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.

Construct validity of the Visual Cognitive Assessment Test (VCAT)—a cross-cultural language-neutral cognitive screening tool

2019 ◽  
Vol 32 (1) ◽  
pp. 141-149 ◽  
Author(s):  
Audrey Low ◽  
Levinia Lim ◽  
Linda Lim ◽  
Benjamin Wong ◽  
Eveline Silva ◽  
...  
Keyword(s):  
Construct Validity ◽  
Internal Consistency ◽  
Cognitive Assessment ◽  
Roc Analysis ◽  
Screening Tool ◽  
Area Under The Curve ◽  
Cross Cultural ◽  
Cognitive Screening ◽  
Domain Specific ◽  
Visual Cognitive

ABSTRACTBackground:The Visual Cognitive Assessment Test (VCAT) is a language-neutral cognitive screening tool designed for use in culturally diverse populations without the need for translations or adaptations. While it has been established to be language-neutral, the VCAT’s construct validity has not been investigated.Methods:471 participants were recruited, comprising 233 healthy comparisons, 117 mild cognitive impairment (MCI), and 121 mild Alzheimer’s disease (AD) patients. VCAT and domain-specific neuropsychological tests were administered in the same sitting. Construct validity was assessed by analyzing domain-specific associations between the VCAT and well-established cognitive assessments. Reliability (internal consistency) was measured by Cronbach’s alpha. Diagnostic ability (area under the curve) and recommended cutoffs were determined by receiver operating characteristic (ROC) analysis.Results:The VCAT and its subdomains demonstrated good construct validity in terms of both convergent and divergent validity and good internal consistency (α = .74). ROC analysis found that the VCAT was on par with the Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) at distinguishing between healthy comparisons, MCI, and mild AD. Consistent with previous studies, VCAT scores were not affected by language of administration or ethnicity in our cohort. Findings suggest the following cutoffs: Dementia 0–19, MCI 20–24, Normal 25–30.Conclusion:This study established the construct validity of the VCAT, which is vital to ensure its subdomains effectively measure the cognitive processes they were designed to. The VCAT is capable of detecting early cognitive impairments and allows for meaningful cross-cultural comparisons, especially useful for international collaborations and clinical trials, and for clinical use in diverse multiethnic populations.

scholarly journals Psychometric Properties of the Persian Montreal Cognitive Assessment in Mild Cognitive Impairment and Alzheimer Disease

2021 ◽  
pp. 51-57
Author(s):  
Vahid Rashedi ◽  
Mahshid Foroughan ◽  
Negin Chehrehnegar
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Alzheimer Disease ◽  
Psychometric Properties ◽  
Cognitive Assessment ◽  
Screening Test ◽  
Cognitive Status ◽  
Montreal Cognitive Assessment ◽  
Cutoff Score ◽  
Persian Version

Introduction: The Montreal Cognitive Assessment (MoCA) is a cognitive screening test widely used in clinical practice and suited for the detection of Mild Cognitive Impairment (MCI). The aims were to evaluate the psychometric properties of the Persian MoCA as a screening test for mild cognitive dysfunction in Iranian older adults and to assess its accuracy as a screening test for MCI and mild Alzheimer disease (AD). Method: One hundred twenty elderly with a mean age of 73.52 ± 7.46 years participated in this study. Twenty-one subjects had mild AD (MMSE score ≤21), 40 had MCI, and 59 were cognitively healthy controls. All the participants were administered the Mini-Mental State Examination (MMSE) to evaluate their general cognitive status. Also, a battery of comprehensive neuropsychological assessments was administered. Results: The mean score on the Persian version of the MoCA and the MMSE were 19.32 and 25.62 for MCI and 13.71 and 22.14 for AD patients, respectively. Using an optimal cutoff score of 22 the MoCA test detected 86% of MCI subjects, whereas the MMSE with a cutoff score of 26 detected 72% of MCI subjects. In AD patients with a cutoff score of 20, the MoCA had a sensitivity of 94% whereas the MMSE detected 61%. The specificity of the MoCA was 70% and 90% for MCI and AD, respectively. Discussion: The results of this study show that the Persian version of the MoCA is a reliable screening tool for detection of MCI and early stage AD. The MoCA is more sensitive than the MMSE in screening for cognitive impairment, proving it to be superior to MMSE in detecting MCI and mild AD.

