In:
International Journal of Geriatric Psychiatry, Wiley, Vol. 31, No. 1 ( 2016-01), p. 4-12
Abstract:
A screening strategy composed of three‐item temporal orientation and three‐word recall has been increasingly used for detecting cognitive impairment. However, the intervening task administered between presentation and recall has varied. We evaluated six brief tasks that could be useful as intervening distractors and possibly provide incremental accuracy: serial subtraction, clock drawing, category fluency, letter fluency, timed visual detection, and digits backwards. Methods Older adults ( n = 230) consecutively referred for suspected cognitive impairment underwent a comprehensive assessment for gold‐standard diagnosis, of whom 56 (24%) presented cognitive impairment not dementia and 68 (30%) presented dementia. Among those with dementia, 87% presented very mild or mild stages (Clinical Dementia Rating 0.5 or 1). The incremental value of each candidate intervening task in a model already containing orientation and word recall was assessed. Results Category fluency (animal naming) presented the highest incremental value among the six candidate intervening tasks. Reclassification analyses revealed a net gain of 12% among cognitively impaired and 17% among normal participants. A four‐point scaled score of the animal naming task was added to three‐item temporal orientation and three‐word recall to compose the 10‐point Cognitive Screener. The education‐adjusted 10‐point Cognitive Screener outperformed the longer Mini‐Mental State Examination for detecting both cognitive impairment (area under the curve 0.85 vs 0.77; p = 0.027) and dementia (area under the curve 0.90 vs 0.83; p = 0.015). Conclusions Based on empirical data, we have developed a brief and easy‐to‐use screening strategy with higher accuracy and some practical advantages compared with commonly used tools. Copyright © 2015 John Wiley & Sons, Ltd.
Type of Medium:
Online Resource
ISSN:
0885-6230
,
1099-1166
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
1500455-7
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