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P1‐183: Body composition is associated with cognitive decline in mild cognitive impairment
Author(s) -
Cronk Benjamin B.,
Johnson David K.,
Harsha Amith,
Burns Jeffrey M.
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.771
Subject(s) - memory span , cognitive decline , verbal fluency test , cognition , neuropsychology , effects of sleep deprivation on cognitive performance , body mass index , cognitive test , medicine , neuropsychological assessment , psychology , audiology , dementia , gerontology , disease , psychiatry , working memory
evaluating frontal dysfunction as a complement to other memory-based bedside instruments. Earlier validation studies reported a cutoff of 11/12 for the diagnosis of dementia. However, there is a paucity of studies validating cut-offs in the earlier stages of cognitive impairment. In this study, we aim to validate the CFAB for subjects with mild cognitive impairment (MCI) and early dementia. We also examined the diagnostic utility of a shortened version of the CFAB for use in the busy clinic setting. Methods: Eighty subjects with early cognitive impairment (MCI and CDR 0.5-1.0 mild dementia) from the Memory Clinic, Tan Tock Seng Hospital and 113 cognitively intact subjects from a community-based cohort study of older adults were studied. ROC analysis was used to determine CFAB’s optimal cut-off scores for age and education-adjusted subgroups. Discriminant function analysis was also performed. Results: CFAB scores were significantly lower in early cognitive impairment compared with cognitively normal controls (9.7 3.5 vs15.4 2.6, P 0.01). The optimal cut-off score was 12/13 (sensitivity 78.8%, specificity 86.7%). A similar cut-off score was obtained following age-adjustment ( 75 years and 75 years) and for subjects with 6 years education. Of note, the optimal cutoff for subjects with 6 years education was 13/14 (sensitivity 77.1%, specificity 89.9%), which improved diagnostic performance when compared with the cut-off of 11/12 (sensitivity 54.2 %, specificity 97.7 %) derived from earlier validation studies. A shorter 3-item CFAB using subscores of conceptualisation, motor programming and mental flexibility was found to retain diagnostic performance with 80% sensitivity and 87.6% specificity. Conclusions: Our reported cut-offs are higher as compared to prior validation studies that involved subjects with less early stages of cognitive impairment. The derivation of education-adjusted normative scores of the CFAB improved the sensitivity of detection of very early cognitive impairment. A shorter 3-item CFAB may be useful in a busy clinic setting to evaluate frontal dysfunction to complement other memory-based bedside instruments.