Performance of cognitive tests, individually and combined, for the
detection of cognitive disorders amongst community-dwelling elderly
people with memory complaints: the EVATEM study
C. Vannier-Nitenberg
a
, V. Dauphinot
b
, B. Bongue
c,d
, C. Sass
c
, A. Bathsavanis
b
, I. Rouch
b,e
, N. Deville
c
,
O. Beauchet
c,f
, P. Krolak-Salmon
b,g,h
and B. Fantino
f,i
a
Centre d’Examens de Sant e de la CPAM du Rh^ one, Lyon;
b
Centre M emoire de Ressources et de Recherche (CMRR) Lyon, H^ opital des
Charpennes, Hospices civils de Lyon, Villeurbanne;
c
Centre Technique d’Appui et de Formation des Centres d’Examens de Sant e
(CETAF), Saint-Etienne;
d
Laboratory EA4607 SNA-EPIS, PRES Lyon, Jean Monnet University of Saint Etienne, Saint Etienne;
e
CMRR de Saint Etienne, Service de Neurologie, CHU de Saint Etienne, Saint Etienne Cedex;
f
Department of Neuroscience, Division of
Geriatric Medicine, Angers University Hospital, Angers;
g
Inserm U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Brain
Dynamics and Cognition Team, Lyon;
h
University Lyon 1, Lyon; and
i
Fili eris, Caisse Autonome Nationale de la S ecurit e Sociale dans les
Mines, Paris, France
Keywords:
Alzheimer’s disease,
cognitive disorders,
dementia, early
diagnosis, memory
complaint, mild
cognitive impairment
Received 7 January 2015
Accepted 2 September 2015
European Journal of
Neurology 2015, 0: 1–8
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 per-
formance 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 pre-
ventive 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 relation-
ship between the diagnosis of MCI-DI/CHI and the neuropsychological tests
was assessed using logistic regressions. The performance of the neuropsycho-
logical 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 per-
formance 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.
Background
Dementia is a leading cause of disability and depen-
dence amongst the aged population. In 2010, the total
cost of dementia in the world was estimated at $604
billion, equivalent to 1% of gross domestic product.
Correspondence: C. Vannier-Nitenberg, 15 rue Baraban, 69456 Lyon
Cedex 06, France (tel.: 04 72 65 16 48; fax: 04 72 65 16 00; e-mail:
christiane.nitenberg@cpam-rhone.cnamts.fr).
Trial registration: ClinicalTrials.gov: NCT01316562.
© 2015 EAN 1
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