Is the Alzheimer's Disease Assessment Scale-Cognitive Subscale useful in screening for mild cognitive impairment and Alzheimer's disease? A systematic review.
{"title":"Is the Alzheimer's Disease Assessment Scale-Cognitive Subscale useful in screening for mild cognitive impairment and Alzheimer's disease? A systematic review.","authors":"Seong-Hi Park, Kuem-Sun Han","doi":"10.2174/1567205019666220404104854","DOIUrl":null,"url":null,"abstract":"BACKGROUND\nMild cognitive impairment (MCI) and Alzheimer's disease (AD) are screened to distinguish whether cognitive decline in older adults is attributed to pathological causes rather than normal aging.\n\n\nOBJECTIVE\nThe purpose of this review was to analyze the diagnostic performance of the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) in screening for MCI and AD.\n\n\nMETHODS\nElectronic searches were performed on MEDLINE, EMBASE, CINAHL, and PsycArticles databases using the following keywords: dementia and ADAS-Cog. The Quality Assessment of Diagnostic Accuracy Studies-2 was used to checked the risk of bias in the diagnostic studies.\n\n\nRESULTS\nWe reviewed 14 studies, including 3,875 patients who met the selection criteria. In 2,624 MCI patients from nine studies, the pooled sensitivity of ADAS-Cog was 0.80 (95% confidence interval [CI], 0.68-0.88), the pooled specificity was 0.84 (95% CI, 0.75-0.90), and the area under the curve of summary receiver-operating characteristic curves (SROC AUC) was 0.89 (SE = 0.03). In 2,517 AD patients from 10 studies, the pooled sensitivity and pooled specificity were 0.91 (95% CI, 0.86-0.95) and 0.93 (95% CI, 0.88-0.95) respectively, and the sROC AUC was 0.97 (SE = 0.01). Although sub-analyzed according to age and years of education, there was no significant difference in the predictive validity of the ADAS-Cog.\n\n\nCONCLUSION\nThe ADAS-Cog has high predictive validity as a screening tool in both MCI and AD, but has better diagnostic performance in patients with AD. When early screening for AD is desired, ADAS-Cog is a first-stage screener that can be initially employed.","PeriodicalId":10810,"journal":{"name":"Current Alzheimer research","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Alzheimer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2174/1567205019666220404104854","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 1
Abstract
BACKGROUND
Mild cognitive impairment (MCI) and Alzheimer's disease (AD) are screened to distinguish whether cognitive decline in older adults is attributed to pathological causes rather than normal aging.
OBJECTIVE
The purpose of this review was to analyze the diagnostic performance of the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) in screening for MCI and AD.
METHODS
Electronic searches were performed on MEDLINE, EMBASE, CINAHL, and PsycArticles databases using the following keywords: dementia and ADAS-Cog. The Quality Assessment of Diagnostic Accuracy Studies-2 was used to checked the risk of bias in the diagnostic studies.
RESULTS
We reviewed 14 studies, including 3,875 patients who met the selection criteria. In 2,624 MCI patients from nine studies, the pooled sensitivity of ADAS-Cog was 0.80 (95% confidence interval [CI], 0.68-0.88), the pooled specificity was 0.84 (95% CI, 0.75-0.90), and the area under the curve of summary receiver-operating characteristic curves (SROC AUC) was 0.89 (SE = 0.03). In 2,517 AD patients from 10 studies, the pooled sensitivity and pooled specificity were 0.91 (95% CI, 0.86-0.95) and 0.93 (95% CI, 0.88-0.95) respectively, and the sROC AUC was 0.97 (SE = 0.01). Although sub-analyzed according to age and years of education, there was no significant difference in the predictive validity of the ADAS-Cog.
CONCLUSION
The ADAS-Cog has high predictive validity as a screening tool in both MCI and AD, but has better diagnostic performance in patients with AD. When early screening for AD is desired, ADAS-Cog is a first-stage screener that can be initially employed.
期刊介绍:
Current Alzheimer Research publishes peer-reviewed frontier review, research, drug clinical trial studies and letter articles on all areas of Alzheimer’s disease. This multidisciplinary journal will help in understanding the neurobiology, genetics, pathogenesis, and treatment strategies of Alzheimer’s disease. The journal publishes objective reviews written by experts and leaders actively engaged in research using cellular, molecular, and animal models. The journal also covers original articles on recent research in fast emerging areas of molecular diagnostics, brain imaging, drug development and discovery, and clinical aspects of Alzheimer’s disease. Manuscripts are encouraged that relate to the synergistic mechanism of Alzheimer''s disease with other dementia and neurodegenerative disorders. Book reviews, meeting reports and letters-to-the-editor are also published. The journal is essential reading for researchers, educators and physicians with interest in age-related dementia and Alzheimer’s disease. Current Alzheimer Research provides a comprehensive ''bird''s-eye view'' of the current state of Alzheimer''s research for neuroscientists, clinicians, health science planners, granting, caregivers and families of this devastating disease.