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Adaptive cognitive testing in cerebrovascular disease and vascular dementia


Wouters, Hans, de Koning, Inge, Zwinderman, Aeilko H., van Gool, Willem A., Schmand, Ben, Buiter, Maarten, Lindeboom, Robert


Dementia And Geriatric Cognitive Disorders, Volume: 28, No.: 5, Pages.: 486-492

Year of Publication



Background/aims: To examine whether brevity can be combined with precision in measuring global cognitive ability in patients with cerebrovascular disease (CVD) or vascular dementia (VaD). Longer tests (e.g. the CAMCOG) are precise but inefficient, whereas brief tests (e.g. the MMSE) are efficient but imprecise.; Methods: A simulated computerized adaptive testing (CAT) algorithm using existing CAMCOG data from 284 patients with CVD of whom 55 were diagnosed with VaD. CAT was used to estimate each individual patient’s total score on a large precise test (the CAMCOG). CAT repeatedly selected only items of appropriate difficulty, depending on whether the previous item was (in)correctly responded to. CAT estimates were compared with total scores on the whole CAMCOG.; Results: Even though there was an average test reduction of more than 40%, CAT estimates were in very high agreement with the whole test results (intraclass correlation >0.97) and had similar accuracy for the diagnosis of dementia (area under the curve = 0.94).; Conclusion: CAT combines efficiency with precision in the measurement of global cognitive ability in CVD patients.; Copyright 2009 S. Karger AG, Basel.

Bibtex Citation

@article{Wouters_2009, doi = {10.1159/000250593}, url = {}, year = 2009, publisher = {S. Karger {AG}}, volume = {28}, number = {5}, pages = {486--492}, author = {Hans Wouters and Inge de Koning and Aeilko H. Zwinderman and Willem A. van Gool and Ben Schmand and Maarten Buiter and Robert Lindeboom}, title = {Adaptive Cognitive Testing in Cerebrovascular Disease and Vascular Dementia}, journal = {Dementia and Geriatric Cognitive Disorders} }


aged, aged, 80 and over, algorithms, cerebrovascular disorders, cognition disorders, dementia vascular, diagnosis, female, humans, logistic models, male, middle aged, neuropsychological tests, reproducibility of results, roc curve, sensitivity and specificity, severity of illness index, standards

Countries of Study


Types of Dementia

Vascular Dementia

Types of Study

Cohort Study

Type of Interventions

Diagnostic Target Identification

Risk Factor Modifications

At risk population