P2–214: CAMCOG as a screening tool for diagnosis of mild cognitive impairment and dementia in Brazil

Combining Cognitive Screening Tests for the Evaluation of Mild Cognitive Impairment in the Elderly

“…Objective cognitive impairment was defined as performance below −1.5 standard deviations in the neuropsychological evaluation, adjusted by age and educational level in the São Paulo elderly population. 9 , 25 Diagnosis of amnestic MCI was made according to the following criteria 26 , 27 : (1) subjective cognitive complaint, preferably corroborated by an informant; (2) objective memory impairment in the neuropsychological assessment; (3) preserved global intellectual function; (4) preserved or minimal impairments in activities of daily living; (5) no signs of dementia. Diagnosis of Alzheimer’s disease was carried out according to established diagnostic criteria 28 .…”

“…Brief cognitive batteries, such as the Cambridge Cognitive Test (CAMCOG), 8 also lack sensitivity to discriminate patients with MCI from cognitively unimpaired subjects, in spite of having a better diagnostic accuracy as compared to its subcomponents, e.g., the Mini-Mental State Examination (MMSE), Verbal Fluency Test (VFT) and Clock Drawing Test (CDT). 9 In clinical settings, the qualitative analysis of the performance in specific cognitive screening may help to improve diagnostic accuracy to detect mild but relevant deficits. 10 …”

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

“…Nevertheless, the CAMCOG appears to be affected by age, gender, social class, and education (Huppert et al ., 1995; Cullum et al ., 2000; Williams et al ., 2003). Although cognitive changes can be detected by the CAMCOG years before the diagnosis of AD (Nielsen et al ., 1999), patients with early stage AD and mild cognitive impairment need a different cut-off for their discrimination from controls (Schmand et al ., 2000; Nunes et al ., 2008). Recently, the CAMCOG also was shown to be vulnerable to education bias (Yassuda et al ., 2009).…”

Reply

“…(2001), who presented data suggesting appropriate psychometric characteristics for the battery. Several other Brazilian studies have used this version (Nunes et al ., 2008). We also agree with our colleagues that “participation in social, cultural and labor activities are fundamental experiences which determine the overall capacity of the brain.” One of the interesting points of our paper is showing that the CAMCOG depends upon aspects other than education.…”

“…(2001), who presented data suggesting appropriate psychometric characteristics for the battery. Several other Brazilian studies have used this version (Nunes et al ., 2008).…”