Detection of MCI in the clinic: evaluation of the sensitivity and specificity of a computerised test battery, the Hopkins Verbal Learning Test and the MMSE

Jager, Celeste A. de; Schrijnemaekers, Anne-Claire; Honey, Thurza E.M.; Budge, Marc

doi:10.1093/ageing/afp068

Cited by 101 publications

(118 citation statements)

References 29 publications

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“…In total, 16 studies [68][69][70][71][72][74][75][76][77][78][79][80][81]83,85,86 were included in the diagnostic accuracy review.…”

Section: Included Studiesmentioning

confidence: 99%

“…Five studies reported results for more than two groups of participants: three included healthy controls, MCI and early dementia, 71,76,86 and two included healthy controls, early dementia and early dementia/MCI combined. 70,74 In total, 10 studies 68,69,71,72,75,76,78,79,85,86 evaluated the use of automated computerised tests to detect MCI alone, seven studies 70,71,74,76,80,81,86 reported results for early dementia, three studies 70,74,77 reported results for combined MCI/early dementia and one study 83 reported results for human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND).…”

Section: Included Studiesmentioning

confidence: 99%

“…[68][69][70][77][78][79][80]85 The studies were judged to be at high risk for this criterion because a case-control study design was used. Regarding the index test criteria for risk of bias, seven studies 70,71,74,76,78,83,85 were judged to be at unclear risk.…”

Section: Study Quality Assessmentmentioning

confidence: 99%

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Automated tests for diagnosing and monitoring cognitive impairment: a diagnostic accuracy review

Aslam

Bates

Dündar

et al. 2016

Health Technol Assess

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BackgroundCognitive impairment is a growing public health concern, and is one of the most distinctive characteristics of all dementias. The timely recognition of dementia syndromes can be beneficial, as some causes of dementia are treatable and are fully or partially reversible. Several automated cognitive assessment tools for assessing mild cognitive impairment (MCI) and early dementia are now available. Proponents of these tests cite as benefits the tests’ repeatability and robustness and the saving of clinicians’ time. However, the use of these tools to diagnose and/or monitor progressive cognitive impairment or response to treatment has not yet been evaluated.ObjectivesThe aim of this review was to determine whether or not automated computerised tests could accurately identify patients with progressive cognitive impairment in MCI and dementia and, if so, to investigate their role in monitoring disease progression and/or response to treatment.Data sourcesFive electronic databases (MEDLINE, EMBASE, The Cochrane Library, ISI Web of Science and PsycINFO), plus ProQuest, were searched from 2005 to August 2015. The bibliographies of retrieved citations were also examined. Trial and research registers were searched for ongoing studies and reviews. A second search was run to identify individual test costs and acquisition costs for the various tools identified in the review.Review methodsTwo reviewers independently screened all titles and abstracts to identify potentially relevant studies for inclusion in the review. Full-text copies were assessed independently by two reviewers. Data were extracted and assessed for risk of bias by one reviewer and independently checked for accuracy by a second. The results of the data extraction and quality assessment for each study are presented in structured tables and as a narrative summary.ResultsThe electronic searching of databases, including ProQuest, resulted in 13,542 unique citations. The titles and abstracts of these were screened and 399 articles were shortlisted for full-text assessment. Sixteen studies were included in the diagnostic accuracy review. No studies were eligible for inclusion in the review of tools for monitoring progressive disease. Eleven automated computerised tests were assessed in the 16 included studies. The overall quality of the studies was good; however, the wide range of tests assessed and the non-standardised reporting of diagnostic accuracy outcomes meant that meaningful synthesis or statistical analysis was not possible.LimitationsThe main limitation of this review is the substantial heterogeneity of the tests assessed in the included studies. As a result, no meta-analyses could be undertaken.ConclusionThe quantity of information available is insufficient to be able to make recommendations on the clinical use of the computerised tests for diagnosing and monitoring MCI and early dementia progression. The value of these tests also depends on the costs of acquisition, training, administration and scoring.Future workResearch is required to establish stable cut-off points for automated computerised tests that are used to diagnose patients with MCI or early dementia. Additionally, the costs associated with acquiring and using these tests in clinical practice should be estimated.Study registrationThe study is registered as PROSPERO CRD42015025410.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…In total, 16 studies [68][69][70][71][72][74][75][76][77][78][79][80][81]83,85,86 were included in the diagnostic accuracy review.…”

Section: Included Studiesmentioning

confidence: 99%

Section: Included Studiesmentioning

confidence: 99%

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Automated tests for diagnosing and monitoring cognitive impairment: a diagnostic accuracy review

