Measuring impairments in memory and executive function in older people using the Revised Cambridge Cognitive Examination.

OBJECTIVES

The Revised Cambridge Cognitive Examination (CAMCOG-R) is a cognitive screen that has been used to discriminate individuals with dementia from cognitively intact older people. It consists of items assessing various cognitive domains, but the construct validity of the cognitive subscores has not been established yet. The authors examine the subscores Memory and Executive Function in relation to extensive neuropsychological testing in a group of older adults with or without cognitive decline.

DESIGN

Observational study.

SETTING

Memory clinic at the department of geriatrics of a university medical center.

PARTICIPANTS

A convenience sample of 36 outpatients diagnosed with cognitive decline and 24 older healthy participants.

MEASUREMENTS

Sensitivity and specificity of the CAMCOG-R Memory subscore and Executive Function subscore were established using extensive neuropsychological assessment of memory (using the Rey-Auditory Verbal Learning Test, Location Learning Test, Visual Association Test, and Story Recall) and executive function (using the Brixton Spatial Anticipation Test, Trail Making Test, and Key Search test) as the gold standard.

RESULTS

For the CAMCOG-R Executive Function subscore, a cutoff point of 16.5 had a good sensitivity (0.82) and adequate specificity (0.73) for discriminating people with and without executive dysfunction. However, the Total Score and Language subscore also differentiated between people with and without executive dysfunction. The CAMCOG-R Memory subscore could not validly distinguish between people with and without memory impairment.

CONCLUSION

The CAMCOG-R subscores Memory and Executive Function have limited validity, and clinicians should be cautious in interpreting these in the absence of other neuropsychological measures or clinical information.