Screening for Cognitive Frailty Using Short Cognitive Screening Instruments: Comparison of the Chinese Versions of the MoCA and Qmci Screen

Xu, Yangfan; Lin, Yangyang; Yi, Lingrong; Zhao, Li; Li, Xian; Yu, Yuying; Guo, Yuxiao; Wang, Yuling; Jiang, Haoying; Chen, Zhuoming; Svendrovski, Anton; Gao, Yang; Molloy, D. William; Ó’Caoimh, Rónán

doi:10.3389/fpsyg.2020.00558

Cited by 7 publications

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“…The optimal cut-off score for cognitive impairment (MCI and dementia vs. normal controls) for the Q mci screen (original English language version) is ≤62/100 ( 20 ). However, the optimal cut-off for the Chinese version (Q mci -CN) is lower at ≤55/100 ( 23 ). This difference is considered to be multi-factorial but most likely relates to the small sample of Chinese patients included in the single validation study to date ( 23 ).…”

Section: Methodsmentioning

confidence: 99%

“…However, the optimal cut-off for the Chinese version (Q mci -CN) is lower at ≤55/100 ( 23 ). This difference is considered to be multi-factorial but most likely relates to the small sample of Chinese patients included in the single validation study to date ( 23 ).…”

Section: Methodsmentioning

confidence: 99%

“…The Qmci screen is more accurate than MMSE in detecting early cognitive changes (17)(18)(19) and when compared to the MoCA, it has similar accuracy and better specificity but a shorter administration time (20)(21)(22). The Chinese version of the Qmci (Qmci-CN) has recently been validated in a Chinese general rehabilitation outpatient clinic sample (23). To date, the Qmci screen has not been examined in patients post-stroke.…”

Section: Introductionmentioning

confidence: 99%

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Screening for Cognitive Impairment After Stroke: Validation of the Chinese Version of the Quick Mild Cognitive Impairment Screen

Lin

et al. 2021

Front. Neurol.

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Background: Screening for post-stroke cognitive impairment (PSCI) is necessary because stroke increases the incidence of and accelerates premorbid cognitive decline. The Quick Mild Cognitive Impairment (Qmci) screen is a short, reliable and accurate cognitive screening instrument but is not yet validated in PSCI. We compared the diagnostic accuracy of a Chinese version of the Qmci screen (Qmci-CN) compared with the widely-used Chinese versions of the Montreal Cognitive Assessment (MoCA-CN) and Mini-Mental State Examination (MMSE-CN).Methods: We recruited 34 patients who had recovered from a stroke in rehabilitation unit clinics in 2 university hospitals in China: 11 with post-stroke dementia (PSD), 15 with post-stroke cognitive impairment no dementia (PSCIND), and 8 with normal cognition (NC). Classification was made based on clinician assessment supported by a neuropsychological battery, independent of the screening test scores. The Qmci-CN, MoCA-CN, and MMSE-CN screens were administered randomly by a trained rater, blind to the diagnosis.Results: The mean age of the sample was 63 ± 13 years and 61.8% were male. The Qmci-CN had statistically similar diagnostic accuracy in differentiating PSD from NC, an area under the curve (AUC) of 0.94 compared to 0.99 for the MoCA-CN (p = 0.237) and 0.99 for the MMSE-CN (p = 0.293). The Qmci-CN (AUC 0.91), MoCA-CN (AUC 0.94), and MMSE-CN (AUC 0.79) also had statistically similar accuracy in separating PSD from PSCIND. The MoCA-CN more accurately distinguished between PSCIND and normal cognition than the Qmci-CN (p = 0.015). Compared to the MoCA-CN, the administration times of the Qmci-CN (329s vs. 611s, respectively, p < 0.0001) and MMSE-CN (280 vs. 611s, respectively, p < 0.0001) were significantly shorter.Conclusion: The Qmci-CN is accurate in identifying PSD and separating PSD from PSCIND in patients post-stroke following rehabilitation and is comparable to the widely-used MoCA-CN, albeit with a significantly shorter administration time. The Qmci-CN had relatively poor accuracy in identifying PSCIND from NC and hence may lack accuracy for certain subgroups. However, given the small sample size, the study is under-powered to show superiority of one instrument over another. Further study is needed to confirm these findings in a larger sample size and in other settings (countries and languages).

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Screening for Cognitive Impairment After Stroke: Validation of the Chinese Version of the Quick Mild Cognitive Impairment Screen

Lin

et al. 2021

Front. Neurol.

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“…The MoCA is an 11-item questionnaire that uses a 30-point Likert scale and includes eight dimensions—attention and concentration, executive function, memory, language, visual structure skills, abstract thinking, calculation, and orientation. A score of 18–25 indicates MCI, with a higher score indicating higher levels of cognitive ability 45 , 46 . In the current study, the Cronbach’s alpha coefficient was 0.82.…”

Section: Methodsmentioning

confidence: 99%

The effects of combined cognitive training on prospective memory in older adults with mild cognitive impairment

Chen

Zhou

Hong

et al. 2021

Sci Rep

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This study aimed to assess the effects of combined cognitive training on prospective memory ability of older adults with mild cognitive impairment (MCI). A total of 113 participants were divided into a control group and three intervention groups. Over three months, the control group received only community education without any training, whereas for the first six weeks, an executive function training group received executive function training, a memory strategy training group received semantic encoding strategy training, and the combined cognitive training group received executive function training twice a week for the first six weeks, and semantic encoding strategy training twice a week for the next six weeks. The combined cognitive training group showed improvement on the objective neuropsychological testing (Montreal Cognitive Assessment scale). The memory strategy training group showed improvement on the self-evaluation scales (PRMQ-PM). Combined cognitive training improved the prospective memory and cognitive function of older adults with MCI.

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“…It was designed to sensitively recognize the specific differences between MCI and normal controls (NCs) [18], and has a quick administration time of approximately five minutes [19]. It is recognized and communicated in English in countries, including Canada [18] and Australia [20,21], as well as multiple other languages, including Turkish [22], Chinese [23], and Dutch [24]. The Qmci screen has six subtests that cover five cognitive domains: orientation, working memory, semantic memory (verbal fluency), visuospatial (clock drawing), and two tests of episodic memory (delayed recall and logical memory) [25].…”

Section: Introductionmentioning

confidence: 99%

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

Rezaei

Shariati

Molloy

et al. 2021

IJERPH

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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.

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Screening for Cognitive Frailty Using Short Cognitive Screening Instruments: Comparison of the Chinese Versions of the MoCA and Qmci Screen

Cited by 7 publications

References 46 publications

Screening for Cognitive Impairment After Stroke: Validation of the Chinese Version of the Quick Mild Cognitive Impairment Screen

Screening for Cognitive Impairment After Stroke: Validation of the Chinese Version of the Quick Mild Cognitive Impairment Screen

The effects of combined cognitive training on prospective memory in older adults with mild cognitive impairment

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

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