Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-22T19:04:18.410Z Has data issue: false hasContentIssue false
  • English
  • Français

Contributions of the Computer-Administered Neuropsychological Screen for Mild Cognitive Impairment (CANS-MCI) for the diagnosis of MCI in Brazil

Published online by Cambridge University Press:  07 May 2014

Cláudia M. Memória ,
Mônica S. Yassuda ,
Eduardo Y. Nakano  and
Orestes V. Forlenza
Cláudia M. Memória
Affiliation:
Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
Mônica S. Yassuda
Affiliation:
Department of Gerontology, School of Arts, Sciences and Humanities (EACH), University of São Paulo, São Paulo, Brazil
Eduardo Y. Nakano
Affiliation:
Department of Statistics, University of Brasília (UNB), Brasília, Brazil
Orestes V. Forlenza*
Affiliation:
Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
*
Correspondence should be addressed to: Dr Orestes V. Forlenza, MD, PhD, Laboratory of Neuroscience (LIM 27), Department and Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Rua Ovídio Pires de Campos, 785, 3rd floor, São Paulo 05403-010, Brazil. Phone: +5511-3069-7924; Fax: +5511-3085-5412. Email: [email protected].
Get access

Abstract

Background:

The Computer-Administered Neuropsychological Screen for Mild Cognitive Impairment (CANS-MCI) is a computer-based cognitive screening instrument that involves automated administration and scoring and immediate analyses of test sessions. The objective of this study was to translate and culturally adapt the Brazilian Portuguese version of the CANS-MCI (CANS-MCI-BR) and to evaluate its reliability and validity for the diagnostic screening of MCI and dementia due to Alzheimer's disease.

Methods:

The test was administered to 97 older adults (mean age 73.41 ± 5.27 years) with at least four years of formal education (mean education 12.23 ± 4.48 years). Participants were classified into three diagnostic groups according to global cognitive status (normal controls, n = 41; MCI, n = 35; AD, n = 21) based on clinical data and formal neuropsychological assessments.

Results:

The results indicated high internal consistency (Cronbach's α = 0.77) in the total sample. Three-month test-retest reliability correlations were significant and robust (0.875; p < 0.001). A moderate level of concurrent validity was attained relative to the screening test for MCI (MoCA test, r = 0.76, p < 0.001). Confirmatory factor analysis supported the three-factor model of the original test, i.e., memory, language/spatial fluency, and executive function/mental control. Goodness of fit indicators were strong (Bentler Comparative Fit Index = 0.96, Root Mean Square Error of Approximation = 0.09). Receiver operating characteristic curve analyses suggested high sensitivity and specificity (81% and 73% respectively) to screen for possible MCI cases.

Conclusions:

The CANS-MCI-BR maintains adequate psychometric characteristics that render it suitable to identify elderly adults with probable cognitive impairment to whom a more extensive evaluation by formal neuropsychological tests may be required.

Keywords

mild cognitive impairmentdementianeuropsychologycognitive screeningcomputerized testselderly
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 9 , September 2014 , pp. 1483 - 1491
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

