Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-18T11:25:53.680Z Has data issue: false hasContentIssue false
  • English
  • Français

Predictors of cognitive decline in Alzheimer's disease and mild cognitive impairment using the CAMCOG: a five-year follow-up

Published online by Cambridge University Press:  26 January 2012

Josep L. Conde-Sala ,
Josep Garre-Olmo ,
Joan Vilalta-Franch ,
Jordi Llinàs-Reglà ,
Oriol Turró-Garriga ,
Manuela Lozano-Gallego ,
Marta Hernández-Ferrándiz ,
Immaculada Pericot-Nierga  and
Secundino López-Pousa
Josep L. Conde-Sala*
Affiliation:
Faculty of Psychology, University of Barcelona, Barcelona, Spain
Josep Garre-Olmo
Affiliation:
Department of Psychology, University of Girona, Girona, Spain Research Unit, Institut d'Assistència Sanitària, Salt, Spain
Joan Vilalta-Franch
Affiliation:
Research Unit, Institut d'Assistència Sanitària, Salt, Spain Dementia Unit, Hospital de Santa Caterina, Institut d'Assistència Sanitària, Salt, Spain
Jordi Llinàs-Reglà
Affiliation:
Dementia Unit, Hospital de Santa Caterina, Institut d'Assistència Sanitària, Salt, Spain
Oriol Turró-Garriga
Affiliation:
Research Unit, Institut d'Assistència Sanitària, Salt, Spain Dementia Unit, Hospital de Santa Caterina, Institut d'Assistència Sanitària, Salt, Spain
Manuela Lozano-Gallego
Affiliation:
Dementia Unit, Hospital de Santa Caterina, Institut d'Assistència Sanitària, Salt, Spain
Marta Hernández-Ferrándiz
Affiliation:
Dementia Unit, Hospital de Santa Caterina, Institut d'Assistència Sanitària, Salt, Spain
Immaculada Pericot-Nierga
Affiliation:
Dementia Unit, Hospital de Santa Caterina, Institut d'Assistència Sanitària, Salt, Spain
Secundino López-Pousa
Affiliation:
Research Unit, Institut d'Assistència Sanitària, Salt, Spain Dementia Unit, Hospital de Santa Caterina, Institut d'Assistència Sanitària, Salt, Spain
*
Correspondence should be addressed to: Josep Lluís Conde-Sala, University of Barcelona, Passeig Vall d'Hebron, 171, 08035 Barcelona, Spain. Phone: +34-93-312-58-14; Fax: +34-93-402-13-68. Email: [email protected].
Get access

Abstract

Background: There are discrepant findings regarding which subscales of the Cambridge Cognitive Examination (CAMCOG) are able to predict cognitive decline. The study aimed to identify the baseline CAMCOG subscales that can discriminate between patients and predict cognitive decline in Alzheimer's disease (AD) and mild cognitive impairment (MCI).

Methods: This was a five-year case-control study of patients with cognitive impairment and a control group. Participants were grouped into AD (n = 121), MCI converted to dementia (MCI-Ad, n = 43), MCI-stable (MCI-St, n = 66), and controls (CTR, n = 112). Differences in the mean scores obtained by the four groups were examined. Receiver operating characteristic curves were used to compare subscale scores in the AD and MCI-Ad groups with those of controls. The influence of age, gender, schooling, and depression on baseline subscale scores was assessed.

Results: Of the CAMCOG subscales, Orientation and Memory (learning and recent) (OR + MEM) showed the highest discriminant capacity in the baseline analysis of the four groups. This baseline analysis indicated that OR + MEM was the best predictor of conversion to AD in the MCI-Ad group (area under the curve, AUC = 0.81), whereas the predictive capacity of the global MMSE and CAMCOG scores was poor (AUC = 0.59 and 0.53, respectively).

Conclusions: In the baseline analysis, the Orientation and Memory (learning and recent) subscales showed the highest discriminant and predictive capacity as regards both cognitive decline in the AD group and conversion to AD among MCI-Ad patients. This was not affected by age, gender, schooling, or depression.

