Early detection of Alzheimer's disease using the Cambridge Cognitive Examination (CAMCOG).
BACKGROUND
Dementia screening instruments, such as the Cambridge Cognitive Examination (CAMCOG), measure a variety of cognitive functions. However, memory impairment generally is the first sign of Alzheimer's disease (AD). It seems logical, therefore, to use only memory-related items for the early detection of AD. We divided the CAMCOG into a memory section and a non-memory section, and tested the hypothesis that the memory section predicts AD better than the non-memory section. We also provide normative data for both sections.


METHODS
Normal subjects (N = 169) and patients with incident AD (i.e. satisfying AD criteria between 1 and 3 years from baseline: N = 25) were participants in the Amsterdam Study of the Elderly (AMSTEL), a population-based longitudinal study on cognitive decline and dementia. Patients with prevalent AD (i.e. satisfying AD criteria at baseline: N = 155) were either recruited in a memory clinic or came from AMSTEL. Normal subjects were cognitively intact at baseline and remained so for at least 3 years. The CAMCOG was administered to all subjects. AD was diagnosed by DSM-III-R criteria.


RESULTS
Logistic regression analysis showed that the memory section was related to prevalent AD, whereas in multivariate analysis the non-memory section was not (after correction for the memory score and demographic characteristics). A similar analysis showed that the memory section predicted incident AD, as did a higher score on the non-memory section. The MMSE did not predict incident AD better than age alone.


CONCLUSIONS
For the early detection of AD it is best to use the memory and non-memory sections separately instead of the total CAMCOG score.
Schmand
B
B
Department of Neurology, Academisch Medisch Centrum, Universiteit van Amsterdam, The Netherlands.
Walstra
G
G
Lindeboom
J
J
Teunisse
S
S
Jonker
C
C
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012680:Sensitivity and Specificity