The Cambridge cognitive examination (CAMCOG): Validation of the Hebrew version in elderly demented patients

Background and purpose. The CAMCOG is the second most popular cognitive tes ting instrument in use by Israeli clinicians. The present study examines th e reliability and validity of a Hebrew version of the CAMCOG in a group of dementia sufferers in a clinical setting. Method: Study participants included 36 dementia sufferers and 19 control no n-demented, depressed elderly subjects, consecutive referrals to an outpati ent psychogeriatric service and an 'open' ward of a psychiatric hospital. O perational clinical criteria for dementia and its subtypes and for the vari ous forms of depression were used as the 'gold' standards. The CAMCOG was t ranslated into Hebrew and then back to English. Seven items needed modifica tions for local usage. Results. Interrater and test-retest scores calculated as exact agreement ra tes ranged from good to excellent for all items. although test-retest relia bility scores were generally lower than interrater scores. Kappa statistics ranged from good to excellent for all but one item in the interrater score s and for two items in the test-retest scores. A strong convergent validity was found with the MMSE score (r = 0.89, p < 0.01), The 79/80 cutoff point provided moderate sensitivity (57.9%), excellent specificity (97.2%) and a strong predictive value (83.6%). Conclusion. The Hebrew version of the CAMCOG was found to be an appropriate instrument to discriminate between demented and non-demented depressed con trols in a clinical setting. In light of the demographic, cultural and ling uistic heterogeneity of the Israeli elderly population, further studies sho uld examine the psychometric characteristics of the CAMCOG in a more varied sample and also using other cutoff points in order to establish if an incr ease in its discriminatory power is obtainable. Copyright (C) 1999 John Wil ey & Sons, Ltd.