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Can the CAMCOG be a good cognitive test for patients with Alzheimer's disease with low levels of education?

Published online by Cambridge University Press:  03 August 2010

Ivan Aprahamian*
Affiliation:
Psychogeriatric Unit, Laboratory of Neuroscience (LIM 27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil
José Eduardo Martinelli
Affiliation:
Geriatrics Division, Jundiaí Medical School, Jundiaí, Brazil
Juliana Cecato
Affiliation:
Geriatrics Division, Jundiaí Medical School, Jundiaí, Brazil
Rafael Izbicki
Affiliation:
Psychogeriatric Unit, Laboratory of Neuroscience (LIM 27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil
Mônica Sanches Yassuda
Affiliation:
Gerontology Division, School of Arts, Sciences and Humanities, São Paulo, Brazil
*
Correspondence should be addressed to: Ivan Aprahamian, MD, MSc, Laboratory of Neurosciences – LIM 27, Rua Dr. Ovidio Pires de Campos, 785, 3rd Floor, Cerqueira César, São Paulo, SP, CEP 05403-010, Brazil. Phone: +55 11 3063 5955; Fax: +55 11 3085 5412. Email: ivan.aprahamian@terra.com.br.

Abstract

Background: The Cambridge Cognitive Examination (CAMCOG) is a useful test in screening for Alzheimer's disease (AD). However, the interpretation of CAMCOG cut-off scores is problematic and reference values are needed for different educational strata. Given the importance of earlier diagnoses of mild dementia, new cut-off values are required which take into account patients with low levels of education. This study aims to evaluate whether the CAMCOG can be used as an accurate screening test among AD patients and normal controls with different educational levels.

Methods: Cross-sectional assessment was undertaken of 113 AD and 208 elderly controls with heterogeneous educational levels (group 1: 1–4 years; group 2: 5–8 years; and group 3: ≥ 9 years) from a geriatric clinic. submitted to a thorough diagnostic evaluation for AD including the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX). Controls had no cognitive or mood complaints. Sensitivity (SE) and specificity (SP) for the CAMCOG in each educational group was assessed with receiver-operator-characteristic (ROC) curves.

Results: CAMCOG mean values were lower when education was reduced in both diagnostic groups (controls – group 1: 87; group 2: 91; group 3: 96; AD – group 1: 63; group 2: 62; group 3: 77). Cut-off scores for the three education groups were 79, 80 and 90, respectively. SE and SP varied among the groups (group 1: 88.1% and 83.5%; group 2: 84.6% and 96%; group 3: 70.8% and 90%).

Conclusion: The CAMCOG can be used as a cognitive test for patients with low educational level with good accuracy. Patients with higher education showed lower scores than previously reported.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2010

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