The combination of cognitive testing and an informant questionnaire in screening for dementia

Knafelc, Richard; Giudice, Dina Lo; Harrigan, Susy; Cook, Roslyn; Flicker, Leon; Mackinnon, Andrew; Ames, David

doi:10.1093/ageing/afg088

Cited by 53 publications

(42 citation statements)

References 14 publications

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“…In addition, the combined use of these tests did not increase the aforementioned diagnostic properties. Our results are in accordance with previously published studies in which these tests used alone or in combination in the screening for dementia, 17 but are in disagreement with a recent publication by Isella et al, 18 who suggested that the IQCODE had a good discriminative power between cognitively unimpaired older adults and patients with MCI. In this study, with similar cutoff values (28 for the MMSE and 3.19 for the IQCODE), both tests had a similar discriminative accuracy, but higher than in the current sample (AUC: 0.86 and 0.84, respectively).…”

Section: Discussionsupporting

confidence: 75%

Combining functional scales and cognitive tests in screening for mild cognitive impairment at a university-based memory clinic in Brazil

Abreu

Nunes

Diniz

et al. 2008

Rev. Bras. Psiquiatr.

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Section: Discussionsupporting

confidence: 75%

Combining functional scales and cognitive tests in screening for mild cognitive impairment at a university-based memory clinic in Brazil

Abreu

Nunes

Diniz

et al. 2008

Rev. Bras. Psiquiatr.

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“…however, combining the MMSE and the IQCODE with the logistic regression did not result in any improvement over the use of the MMSE alone, contrasting with the previous studies presented. The authors discussed that perhaps in samples with lower dementia prevalence rates as in general practice (or in community samples) the weighted sum might be of greater utility 25 , as we found in the present report.…”

Section: Discussionsupporting

confidence: 58%

“…Investigating the same strategy (combining MMSE and IQCODE), 323 patients were assessed at a memory clinic 25 . The sample had a high prevalence of dementia (70.9%), and 31% had left school at the age of 16 and older.…”

Section: Discussionmentioning

confidence: 99%

Combined instruments for the screening of dementia in older people with low Education

Bottino

Zevallos-Bustamante

Lopes

et al. 2009

Arq. Neuro-Psiquiatr.

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-Objective: To determine which combination of cognitive tests and informant reports can improve the diagnostic accuracy of dementia screening in low educated older people. Method: Patients with mild to moderate dementia (n=34) according to ICD-10 and DSM-III-R criteria and 59 older controls were assessed with the Mini-Mental State Examination (MMSE) and the Fuld Object Memory Evaluation (FOME). Informants were assessed using the Informant Questionnaire on Cognitive Decline in the Elderly and the Bayer-Activities of Daily Living Scale. Results: The 4 instruments combined with the mixed rule correctly classified 100% and the logistic regression (weighted sum) classified 95.7% of subjects. The weighted sum had a significantly larger ROC area compared to MMSE (p=0.008) and FOME (p=0.023). The specificity of the tested combinations was superior to the MMSE alone (p=0.002). Conclusions: Cognitive tests combined with informant reports can improve the screening of mild to moderate dementia in low educated older people.KEy WORDS: dementia, screening, cognitive tests, informant report.instrumentos combinados para o rastreio de demência em idosos com baixo nível educacional resumo -Objetivo: Determinar qual combinação de testes cognitivos e avaliações do informante pode melhorar o rastreio de demência em idosos com baixo nível educacional. Método: Pacientes com demência leve a moderada (n=34) de acordo com critérios da CID-10 e DSM-III-R, e 59 controles idosos foram avaliados com o Mini-Exame do Estado Mental (MEEM) e com o "Fuld Object Memory Evaluation" (FOME). Informantes foram avaliados com o "Informant Questionnaire on Cognitive Decline in the Elderly" e a escala Bayer-Atividades da Vida Diária. Resultados: Os quatro instrumentos combinados com a regra mista classificaram 100% e a regressão logística (soma ponderada) classificou 95,7% dos sujeitos. A soma ponderada teve uma área da curva ROC significativamente maior comparada ao MEEM (p=0,008) e FOME (p=0,023). A especificidade das combinações testadas foi superior ao MEEM isolado (p=0,002). Conclusões: Testes cognitivos combinados com relatos dos informantes podem melhorar o rastreio de demência leve a moderada em idosos com baixo nível educacional. PALAVRAS-ChAVE: demência, rastreio, testes cognitivos, relato de informantes.

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“…These results are similar to previous studies with elderly populations. 36,37 Although some of the currently used cognitive screening tests yield good results for recognizing subjects with MCI, they still have important limitations, mainly because they were designed for the diagnosis of established dementia, not of its prodromal and milder manifestations. Therefore, it is important to develop new, more specific tools to tackle the challenge of identifying, with high accuracy, subjects with mild cognitive deficits.…”

Section: Epidemiological Characteristics Of MCI In the Elderlymentioning

confidence: 99%

Mild cognitive impairment (part 1): clinical characteristics and predictors of dementia

Forlenza

Diniz

Stella

et al. 2013

Rev. Bras. Psiquiatr.

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Objective: To critically review and evaluate existing knowledge on the conceptual limits and clinical usefulness of the diagnosis of mild cognitive impairment (MCI) and the neuropsychological assessment and short-and long-term prognosis thereof. Methods: We conducted a systematic search of the PubMed and Web of Science electronic databases, limited to articles published in English between 1999 and 2012. Based on the search terms mild cognitive impairment or MCI and epidemiology or diagnosis, we retrieved 1,698 articles, of which 248 were critically eligible (cross-sectional and longitudinal studies); the abstracts of the remaining 1,450 articles were also reviewed. Results: A critical review on the MCI construct is provided, including conceptual and diagnostic aspects; epidemiological relevance; clinical assessment; prognosis; and outcome. The distinct definitions of cognitive impairment, MCI included, yield clinically heterogeneous groups of individuals. Those who will eventually progress to dementia may present with symptoms consistent with the definition of MCI; conversely, individuals with MCI may remain stable or return to normal cognitive function. Conclusion: On clinical grounds, the cross-sectional diagnosis of MCI has limited prognostic relevance. The characterization of persistent and/or progressive cognitive deficits over time is a better approach for identification of cases at the pre-dementia stages, particularly if these cognitive abnormalities are consistent with the natural history of incipient Alzheimer's disease.

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The combination of cognitive testing and an informant questionnaire in screening for dementia

Abstract: The combination of cognitive testing and an informant report according to a weighted sum rule in this population did not result in any advantage over the use of the Mini-Mental State Examination alone. The mixed results of this study contrast with those of Mackinnon and Mulligan.

Cited by 53 publications

References 14 publications

Combining functional scales and cognitive tests in screening for mild cognitive impairment at a university-based memory clinic in Brazil

Combining functional scales and cognitive tests in screening for mild cognitive impairment at a university-based memory clinic in Brazil

Combined instruments for the screening of dementia in older people with low Education

Mild cognitive impairment (part 1): clinical characteristics and predictors of dementia

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