Hostname: page-component-8448b6f56d-cfpbc Total loading time: 0 Render date: 2024-04-23T13:33:21.864Z Has data issue: false hasContentIssue false
  • English
  • Français

Associations between CAMCOG-R subscale performance and formal education attainment in South African older adults

Published online by Cambridge University Press:  10 November 2014

Katharine A. James ,
Laurian K. Grace ,
Kevin G.F. Thomas  and
Marc I. Combrinck
Katharine A. James*
Affiliation:
ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa Clinical Neurosciences Research Unit, Division of Geriatric Medicine, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
Laurian K. Grace
Affiliation:
Clinical Neurosciences Research Unit, Division of Geriatric Medicine, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
Kevin G.F. Thomas
Affiliation:
ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa
Marc I. Combrinck
Affiliation:
Clinical Neurosciences Research Unit, Division of Geriatric Medicine, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
*
Correspondence should be addressed to: Dr Katharine James, Clinical Neurosciences Research Unit, Rm. 51.2, Floor K.47, Old Main Building, Groote Schuur Hospital Observatory, 7925, Cape Town, South Africa. Phone: +27 21 404 7750. Email: katharine.james@uct.ac.za.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The Cambridge Cognitive Examination-Revised (CAMCOG-R) is a sensitive screening tool for the early diagnosis of dementia in older adults. Overall performance on the CAMCOG-R is influenced by educational attainment. Few studies have, however, examined the association between educational attainment and performance on the individual CAMCOG subscales. We aimed to address this question in a sample from a low-and middle-income country (LAMIC), where resource constraints may have compromised access to, and quality of, education for many older adults.

Methods:

Participants, all over 60 years of age, were 51 cognitively healthy community-dwelling volunteers and 47 individuals diagnosed with mild-moderate stage Alzheimer's disease (AD). Most participants had some high school education. They were administered the CAMCOG-R under standardized conditions.

Results:

Within both the control and AD patient groups, there were significant associations between years of completed education and CAMCOG-R total score, MMSE score, and CAMCOG-R Language subscale score. In both groups, level of education was not associated with scores on these subscales: in controls, recent memory, R2 = .21, p = .055, learning memory, R2 = .16, p = .398, attention/calculation, R2 = .19, p = .467, and perception, R2 = .18, p = .984; in AD patients, recent memory, R2 = .14, p = .340, learning memory, R2 = .03, p = .680, perception, R2 = .09, p = .723, and attention/calculation, R2 = .19, p = .097.

Conclusions:

Some CAMCOG-R subscale scores were more strongly associated with educational attainment than others. Importantly, however, performance on the recent memory and learning memory subscales was not affected by education. These subscales are sensitive indicators of amnestic mild cognitive impairment (MCI) and early AD. These subscales may therefore remain valid for use as an AD screening tool in resource-poor healthcare settings.

