scholarly journals Determining Appropriate Screening Tools and Cutoffs for Cognitive Impairment in the Chinese Elderly

2021 ◽  
Vol 12 ◽  
Author(s):  
Shaowei Zhang ◽  
Qi Qiu ◽  
Shixing Qian ◽  
Xiang Lin ◽  
Feng Yan ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Area Under The Curve ◽  
Screening Tools ◽  
Optimal Cutoff ◽  
Chinese Elderly ◽  
Elderly Individuals ◽  
Highly Educated ◽  
Dementia Patients ◽  
Education Levels ◽  
Cutoff Scores

Background: The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are the most commonly used tools for cognitive impairment screening. The present study aimed to investigate the ability of the MOCA and MMSE to differentiate between cognitively normal elderly individuals, MCI patients and dementia patients at different ages and education levels and to establish the optimal cutoff scores of the MoCA and MMSE for MCI and dementia in the Chinese elderly.Methods: A total of 2,954 Chinese elderly individuals, including 1,746 normal controls, 599 MCI patients and 249 dementia patients, were consecutively recruited in the study. The optimal cutoffs for MoCA and MMSE were determined using receiver operating characteristic (ROC) analysis among the different age and education levels in the three groups. Furthermore, comparison of ROC curves were made to evaluate the performances of the two tests.Results: The area under the curve(AUC) of the MoCA (0.82) for detecting MCI was significantly higher than that of the MMSE (0.75) (P < 0.001). When the sample was divided according to age and education level, the AUC of the MoCA (0.84) was higher than those of the MMSE (0.71) for MCI (P < 0.001) in the younger and more highly-educated groups. The optimal cutoff scores of the MoCA for the groups aged ≤ 75 years old and education ≤ 6 years, aged > 75 years old and education ≤ 6 years, aged ≤ 75 years old and education > 6 years, aged > 75 years old and education > 6 years in screening for MCI were identified as 19.5, 15.5, 24.5 and 24.5, respectively, and the optimal cutoff scores for dementia were 18.5, 10.5, 18.5 and 20.5, respectively. For MMSE in the above four groups, the cutoff scores to detect MCI were 26.5, 22.5, 28.5 and 26.5, respectively, and the optimal cutoff scores for dementia were 23.5, 19.5, 23.5 and 23.5, respectively.Conclusion: Compared to MMSE, the MoCA is more suitable for discriminating MCI in younger and more highly educated elderly Chinese individuals. However, the MMSE has advantage over MoCA in screening MCI in individuals with lower education levels and the older groups of Chinese elderly.

scholarly journals The Prevalence of Mild Cognitive Impairment among Chinese People: A Meta-Analysis

2021 ◽  
Vol 55 (2) ◽  
pp. 79-91
Author(s):  
Yan Deng ◽  
Siqi Zhao ◽  
Guangwen Cheng ◽  
Jiajia Yang ◽  
Benchao Li ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Criteria ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Internal Validity ◽  
Screening Tools ◽  
Chinese Elderly ◽  
Pooled Prevalence

<b><i>Background:</i></b> Mild cognitive impairment (MCI) induced the majority number of dementia patients. The prevalence of MCI in China varied across studies with different screening tools and diagnostic criteria. <b><i>Objective:</i></b> A systematic review and meta-analysis was conducted to estimate the pooled MCI prevalence among the population aged 55 years and older in China. <b><i>Methods:</i></b> PubMed, EMBASE, CNKI, Wanfang, CQVIP, and CBMdisc were searched for studies on prevalence of MCI among Chinese elderly between January 1, 1980, and February 10, 2020. The quality assessment was conducted via external validity, internal validity, and informativity, the pooled prevalence was calculated through the random-effect model, and the homogeneity was evaluated by Cochran’s <i>Q</i> test and <i>I</i><sup>2</sup>. <b><i>Results:</i></b> Fifty-three studies with 123,766 subjects were included. The pooled prevalence of MCI among Chinese elderly was 15.4% (95% CI: 13.5–17.4%). Subgroup analyses indicated that the prevalence calculated with different screening tools was 20.2% (95% CI: 15.1–25.9%) for Montreal Cognitive Assessment (MoCA) and 13.0% (95% CI: 10.7–15.5%) for Mini-Mental State Examination (MMSE). According to different diagnostic criteria, the prevalence was 14.8% (95% CI: 12.2–17.6%) for Petersen criteria, 15.0% (95% CI: 12.7–17.5%) for DSM-IV, and 21.2% (95% CI: 17.5–25.2%) for Chinese Expert Consensus on Cognitive Impairment (CECCI). Besides, women, older adults, illiterate people, rural residents, and those who lived with unhealthy lifestyles and morbidity showed higher prevalence. <b><i>Conclusions:</i></b> The prevalence of MCI in China was 15.4%, which varied by demographics, lifestyles, morbidity, screening tools, and diagnostic criteria. In further studies, screening tools and diagnosis criteria should be considered when estimating MCI prevalence.

