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Cambridge Cognitive Examination-Revised (CAMCOG-R)
Please email the author for information about obtaining the instrument: Dr. Felicia Huppert, or
Supplemental: Mitochondrial Disease (Mito) and Parkinson's Disease (PD)
Short Description of Instrument
Purpose: The CAMCOG was designed to measure severity of cognitive impairment in elderly and is part of the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX). It has been studied more often in PD than Parkinson's disease dementia (PDD), but studies of both are limited.
Construct measured: Global cognitive function.
Generic vs. disease-specific: Generic.
Means of administration: Rater administered (paper and pencil).
Intended respondent (e.g. patient, caregiver, etc): Patient.
Created in 1986, the Cambridge Cognitive Assessment Examination (CAMCOG) is a 107- point complete cognitive assessment and is part of the Cambridge Examination of Mental Disorders of the Elderly (CAMDEX). The revised version, CAMCOG-R (Roth et al., 1999), has a maximum score of 105 points. Domains tested with maximum scores are: orientation (10 points), language (30 points), memory (27 points), attention and calculation (9 points), praxis (12 points), abstraction (8 points) and perception (9 points).
There are no alternate forms. There is a briefer R-CAMCOG (Rotterdam Cambridge Cognitive Examination, a short version often used with stroke and taking 10-15 minutes) (de Koning et al., 2000) and the GPCOG (General Practitioner Assessment of Cognition) (Brodaty et al, 2002). The latter consists of a patient examination (GPCOG-patient) with a maximum score of 9, and an informant interview with a maximum score of 6. The patient examination contains the following cognitive test items: time orientation, clock drawing, reporting a recent event and a word recall.
Versions in Dutch and Spanish exist but reliability and validity are unknown. Normative data (Spain) have been provided for a Spanish version (Pereiro et al., 2015).
Comments/Special Instructions
Parkinson's Disease:
Performance is lower in Parkinson's disease (PD) than in healthy controls (Fathy et al., 2021) but the CAMCOG total score may not be sensitive to change (decline) in PD without dementia. Over three years, the mean annual decline in PD CAMCOG scores was only 1.09 points (Taylor et al., 2008). However, significant declines in mean score over 13 months (3.9 points) were reported by Athey and Walker (2006). The instrument was "suggested" for use as a cognitive rating scale in PD (Skorvanek et al., 2018)
Scoring and Psychometric Properties
Scoring: There are 8 domains. Scoring: 10 points orientation; 9 points comprehension; 21 points expression; 27 points memory; 9 points attention and calculation; 12 points praxis; 8 points abstract thinking; 8 points perception. Maximum = total 105, perception 9 (PD studies have had total of 8). Higher = better cognition. Scores less than 80 are indicative of dementia.
Psychometric Properties: The test is not normed. Huppert et al., (2015) provided means and standard deviations in over 400 persons 77 years or older and separately by age, education, gender, and socioeconomic status.
Limited studies in PD and CAMCOG-R may not be sensitive to decline. Test-retest and interrater reliabilities need to be established in PD and PDD.
Key References:
Roth M, Huppert F, Mountjoy C, Tym E. The Cambridge Examination for Mental Disorders of the Elderly - Revised. Cambridge: Cambridge University Press; 1999.
Roth M, Tym E, Mountjoy CQ, Huppert FA, Hendrie H, Verma S, Goddard R. CAMDEX. A standardized instrument for the diagnosis of mental disorder in the elderly with special reference to the early detection of dementia. Br J Psychiatry. 1986 Dec;149:698-709.
Additional References:
Athey RJ, Porter RW, Walker RW. Cognitive assessment of a representative community population with Parkinson's disease (PD) using the Cambridge Cognitive Assessment-Revised (CAMCOG-R). Age Ageing. 2005 May;34(3):268-73.
Athey RJ, Walker RW. Demonstration of cognitive decline in Parkinson's disease using the Cambridge Cognitive Assessment (Revised) (CAMCOG-R). Int J Geriatr Psychiatry. 2006 Oct;21(10):977-82.
Brodaty H, Pond D, Kemp NM, Luscombe G, Harding L, Berman K, Huppert FA. The GPCOG: a new screening test for dementia designed for general practice. J Am Geriatr Soc. 2002 Mar;50(3):530-4.
de Koning I, Dippel DW, van Kooten F, Koudstaal PJ. A short screening instrument for poststroke dementia : the R-CAMCOG. Stroke. 2000 Jul;31(7):1502-8.
de Koning I, van Kooten F, Dippel DW, van Harskamp F, Grobbee DE, Kluft C, Koudstaal PJ. The CAMCOG: a useful screening instrument for dementia in stroke patients. Stroke. 1998 Oct;29(10):2080-6.
Fathy YY, Hepp DH, de Jong FJ, Geurts JJG, Foncke EMJ, Berendse HW, van de Berg WDJ, Schoonheim MM. Anterior insular network disconnection and cognitive impairment in Parkinson's disease. Neuroimage Clin. 2020;28:102364.
Kulisevsky J, Pagonabarraga J. Cognitive impairment in Parkinson's disease: tools for diagnosis and assessment. Mov Disord. 2009 Jun 15;24(8):1103-10.
Pereiro AX, Ramos-Lema S, Juncos-Rabadan O, Facal D, Lojo-Seoane C. Normative scores of the Cambridge Cognitive Examination-Revised in healthy Spanish population. Psicothema. 2015;27(1):32-9.
Skorvanek M, Goldman JG, Jahanshahi M, Marras C, Rektorova I, Schmand B, van Duijn E, Goetz CG, Weintraub D, Stebbins GT, Martinez-Martin P; members of the MDS Rating Scales Review Committee. Global scales for cognitive screening in Parkinson's disease: Critique and recommendations. Mov Disord. 2018 Feb;33(2):208-218.
Taylor JP, Rowan EN, Lett D, O'Brien JT, McKeith IG, Burn DJ. Poor attentional function predicts cognitive decline in patients with non-demented Parkinson's disease independent of motor phenotype. J Neurol Neurosurg Psychiatry. 2008 Dec;79(12):1318-23.
Document last updated March 2024