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Background/Aims: To detect cognitive decline in older adults, measures of verbal fluency and verbal memory are widely used. Less is known about performance in these measures in younger persons or according to education level and gender. We investigated cognitive performance according to age, education and gender among cognitively healthy adults aged 30–100 years. Methods: The study population comprised 4,174 cognitively healthy persons participating in the nationally representative Finnish Health 2011 survey. Cognitive assessment included verbal fluency, word list memory, word list recall and word list savings from the Consortium to Establish a Registry for Alzheimer’s Disease neuropsychological battery. Results: Total variance in the cognitive test performance explained by age, education and gender varied from 12.3 to 31.2%. A decreasing trend in cognitive performance existed in all subtests by advancing age, with differences appearing between 50 and 55 years. Persons with the highest-education level performed best for all measures. For the participants < 55 years, education explained part of the variance, while age and gender did not. Conclusions: When assessing cognition, age and education should be accounted for in more detail in research and clinical practice. Additionally, the cohort effect and its potential impact on the renewal cycle of future normative values for cognitive tests should be considered.

The purpose of this study was to find means to increase the power of the Cognitive Abilities Screening Instrument, Chinese version (CASI C-2.0) in the screening of dementia. In assessing the performance of the CASI in dementia screening, it is a common practice to determine a cutoff score for the total CASI score and report the respective sensitivity and specificity. In this paper, we showed that an alternative scoring system, i.e., a weighted sum of the scores from the 9 domains in the CASI C-2.0, may improve its effectiveness in screening. In particular, short-term memory and orientation appeared to be the 2 most relevant domains and their combined score was shown to be more effective than the total score in screening dementia. We also showed that such a scoring system could be kept the same across examinees with different demographic backgrounds. With the weighted scoring system of the 9 domains for patients from the targeted population, we hope to make the CASI a clinically more powerful tool in screening dementia.

The Cognitive Abilities Screening Instrument (CASI) contains nine cognitive domains. Its total score has been used to screen for dementia in epidemiological studies conducted in the US, Japan and Taiwan, but its usefulness in distinguishing different levels of dementia has not been examined. This study was conducted to compare CASI scores of patients with Alzheimer’s disease (AD) with different levels of severity of dementia. The CASI was administered to 475 AD patients with mild, moderate or severe dementia according to the Clinical Dementia Rating Scale. The patients’ scores were compared to the scores of 475 age-, education- and gender-matched control subjects. More specifically, each patient’s score, X, was transformed to a z score with reference to the mean and SD of the scores of the control group, where z = (X – mean)/SD. Then, the mean of the z scores and the percentage of patients with z scores of

We constructed a Chinese version of the cognitive component of the Alzheimer’s Disease Assessment Scale (ADAS-Cog). In order to accommodate illiteracy, the Chinese version used pictures instead of words for assessing recall and recognition. The Chinese ADAS-Cog was administered to 125 individuals with no dementia, 127 with questionable dementia, and 77 with Alzheimer’s disease (AD). Their age range was 51–92 years and their education range was 0–20 years. The Chinese ADAS-Cog had high internal consistency (Cronbach’s alpha = 0.87) and very high interrater reliability (intraclass correlation coefficient, or ICC, = 0.99) and test-retest reliability (ICC = 0.96). It had high correlations with scores on the Clinical Dementia Rating Scale (Pearson’s r = 0.85), the Cognitive Abilities Screening Instrument (CASI, Pearson’s r = –0.88), and CASI-estimated scores on the Mini-Mental State Examination (Pearson’s r = –0.85). Performance on the Chinese ADAS-Cog was uninfluenced by age or gender, nor by education level except within the low education range of 0–6 years. Its memory items were best for early detection of dementia; its language items were best for monitoring the progression of dementia. This study found that the Chinese ADAS-Cog is a good instrument for use with Chinese AD patients.