scholarly journals Performance of the Rowland Universal Dementia Assessment Scale for the Detection of Mild Cognitive Impairment and Dementia in a Diverse Cohort of Illiterate Persons From Rural Communities in Peru

2021 ◽  
Vol 12 ◽  
Author(s):  
Nilton Custodio ◽  
Rosa Montesinos ◽  
Monica M. Diaz ◽  
Eder Herrera-Perez ◽  
Kristhy Chavez ◽  
...  
Keyword(s):  
Rural Communities ◽  
Diagnostic Accuracy ◽  
Psychometric Properties ◽  
Gold Standard ◽  
Area Under The Curve ◽  
Assessment Scale ◽  
Screening Tools ◽  
Operating Characteristics ◽  
Clinical Dementia Rating ◽  
Optimal Cutoff

Background: The accurate diagnosis of neurocognitive disorders in illiterate Peruvian populations is challenging, largely owing to scarcity of brief cognitive screening tools (BCST) validated in these diverse populations. The Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) is a BCST that relies minimally on educational attainment and has shown good diagnostic accuracy in an urban illiterate population in Peru, yet its psychometric properties in illiterate populations in rural settings of the country have not been previously investigated.Objectives: To establish the diagnostic accuracy of the RUDAS-PE compared to expert clinical diagnosis using the Clinical Dementia Rating (CDR) Scale in healthy and cognitively impaired illiterate persons living in two culturally and geographically distinct rural communities of Peru.Methods: A cross-sectional, population-based study of residents ≥ 50 years of age living in the Peruvian rural communities of Santa Clotilde and Chuquibambilla. A total of 129 subjects (76 from Santa Clotilde and 53 from Chuquibambilla) were included in this study. Gold standard diagnostic neurocognitive evaluation was based on expert neurological history and examination and administration of the CDR. Receiver operating characteristics, areas under the curve (AUC), and logistic regression analyses were conducted to determine the performance of RUDAS-PE compared to expert gold standard diagnosis.Results: Compared to gold standard diagnosis, the RUDAS-PE was better at correctly discriminating between MCI and dementia than discriminating between MCI and controls in both sites (97.0% vs. 76.2% correct classification in Chuquibambilla; 90.0% vs. 64.7% in Santa Clotilde). In Chuquibambilla, the area under the curve (AUC) of the RUDAS to discriminate between dementia and MCI was 99.4% (optimal cutoff at &lt;18), whereas between MCI and controls it was 82.8% (optimal cutoff at &lt;22). In Santa Clotilde, the area under the curve (AUC) of the RUDAS to discriminate between dementia and MCI was 99.1% (optimal cutoff at &lt;17), whereas between MCI and controls it was 75.5% (optimal cutoff at &lt;21).Conclusions: The RUDAS-PE has acceptable psychometric properties and performed well in its ability to discriminate MCI and dementia in two cohorts of illiterate older adults from two distinct rural Peruvian communities.

Evaluating the Beijing Version of Montreal Cognitive Assessment for Identification of Cognitive Impairment in Monolingual Chinese American Older Adults

2021 ◽  
pp. 089198872110361
Author(s):  
Yue Hong ◽  
Xiaoyi Zeng ◽  
Carolyn W. Zhu ◽  
Judith Neugroschl ◽  
Amy Aloysi ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Demographic Variables ◽  
Chinese Version ◽  
Montreal Cognitive Assessment ◽  
Optimal Cutoff ◽  
Cutoff Scores ◽  
Normal Cognition ◽  
The U.S

Objective: This study aims to evaluate the performance of a Chinese version of the Montreal Cognitive Assessment (MoCA) as a screener to detect mild cognitive impairment (MCI) and dementia from normal cognition in the monolingual Chinese-speaking immigrant population. Method: A cohort of 176 Chinese-speaking older adults from the National Alzheimer’s Coordinating Center Uniform Data Set is used for analysis. We explore the impact of demographic variables on MoCA performance and calculate the optimal cutoffs for the detection of MCI and dementia from normal cognition with appropriate demographic adjustment. Results: MoCA performance is predicted by age and education independent of clinical diagnoses, but not by sex, years of living in the U.S., or primary Chinese dialect spoken (i.e., Mandarin vs. Cantonese). With adjustment and stratification for education and age, we identify optimal cutoff scores to detect MCI and dementia, respectively, in this population. These optimal cutoff scores are different from the established scores for non-Chinese-speaking populations residing in the U.S. Conclusions: Our findings suggest that the Chinese version of MoCA is a valid screener to detect cognitive decline in older Chinese-speaking immigrants in the U.S. They also highlight the need for population-based cutoff scores with appropriate considerations for demographic variables.

