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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: jllconde@ub.edu.
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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

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Supplementary material: File

Conde Sala Supplementary Table 1

Table S1. ROC curves: CAMCOG subscales and MMSE

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Supplementary material: File

Conde Sala Supplementary Table 2

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

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