Usefulness of Orientation to the Year as an Aid to Case Finding of Mild Cognitive Impairment or Depression in Community-Dwelling Older Adults

Abstract

Mild cognitive impairment (MCI) and depression are common and frequently misdiagnosed in older adults in primary care. In particular, depression combined with cognitive dysfunction is associated with a higher risk of dementia. We tried to find the usefulness of orientation to time as an easy case-finding tool for suspecting MCI or depression. This cross-sectional study included 2668 community-dwelling adults aged 70–84 years from the Korean Frailty and Aging Cohort Study (mean age of 76.0 ± 3.9 years). MCI was defined based on the criteria from the National Institute on Aging and the Alzheimer’s Association; depression was defined as a score of ≥ 6 on the Geriatric Depression Scale—Short Form (GDS-SF). Time orientation to year, month, day of the week, date, and season were tested. The sensitivity for the diagnosis of each of MCI and depression was the highest for the orientation to year (MCI, 17.7%; depression, 16.0%). For the diagnosis of MCI or depression, orientation to the year had the highest sensitivity (15.5%), and the specificity, PPV, NPV was 95.5%, 67.0%, 65.5%. In conclusion, asking “what year is it?” can be helpful as an aid to case finding to suspect MCI or depression in community and primary care settings.

Neurobehavioral exam.

“…The examiner may begin by assessing the patient's orientation (i.e., time, location, personal information), awareness of their current circumstances, and appre ciation of any cognitive difficulties (i.e., insight). Disorientation to the year has been shown to be helpful in differentiating mild cogni tive impairment from depression in older adults (Bae et al, 2021), and orientation can predict risk of developing dementia (Dumurgier et al, 2016). asymmetry is indicative of a more functionally meaningful difference in strength/fine motor skills than might be obtained by standard ized motor tasks.…”