scholarly journals Screening for Sleep Apnoea in Mild Cognitive Impairment: The Utility of the Multivariable Apnoea Prediction Index

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Georgina Wilson ◽  
Zoe Terpening ◽  
Keith Wong ◽  
Ron Grunstein ◽  
Louisa Norrie ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Roc Curve ◽  
Area Under The Curve ◽  
Sleep Apnoea ◽  
Self Report ◽  
Screening Tools ◽  
Operating Characteristics ◽  
Roc Curve Analysis ◽  
Obstructive Sleep

Purpose. Mild cognitive impairment (MCI) is considered an “at risk” state for dementia and efforts are needed to target modifiable risk factors, of which Obstructive sleep apnoea (OSA) is one. This study aims to evaluate the predictive utility of the multivariate apnoea prediction index (MAPI), a patient self-report survey, to assess OSA in MCI.Methods. Thirty-seven participants with MCI and 37 age-matched controls completed the MAPI and underwent polysomnography (PSG). Correlations were used to compare the MAPI and PSG measures including oxygen desaturation index and apnoea-hypopnoea index (AHI). Receiver-operating characteristics (ROC) curve analyses were performed using various cut-off scores for apnoea severity.Results. In controls, there was a significant moderate correlation between higher MAPI scores and more severe apnoea (AHI:r=0.47,P=0.017). However, this relationship was not significant in the MCI sample. ROC curve analysis indicated much lower area under the curve (AUC) in the MCI sample compared to the controls across all AHI severity cut-off scores.Conclusions. In older people, the MAPI moderately correlates with AHI severity but only in those who are cognitively intact. Development of further screening tools is required in order to accurately screen for OSA in MCI.

scholarly journals A-81 MoCA Cutoffs for English/ Spanish Bilingual Veterans Assessed in English

2019 ◽  
Vol 34 (6) ◽  
pp. 941-941
Author(s):  
J Phillips ◽  
J Marceaux ◽  
K McCoy ◽  
L Kraemer ◽  
C Fullen
Keyword(s):  
Cognitive Impairment ◽  
Roc Curve ◽  
Curve Analysis ◽  
Cutoff Score ◽  
Roc Curve Analysis ◽  
Optimal Cutoff ◽  
Sample Characterization ◽  
Cutoff Scores

Abstract Objective The Montreal Cognitive Assessment (MoCA) is a well-known screener of global cognitive functioning. Multiple studies have determined optimal cutoff scores for detection of cognitive impairment in various clinical populations. This study aims to determine appropriate cutoff scores in a clinically mixed bilingual (English/Spanish) sample. Methods A sample of n = 57 self-identified bilingual veterans referred for neuropsychological evaluation at a VA hospital completed the MoCA as part of a full battery. All tests were administered in English. The majority were male (96.4%), Hispanic/Latinx, with 14.65 mean years of education. Only MoCA total score without adding one point for ≤12 years of education was included. Descriptive statistics were used for sample characterization. ROC curve analysis assessed diagnostic accuracy of the MoCA for classification of cognitive impairment (CI). The CI group (n = 40) included both major or mild neurocognitive disorder. The nonimpaired group (n = 17) included persons with no CI or psychiatric diagnosis. Results ROC curve analysis was significant (p < .001) with an AUC of .857 (95% confidence interval .746-.969). A cutoff score of ≤24 was yielded an optimal balance of sensitivity (.900) and specificity (.706). Follow-up independent samples t-test and ANOVA were conducted to examine differences between groups. Conclusions Among bilingual individuals, a cutoff of ≤24 on the MoCA maximized sensitivity and specificity of accurately identifying cases of cognitive impairment. Findings have implications for identifying patients requiring further neuropsychological assessment.

scholarly journals Quantitative EEG Applying the Statistical Recognition Pattern Method: A Useful Tool in Dementia Diagnostic Workup

2015 ◽  
Vol 40 (1-2) ◽  
pp. 1-12 ◽  
Author(s):  
Knut Engedal ◽  
Jon Snaedal ◽  
Peter Hoegh ◽  
Vesna Jelic ◽  
Birgitte Bo Andersen ◽  
...  
Keyword(s):  
Characteristic Curve ◽  
Area Under The Curve ◽  
Lewy Body Dementia ◽  
Quantitative Eeg ◽  
Diagnostic Workup ◽  
Elderly Individuals ◽  
Healthy Elderly ◽  
Dementia Patients ◽  
Clinical Diagnoses ◽  
Memory Clinics

