Analysis of the Cambridge Cognitive Examination (CAMCOG) in the elderly aged 80 and over with and without Alzheimer's disease
Keywords:
Cambridge Cognitive Examination – CAMCOG, Alzheimer’s disease, ElderlyAbstract
INTRODUCTION: The CAMCOG is a brief neuropsychological battery that assesses global cognitive function and impairments for the diagnosis of dementia. The increasing aging of the population is well established, with the elderly aged 80 years or older making up the fastest growing population stratum. And it is known that age is an important risk factor for Alzheimer's disease (AD). In addition, there are cognitive differences even when successful aging occurs and there are differences observed between cognitive tests according to education. OBJECTIVES: To evaluate the CAMCOG values in elderly people aged 80 years and over with and without AD, comparing the total score, the values of the subscales regarding the variables g, age group and education, the cutoff points for the discrimination of AD and non-AD for different levels of education and whether the CAMCOG is suitable for cognitive assessment of these subjects. METHOD: Retrospective study through the analysis of 713 medical records of elderly aged 80 years or more with and without AD from the Institute of Geriatrics and Gerontology of Jundiaí. All patients in the study underwent medical evaluation and underwent CAMCOG, laboratory tests and neuroimaging. SPSS 22.0 statistical software was used for descriptive analyzes and hypothesis tests and R 3.1 software was used for construction of ROC curves. All statistical tests were considered significant when p <0.05. ROC curve analyzes were performed to compare the sensitivity and specificity of CAMCOG to differentiate the two groups in educational strata. Nonparametric data were analyzed using Mann-Whitney and Kruskal-Wallis according to the number of variables. The multivariate linear regression model was also used for the multivariate analysis of the variables dependent on the CAMCOG value and independent variables - AD Diagnosis, Gender, Age and Education. RESULTS: It was found that most subjects had AD (58.8%), were female (65.8%, p<0.05%) and had a level of education between 1 and 4 years (54.8 %, p<0.05). The higher the level of education, the greater the value observed in the CAMCOG, in addition, men perform better in the test (p<0.05). In the evaluation of the subscales in all cases, there was a statistically significant difference between patients in the control group and patients with AD. The values obtained in the CAMCOG subscales are higher for patients in the control group, and the difference is significant, leading to the conclusion that patients with AD actually have lower values in all subscales. Multivariate analysis showed that the variables Gender, Age, Diagnosis and Education independently influenced the CAMCOG value. CONCLUSIONS: The CAMCOG value is independently influenced by sex (men have higher values), age (older age leads to worse performance), diagnosis (AD diagnosis guarantees worse performance) and schooling (higher degree of schooling generates a higher result). It was not possible to obtain the cutoff points for the diagnosis of AD for the different levels of education.
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