Evaluation of short cognitive screening tests in 85-year-old men and women

Abstract

IntroductionThe study aimed to investigate different aspects of cognition using the Cognitive Assessment Battery (CAB) in community-dwelling older adults aged 85years. We also investigated the eventual influence of sex on the results and aimed to identify predictors for further cognitive decline after 1year. MethodsCAB consists of 10 subtests covering the cognitive domains of speed and attention, learning and episodic memory, visuospatial abilities, language, and executive functions. Cognitive tests were performed at baseline (n=335) and follow-up after 1year (n=270). ResultsUnivariate statistics revealed that men performed better than women on episodic memory (P<0.05) and on the naming test (P<0.001). However, floor effects in the paragraph memory test were revealed. There was a high rate of abnormal results on Token Test (67%), PaSMO (50%), Clox (48%), and the cube copying (40%) tests in participants with normal cognition. Logistic regression showed that impaired results on the Stroop III test (odds ratio, 2.38; P<0.05) was independently associated with an increased risk of cognitive decline. ConclusionMen performed better than women on the memory and on the naming test. However, due to floor effects in the paragraph memory test in 85year olds, these results can be disputed. The high rate of abnormal results on the Token Test, PaSMO, Clox, and the cube copying tests in cases with normal cognition indicate that these tests are less suitable for screening in the age group. Impaired result on the Stroop test increased the risk more than two-fold for cognitive decline after 1year.