scholarly journals Rapid review of cognitive screening instruments in MCI: proposal for a process-based approach modification of overlapping tasks in select widely used instruments

2017 ◽  
Vol 30 (5) ◽  
pp. 663-672 ◽  
Author(s):  
Unai Díaz-Orueta ◽  
Alberto Blanco-Campal ◽  
Teresa Burke
Keyword(s):  
Test Performance ◽  
Cognitive Task ◽  
Screening Tools ◽  
Clinical Population ◽  
Screening Tests ◽  
Rapid Review ◽  
Diagnostic Process ◽  
Cognitive Screening ◽  
Cognitive Domains ◽  
Test Taking

ABSTRACTBackground:A detailed neuropsychological assessment plays an important role in the diagnostic process of Mild Cognitive Impairment (MCI). However, available brief cognitive screening tests for this clinical population are administered and interpreted based mainly, or exclusively, on total achievement scores. This score-based approach can lead to erroneous clinical interpretations unless we also pay attention to the test taking behavior or to the type of errors committed during test performance.Methods:The goal of the current study is to perform a rapid review of the literature regarding cognitive screening tools for dementia in primary and secondary care; this will include revisiting previously published systematic reviews on screening tools for dementia, extensive database search, and analysis of individual references cited in selected studies.Results:A subset of representative screening tools for dementia was identified that covers as many cognitive functions as possible. How these screening tools overlap with each other (in terms of the cognitive domains being measured and the method used to assess them) was examined and a series of process-based approach (PBA) modifications for these overlapping features was proposed, so that the changes recommended in relation to one particular cognitive task could be extrapolated to other screening tools.Conclusion:It is expected that future versions of cognitive screening tests, modified using a PBA, will highlight the benefits of attending to qualitative features of test performance when trying to identify subtle features suggestive of MCI and/or dementia.

Lifting the veil: how to use clinical neuropsychology to assess dementia

2015 ◽  
Vol 86 (11) ◽  
pp. 1216-1224 ◽  
Author(s):  
James R Burrell ◽  
Olivier Piguet
Keyword(s):  
Neuropsychological Tests ◽  
Neuropsychological Testing ◽  
Screening Tools ◽  
Diagnostic Process ◽  
Cognitive Screening ◽  
Cognitive Assessments ◽  
Clinical Neuropsychology ◽  
Cognitive Domains ◽  
The Veil ◽  
Function Language

Neurologists often struggle to interpret the results of neuropsychological testing, even though cognitive assessments are an integral component of the diagnostic process in dementia syndromes. This article reviews the principles underlying clinical neuropsychology, background on common neuropsychological tests, and tips on how to interpret the results when assessing patients with dementia. General cognitive screening tools, appropriate for use by general neurologists and psychiatrists, as well as specific cognitive tests examining the main cognitive domains (attention and orientation, memory, visuospatial function, language and executive function) in patients with dementia are considered. Finally, the pattern of deficits, helpful in defining clinical dementia phenotypes and sometimes in predicting the underlying molecular pathology, are outlined. Such clinicopathological associations will become invaluable as disease-modifying treatments for dementia are developed and implemented.

scholarly journals Screening tools for the identification of dementia for adults with age-related acquired hearing or vision impairment: a scoping review

2017 ◽  
Vol 29 (11) ◽  
pp. 1771-1784 ◽  
Author(s):  
Annie Pye ◽  
Anna Pavlina Charalambous ◽  
Iracema Leroi ◽  
Chrysoulla Thodi ◽  
Piers Dawes
Keyword(s):  
Hearing Impairment ◽  
Cognitive Assessment ◽  
Negative Impact ◽  
Sensory Modality ◽  
Vision Impairment ◽  
Assessment Tools ◽  
Screening Tools ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Age Related

ABSTRACTBackground:Cognitive screening tests frequently rely on items being correctly heard or seen. We aimed to identify, describe, and evaluate the adaptation, validity, and availability of cognitive screening and assessment tools for dementia which have been developed or adapted for adults with acquired hearing and/or vision impairment.Method:Electronic databases were searched using subject terms “hearing disorders” OR “vision disorders” AND “cognitive assessment,” supplemented by exploring reference lists of included papers and via consultation with health professionals to identify additional literature.Results:1,551 papers were identified, of which 13 met inclusion criteria. Four papers related to tests adapted for hearing impairment; 11 papers related to tests adapted for vision impairment. Frequently adapted tests were the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MOCA). Adaptations for hearing impairment involved deleting or creating written versions for hearing-dependent items. Adaptations for vision impairment involved deleting vision-dependent items or spoken/tactile versions of visual tasks. No study reported validity of the test in relation to detection of dementia in people with hearing/vision impairment. Item deletion had a negative impact on the psychometric properties of the test.Conclusions:While attempts have been made to adapt cognitive tests for people with acquired hearing and/or vision impairment, the primary limitation of these adaptations is that their validity in accurately detecting dementia among those with acquired hearing or vision impairment is yet to be established. It is likely that the sensitivity and specificity of the adapted versions are poorer than the original, especially if the adaptation involved item deletion. One solution would involve item substitution in an alternative sensory modality followed by re-validation of the adapted test.