Background/Aim: The aim of this study was to examine the discriminatory power of quantitative EEG (qEEG) applying the statistical pattern recognition (SPR) method to separate Alzheimer's disease (AD) patients from elderly individuals without dementia and from other dementia patients. Methods: The participants were recruited from 6 Nordic memory clinics: 372 unselected patients [mean age 71.7 years (SD 8.6), 54% women] and 146 healthy elderly individuals [mean age 66.5 years (SD 7.7), 60% women]. After a standardized and comprehensive assessment, clinical diagnoses were made according to internationally accepted criteria by at least 2 clinicians. EEGs were recorded in a standardized way and analyzed independently of the clinical diagnoses, using the SPR method. Results: In receiver operating characteristic curve analyses, the qEEGs separated AD patients from healthy elderly individuals with an area under the curve (AUC) of 0.90, representing a sensitivity of 84% and a specificity of 81%. The qEEGs further separated patients with Lewy body dementia or Parkinson's disease dementia from AD patients with an AUC of 0.9, a sensitivity of 85% and a specificity of 87%. Conclusion: qEEG using the SPR method could be a useful tool in dementia diagnostic workup.

scholarly journals Detecting cognitive impairment in patients with Parkinson's disease using a brief cognitive screening tool: Addenbrooke's Cognitive Examination (ACE)

2008 ◽  
Vol 2 (3) ◽  
pp. 197-200 ◽  
Author(s):  
Anabel Chade ◽  
María Roca ◽  
Teresa Torralva ◽  
Ezequiel Gleichgerrcht ◽  
Nicolás Fabbro ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cognitive Status ◽  
Screening Tools ◽  
Spanish Version ◽  
Healthy Controls ◽  
Cognitive Difficulties ◽  
Dementia Patients ◽  
Addenbrooke’S Cognitive Examination

Abstract Detecting cognitive impairment in patients with Parkinson's disease is crucial for good clinical practice given the new therapeutic possibilities available. When full neuropsychological evaluations are not available, screening tools capable of detecting cognitive difficulties become crucial. Objective: The goal of this study was to investigate whether the Spanish version of the Addenbrooke's Cognitive Examination (ACE) is capable of detecting cognitive difficulties in patients with Parkinson's disease and discriminating their cognitive profile from patients with dementia. Methods: 77 early dementia patients (53 with Alzheimer's Disease and 24 with Frontotemporal Dementia), 22 patients with Parkinson's disease, and 53 healthy controls were evaluated with the ACE. Results: Parkinson's disease patients significantly differed from both healthy controls and dementia patients on ACE total score. Conclusions: This study shows that the Spanish version of the ACE is capable of detecting patients with cognitive impairment in Parkinson's disease and is able to differentiate them from patients with dementia based on their general cognitive status.

scholarly journals Validation of the Visual Cognitive Assessment Test (VCAT) for the Early Diagnosis of Cognitive Impairment in Multilingual Population in Malaysia

Psych ◽  
2022 ◽  
Vol 4 (1) ◽  
pp. 38-48
Author(s):  
Li Yun Ng ◽  
Chen Joo Chin ◽  
Monica Danial ◽  
Stephenie Ann Albart ◽  
Purnima Devi Suppiah ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
Population Aging ◽  
Area Under The Curve ◽  
Cutoff Score ◽  
Early Screening ◽  
Mild Dementia ◽  
Dementia Patients ◽  
Visual Cognitive

As Malaysia undergoes a demographic transformation of population aging, the prevalence of dementia is expected to rise, posing a major public health threat issue. Early screening to detect cognitive impairment is important to implement appropriate clinical interventions. The Visual Cognitive Assessment Test (VCAT) is a language-neutral cognitive assessment screening tool suitable for multilingual populations. This study was aimed to validate the VCAT screening tool for the detection of cognitive impairment amongst the population of Malaysia. A total of 184 participants were recruited, comprising 79 cognitively healthy participants (CHP), 46 mild cognitive impairment (MCI) patients, and 59 mild dementia (Alzheimer’s disease and Vascular Dementia) patients from five hospitals between May 2018 and December 2019 to determine the usefulness of VCAT. Diagnostic performance was assessed using area under the curve (AUC), and receiver operating characteristic (ROC) analysies was performed to determine the recommended cutoff scores. ROC analyses for the VCAT was comparable with that of MoCA (Montreal Cognitive Assessment) in differentiating between CHP, MCI, and mild dementia (AD and VaD) participants. The findings of this study suggest the following optimal cutoff score for VCAT: Dementia 0–19, MCI 20–23, Normal 24–30. The mean ± SD time to complete the VCAT was 10.0 ± 2.75 min in the CHP group and 15.4 ± 4.52 min in the CI group. Results showed that 76.0% of subjects thought that the instructions in VCAT were similar or easier to understand compared with MoCA. This study showed that the VCAT is a valid and useful screening tool for patients with cognitive impairment in Malaysia and is feasible to be used in the clinical settings.

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