scholarly journals Screening for Alzheimer's disease in low-educated or illiterate older adults in Brazil: a systematic review

2019 ◽  
Vol 77 (4) ◽  
pp. 279-288 ◽  
Author(s):  
Luciane de Fátima Viola Ortega ◽  
Ivan Aprahamian ◽  
Marcus Kiiti Borges ◽  
João de Castilho Cação ◽  
Mônica Sanches Yassuda
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Diagnostic Accuracy ◽  
Screening Tools ◽  
Screening Tests ◽  
Screening Instruments ◽  
Cognitive Screening ◽  
Inclusion Criteria ◽  
Low Education ◽  
Low Educated

ABSTRACT Cognitive screening instruments are influenced by education and/or culture. In Brazil, as illiteracy and low education rates are high, it is necessary to identify the screening tools with the highest diagnostic accuracy for Alzheimer's disease (AD). Objective: To identify the cognitive screening instruments applied in the Brazilian population with greater accuracy, to detect AD in individuals with a low educational level or who are illiterate. Methods: Systematic search in SciELO, PubMed and LILACS databases of studies that used cognitive screening tests to detect AD in older Brazilian adults with low or no education. Results: We found 328 articles and nine met the inclusion criteria. The identified instruments showed adequate or high diagnostic accuracy. Conclusion: For valid cognitive screening it is important to consider sociocultural and educational factors in the interpretation of results. The construction of specific instruments for the low educated or illiterate elderly should better reflect the difficulties of the Brazilian elderly in different regions of the country.

scholarly journals A new Brief computerized cognitive screening battery (CompCogs) for early diagnosis of Alzheimer's disease

2008 ◽  
Vol 2 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Helenice Charchat Fichman ◽  
Ricardo Nitrini ◽  
Paulo Caramelli ◽  
Koichi Sameshima
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Logistic Regression ◽  
Early Diagnosis ◽  
Short Term Memory ◽  
Neuropsychological Test ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Cognitive Components ◽  
Diagnosis Of Dementia

Abstract Screening tests for early diagnosis of dementia are of great clinical relevance. The ideal test set must be brief and reliable, and should probe cognitive components impaired in Alzheimer's disease (AD). Objectives: To develop a new Computerized Cognitive Screening test (CompCogs), and to investigate its validity for the early diagnosis of AD, and evaluate its heuristic value in understanding the processing of information in AD. Methods: The computerized neuropsychological performance battery, originally including six tests, was applied in forty seven patients with probable mild AD and 97 controls matched for age and education. This computerized neuropsychological test battery, developed with MEL Professional, allows control of timing and order of stimuli presentation, as well as recording of response type and latency. A brief-screening version, CompCogs, was selected using the most discriminative neuropsychological test variables derived from logistic regression analysis. Full battery administration lasted about 40 minutes, while the CompCogs took only 15 minutes. Results: CompCogs included the Face test (correct response) and Word and Forms with Short term memory tests (reaction time). CompCogs presented 91.8% sensitivity and 93.6% specificity for the diagnosis of AD using ROC analyses of AD diagnosis probability derived by logistic regression. Conclusions: CompCogs showed high validity for AD early diagnosis and, therefore, may be a useful alternative screening instrument.

The Short Cognitive Performance Test (SKT): a preliminary study of its psychometric properties in Brazil

2005 ◽  
Vol 18 (1) ◽  
pp. 121-133 ◽  
Author(s):  
Mariana K. Flaks ◽  
Monica S. Yassuda ◽  
Ana Carolina B. Regina ◽  
Carla G. Cid ◽  
Cândida H. P. Camargo ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Psychometric Properties ◽  
Cognitive Performance ◽  
Performance Test ◽  
Population Sample ◽  
Screening Tools ◽  
Screening Tests ◽  
Elderly Subjects ◽  
Dementia Screening

Background: Most instruments designed to detect dementia can lack appropriate sensitivity in the early stages of Alzheimer's disease (AD), and are subject to educational bias. The Short Cognitive Performance Test (Syndrom-Kurztest, SKT) is considered a suitable instrument to measure cognitive decline as it assesses memory, attention, and related cognitive functions, taking into account the speed of information processing.Objectives: The aim of this study was to examine the psychometric characteristics of the SKT as a dementia screening instrument in a Brazilian population sample, as compared to the Mini-mental State Examination (MMSE) and the Clock-Drawing Test (CDT). The effect of educational level on performance in the three screening tests was also verified.Methods: Fifty-one elderly subjects were assessed. Consensus diagnoses were established by an expert multidisciplinary team, considering clinical, neuropsychological and neuroimaging data. Subjects were further classified into those with (1) mild and moderate AD, (2) non-Alzheimer's dementia, (3) mild cognitive impairment, and (4) controls, according to National Institute for Communicative Disorders and Stroke – Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria.Results: Statistical analyses revealed high internal consistency for the SKT (Cronbach's α = 0.80) and significant correlations between the total score and the SKT subscores separately (p < 0.01). Comparison of the three tests revealed strong correlations between the SKT and the MMSE (r = −0.66, p < 0.0001) and between the SKT and the CDT (r = −0.57, p < 0.0001). The SKT, MMSE and CDT scores were correlated with education.Conclusions: The Brazilian version of the SKT maintains its original psychometric properties and displays significant correlation with previously validated screening tools for dementia. Like other dementia screening tests, the SKT is subject to educational bias.

