CERAD Neuropsychological Battery Total Score in Multinational Mild Cognitive Impairment and Control Populations: The AddNeuroMed Study

Article type: Research Article

Authors: Paajanen, Teemu^a | Hänninen, Tuomo^{a; b} | Tunnard, Catherine^c | Mecocci, Patrizia^e | Sobow, Tomasz^f | Tsolaki, Magda^g | Vellas, Bruno^h | Lovestone, Simon^{c; d} | Soininen, Hilkka^{a; *} | for the AddNeuroMed Consortium,

Affiliations: [a] Department of Neurology, University of Eastern Finland, University Hospital, Kuopio, Finland | [b] The Finnish Centre for Interdisciplinary Gerontology, University of Jyväskylä, Finland | [c] King's College London, Institute of Psychiatry, London, UK | [d] NIHR Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King's College London. London, UK | [e] Institute of Gerontology and Geriatrics, University of Perugia, Italy | [f] Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland | [g] Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece | [h] Toulouse Gerontopole University Hospital, Paul Sabatier University, INSERM U 558, France

Correspondence: [*] Correspondence to: Hilkka Soininen, MD, PhD, Professor, Department of Neurology, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FIN 70211, Kuopio, Finland. Tel.: +358 17 173012; Fax +358 17 173019; E-mail: hilkka.soininen@uef.fi.

Abstract: An important focus in Alzheimer's disease (AD) research is the development of methods for early diagnosis. Despite progress with some other biomarkers, sensitive and specific neuropsychological measures for identifying subjects in the prodromal phase of AD remain the most promising early diagnostic tool. We evaluated the value of the composite score for the Consortium to Establish a Registry for Alzheimer's disease Neuropsychological Battery (CERAD-NB) in Europeans with mild cognitive impairment (MCI) and in control populations. Baseline clinical data were analyzed from 223 healthy elderly and 224 subjects with MCI from the prospective AddNeuroMed study carried out in Finland, France, Greece, Italy, Poland, and the United Kingdom. The total score for CERAD-NB was calculated by the subtest addition method. The CERAD total score, adjusted for age, gender, education, and country, clearly differentiated the control and MCI groups (p < 0.001). The optimal between-groups cut-off point for the CERAD total score derived from ROC analysis yielded 81.5% sensitivity and 75.4% specificity (AUC = 0.848, p < 0.001). The CERAD total score was superior to the Mini-Mental Status Examination, or any single CERAD subtest in discriminating between the control and MCI groups. While the overall level of the CERAD total score varied between the different countries, it remained accurate in differentiating controls and MCI subjects within each country. We conclude that the CERAD total score is an accurate measure for detecting mild cognitive impairment, but implementing specific cut-off points needs to be based upon country specific normative data.

Keywords: Alzheimer's disease, cognition, memory, mild cognitive impairment, neuropsychology

DOI: 10.3233/JAD-2010-100459

Journal: Journal of Alzheimer's Disease, vol. 22, no. 4, pp. 1089-1097, 2010