A comparison of test-retest reliability of four cognitive screening tools in people with dementia

Lee, Ya-Chen; Lin, Yi-Te; Chiu, En-Chi

doi:10.1080/09638288.2021.1891466

Cited by 15 publications

(13 citation statements)

References 34 publications

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“…Four commonly-used cognitive screening tools have been used for the early detection of dementia including the Mini-Mental State Examination (MMSE), the Short Portable Mental Status Questionnaire, the Montreal Cognitive Assessment, and the Saint Louis University Status Examination [6]. Each of abovementioned screening tools has its own merits and among these four, the MMSE has been the most extensively used in clinical and research settings due to its practicality.…”

Section: Introductionmentioning

confidence: 99%

“…Each of abovementioned screening tools has its own merits and among these four, the MMSE has been the most extensively used in clinical and research settings due to its practicality. The MMSE is easy to administer and requires no specialized equipment or training [6][7][8]. It has been reported that overall, the four screening tools are similar in test-retest reliability; however, the MMSE has demonstrated higher test-retest reliability with acceptable random measurement error and small practice effect [6].…”

Section: Introductionmentioning

confidence: 99%

“…The MMSE is easy to administer and requires no specialized equipment or training [6][7][8]. It has been reported that overall, the four screening tools are similar in test-retest reliability; however, the MMSE has demonstrated higher test-retest reliability with acceptable random measurement error and small practice effect [6]. Although the MMSE has its own weaknesses, such as less sensitive to change with increasing age, having a ceiling effect, and vulnerability to practice effect [9,10], the new version of MMSE, the Mini-Mental State Examination-Second Edition (MMSE-2) was developed to overcome these issues [7].…”

Section: Introductionmentioning

confidence: 99%

“…One of the methods to reduce practice effects is by using alternate forms [17, 18], Test-retest reliability concerns the extent of agreement between repeated assessments under similar assessments conditions [19]. A measure with acceptable testretest reliability allows users to consistently identify those at risk for cognitive function decline [6]. The abovementioned psychometric properties are essential for a measure to ensure its utility for repeated assessments in people with dementia.…”

Section: Introductionmentioning

confidence: 99%

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Practice effect and test-retest reliability of the Mini-Mental State Examination-2 in people with dementia

Lee

Chiu

2022

BMC Geriatr

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Background The Mini-Mental State Examination-Second Edition (MMSE-2) consists of three visions: a brief version (MMSE-2:BV), a standard version (MMSE-2:SV), and an expanded version (MMSE-2: EV). Each version was equipped with alternate forms (blue and red). There was a lack of evidence on the practice effect and test-retest reliability of the three versions of the MMSE-2, limiting its utility in both clinical and research settings. The purpose of this study was to examine the practice effect and test-retest reliability of the MMSE-2 in people with dementia. Methods One hundred and twenty participants were enrolled, of which 60 were administered with the blue form twice (i.e., the same-form group, [SF group]) and 60 were administered with the blue form first and then the red form (alternate-form group, [AF group]). The practice effect was evaluated using a paired t-test and Cohen’s d. The test-retest reliability was examined using the intraclass correlation coefficient (ICC). Results For the practice effects, in the SF group, no statistically significant differences were found for the MMSE-2:BV and MMSE-2: EV total scores and eight subtests (p = 0.061–1.000), except for the MMSE-2:SV total score (p = 0.029). In the AF group, no statistically significant differences were found for all three versions of the total scores and subtests (p = 0.106–1.000), except for the visual-constructional ability subtest (p = 0.010). Cohen’s d of all three versions’ total scores and subtests were 0.00–0.20 and 0.00–0.26 for SF group and AF group, respectively. For the test-retest reliability, ICC values for all three versions and eight subtests in SF and AF groups were 0.60–0.93 and 0.56–0.93, respectively. Conclusion Our results demonstrated that the practice effect could be minimized when alternate forms of the MMSE-2 were used. The MMSE-2 had good to excellent test-retest reliability, except for three subtests (i.e., visual-constructional ability, registration, and recall). Caution should be taken when interpreting the results of visual-constructional ability, registration, and recall subtests of the MMSE-2.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Practice effect and test-retest reliability of the Mini-Mental State Examination-2 in people with dementia

Lee

Chiu

2022

BMC Geriatr

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“…Thus, clinicians still lack a validated metric for determining what is considered a “significant” cognitive improvement for individual patients. Due to the high variability of cognitive measures in impaired patients, clinicians can be misled by mild cognitive improvements ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

The Clinical Utility of the MOCA in iNPH Assessment

et al. 2022

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ObjectivesWe sought to estimate reliable change thresholds for the Montreal Cognitive Assessment (MoCA) for older adults with suspected Idiopathic Normal Pressure Hydrocephalus (iNPH). Furthermore, we aimed to determine the likelihood that shunted patients will demonstrate significant improvement on the MoCA, and to identify possible predictors of this improvement.MethodsPatients (N = 224) presenting with symptoms of iNPH were given a MoCA assessment at their first clinic visit, and also before and after tap test (TT) or extended lumbar drainage (ELD). Patients who were determined to be good candidates for shunts (N = 71, 31.7%) took another MoCA assessment following shunt insertion. Reliable change thresholds for MoCA were derived using baseline visit to pre-TT/ELD assessment using nine different methodologies. Baseline characteristics of patients whose post-shunt MoCA did and did not exceed the reliable change threshold were compared.ResultsAll nine of reliable change methods indicated that a 5-point increase in MoCA would be reliable for patients with a baseline MoCA from 16 to 22 (38.4% of patients). Furthermore, a majority of reliable change methods indicated that a 5-point increase in MoCA would be reliable for patients with a baseline MoCA from 14 to 25. Reliable change thresholds varied across methods from 4 to 7 points for patients outside of this range. 10.1% had at least a 5-point increase from baseline to post-TT/ELD. Compared to patients who did not receive a shunt, patients who received a shunt did not have lower average MoCA at baseline (p = 0.88) or have better improvement in MoCA scores after the tap test (p = 0.17). Among shunted patients, 23.4% improved by at least 5 points on the MoCA from baseline to post-shunt. Time since onset of memory problems and post-TT/ELD gait function were the only clinical factors significantly associated with having a reliable change in MoCA after shunt insertion (p = 0.019; p = 0.03, respectively).ConclusionsIn patients with iNPH, clinicians could consider using a threshold of 5 points for determining whether iNPH-symptomatic patients have experienced cognitive benefits from cerebrospinal fluid drainage at an individual level. However, a reliable change cannot be detected for patients with a baseline MoCA of 26 or greater, necessitating a different cognitive assessment tool for these patients.

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Is the difference real, is the difference relevant: the minimal detectable and clinically important changes in the Montreal Cognitive Assessment

Lindvall,

Abzhandadze,

Quinn

et al. 2024

Cerebral Circulation - Cognition and Behavior

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A comparison of test-retest reliability of four cognitive screening tools in people with dementia

Cited by 15 publications

References 34 publications

Practice effect and test-retest reliability of the Mini-Mental State Examination-2 in people with dementia

Practice effect and test-retest reliability of the Mini-Mental State Examination-2 in people with dementia

The Clinical Utility of the MOCA in iNPH Assessment

Is the difference real, is the difference relevant: the minimal detectable and clinically important changes in the Montreal Cognitive Assessment

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