Adaptation and Validation of the Mini-Addenbrooke’s Cognitive Examination in Dementia in Arabic Speakers in Egypt

2020 ◽  
Vol 49 (6) ◽  
pp. 611-616
Author(s):  
Tarik Qassem ◽  
Mohamed S. Khater ◽  
Tamer Emara ◽  
Doha Rasheedy ◽  
Heba M. Tawfik ◽  
...  
Keyword(s):  
Screening Tool ◽  
Characteristic Curve ◽  
High Sensitivity ◽  
Receiver Operator Characteristic Curve ◽  
Cutoff Score ◽  
Arabic Speakers ◽  
Dementia Patients ◽  
Significant Difference ◽  
Sensitivity Specificity ◽  
Addenbrooke’S Cognitive Examination

<b><i>Background:</i></b> The mini-Addenbrooke’s Cognitive Examination (m-ACE) is a brief cognitive battery that assesses 5 subdomains of cognition (attention, memory, verbal fluency, visuospatial abilities, and memory recall). It is scored out of 30 and can be administered in under 5 min providing a quick screening tool for assessment of cognition. <b><i>Objectives:</i></b> We aimed to adapt the m-ACE in Arabic speakers in Egypt and to validate it in dementia patients to provide cutoff scores. <b><i>Methods:</i></b> We included 37 patients with dementia (Alzheimer’s disease [<i>n</i> = 25], vascular dementia [<i>n</i> = 8], and dementia with Lewy body [<i>n</i> = 4]) and 43 controls. <b><i>Results:</i></b> There was a statistically significant difference (<i>p</i> &#x3c; 0.001) on the total m-ACE score between dementia patients (mean 10.54 and standard deviation [SD] 5.83) and controls (mean 24.02 and SD 2.75). There was also a statistically significant difference between dementia patients and controls on all sub-score domains of the m-ACE (<i>p</i> &#x3c; 0.05). Performance on the m-ACE significantly correlated with both the Mini-Mental State Examination (MMSE) and the Addenbrooke’s Cognitive Examination-III (ACE-III). Using a receiver operator characteristic curve, the optimal cutoff score for dementia on the m-ACE total score was found to be 18 (92% sensitivity, 95% specificity, and 94% accuracy). <b><i>Conclusions:</i></b> We adapted the m-ACE in Arabic speakers in Egypt and provided objective validation of it as a screening tool for dementia, with high sensitivity, specificity, and accuracy.

Montreal Cognitive Assessment for Screening Mild Cognitive Impairment: Variations in Test Performance and Scores by Education in Singapore

2015 ◽  
Vol 39 (3-4) ◽  
pp. 176-185 ◽  
Author(s):  
Tze Pin Ng ◽  
Lei Feng ◽  
Wee Shiong Lim ◽  
Mei Sian Chong ◽  
Tih Shih Lee ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Test Performance ◽  
Cognitive Assessment ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Montreal Cognitive Assessment ◽  
Community Based ◽  
Education Group ◽  
And Gender

Background: The Montreal Cognitive Assessment (MoCA) was developed as a screening instrument for mild cognitive impairment (MCI). We evaluated the MoCA's test performance by educational groups among older Singaporean Chinese adults. Method: The MoCA and Mini-Mental State Examination (MMSE) were evaluated in two independent studies (clinic-based sample and community-based sample) of MCI and normal cognition (NC) controls, using receiver operating characteristic curve analyses: area under the curve (AUC), sensitivity (Sn), and specificity (Sp). Results: The MoCA modestly discriminated MCI from NC in both study samples (AUC = 0.63 and 0.65): Sn = 0.64 and Sp = 0.36 at a cut-off of 28/29 in the clinic-based sample, and Sn = 0.65 and Sp = 0.55 at a cut-off of 22/23 in the community-based sample. The MoCA's test performance was least satisfactory in the highest (>6 years) education group: AUC = 0.50 (p = 0.98), Sn = 0.54, and Sp = 0.51 at a cut-off of 27/28. Overall, the MoCA's test performance was not better than that of the MMSE. In multivariate analyses controlling for age and gender, MCI diagnosis was associated with a <1-point decrement in MoCA score (η2 = 0.010), but lower (1-6 years) and no education was associated with a 3- to 5-point decrement (η2 = 0.115 and η2 = 0.162, respectively). Conclusion: The MoCA's ability to discriminate MCI from NC was modest in this Chinese population, because it was far more sensitive to the effect of education than MCI diagnosis.

Digit Span Forward as a Performance Validity Test in Dementia Evaluations: Specificity in Mild Cognitive Impairment, Mild Dementia, and Moderate Dementia

2019 ◽  
Vol 34 (6) ◽  
pp. 837-837
Author(s):  
H Clark ◽  
P Martin ◽  
R Schroeder
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Digit Span ◽  
Future Research ◽  
Performance Validity ◽  
Mild Dementia ◽  
Dementia Patients ◽  
Moderate Dementia ◽  
Neuropsychological Evaluations ◽  
Validity Tests

