Screening for Alzheimer’s Disease with the Short Cognitive Evaluation Battery

Because Alzheimer’s disease (AD) tends to be underdiagnosed, there is an increasing need for accurate neuropsychological screening tools that are easy to administer by general practitioners or specialists. The aim of the present study was to validate, in French, a sensitive and specific screening battery designed to improve the discrimination between patients with AD, patients with depression and healthy elderly subjects. The Short Cognitive Evaluation Battery (SCEB) consists of 4 brief tests: temporal orientation, 5-word test, clock-drawing test and a semantic verbal fluency task. The SCEB was administered to 123 ambulatory subjects (mean age 76.4±2.3 years): 49 patients with mild AD, 27 patients with depressive symptoms and 47 healthy elderly subjects. The mean time for administration of the test was 11.2 min in the AD group, 8.2 min in the depressive group and 7.2 min in the control group (p < 0.001). Multivariate analysis showed that, compared with controls, patients with mild AD were significantly impaired for all four tests. Response operating characteristics analysis of the SCEB showed: 93.8% sensitivity and 85% specificity for discriminating AD from control patients, and 63% sensitivity and 96% specificity for discriminating AD from depressive patients. In summary, the SCEB appears to be a highly sensitive and specific tool for discriminating between patients with mild AD and healthy elderly individuals. Furthermore, in combination with clinical evaluation, the SCEB could improve the specificity of the difficult discrimination between mild AD and depression.

[1]  J. Greene Contributions to Neuropsychological Assessment , 1995 .

[2]  H. Buschke,et al.  Genuine memory deficits in dementia , 1987 .

[3]  M. Åsberg,et al.  A New Depression Scale Designed to be Sensitive to Change , 1979, British Journal of Psychiatry.

[4]  Steve Mclean Assessing Dementia. Part I: Difficulties, Definitions and Differential Diagnosis , 1987, The Australian and New Zealand journal of psychiatry.

[5]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[6]  Bridget Kelly,et al.  A 7 minute neurocognitive screening battery highly sensitive to Alzheimer's disease. , 1998, Archives of neurology.

[7]  T. Tombaugh,et al.  The Mini‐Mental State Examination: A Comprehensive Review , 1992, Journal of the American Geriatrics Society.

[8]  Alzheimer's Disease: Assessment of Functional Status , 1983, Journal of the American Geriatrics Society.

[9]  M. Albert,et al.  Prevalence of Alzheimer's disease in a community population of older persons. Higher than previously reported. , 1989, JAMA.

[10]  J. Lindeboom,et al.  The effects of intelligence and education on the development of dementia. A test of the brain reserve hypothesis , 1997, Psychological Medicine.

[11]  S. Iliffe,et al.  Assessment of elderly people in general practice. 1. Social circumstances and mental state. , 1991, The British journal of general practice : the journal of the Royal College of General Practitioners.

[12]  G. Wells,et al.  Clock Drawing: A Neuropsychological Analysis , 1995 .

[13]  G. Wolf-Klein,et al.  Screening for Alzheimer's Disease by Clock Drawing , 1989, Journal of the American Geriatrics Society.

[14]  N Butters,et al.  Comparisons of verbal fluency tasks in the detection of dementia of the Alzheimer type. , 1992, Archives of neurology.

[15]  W F Stewart,et al.  Screening for dementia with the Memory Impairment Screen , 1999, Neurology.