Diagnostic accuracy of CERAD total score in a Colombian cohort with mild cognitive impairment and Alzheimer's disease affected by E280A mutation on presenilin-1 gene

2015 ◽  
Vol 28 (3) ◽  
pp. 503-510 ◽  
Author(s):  
Daniel Camilo Aguirre-Acevedo ◽  
Fabian Jaimes-Barragán ◽  
Eliana Henao ◽  
Victoria Tirado ◽  
Claudia Muñoz ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
High Education ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Education Level ◽  
Presenilin 1 ◽  
Education Group ◽  
Low Education

ABSTRACTBackground:This study aimed to determine Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Neuropsychological Assessment Battery total score diagnostic accuracy in the diagnosis of mild cognitive impairment (MCI) and dementia in familial Alzheimer's disease (FAD) with E280A mutation on presenilin-1 gene (PSEN1).Methods:A cross-sectional study was conducted in a cohort of PSEN1 E280A carriers and non-carriers assessed between January 1995 and February 2013. During the first neuropsychological assessment, 76 were having dementia, 46 had MCI, and 1,576 were asymptomatic. CERAD cut-off points were established for MCI and dementia using a Receiver Operating Characteristics (ROC) analysis, and were further analyzed according to education level in two groups: low education level (eight years or less), and high education level (over eight years).Results:The area under curve–ROC CERAD total score for dementia was 0.994 (95% CI = 0.989–0.999), and that for MCI was 0.862 (95% CI = 0.816–0.908). The dementia diagnosis cut-off point for the low education group was 54, (98.4% sensitivity, 92.6% specificity), and that for the high education group was 67 (100% sensitivity, 94.1% specificity). The MCI diagnosis cut-off point for the low education group was 66 (91.2% sensitivity, 56.4% specificity), and that for the high education group was 72 (91.7% sensitivity, 76.3% specificity).Conclusions:The CERAD total score is a useful screening tool for dementia and MCI in a population at risk of FAD.

[P3-446]: DIAGNOSTIC ACCURACY FOR ALZHEIMER DISEASE OF A SET OF COGNITIVE SCREENING TESTS APPROPRIATE FOR LOW EDUCATION

2017 ◽  
Vol 13 (7S_Part_23) ◽  
pp. P1140-P1141
Author(s):  
Luciane de Fátima Viola Ortega ◽  
Anelize de Carvalho Ferreira ◽  
Luana Colturato Dalul ◽  
Ana Carolina Garcia e Garcia ◽  
Silvia Aparecida Soares ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Diagnostic Accuracy ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Low Education

Performance of three cognitive screening tools in a sample of older New Zealanders

2015 ◽  
Vol 27 (6) ◽  
pp. 981-989 ◽  
Author(s):  
G. Cheung ◽  
A. Clugston ◽  
M. Croucher ◽  
D. Malone ◽  
E. Mau ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Cognitive Assessment ◽  
Random Order ◽  
Screening Tools ◽  
Screening Tests ◽  
Future Research ◽  
Clinical Settings ◽  
Strongly Correlated ◽  
Cognitive Screening ◽  
Mild Dementia

ABSTRACTBackground:With the ubiquitous Mini-Mental State Exam now under copyright, attention is turning to alternative cognitive screening tests. The aim of the present study was to investigate three common cognitive screening tools: the Montreal Cognitive Assessment (MoCA), the Rowland Universal Dementia Assessment Scale (RUDAS), and the recently revised Addenbrooke's Cognitive Assessment Version III (ACE-III).Methods:The ACE-III, MoCA and RUDAS were administered in random order to a sample of 37 participants with diagnosed mild dementia and 47 comparison participants without dementia. The diagnostic accuracy of the three tests was assessed.Results:All the tests showed good overall accuracy as assessed by area under the ROC Curve, 0.89 (95% CI = 0.80–0.95) for the ACE-III, 0.84 (0.75–0.91) for the MoCA, and 0.86 (0.77–0.93) for RUDAS. The three tests were strongly correlated: r(84) = 0.85 (0.78–0.90) between the ACE-III and MoCA, 0.70 (0.57–0.80) between the ACE-III and RUDAS; and 0.65 (0.50–0.76) between the MoCA and RUDAS. The data derived optimal cut-off points for were lower than the published recommendations for the ACE-III (optimal cut-point ≤76, sensitivity = 81.1%, specificity = 85.1%) and the MoCA (≤20, sensitivity = 78.4%, specificity = 83.0%), but similar for the RUDAS (≤22, sensitivity = 78.4%, specificity = 85.1%).Conclusions:All three tools discriminated well overall between cases of mild dementia and controls. To inform interpretation of these tests in clinical settings, it would be useful for future research to address more inclusive and potentially age-stratified local norms.

