificity.…”

Experiencia en el área de neuropsicología de un hospital

“…Las personas entre 70 y 79 años tienen un aumento en el 10% en la prevalencia del deterioro cognitivo (Custodio et al, 2013). que mide memoria inmediata, memoria de orientación temporal, memoria remota, memoria de evocación libre y memoria de evocación con pistas (Custodio et al, 2017). Se eligió esta prueba ya que la memoria que es la capacidad que tiene la persona para retener la información que uno adquiere (Valencia, Morante y Soto, 2014) y poder manipularla es un indicador sensible de la reducción de resto de funciones cognitivas (Leite, Castioni, Kirchner y Hildebrandt, 2015…”