scholarly journals Screening for Alzheimer's disease in low-educated or illiterate older adults in Brazil: a systematic review

2019 ◽  
Vol 77 (4) ◽  
pp. 279-288 ◽  
Author(s):  
Luciane de Fátima Viola Ortega ◽  
Ivan Aprahamian ◽  
Marcus Kiiti Borges ◽  
João de Castilho Cação ◽  
Mônica Sanches Yassuda
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Diagnostic Accuracy ◽  
Screening Tools ◽  
Screening Tests ◽  
Screening Instruments ◽  
Cognitive Screening ◽  
Inclusion Criteria ◽  
Low Education ◽  
Low Educated

ABSTRACT Cognitive screening instruments are influenced by education and/or culture. In Brazil, as illiteracy and low education rates are high, it is necessary to identify the screening tools with the highest diagnostic accuracy for Alzheimer's disease (AD). Objective: To identify the cognitive screening instruments applied in the Brazilian population with greater accuracy, to detect AD in individuals with a low educational level or who are illiterate. Methods: Systematic search in SciELO, PubMed and LILACS databases of studies that used cognitive screening tests to detect AD in older Brazilian adults with low or no education. Results: We found 328 articles and nine met the inclusion criteria. The identified instruments showed adequate or high diagnostic accuracy. Conclusion: For valid cognitive screening it is important to consider sociocultural and educational factors in the interpretation of results. The construction of specific instruments for the low educated or illiterate elderly should better reflect the difficulties of the Brazilian elderly in different regions of the country.

The Utility of Cognitive Screeners in the Detection of Dementia Spectrum Disorders in Spanish-Speaking Populations

2020 ◽  
pp. 089198872091551
Author(s):  
Shanna L. Burke ◽  
Adrienne Grudzien ◽  
Aaron Burgess ◽  
Miriam J. Rodriguez ◽  
Yesenia Rivera ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Normative Data ◽  
Screening Tools ◽  
Screening Tests ◽  
Culturally Appropriate ◽  
Cognitive Screening ◽  
Spanish Speaking ◽  
Search Terms ◽  
Mini Mental Status Examination ◽  
Spectrum Disorders

Increasing rates of dementia spectrum disorders among Spanish-speaking geriatric populations necessitate the development of culturally appropriate cognitive screening tests that can identify neurodegenerative disorders in their earliest stages when emerging disease-modifying treatments are most likely to be effective. This scoping review identified 26 brief Spanish language cognitive screening tools (<20 minutes) by searching academic databases using a combination of search terms. Results suggest that the Mini-Mental Status Examination and Montreal Cognitive Assessment appear to be less valid than other screeners. Instruments such as the 7-Minute Screen and Mini-Cog evidence higher classification rates of dementia, while Phototest detected mild cognitive impairment at higher rates more consistently than other screeners. Different sensitivity and specificity outcomes and cutoffs were observed when the same cognitive screener was evaluated in different countries. Results indicate that it is imperative to increase nation-specific validation and normative data for these instruments to best serve diverse populations.

Feasibility of Using Tablet-Based Cognitive Screening Tools in India

2017 ◽  
Vol 2 (1) ◽  
pp. 34-44 ◽  
Author(s):  
Aparna Sahu
Keyword(s):  
Indian Population ◽  
Screening Tools ◽  
Screening Tests ◽  
Healthy Controls ◽  
Cognitive Screening ◽  
The West ◽  
Large Samples ◽  
Population Potential ◽  
Smart Technologies

Tablet-based cognitive screening batteries are becoming popular in the West due to the ease of administration on patients and healthy controls, collection of data from large samples, and scoring and reporting of test performances. These tests have garnered positive reception from clinical professionals, researchers, and patients. The article seeks to assess the feasibility of introducing tablet-based screening tests for the Indian population. Potential advantages and concerns on the use of smart technologies for testing are addressed in the light of past and current research.

