Validation of the Neurobehavioral Cognitive Status Examination and the Rivermead Behavioural Memory Test in investigations of dementia

Abstract

The aim of this retrospective study was to validate two commonly used instruments, Cognistat and the Rivermead Behavioural Memory Test, RBMT, for detection of MCI and mild dementia. Two different diagnosis groups, mild cognitive impairment (MCI) and Alzheimer's disease combined with mixed dementia representing mild dementia (MD), were compared with a group of patients who did not receive a diagnosis of dementia. All patients were assessed at a specialized outpatient memory clinic in a university hospital in Sweden using the Mini Mental State Examination (MMSE), Cognistat, and RBMT. Sensitivity, specificity, predictive value, and likelihood ratio were calculated for the tests. The Cognistat and RBMT have moderate validity in the detection of MCI and mild dementia. On their own, none of the tests used is sufficient for diagnosing MCI or mild dementia. A combination of the Cognistat and RBMT provides additional information in early stage dementia; in this regard the RBMT is better than the Cognistat, which also has other limitations. The RBMT can be helpful for distinguishing between MCI and mild dementia. There is a need for a more sensitive screening test to capture early cognitive impairment related to patients' occupational performance and problems in daily life.

Clinical Utility of Cognistat in Multiprofessional Team Evaluations of Patients with Cognitive Impairment in Swedish Primary Care

“…Earlier research [13, 33, 34] supports our finding that the sensitivity of Cognistat was higher than that of the MMSE, but the relatively high specificity is more prominent in this study group than in earlier research, a difference that suggests that Cognistat would be useful in primary care settings. In comparison with MMSE and CDT combined, Cognistat is more sensitive with the same specificity and a slightly higher PPV.…”

“…Cognistat assesses several cognitive domains separately but does not sum global cognitive function [11, 12]. The test has been validated in a secondary care (SC) population by retrospectively comparing test results with final clinical diagnoses [13]. However, there are no data on the accuracy of the test for diagnosing dementia in a primary care setting in Sweden.…”

Cognitive impairment and its consequences in everyday life

“…Earlier research (Johansson and Wressle, 2012, Lamarre and Patten, 1994, Fields et al, 1992 supports our finding that the sensitivity of Cognistat was higher than that of the MMSE, but the relatively high specificity is more prominent in this study group than in earlier research, which suggests that Cognistat would be useful in primary care settings. In comparison with MMSE and CDT combined, Cognistat is more sensitive with the same specificity and a slightly higher PPV.…”

Association between oral health, cognitive impairment and oral health–related quality of life

“…As we were not aware of other studies on this issue, then, well‐designed studies had to be carried out in this field. Instruments for measuring OH‐QoL are not for cognitively impaired people because of changes in their memory, learning ability, attention, orientation and comprehension 12 . People presenting MCI may have normal lives and even be independent.…”