Keywords

Alzheimer’s diseasecognitive impairmenteducationneuropsychological testing
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 2 , February 2015 , pp. 251 - 260
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aprahamian, I., Martinelli, J. E., Cecato, J., Izbicki, R. and Yassuda, M. S. (2010). Can the CAMCOG be a good cognitive test for patients with Alzheimer's disease with low levels of education? International Psychogeriatrics, 23, 96–101. doi:10.1017/S104161021000116X.Google Scholar
Brucki, S. M. D., Mansur, L. L., Carthery-Goulart, M. T. and Nitrini, R. (2011). Formal education, health literacy and Mini-Mental State Examination. Dementia and Neuropsychologia, 5, 26–30.Google Scholar
Burger, K. (2010). How does early childhood care and education affect cognitive development? An international review of the effects of early interventions for children from different social backgrounds. Early Childhood Research Quarterly, 25, 140–165.Google Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, 2nd edn. Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
Combrinck, M. I. et al. (2006). Levels of CSF prostaglandin E2, cognitive decline, and survival in Alzheimer's disease. Journal of Neurology, Neurosurgery and Psychiatry, 77, 85–88. doi: 10.1136/jnnp.2005.063131.Google Scholar
Conde-Sala, J. L. et al. (2012). Predictors of cognitive decline in Alzheimer's disease and mild cognitive impairment using the CAMCOG: a five-year follow-up. International Psychogeriatrics, 24, 948–958. doi:10.1017/S1041610211002158.CrossRefGoogle ScholarPubMed
Crowe, M. et al. (2012). Indicators of childhood quality of education in relation to cognitive function in older adulthood. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 68, 198–204. doi:10.1093/gerona/gls122.CrossRefGoogle ScholarPubMed
Cullum, S. et al. (2000). Decline across different domains of cognitive function in normal ageing: results of a longitudinal population-based study using CAMCOG. International Journal of Geriatric Psychiatry, 15, 853–862.Google Scholar
Della Sala, S., Lucchelli, F. and Spinnler, H. (1987). Ideomotor apraxia in patients with dementia of Alzheimer type. Journal of Neurology, 234, 91–93.Google Scholar
Evans, D. A. et al. (1997). Education and other measures of socioeconomic status and risk of incident Alzheimer disease in a defined population of older persons. Archives of Neurology, 54, 1399–1405.Google Scholar
Faul, F., Erdfelder, E., Buchner, A. and Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behavior Research Methods, 41, 1149–1160.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatry, 12, 189–198.Google Scholar
Getsios, D., Blume, S., Ishak, K. J., Maclaine, G. and Hernández, L. (2012). An economic evaluation of early assessment for Alzheimer's disease in the United Kingdom. Alzheimer's and Dementia, 8, 22–30.Google Scholar
Heckmann, J. M. et al. (2004). Novel presenilin 1 mutation with profound neurofibrillary pathology in an indigenous Southern African family with early-onset Alzheimer's disease. Brain, 127, 133–142.Google Scholar
Huppert, F. A., Brayne, C., Gill, C., Paykel, E. S. and Beardsall, L. (1995). CAMCOG – a concise neuropsychological test to assist dementia diagnosis: sociodemographic determinants in an elderly population sample. British Journal of Clinical Psychology, 34, 529–541. doi:10.1111/j.2044-8260.1995.tb01487.Google Scholar
Huppert, F. A. et al. (1996). Psychometric properties of the CAMCOG and its efficacy in the diagnosis of dementia. Aging, Neuropsychology, and Cognition, 3, 201–214.Google Scholar
Karp, A., Kâreholt, I., Qiu, C., Bellander, T., Winblad, and Fratiglioni, L. (2004). Relation of education and occupation-based socioeconomic status to incident Alzheimer's disease. American Journal of Epidemiology, 159, 175–183. doi:10.1093/aje/kwh018.Google Scholar
Kliegel, M., Zimprich, D. and Rott, C. (2004). Life-long intellectual activities mediate the predictive effect of early education on cognitive impairment in centenarians: a retrospective study. Aging and Mental Health, 8, 430–437. doi.org/10.1080/13607860410001725072.CrossRefGoogle ScholarPubMed
Lezak, M. D, Howieson, D. B. and Loring, D. W. (2004). Neuropsychological Assessment, 4th edn. New York, NY: Oxford University Press.Google Scholar
Lindeboom, J., Ter Horst, R., Hooyer, C., Dinkgreve, M. and Jonker, C. (1993). Some psychometric properties of the CAMCOG. Psychological Medicine, 23, 213–219. doi:10.1017/S0033291700039003.Google Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer's disease. Neurology, 34, 939–944.Google Scholar
Moreira Ide, F., Lourenco, R. A., Soares, C., Engelhardt, E. and Laks, J. (2009). Cambridge Cognitive Examination: performance of healthy elderly Brazilians with low education levels. Cadernos de Saúde Pública, 25, 1774–1780. doi:10.1590/S0102-311X200900080001.Google Scholar
Nell, V. (2000). Cross-Cultural Neuropsychological Assessment: Theory and Practice. Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
Richards, M. and Hatch, S. L. (2011). A life course approach to the development of mental skills. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 66, 26–35. doi:10.1093/geronb/gbr013.Google Scholar
Roth, M., Huppert, F. A., Mountjoy, C. Q. and Tym, E. (1998). CAMDEX-R: The Cambridge Examination for Mental Disorders of the Elderly – Revised. Cambridge, MA: Cambridge University Press.Google Scholar
Salmon, D. P. and Bondi, M. W. (2009). Neuropsychological assessment of dementia. Annual Review of Psychology, 60, 257–282. doi:10.1146/annurev.psych.57.102904.190024.Google Scholar
Schmand, B., Walstra, G., Lindeboom, J., Teunisse, S. and Jonker, C. (2000). Early detection of Alzheimer's disease using the Cambridge cognitive examination (CAMCOG). Psychological Medicine, 30, 619–627.Google Scholar
Sheikh, J. I. and Yesavage, J. A. (1986). Geriatric depression scale (GDS): recent evidence and development of a shorter version. Clinical Gerontology, 5, 165–173.Google Scholar
Shuttleworth-Edwards, A. B., Kemp, R. D., Rust, A. L., Muirhead, J. G., Hartman, N. P. and Radloff, S. E. (2004). Cross-cultural effects on IQ test performance: a review and preliminary normative indications on WAIS-III test performance. Journal of Clinical and Experimental Neuropsychology, 26, 903–920. doi:10.1080/13803390490510824.CrossRefGoogle ScholarPubMed
Stern, Y., Gurland, B., Tatemichi, T. K., Tang, M. X., Wilder, D. and Mayeux, R. (1994). Influence of education and occupation on the incidence of Alzheimer's disease. Journal of the American Medical Association, 271, 1004–1010.CrossRefGoogle ScholarPubMed
Travniczek-Marterer, A., Danielczyk, W., Simanyi, M. and Fischer, P. (1993). Ideomotor apraxia in Alzheimer's disease. Acta Neurologica Scandinavica, 88, 1–4.Google Scholar
Wilson, R. S., Hebert, L. E., Scherr, P. A, Barnes, L. L., Mendes de Leon, C. F. and Evans, D. A. (2009). Educational attainment and cognitive decline in old age. Neurology, 72, 460–465. doi:10.1212/01.wnl.0000341782.71418.6c.Google Scholar
Yassuda, M. S. (2009). Neuropsychological profile of Brazilian older adults with heterogeneous educational backgrounds. Archives of Clinical Neuropsychology, 24, 71–79 Google Scholar
Supplementary material: File

James Supplementary Material

Table S1

Download James Supplementary Material(File)
File 21.5 KB
Supplementary material: File

James Supplementary Material

Tables S2-S13

Download James Supplementary Material(File)
File 56 KB