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

Abstract

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.

The CAMCOG for patients with Alzheimer's disease with low levels of education

“…Finally, in spite of the results presented by Aprahamian et al (2011), the cumulative evidence of the last few decades is clear in pointing out that cultural level is heavily associated with cognitive performance, and that individuals with lower schooling have worse performance when compared with their higher schooled counterparts. Of course, there is no reason but one -bias -for a different behavior in the case of the CAMCOG.…”

“…In our opinion, the paper "Can the CAMCOG be a good cognitive test for patients with Alzheimer's disease with low levels of education?" (Aprahamian et al, 2011) is welcome as another trial by Brazilian scientists in this ongoing process. Notwithstanding, we believe that some comments about the methodological aspects of the paper are in order.…”

“…Therefore, from the point of view of scientific evidence, it is not incorrect to classify as having AD, some of the individuals diagnosed as having MCI, although in order to do this it is necessary to determine the individual status relative to biological markers of beta-amyloid protein deposition and neuronal injury, associated with AD (Albert et al, 2011). In their work, Aprahamian et al (2011) considered all 37 individuals classified as CDR = 0.5 as suffering from AD. This was almost a third of their total AD sample (113) classified by a questionable criterion, given that there is no determination of biological markers in their study protocol.…”

“…Secondly, the authors' statement that "the CAMCOG in its original and revised versions are validated in Brazil" (Aprahamian et al, 2011) must be put in perspective. To this end, we draw on the well-established concept of equivalences, as developed by Herdman et al (1998).…”

“…Of course, there is no denying that individuals with higher socioeconomic status also have better access to information and services throughout their lives, as well as intellectual challenges that constitute important stimuli for improving their cognitive capacity. The sample in the Aprahamian et al (2011) study was made up of 321 community-dwelling outpatients from a private geriatric institution. Although lacking full data on the sample's socioeconomic status, patients assisted at private clinics in Brazil are people with better economic conditions, since they have the means either to afford such services or to contribute to private health insurance policies.…”