Abstract
BackgroundEarly symptoms of dementia may not be apparent and are sometimes even concealed during short office visits initiated for other complaints. The aim of the study is to find out if the combined use of VF/CDT, VF/BNT, or CDT/BNT could improve the accuracy of detecting mild NCD in an outpatient setting, compared with either test used alone.ParticipantsCommunity-dwelling older adults, attending the outpatient Geriatrics Clinic at Ain Shams University hospitals between June 1, 2017 and January 31, 2018. All participants received a comprehensive geriatric assessment (CGA) which included the mini-mental state examination test. Participants with a score of less than 24 and fulfil DSM5 criteria for mild neurocognitive disorder (NCD) are considered cognitively impaired otherwise are considered normal. Then participants were further examined by the Arabic versions of CDT, BNT, and VF animal category.ResultsWe recruited 143 male and female participants mean age 67.17 ± 5.41, females are 56.6%, and 48.9% of all participants have mild NCD according to DSM5 criteria. AUC for individual neurocognitive tests in illiterates is 0.893 for clock drawing test, 0.907 for verbal fluency animal category, and 0.904 for Boston naming test, while AUC for neurocognitive test combinations in illiterates is 0.932 for VF + CDT, 0.917 for VF + BNT, and 0.932 for BNT + CDT. On the other hand, AUC for individual neurocognitive tests in educated participants is 0.925 for clock drawing test, 0.921 for verbal fluency animal category, and 0.907 for Boston naming test, whereas AUC for neurocognitive test combinations in educated participants is 0.958 for VF + CDT, 0.963 for VF + BNT, and 0.953 for BNT + CDT.ConclusionFrom the current study, we can conclude that any of the studied combinations have better diagnostic accuracy (although small) than individual test in both literate and illiterate older adults.
Highlights
Symptoms of dementia may not be apparent and are sometimes even concealed during short office visits initiated for other complaints
Assessment of cognitive function as part of the comprehensive geriatric assessment can take a long time in an outpatient clinic setting
One of the comprehensive neuropsychological packages for assessment of cognitive function is The Consortium to Establish a Registry for Alzheimer’s disease (CERAD) which has been translated into Arabic and adapted and validated for the Egyptian language and culture [2]
Summary
Symptoms of dementia may not be apparent and are sometimes even concealed during short office visits initiated for other complaints. There are different ways for assessment of cognitive function either through single neuropsychological tests or by more detailed comprehensive neuropsychological packages. One of the comprehensive neuropsychological packages for assessment of cognitive function is The Consortium to Establish a Registry for Alzheimer’s disease (CERAD) which has been translated into Arabic and adapted and validated for the Egyptian language and culture [2]. CERAD includes a group of simple and quick to administer tests like the animal category test of semantic verbal fluency (VF) [3], the fifteen-item short version of the Boston naming test (BNT) [4], and the clock drawing test (CDT) [5] which can be used alone or in different combinations for detecting of cognitive impairment in an outpatient setting
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