The Diagnosis of Dementia in Subjects with Heterogeneous Educational Levels

  • Maria Teresa Carthery-Goulart
  • Paulo Caramelli
  • Ricardo Nitrini


Performance in cognitive tests is influenced by age, education and culture. Many batteries for screening and diagnosing dementia were developed in countries where low education and illiteracy are uncommon and therefore they may not be suitable for evaluation of populations with heterogeneous educational backgrounds. In this chapter, we discuss the influences of education in the diagnosis of dementia and present the results of studies with the Brief Cognitive Screening Battery (BCSB) or Brief Cognitive Battery unbiased by education (BCB-Edu) developed by Nitrini et al. (1994). The BCB-Edu has been employed for the diagnosis of dementia and Alzheimer’s disease (AD) in subjects with heterogeneous educational background (illiterate, low/medium/high levels of education). The delayed recall (DR) test of BCB-Edu proved to be more accurate than DR of Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) battery for the diagnosis of dementia in illiterate subjects [sensitivity = 93.3%, specificity = 95.7%, area under receiver operator characteristic curves (AUC-ROC) = 0.975]. DR of BCB-Edu also showed high sensitivity (82.2%) and specificity (90.4%) for the diagnosis of AD in patients with medium/high levels of education. A mathematical model including the results of core tests is also suggested to be employed in clinical practice. The BCB-Edu is a simple and useful tool for diagnosis and screening of dementia, particularly AD, in populations with heterogeneously educated individuals.


Delay Recall Clock Drawing Test Receiver Operator Characteristic Curf aMCI Patient Dementia Screening 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP).


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Maria Teresa Carthery-Goulart
    • 1
  • Paulo Caramelli
    • 1
  • Ricardo Nitrini
    • 1
  1. 1.Behavioral and Cognitive Neurology UnitDepartment of NeurologySão PauloBrazil

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