Sensitivity and specificity of the attention, memory, and frontal abilities screening test to identify objective cognitive impairment in older adults: a pilot study.

Abstract

Objective: The use of screening tests is part of the neuropsychological assessment. Recently, the Attention, Memory and Frontal Abilities Screening Test (AMFAST) has been developed and translated to Spanish. However, its diagnostic properties have never been compared to other tests used to identify cognitive impairment. The goal of this pilot study is to compare the diagnostic properties of the AMFAST with those of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD)-Neuropsychological Battery (CERAD-NB) in their ability to distinguish pre-defined clinical groups in a heterogeneous clinical sample of Spanish older adults.

Methods: Ninety-four participants (66 cognitively unimpaired - CU; 28 cognitively impaired - CI) aged 50 or older were assessed with the AMFAST and the CERAD-NB, and differences between groups were analyzed with beta-binomial models. The diagnostic properties of both tests were calculated with adjusted-ROC curves, and areas under the curve (AUCs) were compared.

Results: The CU group outperformed the CI group both on the AMFAST (b = -1.67, std. error (SE) = 0.19, p < .001) and on the CERAD-NB (b = -1.02, SE = 0.12, p < .001). The adjusted-ROC curves showed no differences in sensitivity and specificity compared to the model with test scores only, neither for the AMFAST (z = -1.03, p = .305) nor for the CERAD (z = -1.16, p = .246), with no statistically significant differences in the AUC (AMFAST = 0.954, CERAD = 0.954, p = .989).

Conclusions: Our preliminary results based on a small, diagnostically heterogeneous sample suggest that the AMFAST and the CERAD-NB did not differ significantly to identify objective cognitive impairment. Future studies with larger, more homogenous samples are needed.