A cognitive screening battery for dementia in the elderly (original) (raw)

The Development of the Dementia Screening Battery-100: Instrument Presentation, Reliability, and Construct Validity

Dementia and Geriatric Cognitive Disorders Extra

Background/Aim: The screening of dementia in non-Westerners has so far relied on translations and adaptations of reputed instruments. Other efforts focused on developing culturally appropriate tests or tests in touch with new developments in the field. This study presents the rationale behind the construction of a new dementia screening test: the Dementia Screening Battery-100 (DSB-100). Methods: The DSB-100 was administered to 46 demented individuals and 159 healthy matched controls. All demented participants met the DSM-IV criteria for dementia. The healthy controls showed no cognitive impairment and were independent in activities of daily living. The DSB-100 was administered as part of a larger neuropsychological assessment to collect additional indices on the severity of patients' dementia, depression, and frontal dysfunctions. The same information was used for comparisons with DSB-100 scores. Results: Multiple regression analysis suggested that age and education, but not the variable sex, are essential in predicting cognitive performance. Construct validation yielded 4 factors, namely attention-visuospatial factors, memory, language, and executive functions. The results showed that the DSB-100 has a high interrater reliability and an acceptable overall internal homogeneity. Conclusion: These results validate the DSB-100 and suggest its appropriateness for dementia screening in Tunisian elderly and possibly elderly people from other cultures with modifications to some subscales.

Development and Validation of the Memory Orientation Screening Test (MOST™): A Better Screening Test for Dementia

American Journal of Alzheimers Disease and Other Dementias, 2010

Objectives: Accurate, economical identification of cognitive impairment would increase dementia detection and improve care of older patients. Design: Analysis of archival neuropsychological data combined 3-word recall, time orientation, list memory, and clock drawing into the Memory Orientation Screening Test (MOST ™). The MOST was compared with Folstein Mini Mental State Examination (MMSE) and Mini-Cog to detect dementia presence and severity, and convergence with standardized neuropsychological tests. Internal consistency, retest reliabilities, completion likelihood, and time costs were calculated. Results: The MOST was significantly more sensitive than MMSE or Mini-Cog, twice as accurate as MMSE for identifying mild dementia, better correlated with standardized memory tests, more reliable over time, and minimally related to depression. Conclusions: The MOST is routinely administered in less than 5 minutes by a medical assistant, more accurately identifies dementia and severity than current screening tests, and emulates longer memory testing, making it valuable for Annual Wellness Visits and many applied clinical settings.

A Brief Dementia Test with Subjective and Objective Measures

Dementia and Geriatric Cognitive Disorders Extra, 2015

Background: The development of an effective brief dementia test will help in the early identification of dementia. Aim: This study investigates the diagnostic utility of a brief cognitive test for dementia which combines a short subjective informant-rated questionnaire (AD8) with an objective cognitive measure (Mini-Mental State Examination, MMSE) or its subcomponents. Methods: Subjects with mild dementia (Clinical Dementia Rating Scale score ≤ 1) were matched with community-dwelling, cognitively intact controls. MMSE and Clinical Dementia Rating Scale were administered to all subjects, while AD8 was completed by a reliable informant. Receiver operating characteristics analysis determined the diagnostic accuracies of AD8, MMSE, and AD8 combined with MMSE (AD8+MMSE). Stepwise logistic regression identified the subcomponents of MMSE which, combined with AD8, best discriminated dementia patients from controls. Results: The AD8 (area under the curve [AUC] = 0.92, 95% confidence interval [CI] 0.89-0.95) was superior to the MMSE (AUC = 0.87, 95% CI 0.83-0.92) in discriminating mild dementia patients from controls, and AD8+MMSE (AUC = 0.95, 0.92-0.98) increased its superior discrimination over MMSE alone. AD8 combined with three-item recall and intersecting pentagon copy (AUC = 0.95, 95% CI 0.92-0.97) performed as well as AD8 combined with full MMSE. Conclusion: AD8 combined with the MMSE subcomponents threeitem recall and intersecting pentagon copy has excellent diagnostic utility and is a promising brief cognitive test for early dementia.

Validation of a short cognitive tool for the screening of dementia in elderly people with low educational level