Aslam

Bates

Dündar

et al. 2016

Health Technol Assess

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“…The Cogstate brief battery, a computerized series of neuropsychological tests [5], has demonstrated good validity and high test-retest reliability in cognitively normal older adults as well as those with mild cognitive impairment (MCI) or dementia [5][6][7][8]. The Cogstate battery is also sensitive enough to detect subtle cognitive decline over 12 months in a population of older adults with MCI [9] and to differentiate between normal cognitive function, MCI, and Alzheimer's disease [6].…”

Section: Hhs Public Accessmentioning

confidence: 99%

“…However, task comprehension will likely improve in future cohorts as computer literacy increases in older adults [20]. Additionally, although prior studies of the Cogstate battery in older adults demonstrate good correlation with performance on other neuropsychological test instruments [8,21], the Cogstate battery may not adequately measure some cognitive domains such as executive functions or semantic and verbal fluency. …”

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confidence: 99%

O3‐12‐06: Evaluation of a self‐administered computerized cognitive battery in an older population

Koyama

Hagan

Grodstein

2015

Alzheimer's & Dementia

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Objective-To assess the utility of the Cogstate self-administered computerized neuropsychological battery in a large population of older men.Methods-We invited 7,167 men (mean age: 75 years) from the Health Professionals Follow-up Study, a prospective cohort of male health professionals. We considered individual Cogstate scores and composite scores measuring psychomotor speed and attention, learning and working memory, and overall cognition. Multivariate linear regression was used to assess the association between risk factors measured 4 and 28 years prior to cognitive testing and each outcome.Results-The 1,866 men who agreed to complete Cogstate testing were similar to the 5,301 nonresponders. Many expected risk factors were associated with Cogstate scores in multivariateadjusted models. Increasing age was significantly associated with worse performance on all outcomes (p < 0.001). For risk factors measured four years prior to testing and overall cognition, a history of hypertension was significantly associated with worse performance (mean difference= −0.08 standard units [95% CI −0.16, 0.00]) and higher nut consumption was significantly associated with better performance (>2 servings/week vs. <1 serving/month: 0.15 [0.03, 0.27 ]).Conclusions-The self-administered Cogstate battery showed significant associations with several risk factors known to be associated with cognitive function. Future studies of cognitive aging may benefit from the numerous advantages of self-administered computerized testing. Keywords epidemiology; dementia; alzheimer's; cognitive function; neuropsychological assessment Corresponding Author: Alain K. Koyama, 181 Longwood Ave, 3 rd Floor, Boston, MA 02115, akoyama@post.harvard.edu, Phone: 617-525-2253, Fax: 617-525-2008. Epidemiologic studies of cognitive aging typically rely on neuropsychological tests, which can provide a breadth of data on cognitive function, but require trained interviewers (introducing both inter-and intra-interviewer variability) as well as substantial time and cost on the part of both investigators and study participants. In contrast, computerized cognitive testing offers numerous advantages over traditional neuropsychological testing such as substantially increased cost-efficiency and convenience, accurate response time measurement, and decreased susceptibility to sources of human error such as interviewer bias [4]. HHS Public AccessThe Cogstate brief battery, a computerized series of neuropsychological tests [5], has demonstrated good validity and high test-retest reliability in cognitively normal older adults as well as those with mild cognitive impairment (MCI) or dementia [5][6][7][8]. The Cogstate battery is also sensitive enough to detect subtle cognitive decline over 12 months in a population of older adults with MCI [9] and to differentiate between normal cognitive function, MCI, and Alzheimer's disease [6]. However, prior studies using the Cogstate battery in older populations are in predominately small samples and often used only in supervised ...

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Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations

Creavin

Wisniewski

Noel-Storr

et al. 2016

Cochrane Database of Systematic Reviews

540

424

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Detection of MCI in the clinic: evaluation of the sensitivity and specificity of a computerised test battery, the Hopkins Verbal Learning Test and the MMSE

Abstract: overall, we conclude that the HVLT has better sensitivity for the detection of MCI in older adults than the CogState, but that CogState may enable the identification of cognitive deficits above and beyond impairments in memory.

Cited by 101 publications

References 29 publications

Automated tests for diagnosing and monitoring cognitive impairment: a diagnostic accuracy review

Automated tests for diagnosing and monitoring cognitive impairment: a diagnostic accuracy review

O3‐12‐06: Evaluation of a self‐administered computerized cognitive battery in an older population

Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations

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