Cognitive screening tools for identification of dementia in illiterate and low-educated older adults, a systematic review and meta-analysis

2017 ◽  
Vol 29 (6) ◽  
pp. 897-929 ◽  
Author(s):  
Stella-Maria Paddick ◽  
William K. Gray ◽  
Jackie McGuire ◽  
Jenny Richardson ◽  
Catherine Dotchin ◽  
...  
Keyword(s):  
Older Adults ◽  
Validation Studies ◽  
Meta Analysis ◽  
Significant Proportion ◽  
Educational Background ◽  
Screening Tools ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Low Literacy ◽  
Prevalence Studies

ABSTRACTBackground:The majority of older adults with dementia live in low- and middle-income countries (LMICs). Illiteracy and low educational background are common in older LMIC populations, particularly in rural areas, and cognitive screening tools developed for this setting must reflect this. This study aimed to review published validation studies of cognitive screening tools for dementia in low-literacy settings in order to determine the most appropriate tools for use.Method:A systematic search of major databases was conducted according to PRISMA guidelines. Validation studies of brief cognitive screening tests including illiterate participants or those with elementary education were eligible. Studies were quality assessed using the QUADAS-2 tool. Good or fair quality studies were included in a bivariate random-effects meta-analysis and a hierarchical summary receiver operating characteristic (HSROC) curve constructed.Results:Forty-five eligible studies were quality assessed. A significant proportion utilized a case–control design, resulting in spectrum bias. The area under the ROC (AUROC) curve was 0.937 for community/low prevalence studies, 0.881 for clinic based/higher prevalence studies, and 0.869 for illiterate populations. For the Mini-Mental State Examination (MMSE) (and adaptations), the AUROC curve was 0.853.Conclusion:Numerous tools for assessment of cognitive impairment in low-literacy settings have been developed, and tools developed for use in high-income countries have also been validated in low-literacy settings. Most tools have been inadequately validated, with only MMSE, cognitive abilities screening instrument (CASI), Eurotest, and Fototest having more than one published good or fair quality study in an illiterate or low-literate setting. At present no screening test can be recommended.

scholarly journals Effects of Sociodemographic Variables and Depressive Symptoms on MoCA Test Performance in Native Germans and Turkish Migrants in Germany

2021 ◽  
Vol 18 (12) ◽  
pp. 6335
Author(s):  
Görkem Anapa ◽  
Mandy Roheger ◽  
Ümran Sema Seven ◽  
Hannah Liebermann-Jordanidis ◽  
Oezguer A. Onur ◽  
...  
Keyword(s):  
Sex Education ◽  
Test Performance ◽  
Statistical Significance ◽  
Sociodemographic Factors ◽  
Migration Background ◽  
Screening Tools ◽  
Cognitive Screening ◽  
Linear Regression Models ◽  
Turkish Migrants ◽  
And Migration

The validity of the Montreal Cognitive Assessment (MoCA) in migrants is questionable, as sociodemographic factors and the migration process may influence performance. Our aim was to evaluate possible predictors (age, education, sex, depression, and migration) of MoCA results in Turkish migrants and Germans living in Germany. Linear regression models were conducted with a German (n = 419), a Turkish (n = 133), and an overall sample. All predictor analyses reached statistical significance. For the German sample, age, sex, education, and depression were significant predictors, whereas education was the only predictor for Turkish migrants. For the overall sample, having no migration background and higher education were significant predictors. Migration background and education had an impact on MoCA performance in a sample of German and Turkish individuals living in Germany. Thus, culture-specific normative data for the MoCA are needed, and the development of culture-sensitive cognitive screening tools is encouraged.

The use of cognitive screens within major trauma centres in England: A survey of current practice

Trauma ◽  
2019 ◽  
Vol 22 (3) ◽  
pp. 201-207
Author(s):  
AJ Teager ◽  
A Methley ◽  
B Dawson ◽  
H Wilson
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Major Trauma ◽  
Brain Injuries ◽  
Clinical Psychologists ◽  
Screening Tools ◽  
Clinical Population ◽  
Cognitive Screening ◽  
Trauma Centres ◽  
Serious Injury

Introduction Major trauma centres are effective in reducing morbidity and mortality rates following serious injury. Many patients attending major trauma centres present with traumatic brain injuries, requiring specialist assessment in screening for potential cognitive deficits. Numerous cognitive screens exist but it is currently unclear which are used most frequently within major trauma centres. This study aimed to identify which screening tools are used most frequently in major trauma centres in England to enable discussion around their suitability for this clinical population. Method Electronic surveys were distributed via a mailing list to Clinical Psychologists and Clinical Neuropsychologists in major trauma centres across England to gather data on the use of cognitive screens. Results Fourteen Clinical Psychologists in Neuropsychology participated. Results suggest major trauma centres in England are currently using the ACE-III (50%) or MoCA (42%) as the most frequently used screens for cognitive difficulties following traumatic brain injury. Cognitive screening pathways are multi-disciplinary involving OTs (86%), psychologists (qualified 79%; assistant 57%) psychiatrists (36%), mental health nurses (7%) and therapy assistants (7%). Conclusions Major trauma centres are using evidence-based cognitive screens at present, but further work is needed to develop more effective, better validated cognitive screens for traumatic brain injury populations. Increased inter-professional discussion on the practice of cognitive screening would be beneficial for patients seen within major trauma centres.