International Journal of Geriatric Psychiatry, 2003

Aim To validate the 'Prueba Cognitiva de Leganés' (PCL) as a screening tool for cognitive impairment in elderly people with little formal education. Methods The PCL is a simple cognitive test with 32 items that includes two scores of orientation and memory and a global score of 0-32 points. It was applied to a population sample of 527 elderly people over 70 with low educational level, who were independently diagnosed by consensus between two neurologists as having normal cognitive function, age associated cognitive decline (AACD, IPA-OMS criteria) or dementia (DSM-IV criteria). Individuals with severe visual or hearing defects and those who rejected the exam were excluded from the study. The PCL was validated in a sample of 375 individuals: 300 normal, 42 with AACD and 33 with dementia. The sensitivity, specificity, accuracy and likelihood ratios, as well as the ROC curves for dementia and for AACD-dementia, were calculated. The confounding effect of sociodemographic variables was assessed by logistic regression analysis and convergent validity by partial correlations of the PCL with other cognitive tests. Inter-rater reliability was evaluated with the intraclass correlation coefficient. Results The PCL identified dementia (cut-off 22) and AACD-dementia (cut-off 26), with the following diagnostic parameters, respectively: sensitivity 93.9%-80%, specificity 94.7%-84.3%, positive likelihood ratio 17.8-5.1, negative likelihood ratio 0.06-0.24, and accuracy 94.6%-83.4%. The areas under the ROC curve were 0.985 (95% Confidence Intervals (CI) 0.967-0.995) and 0.904 (95% CI: 0.870-0.932) respectively. The intraclass correlation coefficient was 0.79 (0.74-0.83). Conclusion The PCL is a simple instrument, which is both valid and reliable, for the screening of dementia in population samples of individuals with low educational level. This instrument could be useful in primary health care.

An Abbreviated Montreal Cognitive Assessment (MoCA) for Dementia Screening

The Clinical neuropsychologist, 2015

The Montreal Cognitive Assessment (MoCA) is a cognitive screening instrument growing in popularity, but few studies have conducted psychometric item analyses or attempted to develop abbreviated forms. We sought to derive and validate a short-form MoCA (SF-MoCA) and compare its classification accuracy to the standard MoCA and Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI), Alzheimer disease (AD), and normal aging. 408 subjects (MCI n = 169, AD n = 87, and normal n = 152) were randomly divided into derivation and validation samples. Item analysis in the derivation sample identified most sensitive MoCA items. Receiver Operating Characteristic (ROC) analyses were used to develop cut-off scores and evaluate the classification accuracy of the SF-MoCA, standard MoCA, and MMSE. Net Reclassification Improvement (NRI) analyses and comparison of ROC curves were used to compare classification accuracy of the three measures. Serial subtraction (Cramer's V = .408), de...

Instruments for Cognitive Screening in the Elderly

Nursing & Care Open Access Journal, 2017

Aging is a natural process that produces a progressive decrease in the functional and cognitive capacity of people, also known as senescence. However, overloads from events such as illness, accidents and emotional stress can cause a pathological condition that will require assistance. One of the conditions that can affect the elderly are cognitive deficits. Cognitive assessment is an important process in this context because it measures the measure of an individual's ability to acquire and use information in order to adapt to the demands of the environment. There are for this purpose several instruments for cognitive screening that configure scales of easy and fast application, comprising the domains: temporo-spatial orientation, immediate memory and evocation, calculation, language, naming, comprehension, writing, praxia, among others. The cognitive battery is a set of several combined and correlated screening instruments. The impact of cognitive evaluation on the health of the elderly presupposes that a cognitive-functional evaluation is essential for obtaining a broad diagnosis, which will both serve preventive actions as well as to assist in the treatment decisions and care needed for elder care. The purpose of this article is to present the most used cognitive evaluation instruments for cognitive screening of the elderly, as well as the parameters used in these evaluations.

Screening for dementia with the Memory Impairment Screen

Neurology, 1999

Article abstract-Objectives: To validate a sensitive and specific screening test for AD and other dementias, assess its reliability and discriminative validity, and present normative data for its use in various applied settings. Background: To improve discrimination in screening for AD and dementia, we developed the Memory Impairment Screen (MIS), a 4-minute, four-item, delayed free-and cued-recall test of memory impairment. The MIS uses controlled learning to ensure attention, induce specific semantic processing, and optimize encoding specificity to improve detection of dementia. Methods: Equivalent forms of the MIS were given at the beginning and end of the testing session to assess alternate forms reliability. Discriminative validity was assessed in a criterion sample of 483 aged individuals, 50 of whom had dementia according to Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised) criteria. Results: The MIS had good alternate forms reliability, high construct validity for memory impairment, and good discriminative validity in terms of sensitivity, specificity, and positive predictive value. We present normative data for use in settings with different base rates (prevalences) of AD and dementia. Conclusion: The MIS provides efficient, reliable, and valid screening for AD and other dementias.

The cognitive disorders examination (Codex) is a reliable 3-minute test for detection of dementia in the elderly (validation study on 323 subjects)

La Presse Médicale, 2007

Codex, un test fiable en 3 minutes pour la détection de la démence chez le sujet âgés (étude de validation sur 323 sujets) Contexte > La démence est souvent diagnostiquée au stade modéré ou sévère, ce qui constitue une perte de chance pour les patients. Une détection plus précoce de la démence pourrait être améliorée par des outils faciles à employer en soin primaire. But > Élaborer et valider un test très bref pour la détection de la démence. Méthodes > Étude d'élaboration : chez les patients consécutifs d'une consultation mémoire vus pendant 2 ans, le niveau de l'éducation, les scores et sous-scores du Mini Mental Status Examination (MMSE) et un test d'horloge simplifié (THs) ont été recueillis. Le diagnostic de