Associations between CAMCOG-R subscale performance and formal education attainment in South African older adults
ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa; Clinical Neurosciences Research Unit, Division of Geriatric Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
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, R 2 =.21, p =.055, learning memory, R 2 =.16, p =.398, attention/calculation, R 2 =.19, p =.467, and perception, R 2 =.18, p =.984; in AD patients, recent memory, R 2 =.14, p =.340, learning memory, R 2 =.03, p =.680, perception, R 2 =.09, p =.723, and attention/calculation, R 2 =.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. Copyright © International Psychogeriatric Association 2014.
aged; Alzheimer disease; Article; attention; Cambridge Cognitive Examination Revised; clinical article; cognitive defect; community sample; controlled study; educational status; female; human; learning; male; memory; psychologic test; South African; volunteer