scholarly journals On the design of early-phase Alzheimer’s disease clinical trials with cerebrospinal fluid tau outcomes

2021 ◽  
pp. 174077452110344
Author(s):  
Michelle M Nuño ◽  
Joshua D Grill ◽  
Daniel L Gillen ◽  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Clinical Trials ◽  
Cerebrospinal Fluid ◽  
Phosphorylated Tau ◽  
Inclusion Criteria ◽  
Eligibility Criteria ◽  
Total Tau ◽  
Prodromal Alzheimer’S Disease ◽  
Study Power

Background/Aims: The focus of Alzheimer’s disease studies has shifted to earlier disease stages, including mild cognitive impairment. Biomarker inclusion criteria are often incorporated into mild cognitive impairment clinical trials to identify individuals with “prodromal Alzheimer’s disease” to ensure appropriate drug targets and enrich for participants likely to develop Alzheimer’s disease dementia. The use of these eligibility criteria may affect study power. Methods: We investigated outcome variability and study power in the setting of proof-of-concept prodromal Alzheimer’s disease trials that incorporate cerebrospinal fluid levels of total tau (t-tau) and phosphorylated (p-tau) as primary outcomes and how differing biomarker inclusion criteria affect power. We used data from the Alzheimer’s Disease Neuroimaging Initiative to model trial scenarios and to estimate the variance and within-subject correlation of total and phosphorylated tau. These estimates were then used to investigate the differences in study power for trials considering these two surrogate outcomes. Results: Patient characteristics were similar for all eligibility criteria. The lowest outcome variance and highest within-subject correlation were obtained when phosphorylated tau was used as an eligibility criterion, compared to amyloid beta or total tau, regardless of whether total tau or phosphorylated tau were used as primary outcomes. Power increased when eligibility criteria were broadened to allow for enrollment of subjects with either low amyloid beta or high phosphorylated tau. Conclusion: Specific biomarker inclusion criteria may impact statistical power in trials using total tau or phosphorylated tau as the primary outcome. In concert with other important considerations such as treatment target and population of clinical interest, these results may have implications to the integrity and efficiency of prodromal Alzheimer’s disease trial designs.

scholarly journals Interaction of Alzheimer’s Disease-Associated Genetic Risk with Indicators of Socioeconomic Position on Mild Cognitive Impairment in the Heinz Nixdorf Recall Study

2021 ◽  
pp. 1-11
Author(s):  
Mirjam Frank ◽  
Jonas Hensel ◽  
Lisa Baak ◽  
Sara Schramm ◽  
Nico Dragano ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Socioeconomic Position ◽  
Genetic Risk ◽  
Late Onset ◽  
Heinz Nixdorf Recall Study ◽  
Low Education ◽  
Additive Scale

Background: The apolipoprotein E (APOE) ɛ4 allele is reported to be a strong genetic risk factor for mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Additional genetic loci have been detected that influence the risk for late-onset AD. As socioeconomic position (SEP) is also strongly related to cognitive decline, SEP has been suggested to be a possible modifier of the genetic effect on MCI. Objective: To investigate whether APOE ɛ4 and a genetic sum score of AD-associated risk alleles (GRSAD) interact with SEP indicators to affect MCI in a population-based cohort. Methods: Using data of 3,834 participants of the Heinz Nixdorf Recall Study, APOE ɛ4 and GRSAD by SEP interactions were assessed using logistic regression models, as well as SEP-stratified genetic association analysis. Interaction on additive scale was calculated using the relative excess risk due to interaction (RERI). All analysis were additionally stratified by sex. Results: Indication for interaction on the additive scale was found between APOE ɛ4 and low education on MCI (RERI: 0.52 [95% -confidence interval (CI): 0.01; 1.03]). The strongest genetic effects of the APOE ɛ4 genotype on MCI were observed in groups of low education (Odds ratio (OR): 1.46 [95% -CI: 0.79; 2.63] for≤10 years of education versus OR: 1.00 [95% -CI: 0.43; 2.14] for≥18 years of education). Sex stratified results showed stronger effects in women. No indication for interaction between the GRSAD and SEP indicators on MCI was observed. Conclusion: Results indicate that low education may have an impact on APOE ɛ4 expression on MCI, especially among women.

scholarly journals Validity of the QUADAS-2 in Assessing Risk of Bias in Alzheimer's Disease Diagnostic Accuracy Studies

2018 ◽  
Vol 9 ◽  
Author(s):  
Alisson Venazzi ◽  
Walter Swardfager ◽  
Benjamin Lam ◽  
José de Oliveira Siqueira ◽  
Nathan Herrmann ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Diagnostic Accuracy ◽  
Risk Of Bias
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