scholarly journals Norms and equivalences for MoCA-30, MoCA-22, and MMSE in the oldest-old

2021 ◽  
Author(s):  
Zarui A. Melikyan ◽  
Michael Malek-Ahmadi ◽  
Kathleen O’Connor ◽  
Alireza Atri ◽  
Claudia H. Kawas ◽  
...  
Keyword(s):  
Healthy Aging ◽  
Oldest Old ◽  
Screening Tests ◽  
Cognitive Tests ◽  
Cognitive Screening ◽  
Maximum Score ◽  
Cognitive Domains ◽  
Linear Smoothing ◽  
Log Linear ◽  
State Examination

Abstract Background Cognitive screening is important for the oldest-old (age 90 +). This age group is the fastest growing and has the highest risk of dementia. However, norms and score equivalence for screening tests are lacking for this group. Aims To provide norms and score equivalence for commonly used cognitive screening tests for the oldest-old. Methods Data on 157 participants of the Center for Healthy Aging Longevity Study aged 90 + were analyzed. First, we derived norms for (1) subtests and cognitive domains of the in-person Montreal Cognitive Assessment having a maximum score of 30 (MoCA-30) and (2) the total MoCA-22 score, obtained from the in-person MoCA-30 by summing the subtests that do not require visual input to a maximum score of 22. These norms were derived from 124 participants with a Mini-Mental State Examination (MMSE) ≥ 27. Second, we derived score equivalences for MMSE to MoCA-30 and MoCA-22, and MoCA-30 to MoCA-22 using equipercentile equating method with log-linear smoothing, based on all 157 participants. Results MoCA-22 total score norms are: mean = 18.3(standard deviation = 2.2). An MMSE score of 27 is equivalent to a MoCA-30 score of 22 and a MoCA-22 score of 16. Discussion and conclusions Subtest, domain and MoCA-22 norms will aid in evaluation of the oldest-old who cannot complete the MoCA-30 or are tested over the phone. The equivalences of the three cognitive tests (MMSE, MoCA-30, MoCA-22) in the oldest-old will facilitate continuity of cognitive tracking of individuals tested with different tests over time and comparison of the studies that use different cognitive tests.

Performance of three cognitive screening tools in a sample of older New Zealanders

2015 ◽  
Vol 27 (6) ◽  
pp. 981-989 ◽  
Author(s):  
G. Cheung ◽  
A. Clugston ◽  
M. Croucher ◽  
D. Malone ◽  
E. Mau ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Cognitive Assessment ◽  
Random Order ◽  
Screening Tools ◽  
Screening Tests ◽  
Future Research ◽  
Clinical Settings ◽  
Strongly Correlated ◽  
Cognitive Screening ◽  
Mild Dementia

ABSTRACTBackground:With the ubiquitous Mini-Mental State Exam now under copyright, attention is turning to alternative cognitive screening tests. The aim of the present study was to investigate three common cognitive screening tools: the Montreal Cognitive Assessment (MoCA), the Rowland Universal Dementia Assessment Scale (RUDAS), and the recently revised Addenbrooke's Cognitive Assessment Version III (ACE-III).Methods:The ACE-III, MoCA and RUDAS were administered in random order to a sample of 37 participants with diagnosed mild dementia and 47 comparison participants without dementia. The diagnostic accuracy of the three tests was assessed.Results:All the tests showed good overall accuracy as assessed by area under the ROC Curve, 0.89 (95% CI = 0.80–0.95) for the ACE-III, 0.84 (0.75–0.91) for the MoCA, and 0.86 (0.77–0.93) for RUDAS. The three tests were strongly correlated: r(84) = 0.85 (0.78–0.90) between the ACE-III and MoCA, 0.70 (0.57–0.80) between the ACE-III and RUDAS; and 0.65 (0.50–0.76) between the MoCA and RUDAS. The data derived optimal cut-off points for were lower than the published recommendations for the ACE-III (optimal cut-point ≤76, sensitivity = 81.1%, specificity = 85.1%) and the MoCA (≤20, sensitivity = 78.4%, specificity = 83.0%), but similar for the RUDAS (≤22, sensitivity = 78.4%, specificity = 85.1%).Conclusions:All three tools discriminated well overall between cases of mild dementia and controls. To inform interpretation of these tests in clinical settings, it would be useful for future research to address more inclusive and potentially age-stratified local norms.

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