Performance of cognitive tests, individually and combined, for the detection of cognitive disorders amongst community-dwelling elderly people with memory complaints: the EVATEM study

• Published in: European journal of neurology Vol. 23; no. 3; pp. 554 - 561
• Main Authors: Vannier-Nitenberg, C., Dauphinot, V., Bongue, B., Sass, C., Bathsavanis, A., Rouch, I., Deville, N., Beauchet, O., Krolak-Salmon, P., Fantino, B.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.03.2016; John Wiley & Sons, Inc
• Subjects: Aged; Aged, 80 and over; Alzheimer's disease; Cognitive ability; cognitive disorders; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - epidemiology; Complaints; Cross-Sectional Studies; Dementia; Dementia - diagnosis; Dementia - epidemiology; early diagnosis; Female; Follow-Up Studies; France - epidemiology; Humans; Independent Living - statistics & numerical data; Male; Memory; memory complaint; Memory Disorders - diagnosis; Memory Disorders - epidemiology; mild cognitive impairment; Neuropsychological Tests; Older people; Teenagers; early diagnosis; memory complaint; dementia; mild cognitive impairment; Alzheimer's disease; cognitive disorders
• ISSN: 1351-5101; 1468-1331; 1468-1331
• DOI: 10.1111/ene.12888

Background and purpose Dementia is a leading cause of dependence amongst the aged population. Early identification of cognitive impairment could help to delay advanced stages of dependence. This study aimed at assessing the performance of three neuropsychological tests to detect cognitive disorders in elderly subjects with memory complaints. Methods The EVATEM study is a prospective multicentre cohort with a 1‐year follow‐up. Subjects with memory complaints were selected during preventive health examinations, and three neuropsychological tests (five‐word, cognitive disorders examination, verbal fluency) were administered. Two groups were identified in memory clinics: (i) cognitively healthy individuals (CHI) and (ii) mild cognitive impairment or demented individuals (MCI‐DI). Cross‐sectional analyses were performed on data at inclusion. The relationship between the diagnosis of MCI‐DI/CHI and the neuropsychological tests was assessed using logistic regressions. The performance of the neuropsychological tests, individually and combined, to detect cognitive disorders was calculated. Results Of 585 subjects, 31.11% had cognitive disorders (MCI, 176 subjects; DI, six subjects). Amongst the three tests studied, the odds ratio for MCI‐DI was higher for the five‐word test <10 [odds ratio 3.2 (1.81; 5.63)]. The best performance was observed when the three tests were combined: specificity 90.5% and sensitivity 42.4% compared to respectively 89.2% and 28.3% for the five‐word test. Conclusions Despite the poor sensitivity of the five‐word test, it seems to be the most adapted for the diagnosis of MCI‐DI in older adults with a memory complaint, in prevention centres, taking into account its high specificity and its rapid administration compared to the other tests.