Abstract Objective Traditional performance validity tests (PVTs) often yield high false positive rates in dementia evaluations. The current study examined the frequency of extremely low scores (≤ 2 percentile) on WAIS-IV Digit Span Forward (DSF) in older adults with Mild Cognitive Impairment (MCI) or dementia to evaluate its possible utility as a PVT in these populations. Method Archival data from outpatient neuropsychological evaluations were analyzed. Individuals who were not diagnosed with a neurocognitive disorder, had missing data, or were believed to be invalidly performing were excluded. Participants (n = 195; mean age = 72.8; mean education = 13.2 years) were classified according to their evaluation diagnosis of MCI (n = 72; mean RBANS Total Score = 86.8) or dementia. Dementia patients were further divided by MoCA score into groups of mild dementia (n = 90; MoCA≥15; mean RBANS Total Score = 71.0) or moderate dementia (n = 33; MoCA < 15; mean RBANS Total Score = 55.9). Frequencies of scaled scores were analyzed to calculate specificity values for each group. Results A WAIS-IV DSF scaled score of ≤4 (≤ 2 percentile) resulted in specificity values of 0.99 and 0.94 in MCI and mild dementia, respectively. Conversely, in moderate dementia, ≥0.90 specificity was achieved only when using a more conservative cutoff of ≤2. Conclusions Low DSF scaled scores occurred infrequently in MCI and mild dementia, indicating strong specificity and potential utility as a PVT in these populations. However, in moderate dementia, low DSF scores were more common, requiring use of a more stringent cutoff. Future research should examine DSF sensitivity to invalid performance, as well as DSF specificity according to specific etiologies of MCI and dementia.

Normative Data for the Montreal Cognitive Assessment in Greek Older Adults With Subjective Cognitive Decline, Mild Cognitive Impairment and Dementia

2019 ◽  
Vol 32 (5) ◽  
pp. 265-274 ◽  
Author(s):  
Eleni Poptsi ◽  
Despina Moraitou ◽  
Marina Eleftheriou ◽  
Fotini Kounti-Zafeiropoulou ◽  
Chrysa Papasozomenou ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Educational Level ◽  
Cognitive Assessment ◽  
Normative Data ◽  
Montreal Cognitive Assessment ◽  
Subjective Cognitive Decline ◽  
High Educational Level ◽  
Cutoff Score ◽  
High Educational

Montreal Cognitive Assessment (MoCA) is among the most commonly used screening tools worldwide. Objective: The aim of the study was to provide normative data for the MoCA in a Greek cohort of people older than 60 years who meet criteria for subjective cognitive decline (SCD), mild cognitive impairment (MCI), or dementia in order to optimize cutoff scores for each diagnostic group. Method: Seven hundred forty-six community-dwelling older adults, visitors of the Day Center of Alzheimer Hellas were randomly chosen. Three hundred seventy-nine of them met the criteria for dementia, 245 for MCI and 122 for SCD. Results: Initial statistical analyses showed that the total MoCA score is not affected by gender ( P = .164), or age ( P = .144) but is affected by educational level ( P < .001). A cutoff score of 23 for low educational level (≤6 years) can distinguish people with SCD from MCI (sensitivity 71.4%, specificity 84.2%), while 26 is the cutoff score for middle educational level (7-12 years; sensitivity 73.2%, specificity 67.0%) and high educational level (≥13 years; sensitivity 77.6%, specificity 74.7%). Montreal Cognitive Assessment can discriminate older adults with SCD from dementia, with a cutoff score of 20 for low educational level (sensitivity 100%, specificity 92.3%) and a cutoff score 23 for middle educational level (sensitivity 97.6%, specificity 92.7%) and high educational level (sensitivity 98.5%, specificity 100%). Conclusion: Montreal Cognitive Assessment is not affected by age or gender but is affected by the educational level. The discriminant potential of MoCA between SCD and MCI is good, while the discrimination of SCD from dementia is excellent.

The Mini-Mental State Examination: Czech Norms and Cutoffs for Mild Dementia and Mild Cognitive Impairment due to Alzheimer's Disease

2016 ◽  
Vol 42 (1-2) ◽  
pp. 50-57 ◽  
Author(s):  
Ales Bartos ◽  
Miloslava Raisova
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Mild Dementia ◽  
Dementia Patients ◽  
Early Alzheimer’S Disease ◽  
State Examination

Background: There is a lack of normative studies of the Mini-Mental State Examination (MMSE) for comparison with early Alzheimer's disease (AD) according to new diagnostic criteria. Participants and Methods: We administered the MMSE to normal elderly Czechs and to patients with mild cognitive impairment (MCI) and mild dementia due to AD according to NIA-AA criteria. Results: We established percentile- and standard deviation-based norms for the MMSE from 650 normal seniors (age 69 ± 8 years, education 14 ± 3 years, MMSE score 28 ± 2 points) stratified by education and age. Dementia patients scored significantly lower than the MCI patients and both groups (110 early AD patients) had significantly lower MMSE scores than the normal seniors (22 ± 5 or 25 ± 3 vs. 28 ± 2 points) (p < 0.01). The optimal cutoff was ≤27 points with sensitivity of 86% and specificity of 79% for early detection of AD patients. Conclusion: We provided MMSE norms, several cutoffs, and higher cutoff scores for early AD using recent guidelines.

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