Prediction of geriatric rehabilitation outcomes: Comparison between three cognitive screening tools

ABSTRACTBackground:Cognitive status has been reported to be an important predictor of rehabilitation outcome. The Montreal Cognitive Assessment (MoCA) was designed to overcome some of the limitations of established cognitive screening tools such as the Mini-Mental State Examination (MMSE). The purpose of this study is to evaluate the psychometric characteristics of the MoCA as a screening tool in a geriatric rehabilitation program and its ability to predict rehabilitation outcome.Methods:Forty-seven geriatric rehabilitation program patients participated in the study. Assessments of each patient's functional (Functional Independence Measure) and cognitive status (MMSE and MoCA) were performed. Information on discharge destinations were obtained and rehabilitation efficacy and efficiency scores were calculated.Results:Significant correlations were found between the MoCA and other cognitive status measures. Cognitive status at admission and successful rehabilitation were also associated. Defining rehabilitation success on the basis of relative functional efficacy (an indicator that includes the patient's potential for improvement), the sensitivity and specificity of the MoCA were 80% and 30% respectively. The attention subscale of the MoCA was also uniquely predictive of rehabilitation success. The attention subscale (cutoff 5/6) of the MoCA had a sensitivity of 40% and specificity of 90%, as did the MMSE.Conclusions:As a cognitive screening tool, the MoCA appears to have acceptable psychometric properties. Results suggest that the MoCA can have a considerable advantage over the MMSE in sensitivity and equivalence in specificity using both total and attention scale scores. The MoCA may be a more useful measure for detecting cognitive impairment and predicting rehabilitation outcome in this population.

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Review for "Diagnostic accuracy of cognitive screening tools under different neuropsychological definitions for poststroke cognitive impairment"

10.1002/brb3.1671/v1/review1 ◽

2019 ◽

Keyword(s):

Cognitive Impairment ◽

Diagnostic Accuracy ◽

Screening Tools ◽

Cognitive Screening

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Decision letter for "Diagnostic accuracy of cognitive screening tools under different neuropsychological definitions for poststroke cognitive impairment"

10.1002/brb3.1671/v1/decision1 ◽

2019 ◽

Keyword(s):

Cognitive Impairment ◽

Diagnostic Accuracy ◽

Screening Tools ◽

Cognitive Screening

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A Memory Clinic at a Geriatric Hospital: A Report on 577 Patients Assessed with the CAMDEX Over 9 Years

Australian & New Zealand Journal of Psychiatry ◽

10.1046/j.1440-1614.2003.01174.x ◽

2003 ◽

Vol 37 (3) ◽

pp. 319-326 ◽

Cited By ~ 29

Author(s):

Joe A. Stratford ◽

Dina Logiudice ◽

Leon Flicker ◽

Roslyn Cook ◽

Wendy Waltrowicz ◽

...

Keyword(s):

Psychiatric Disorders ◽

The Elderly ◽

International Classification Of Diseases ◽

Screening Tools ◽

Cognitive Screening ◽

Memory Clinic ◽

Mental Test Score ◽

Patient Demographics ◽

Significant Difference ◽

Icd 10

Objective: To report 9 years’ experience of an Australian memory clinic using the Cambridge Mental Disorders in the Elderly Examination (CAMDEX) assessment schedule, summarizing patient demographics, diagnoses at presentation and the utility of four instruments used in distinguishing patients with and without dementia. Methods: All patients seen at the clinic between December 1989 and September 1998 were assessed using the CAMDEX. Diagnoses were determined according to criteria of the International Classification of Diseases, tenth edition (ICD-10). Results: The mean age of 577 patients seen was 72.9 years and 60.8% were female. Over 40% fulfilled ICD-10 diagnostic criteria for dementia in Alzheimer's disease. A further 24% had another dementing illness. Only 28 patients were ‘normal’. There was no significant difference in the ability of the 107-item Cambridge cognitive examination, the 30-item mini-mental state examination, the 10-item abbreviated mental test score and the 26-item informant questionnaire on cognitive decline in the elderly to differentiate dementia patients from those who were normal or had functional psychiatric disorders. The four cognitive screening tools had high correlations with one another (r = −0.57 to 0.93). Conclusion: Patient demographics and diagnoses were similar to those found in other clinics. Most people who attended the memory clinic had significant cognitive or psychiatric disorders.

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

International Psychogeriatrics ◽

10.1017/s104161021700120x ◽

2017 ◽

Vol 29 (11) ◽

pp. 1771-1784 ◽

Cited By ~ 20

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.

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

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20190024 ◽

2019 ◽

Vol 77 (4) ◽

pp. 279-288 ◽

Cited By ~ 3

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.

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Validation of the Sinhala Version of the Addenbrooke’s Cognitive Examination-Revised for the Detection of Dementia in Sri Lanka: Comparison with the Mini-Mental Status Examination and the Montreal Cognitive Assessment

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000497743 ◽

2019 ◽

Vol 47 (4-6) ◽

pp. 198-208 ◽

Cited By ~ 1

Author(s):

Vindika Suriyakumara ◽

Srinivasan Srikanth ◽

Ruwani Wijeyekoon ◽

Harsha Gunasekara ◽

Chanaka Muthukuda ◽

...

Keyword(s):

Sri Lanka ◽

Diagnostic Accuracy ◽

Cognitive Assessment ◽

Intraclass Correlation ◽

Screening Tools ◽

Montreal Cognitive Assessment ◽

Cutoff Score ◽

Cognitive Screening ◽

Dementia Prevalence ◽

Addenbrooke’S Cognitive Examination

Background: Sri Lanka is a rapidly aging country, where dementia prevalence will increase significantly in the future. Thus, inexpensive and sensitive cognitive screening tools are crucial. Objectives: To assess the reliability, validity, and diagnostic accuracy of the Sinhalese version of the Addenbrooke’s Cognitive Examination-Revised (ACE-R s). Method: The ACE-R was translated into Sinhala with cultural and linguistic adaptations and administered, together with the Sinhala version of the Montreal Cognitive Assessment (MoCA), to 99 patients with dementia and 93 gender-matched controls. Results: The ACE-R s cutoff score for dementia was 80 (sensitivity 91.9%, specificity 76.3%). The areas under the curve for the ACE-R s, Mini-Mental State Examination (MMSE) and MoCA were 0.90, 0.86, and 0.86, respectively. The ACE-R s had good interrater reliability (intraclass correlation = 0.94), test-retest reliability (intraclass correlation = 0.99), and internal consistency (Cronbach’s α = 0.8442). Conclusions: The ACE-R s is sensitive, specific and reliable to detect dementia in persons aged ≥50 years in a Sinhala-speaking population and its diagnostic accuracy is superior to previously validated tools (MMSE and MoCA).

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