A score based on screening tests to differentiate mild cognitive impairment from subjective memory complaints

Abstract

It is not easy to differentiate patients with mild cognitive impairment (MCI) from subjective memory complainers (SMC). Assessments with screening cognitive tools are essential, particularly in primary care where most patients are seen. The objective of this study was to evaluate the diagnostic accuracy of screening cognitive tests and to propose a score derived from screening tests. Elderly subjects with memory complaints were evaluated using the Mini Mental State Examination (MMSE) and the Brief Cognitive Battery (BCB). We added two delayed recalls in the MMSE (a delayed recall and a late-delayed recall, LDR), and also a phonemic fluency test of letter P fluency (LPF). A score was created based on these tests. The diagnoses were made on the basis of clinical consensus and neuropsychological testing. Receiver operating characteristic curve analyses were used to determine area under the curve (AUC), the sensitivity and specificity for each test separately and for the final proposed score. MMSE, LDR, LPF and delayed recall of BCB scores reach statistically significant differences between groups (P=0.000, 0.03, 0.001 and 0.01, respectively). Sensitivity, specificity and AUC were MMSE: 64%, 79% and 0.75 (cut off <29); LDR: 56%, 62% and 0.62 (cut off <3); LPF: 71%, 71% and 0.71 (cut off <14); delayed recall of BCB: 56%, 82% and 0.68 (cut off <9). The proposed score reached a sensitivity of 88% and 76% and specificity of 62% and 75% for cut off over 1 and over 2, respectively. AUC were 0.81. In conclusion, a score created from screening tests is capable of discriminating MCI from SMC with moderate to good accurancy.

Performance on cognitive tests, instrumental activities of daily living and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro, Brazil

“…These findings are consistent with previous studies. 5 , 10 , 12 , 27 , 29 , 30 The mean VFT score in the present study was similar to that found in other studies evaluating healthy elderly adults. Performance on this test can be considered indicative of normal aging, for which it is highly sensitive in discriminating early stages of dementia.…”

“… 6 , 28 This pattern of results contrasts with other studies. 17 , 29 With regard to age, no difference in functional capacity for instrumental activities was found between the age groups. However, an association was found between performance on activities of daily living and education.…”

“…The BCSB is a precise battery used to diagnose cognitive impairment in heterogeneous populations. It has been employed in different contexts, including epidemiological studies, 4 , 10 , 12 patients diagnosed with Alzheimer's disease, 4 , 8 , 14 neurology outpatients with cognitive complaints and depressive symptoms, 28 in geriatric clinics, 17 , 29 and in individuals diagnosed with dementia in communities with a high prevalence of illiteracy. 16 In the present study, the BCSB was used in a specific sample of community-dwelling elderly adults.…”

Brief Cognitive Tests Used in Primary Care Cannot Accurately Differentiate Mild Cognitive Impairment from Subjective Cognitive Decline

“…To the best of our knowledge, only one previous study has examined the accuracy of either MMSE, CDT, or AQT for identifying MCI and differentiating it from SCD [ 42 ]. In that study, 32 elderly with subjective memory complaints and 74 with MCI were recruited from community centers for the elderly.…”

Brain metabolism and cerebrospinal fluid biomarkers profile of non-amnestic mild cognitive impairment in comparison to amnestic mild cognitive impairment and normal older subjects

“…Scores were adjusted according to appropriate age and education norms. Additional details of the evaluation protocol used, and neuropsychological tests administered, are reported in de Gobbi Porto et al [ 20 ].…”