The Persian Version of the Quick Mild Cognitive Impairment Screen (Qmci-Pr): Psychometric Properties among Middle-Aged and Older Iranian Adults

Abstract

Brief cognitive screening instruments are used to identify patients presenting with cognitive symptoms that warrant further assessment. This study aimed to evaluate the reliability and validity of the Persian version of the Quick Mild Cognitive Impairment (Qmci-Pr) among middle-aged and older Iranian adults. Consecutive patients aged ≥55 years and caregivers attending with them as normal controls (NCs) were recruited from geriatric outpatient clinics and a hospital in Tehran, Iran. All patients completed the Qmci-Pr before completing an independent detailed neuropsychological assessment and staging using the Clinical Dementia Rating (CDR) Scale. NCs underwent the same assessment. In all, 92 participants with a median age of 70 years (±13) were available. Of these, 20 participants were NCs, 24 had subjective memory complaints (SMC), 24 had mild cognitive impairment (MCI), and 24 had Alzheimer’s disease (AD). The Qmci-Pr had good accuracy in differentiating SMC and NC from MCI (area under the curve (AUC): 0.80 (0.69–0.91)) and in identifying cognitive impairment (MCI and mild AD) (AUC: 0.87 (0.80–0.95)) with a sensitivity of 88% and specificity of 80%, at an optimal cut-off of <53/100. The Qmci-Pr is an accurate short cognitive screening impairment for separating NC and patients with SMC from MCI and identifying cognitive impairment. Further research with larger samples and comparison with other widely used instruments such as the Montreal Cognitive Assessment is needed. Given its established brevity, the Qmci-Pr is a useful screen for Iranian adults across the spectrum of cognitive decline.

Diagnostic accuracy, reliability, and construct validity of the German quick mild cognitive impairment screen

“…In addition, our findings are consistent with pooled data of 2019 for the Qmci demonstrating an AUC of 0.84 [ 11 ], a sensitivity between 77% [ 11 ] to 82% [ 23 ], and a specificity of 79% [ 11 ] to 82% [ 23 ] at a given cut-off score (i.e., the recommended cut-off score or, in case several sensitivity/specificity pairs were presented in the original studies analyses in these systematic reviews and meta-analyses, the cut-off score that was described as optimal by the respective authors or produced the largest AUC). Finally, our findings are also consistent with more recent validation studies of the Qmci in other translations, including Greek (AUC = 0.79 [ 28 ] and AUC = 0.76 [ 27 ]), Japanese (Sensitivity = 94%, Specificity = 72%) [ 29 ], Persian (AUC = 0.80) [ 30 ], Taiwanese (AUC = 0.89) [ 31 ], and Turkish (AUC = 0.80) [ 32 ]. The considerably higher AUC as compared to previous publications may be attributed to several characteristics of our analysis pertaining to the recruitment and characteristics of the participant sample under investigation.…”

“…As summarized in the introduction, the original Qmci was shown to accurately discriminate between individuals with normal cognitive functioning, mNCD, and MNCD [ 24 ] with high diagnostic accuracy, sensitivity, and specificity. In addition, the Qmci has undergone successful validation in multiple languages, including Chinese [ 25 ], Dutch [ 26 ], Greek [ 27 , 28 ], Japanese [ 29 ], Persian [ 30 ], Taiwanese [ 31 ], and Turkish [ 32 ]. These studies were adequately powered according to a priori sample size calculations.…”

“…The original English Qmci was shown to accurately discriminate between individuals with normal cognitive functioning ( n = 623), mNCD ( n = 147), and MNCD ( n = 165) [ 24 ]. In addition, the Qmci has undergone successful validation in multiple languages, including Chinese [ 25 ], Dutch [ 26 ], Greek [ 27 , 28 ], Japanese [ 29 ], Persian [ 30 ], Taiwanese [ 31 ], and Turkish [ 32 ]. However, the optimal cut-off for discriminating between mNCD and HOA as well as the diagnostic accuracy of the German version of the Qmci (Qmci-G) have not yet been scientifically determined and validated.…”

Diagnostic accuracy of cognitive screening tools validated for older adults in Iran: a systematic review and meta-analysis

“…At an optimal cutoff score of < 53/100, it exhibits a sensitivity of 79%, specificity of 80%, LR + of 3.95, LR- of 0.26, and DOR of 15.19). This test accurately identifies moderate to severe dementia, with a sensitivity of 88%, specificity of 90%, LR + of 8.8, LR- of 0.13, and DOR of 67.69 at an optimal cutoff of < 38/100 [ 44 ].…”

Diagnostic Accuracy of Cognitive Screening Tools Validated for Older Adults in Iran: A Systematic Review and Meta-analysis

“…At an optimal cutoff score of < 53/100, it exhibits a sensitivity of 79%, speci city of 80%, LR + of 3.95, LR-of 0.26, and DOR of 15.19). This test accurately identi es moderate to severe dementia, with a sensitivity of 88%, speci city of 90%, LR + of 8.8, LR-of 0.13, and DOR of 67.69 at an optimal cutoff of < 38/100 (37).…”