Ahmed, S., de Jager, C. and Wilcock, G. (2012). A comparison of screening tools for the assessment of mild cognitive impairment: preliminary findings. Neurocase, 18, 336–351.CrossRefGoogle ScholarPubMed
Albert, M. S. et al. (2011). The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 7, 270–279.CrossRefGoogle ScholarPubMed
Bozoki, A., Giordani, B., Heidebrick, J. L., Berent, S. and Foster, N. L. (2001). Mild cognitive impairments predict dementia in non-demented elderly patients with loss. Archives of Neurology, 58, 411–416.CrossRefGoogle Scholar
Caramelli, P., Carthery-Goulart, M. T., Porto, C. S., Charchat-Fichman, H. and Nitrini, R. (2007) Category fluency as a screening test for Alzheimer's disease in illiterate and literate patients. Alzheimer Disease and Associated Disorders, 21, 65–67.CrossRefGoogle ScholarPubMed
Charchat, H., Nitrini, R., Caramelli, P. and Sameshima, K. (2001). Investigação de marcadores clínicos dos Estágios Iniciais da Doença de Alzheimer com testes neuropsicológicos computadorizados. Psicologia: Reflexão e Crítica, 14, 305–316.Google Scholar
Dwolatzky, T. et al. (2003). Validity of a novel computerized cognitive battery for mild cognitive impairment. BMC Geriatrics, 2, 3–4.Google Scholar
Égerházi, A., Berecz, R., Bartók, E. and Degrell, I. (2007). Automated Neuropsychological Test Battery (CANTAB) in mild cognitive impairment and in Alzheimer's disease. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 31, 746–751.CrossRefGoogle ScholarPubMed
Forlenza, O. F., Diniz, B. S., Nunes, P. V., Memoria, C. M., Yassuda, M. S. and Gattaz, W. F. (2009). Diagnostic transitions in mild cognitive impairment subtypes. International Psychogeriatrics, 21, 1088–1095.CrossRefGoogle ScholarPubMed
Gorus, E., De Raedt, R., Lambert, M., Lemper, J. C. and Mets, T. (2008). Reaction time and performance variability in normal aging, mild cognitive impairment, and Alzheimer's disease. Journal of Geriatric Psychiatric and Neurology, 21, 204–218.CrossRefGoogle ScholarPubMed
Grönholm-Nyman, P., Rinne, J. O. and Laine, M. (2010). Learning and forgetting new names and objects in MCI and AD. Neuropsychologia, 48, 1079–1088.CrossRefGoogle ScholarPubMed
Hammers, D. et al. (2012). Validity of a brief computerized cognitive screening test in dementia. Journal of Geriatric Psychiatry and Neurology, 25, 89–99.CrossRefGoogle ScholarPubMed
Malloy-Diniz, L. F., Lasmar, V. A. P., Gazinelli, L. S. R., Fuentes, D. and Salgado, J. V. (2007). The Rey Auditory-Verbal Learning Test: applicability for the Brazilian elderly population. Revista Brasileira de Psiquiatria, 29, 324–329.CrossRefGoogle ScholarPubMed
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 the Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 1984, 939–944.CrossRefGoogle Scholar
McKhann, G. et al. (2011). The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging–Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 7, 263–269.CrossRefGoogle ScholarPubMed
Memória, C. M., Yassuda, M. S., Nakano, E. Y. and Forlenza, O. V. (2013). Brief screening for mild cognitive impairment: validation of the Brazilian version of the Montreal Cognitive Assessment. International Journal of Geriatric Psychiatry, 28, 34–40.CrossRefGoogle ScholarPubMed
Nasreddine, Z. S. et al. (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53, 699–699.CrossRefGoogle Scholar
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183–194.CrossRefGoogle ScholarPubMed
Petersen, R. C. et al. (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303–308.CrossRefGoogle ScholarPubMed
Ready, R. E., Ott, B. R., Grace, J. and Cahn-Weiner, D. A. (2003). Apathy and executive dysfunction in mild cognitive impairment and Alzheimer's disease. American Journal of Geriatric Psychiatry, 11, 222–228.CrossRefGoogle Scholar
Rey, A. (1964). L’Examen Clinique en Psychologie. Paris, France: Press Universitaire de France.Google Scholar
Robbins, T. W., James, M., Owen, A. M., Sahakian, B. J., McInnes, L. and Rabbitt, P. M. (1994). Cambridge Neuropsychological Test Automated Battery (CANTAB): a factor analytic study of a large sample of normal elderly volunteers. Dementia, 5, 266–281.Google ScholarPubMed
Saxton, J., Morrow, L., Eschman, A., Archer, G., Luther, J. and Zuccolotto, A. (2009). Computer assessment of mild cognitive impairment. Postgraduate Medical Journal, 12, 177–185.CrossRefGoogle Scholar
Schlegel, R. E. and Gilliland, K. (2007). Development and quality assurance of computer-based assessment batteries. Archives of Clinical Neuropsychology, 22, S49–S61.CrossRefGoogle ScholarPubMed
Snyder, P. J. et al. (2011). Assessment of cognition in mild cognitive impairment: a comparative study. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 7, 338–355.CrossRefGoogle ScholarPubMed
Tornatore, J. B., Hill, E., Laboff, J. A. and McGann, M. E. (2005). Self-administered screening for mild cognitive impairment: initial validation of a Computerized Test Battery. Journal of Neuropsychiatric Clinical Neurosciences, 17, 98–105.CrossRefGoogle ScholarPubMed
Wechsler, D. (2004). Manual Para Administração e Avaliação, Versão Bras.: Elizabeth do Nascimento. São Paulo, Brazil: Casa do Psicólogo.Google Scholar
Wild, K., Howieson, D., Webbe, F., Seelye, A. and Kaye, J. (2008). Status of computer cognitive testing in aging: a systematic review. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 4, 428–437.CrossRefGoogle ScholarPubMed
Yassuda, M. S. et al. (2009). Neuropsychological profile of Brazilian older adults with heterogeneous educational backgrounds. Archives of Clinical Neuropsychology, 24, 71–79.CrossRefGoogle ScholarPubMed