The Cambridge Cognitive Examination (CAMCOG): A validation study in outpatients suffering from dementia and non-demented elderly subjects (including Age Associated Cognitive Decline patients) in Greece

Abstract

Introduction: The Cambridge Cognitive Examination for the elderly (CAMCOG) was first published in 1986 as a reliable instrument for the study of patients with cognitive function impairment. Objective: To standardize the Greek version of CAMCOG. Setting: Dementia Outpatient Clinic, 3rd Department of Neurology, Aristotle University of Thessaloniki. Participants: 150 nondemented controls and 100 patients suffering from mild to severe dementia of various types took part in the study. Results: CAMCOG manifests Cronbach's alpha=0.93. In the group of patients under 75, sensitivity (Sn) is 90.00 percent at the level of 76/77 and specificity is 91.89 percent at the level of 70/71. The respective scores for the group of patients over 74 are 68/69 (Sn=90.00 percent) and 60/61 (Sp=92.30 percent). It seems that CAMCOG shows an “uncertainty zone” in both groups between the scores of 71 to 76 for the first group and of 61 to 68 for the second. The MMSE cut-off point, for the two groups are 23/24 (Sn=94.28 percent, Sp=90.99 percent) and 22/23 (Sn=96.60 percent, Sp=94.87 percent), respectively. Conclusion: The Greek version of CAMCOG manifests different properties than the original British Version. This is probably due to differences in education and social background (e.g., cultural isolation of rural areas). MMSE performs better than CAMCOG mainly because diagnosis is based on the assessment of fundamental aspects of cognitive function, which is reflected in MMSE in a way that is less affected by the mental or educational status of the subject.