Screening for dementia: single yes/no question or Likert scale?

Metamemory: A construct with diagnostic utility in a cognitive disorders clinic?

“…As the study setting, a dedicated memory disorders clinic, was anticipated to have a high prevalence of cognitive impairment, it was surprising that so many patients answered “No” to the Dementia CQUIN screening question. Indeed, this study observed a lower self‐rating of memory impairment using the yes/no screening question (60%) than using the Likert scale (90%), the reverse of the findings in epilepsy clinic‐based patient cohorts …”

“…A pragmatic diagnostic test accuracy study was performed examining two simple tests which may be judged to access the construct of metamemory (i.e., subjective memory judgments): the Dementia Commissioning for Quality and Innovation (Dementia CQUIN) screening question (“Have you been more forgetful in the past 12 months to the extent that it has significantly affected your life?”) and a five‐point SMC Likert scale (“In general, how would you rate your memory?”: 1 = poor; 2 = fair; 3 = good; 4 = very good; 5 = excellent; ratings of either fair or poor defined as SMC+). Prior experience has been gained with administration of both these tests . A standard patient assessment cognitive screening instrument, the Mini‐Addenbrooke's Cognitive Examination (MACE), was also administered, using the cut‐off for cognitive impairment from the index study (MACE ≤25/30).…”

Cognitive Symptoms in Patients with Epilepsy: Role of Sleep and Mood Disturbance

“…The demographic data were similar with respect to age in the prior study (SMC+ 42.7 ± 15.1 years, SMC-42.0 ± 16.3) [2]. However, the possible association of disease duration with subjective memory complaint which was previously noted [2,4] was not observed in this cohort.…”

“…Study shortcomings include the small size of the cohort: the number of SMC+ patients was unexpectedly lower than anticipated (6%, vs. 20% in a previous study [2]) the reasons for which are not immediately apparent. The demographic data were similar with respect to age in the prior study (SMC+ 42.7 ± 15.1 years, SMC-42.0 ± 16.3) [2]. However, the possible association of disease duration with subjective memory complaint which was previously noted [2,4] was not observed in this cohort.…”

“…Memory complaints are frequently encountered in patients attending epilepsy clinics. For example, 20% of patients in an epilepsy outpatient clinic population administered a subjective memory complaint (SMC) five-item Likert scale [1] assessed their memory to be either poor or fair and hence were classified as SMC+ [2]. Using the Ascertain Dementia 8 (AD8) screening questionnaire for cognitive impairment [3], no less than 48% of patients in an epilepsy clinic population scored above the test cut-off suggesting "cognitive impairment likely to be present" [4].…”