Designing a Brief Alzheimer Screen (BAS)

Context: With advances in the treatment of Alzheimer's disease (AD), clinical focus has shifted to early patient identification. Memory recall tests and category fluency distinguish normal individuals from early AD patients. Objective: Develop a brief test for general practitioners to screen for AD. Design Examination of items from the MMSE and category fluency. Setting and Participants: A Brief Alzheimer Screen (BAS) was developed from cognitive assessments on 406 normal subjects and 342 mild AD patients in the CERAD (Consortium to Establish a Registry for AD) dataset. The derived measure was then applied to a second validation sample. Main Outcome Measure: Logistic regression was used to derive a predictive equation, which was then applied to two validation samples to estimate sensitivity and specificity. Results: The resulting logistic model for discriminating between mild AD and controls included: recall of 3 words, number of animals named in 30 seconds, date, and spelling of WORLD backwards, (p < 0.001 for each) accounting for 77% of the variance. When applied to the validation samples, sensitivity and specificity were over 99% and 87%, respectively. Conclusions: These data support the use of the BAS as a potential screen of patients over 60 years of age.