title: Early detection of memory impairment in people over 65 years old consulting at Health Examination Centers for the French health insurance: the EVATEM protocol.
abstract: BACKGROUND
  Only half of those living with Alzheimer's disease in France are currently diagnosed, and only one patient in three is supported during the early stages of dementia. This study aims to evaluate three cognitive tests for their predictive ability to diagnose mild cognitive impairments and Alzheimer's disease and related disorders. For people aged 65 years or over, presenting with a memory complaint, these tests can be performed easily during a preventative consultation.
  
  
  METHODS
  The EVATEM (évaluation des troubles de l'équilibre et de la mémoire (evaluation of balance and memory problems)) cohort study was designed to prospectively assess the predictive value of tests for the diagnosis of mild cognitive impairments and Alzheimer's disease in elderly subjects aged 65 years or over. Subjects were recruited from three health examination centers that are part of the French health insurance system. If a memory complaint was identified (using a dedicated questionnaire), the five-word test, the cognitive disorders examination test and the verbal fluency test were administered during a preventative consultation. A memory consultation was performed at a University Hospital to diagnosis any potential cognitive disorder and a one-year follow-up consultation was also scheduled. We recorded 2041 cases of memory complaint at our Health Examination Centers. Cognitive tests were refused by 33.6% of people who had a memory complaint. The number of subjects sent to a University Hospital memory consultation was 832 and 74.5% of them completed this consultation. The study population therefore includes 620 subjects.
  
  
  CONCLUSIONS
  Tests for the early diagnosis of a mild cognitive impairment or Alzheimer's disease and related disorders should be used in centers dedicated to disease prevention. These should guide subjects with memory impairment to full memory consultations at hospitals and improve the access to early medical and behavioral support.
  
  
  BACKGROUND
  ClinicalTrials.gov:NCT01316562.
authors.affiliation: Centre d'Examens de Santé de la CPAM du Rhône, Lyon, France. Christiane.nitenberg@cpam-rhone.cnamts.fr
authors.forename: Christiane
authors.initials: C
authors.lastname: Vannier-Nitenberg
authors.forename: Virginie
authors.initials: V
authors.lastname: Dauphinot
authors.forename: Bienvenu
authors.initials: B
authors.lastname: Bongue
authors.forename: Catherine
authors.initials: C
authors.lastname: Sass
authors.forename: Isabelle
authors.initials: I
authors.lastname: Rouch
authors.forename: Olivier
authors.initials: O
authors.lastname: Beauchet
authors.forename: Pierre
authors.initials: P
authors.lastname: Krolak-Salmon
authors.forename: Bruno
authors.initials: B
authors.lastname: Fantino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D015331:Cohort Studies; D003151:Community Health Centers; D042241:Early Diagnosis; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D007348:Insurance, Health; D008569:Memory Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D009483:Neuropsychological Tests; D011446:Prospective Studies; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology