Validation of a brief Multicultural Cognitive Examination (MCE) for evaluation of dementia

Abstract

Background The aims of this study were to present the psychometric properties of a newly designed cognitive screening instrument, the Multicultural Cognitive Examination (MCE), and to compare it with the Rowland Universal Dementia Assessment Scale (RUDAS) in a multicultural population. Methods The study was a Western European cross‐sectional multicenter study. The MCE consists of four components evaluating separate cognitive functions and was constructed by adding measures of memory, verbal fluency, and visuospatial function to the RUDAS to create a scale with 0 to 100 points. Results A total of 66 patients with dementia and 123 cognitively intact participants were included across six memory clinics; 96 had minority ethnic background, and 93 had majority ethnic background. Moderate to large differences were present between patients with dementia and control participants on all MCE components. The MCE significantly improved diagnostic accuracy compared with using the RUDAS alone, with area under the curves of .918, .984, and .991 for the RUDAS, MCE composite, and demographically corrected composite scores, respectively. Diagnostic accuracy of the MCE did not significantly differ between minority and majority ethnic groups. Across MCE subcomponents, patients with Alzheimer's disease (AD) dementia performed significantly poorer on the memory component compared with those with non‐AD dementia. Conclusions The MCE is a brief cross‐cultural cognitive screening instrument that expands evaluation of the cognitive functions covered by the RUDAS, does not require any specialized training, and may be useful for classification of mild dementia or dementia subtypes.

Cross-cultural dementia screening using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis

“…This makes the RUDAS a valuable cross-cultural dementia screening instrument in clinical practice and in research. Studies have suggested that diagnostic accuracy of the RUDAS may be improved by adjusting raw scores in people with limited or no formal education (Nielsen et al, 2019c), by combining the RUDAS with informant report (Nielsen et al, 2016), or by adding other measures to the RUDAS to achieve a more comprehensive cognitive examination (Nielsen et al, 2019a). However, this needs to be further evaluated in future research.…”

Cross-cultural neuropsychological assessment in Europe: Position statement of the European Consortium on Cross-Cultural Neuropsychology (ECCroN)

“…Several of such widely-applicable instruments have already been developed over the years across Europe, such as the aforementioned European Cross-Cultural Neuropsychological Test Battery (CNTB, Nielsen et al, 2018), the Multicultural Cognitive Examination (MCE, Nielsen et al, 2019), the Cross-Cultural Dementia Screening (CCD, Goudsmit et al, 2017), the computerized EMBRACED battery (Ibanez-Casas et al, in press), the computerized Battery for Neuropsychological Evaluation of Children (BENCI, Fasfous et al, 2015), an innovative verbal fluency-switching task (TFA-93, Narme et al, 2019) and a number of culturally -or regionally -appropriate picture-based memory tests, such as the Recall of Pictures Test (RPT, Nielsen et al, 2012), modified Visual Association Test (mVAT, Franzen et al, 2019), TMA-93 (Maillet et al, 2017), and TNI-93 (Maillet et al, 2016). A normative data and validation study was carried out for European majority groups, Pakistani/Indian, Polish, Turkish, and to a lesser extent Moroccan and Former yugoslavian participants for CNTB (using multilingual research assistants or trained interpreters); for the CCD, the normative data and validation study was conducted among native Dutch, Moroccan-Arabic, Moroccan-Amazigh (Berber), Turkish, Surinamese-Creole, and Surinamese-Hindustani participants (assessed by bilingual, bicultural neuropsychologists); a general multicultural immigrant population as well as native French individuals were studied for the normative data and validity studies of the .…”

Cross-cultural neuropsychological assessment in the European Union: a Delphi expert study

“…2000a ; Rait et al. 2000b ) were used in the UK; the modified Visual Association Test ( Franzen et al., 2019 ), a literacy screener (unpublished), and the Stick Design Test ( Baiyewu et al., 2005 ) in the Netherlands; the computerized EMBRACED battery (unpublished) in Spain; the Cross-Linguistic Naming Test ( Ardila, 2007b ), the WHO/UCLA adaptation of the Rey Auditory Verbal Learning Test ( Maj et al., 1993 ), and the Multicultural Cognitive Examination ( Nielsen et al., 2019a ) in Denmark; and the TNI-93 ( Maillet et al., 2016 ), TMA-93 ( Maillet et al., 2017 ), TFA-93 ( Narme et al., 2019 ), and Montreal Cognitive Assessment ( Nasreddine et al., 2005 ) in France.…”