[Does education influence the results of the Amsterdam Dementia-Screening Test (ADS)?]

The goal of this study was to explore the correlation between education and the results of five dementia screening tests. In a study of 551 consecutively enrolled psychogeriatric day care attendants individual differences in education explained only very small portions of variance (< or = 0.63%) in four tests (visual recognition memory, orientation, category fluency and alternating sequences) of the Amsterdam Dementia Screening Test, a standard neuropsychological battery. The only exception was graphical copying of two- or three-dimensional geometric designs, where education explained 6.25% of the variance in copying accuracy. The more education participants had (from incomplete or complete primary education, through extended primary education, lower technical and vocational training, and secondary to higher education), the better their copying performance was. There was however one exception, in that participants with secondary education copied designs significantly less accurately than participants with lower technical and vocational training. Differences in copying accuracy of subjects with higher versus lower educational attainment were largest for participants matched for high levels of cognitive function. More severe cognitive impairment attenuated education effects. Higher education did not protect against decline of copying performance as a consequence of increasing cognitive impairment. For each of three educational levels, premorbid copying performance was estimated by constructing a regression equation using an independent measure of cognitive functioning (in terms of visual recognition memory, orientation and category fluency) as the predictor variable. The results support the clinical utility of controlling for educational level when interpreting individual copying performance.