Keywords

risk factorsdementianeuropsychological testsconversion to dementiaorientationmemoryaging
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 6 , June 2012 , pp. 948 - 958
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2000). Manual Diagnóstico y Estadístico de Los Trastornos Mentales, 4th edn, texto revisado (DSM-IV-TR). Barcelona, Spain: Masson.Google Scholar
Armas, J. (2009). Clinical and neuropsychological risk factors to conversion from mild cognitive impairment to Alzheimer. Alzheimer's & Dementia, 5, P382.CrossRefGoogle Scholar
Blessed, G., Tomlinson, B. E. and Roth, M. (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 114, 797–811.CrossRefGoogle ScholarPubMed
Cabranes, J. A. et al. (2004). Relevance of functional neuroimaging in the progression of mild cognitive impairment. Neurological Research, 26, 496–501.CrossRefGoogle ScholarPubMed
Chapman, R. M. et al. (2010). Predicting conversion from mild cognitive impairment to Alzheimer's disease using neuropsychological tests and multivariate methods. Journal of Clinical and Experimental Neuropsychology, 13, 1–13.Google Scholar
Dierckx, E. et al. (2009).Verbal cued recall as a predictor of conversion to Alzheimer's disease in mild cognitive impairment. International Journal of Geriatric Psychiatry, 24, 1094–1100.Google Scholar
Dubois, B. et al. (2007). Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria. Lancet Neurology, 6, 734–746.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatry Research, 12, 397–408.Google Scholar
Gallagher, D. et al. (2010). Detecting prodromal Alzheimer's disease in mild cognitive impairment: utility of the CAMCOG and other neuropsychological predictors. International Journal of Geriatric Psychiatry, 25, 1280–1287.Google Scholar
Heinik, J. and Shaikewitz, D. (2009). The clock drawing test—modified and integrated approach (CDT-MIA) as an instrument for detecting mild cognitive impairment in a specialized outpatient setting. Journal of Geriatric Psychiatry and Neurology, 22, 171–180.Google Scholar
Horn, J. L. (1982). The theory of fluid and crystallized intelligence in relation to concepts of cognitive psychology and aging in adulthood. InCraik, F. I. M. and Trehud, S. (eds.), Aging and Cognitive Processes (pp. 237–278). New York: Plenum.CrossRefGoogle Scholar
Lekeu, F. et al. (2010). The California Verbal Learning Test and other standard clinical neuropsychological tests to predict conversion from mild memory impairment to dementia. Journal of Clinical and Experimental Neuropsychology, 32, 164–173.Google Scholar
López-Pousa, S., Vilalta-Franch, J., Llinàs-Reglà, J., Garre-Olmo, J. and Román, G. C. (2004). Incidence of dementia in a rural community in Spain: the Girona cohort study. Neuroepidemiology, 23, 170–177.CrossRefGoogle Scholar
Lozano-Gallego, M., Vilalta-Franch, J., Llinàs-Reglà, J. and López-Pousa, S. (1999). The Cambridge Cognitive Examination as a tool for detection of dementia. Revista de Neurología, 28, 348–352.Google ScholarPubMed
Lozano-Gallego, M., Llinàs-Reglà, J., López-Pousa, S. and Vilalta-Franch, J. (2000). El CAMDEX-R en la evaluación clínica de las demencias. Actas Españolas de Psiquiatría, 28, 125–129.Google Scholar
Marcos, A. et al. (2006). Neuropsychological markers of progression from mild cognitive impairment to Alzheimer's disease. American Journal of Alzheimer's Disease and Other Dementias, 21, 189–196.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer disease: report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer Disease. Neurology, 34, 939–944.CrossRefGoogle Scholar
Nielsen, H., Lolk, A., Andersen, K., Andersen, J. and Kragh-Sørensen, P. (1999). Characteristics of elderly who develop Alzheimer's disease during the next two years: a neuropsychological study using CAMCOG. The Odense Study. International Journal of Geriatric Psychiatry, 14, 957–963.3.0.CO;2-B>CrossRefGoogle Scholar
Nunes, P. V. et al. (2008). CAMCOG as a screening tool for diagnosis of mild cognitive impairment and dementia in a Brazilian clinical sample of moderate to high education. International Journal of Geriatric Psychiatry, 23, 1127–1133.Google Scholar
Oulhaj, A., Wilcock, G. K., Smith, A. D. and de Jager, C. A. (2009). Predicting the time of conversion to MCI in the elderly: role of verbal expression and learning. Neurology, 73, 1436–1442.CrossRefGoogle ScholarPubMed
Peña-Casanova, J. et al. . for the NORMACODEM Group (2005). Diagnostic value and test-retest reliability of the Blessed Dementia Rating Scale for Alzheimer's disease: data from the NORMACODEM project. Neurología, 20, 349–355.Google Scholar
Portet, F. et al. . for the MCI Working Group of the European Consortium on Alzheimer's Disease (EADC) (2006). Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer's Disease. Journal of Neurology, Neurosurgery & Psychiatry, 77, 714–718.Google Scholar
Rami, L., Bosch, B., Sanchez-Valle, R. and Molinuevo, J. L. (2010). The memory alteration test (M@T) discriminates between subjective memory complaints, mild cognitive impairment and Alzheimer's disease. Archives of Gerontology and Geriatrics, 50, 171–174.Google Scholar
Roth, M. et al. (1986). CAMDEX: a standardised instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. British Journal of Psychiatry, 149, 698–709.Google Scholar
Roth, M., Huppert, F. A., Tym, E. and Mountjoy, C. Q. (1998). CAMDEX-R: The Cambridge Examination for Mental Disorders of the Elderly - Revised. Cambridge: Cambridge University Press.Google Scholar
Schmand, B., Walstra, G., Lindeboom, J., Teunisse, S. and Jonker, C. (2000). Early detection of Alzheimer's disease using the Cambridge Cognitive Examination (CAMCOG). Psychological Medicine, 30, 619–627.CrossRefGoogle ScholarPubMed
Tabert, M. H. et al. (2006). Neuropsychological prediction of conversion to Alzheimer disease in patients with mild cognitive impairment. Archives of General Psychiatry, 63, 916–924.Google Scholar
Vilalta-Franch, J., Llinàs-Reglà, J., Lopez-Pousa, S., Amiel, J. and Vidal, C. (1990). The Cambridge Mental Disorders of the Elderly Examination: validation of the Spanish adaptation. Neurología, 5, 117–120.Google Scholar
Vilalta-Franch, J., López-Pousa, S. and Llinàs-Reglà, J. (2000). The prevalence of dementias in a rural area: a study in Girona. Revista de Neurología, 30, 1026–1032.Google Scholar
Williams, J. G., Huppert, F. A., Matthews, F. E. and Nickson, J. (2003). Performance and normative values of a concise neuropsychological test (CAMCOG) in an elderly population sample. International Journal of Geriatric Psychiatry, 18, 631–644.Google Scholar
Supplementary material: File

Conde Sala Supplementary Table 1

Table S1. ROC curves: CAMCOG subscales and MMSE

Download Conde Sala Supplementary Table 1(File)
File 37.9 KB
Supplementary material: File

Conde Sala Supplementary Table 2

Table S 2. Longitudinal changes after five years: Improvement and decline relative to baseline

Download Conde Sala Supplementary Table 2(File)
File 47.1 KB