Is the Alzheimer's Disease Assessment Scale-Cognitive Subscale Useful in Screening for Mild Cognitive Impairment and Alzheimer's Disease? A Systematic Review

Seong Hi Park, Kuemsun Han

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)

Abstract

Background: Mild cognitive impairment (MCI) and Alzheimer’s disease (AD) are screened to distinguish whether the 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 check 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 in-terval [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 and has better diagnostic performance in patients with AD. When early screening for AD is desired, ADAS-Cog is a first-stage screening tool that can be initially employed.

Original languageEnglish
Pages (from-to)202-211
Number of pages10
JournalCurrent Alzheimer Research
Volume19
Issue number3
DOIs
Publication statusPublished - 2022

Bibliographical note

Funding Information:
This paper was supported by the 2021 Sabbatical Year of Soonchunhyang University. The funders of this study had no role in the study design, analysis, or interpretation of data or in the writing of the article or decision to submit the article for publication.

Publisher Copyright:
© 2022 Bentham Science Publishers.

Keywords

  • Alzheimer’s disease
  • cognitive dysfunction
  • neuropsychological tests
  • older adults
  • sensitivity
  • specificity
  • systematic review

ASJC Scopus subject areas

  • General Medicine

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