title: Accuracy of a Brief Neuropsychological Battery for the Diagnosis of Dementia and Mild Cognitive Impairment: An Analysis of the NEDICES Cohort.
abstract: Early separation of mild cognitive impairment (MCI) from normal aging and mild cases of dementia remains a challenge, especially in the general population. We aimed to analyze the diagnostic accuracy of a brief neuropsychological battery (BNB) in dementia and MCI cases from the Neurological Disorders in Central Spain (NEDICES) population-based cohort study. We screened 3,891 participants into dementia and non-dementia groups using a two-phase procedure: screening (MMSE-37 and Pfeffer-11) and clinical diagnosis by specialists (DSM-IV criteria). We selected subsequently a subsample of dementia (n = 98), MCI (n = 71), and cognitively healthy (n = 123) participants matched in socio-demographic characteristics. The clinical validity of each test of the BNB was determined by the area under the ROC curve. We determined the best combination of tests to classify individuals into the diagnostic groups by logistic regression analyses. The results indicated that dementia and MCI groups could be best discriminated from the healthy control group on the basis of their scores on the semantic verbal fluency and delayed recall subtests of the BNB. As for discriminating the MCI group from the dementia group, immediate recall tasks (stories and pictures) yielded the highest level of accuracy. Probably the most interesting finding is that the verbal fluency task consistently allowed discrimination among the diagnostic groups. Overall, subtests of the BNB are more accurate in differentiating dementia patients than MCI patients from healthy controls. In this population-based sample, a more fine-grained discrimination that includes MCI patients should follow a systematic subtest-wise analysis and decision.
authors.affiliation: Department of Personality, Evaluation and Psychological Treatment, University of Salamanca, Salamanca, Spain.
authors.forename: Adriana
authors.initials: A
authors.lastname: Serna
authors.affiliation: Department of Basic Psychology, Psychobiology and Methodology of Behavioral Science, University of Salamanca, Salamanca, Spain.
authors.forename: Israel
authors.initials: I
authors.lastname: Contador
authors.affiliation: Research Institute (Imas12), University Hospital "12 de Octubre", Madrid, Spain.|Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain.|Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), Madrid, Spain.
authors.forename: Félix
authors.initials: F
authors.lastname: Bermejo-Pareja
authors.affiliation: Leicestershire Partnership NHS Trust and University of Leicester, UK.
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Mitchell
authors.affiliation: Department of Psychology, Federal University of Rio Grande do Norte, Brazil.
authors.forename: Bernardino
authors.initials: B
authors.lastname: Fernández-Calvo
authors.affiliation: Department of Personality, Evaluation and Psychological Treatment, University of Salamanca, Salamanca, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Ramos
authors.affiliation: Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), Madrid, Spain.|Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Villarejo
authors.affiliation: Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), Madrid, Spain.|Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.
authors.forename: Julián
authors.initials: J
authors.lastname: Benito-León
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D018672:Community Health Planning; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D013030:Spain / Q000453:epidemiology
keywords: Dementia; memory; mild cognitive impairment; neuropsychological assessment; population based-study; test accuracy