Psychological Medicine



Early detection of Alzheimer's disease using the Cambridge Cognitive Examination (CAMCOG)


B. SCHMAND a1c1, G. WALSTRA a1, J. LINDEBOOM a1, S. TEUNISSE a1 and C. JONKER a1
a1 Department of Neurology, Academisch Medisch Centrum, Universiteit van Amsterdam, AMSTEL Project, Institute of Extramural Research, Vrije Universiteit and Academic Hospital of the Vrije Universiteit, Department of Medical Psychology, Amsterdam, The Netherlands; and Department of Psychology, University of Aberdeen

Abstract

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.

Conclusion. For the early detection of AD it is best to use the memory and non-memory sections separately instead of the total CAMCOG score.


Correspondence:
c1 Address for correspondence: Dr Ben Schmand, Department of Neurology, H2-222, Academic Medical Center, University of Amsterdam, PO Box 22700, NL-1100 DE Amsterdam, The Netherlands.


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