Validating the DemTect with 18-fluoro-2-deoxy-glucose positron emission tomography as a sensitive neuropsychological screening test for early alzheimer disease in patients of a memory clinic.
OBJECTIVE
The first study to validate the diagnostic value of the DemTect, a short neuropsychological screening test for dementia (8-10 min), using 18-fluoro-2-deoxy-glucose positron emission tomography (FDG-PET) in patients of a memory clinic.


METHODS
DemTect results were compared to the clinical diagnosis and to FDG-PET as a reference method for the early in vivo detection of Alzheimer's disease (AD).


RESULTS
38 patients (age 65.2 +/- 9.8 years, 16 men, 22 women) were investigated using clinical standard examination, FDG-PET, and cranial magnetic resonance imaging. According to NINCDS-ADRDA and Petersen's criteria, 18 patients had dementia of the Alzheimer type (DAT) and 13 patients received the diagnosis of mild cognitive impairment (MCI). Compared to the clinical diagnosis, a DemTect cutoff score of < or =11 points demonstrated good sensitivity (83.3%) and specificity (70.0%) for the detection of DAT, whereas the best cutoff score for MCI was < or =13 points with comparable sensitivity (84.6%) and specificity (85.7%). With regard to FDG-PET, the DemTect demonstrated excellent sensitivity (93%) and low specificity (50%) for the detection of AD-typical patterns of cerebral glucose metabolism (cutoff < or =13 points).


CONCLUSIONS
DemTect is a favorable neuropsychological screening instrument for detecting cognitive dysfunction even in predementia stages of AD. For definite cross-sectional diagnosis, further diagnostic evaluation with higher specificity, e.g. comprehensive neuropsychological examination, FDG-PET or other biomarkers, is necessary.
Scheurich
Armin
A
Department of Psychiatry, University of Mainz, Mainz, Germany. scheurich@psychiatrie.klinik.uni-mainz.de
Muller
Matthias J
MJ
Siessmeier
Thomas
T
Bartenstein
Peter
P
Schmidt
Lutz G
LG
Fellgiebel
Andreas
A
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000523:psychology; D003071:Cognition / Q000502:physiology; D003627:Data Interpretation, Statistical; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000523:psychology; D008297:Male; D008568:Memory / Q000502:physiology*; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D012372:ROC Curve; D019275:Radiopharmaceuticals
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18