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Open Access 01-12-2020 | Alzheimer's Disease | Research article

A comparative study on the validations of three cognitive screening tests in identifying subtle cognitive decline

Authors: Feng-Feng Pan, Lin Huang, Ke-liang Chen, Qian-hua Zhao, Qi-hao Guo

Published in: BMC Neurology | Issue 1/2020

Abstract

Background

Subtle cognitive decline (SCD) may represent a very early stage of objective cognitive impairment before mild cognitive impairment (MCI), with less neuronal damage and more functional reservation. Detecting individuals with SCD is imperative for dementia prevention and treatment. In this study, we aimed to compare the validations of three cognitive screening tests, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment-Chinese Version (MoCA-CV), and Memory and Executive Screening (MES), in identifying subtle cognitive decline.

Methods

A total of 407 individuals were recruited, including 147 cognitively normal controls (NC), 102 individuals with subtle cognitive decline (SCD) and 158 individuals with mild cognitive impairment (MCI) according to the operational neuropsychological criteria proposed by Jak and Bondi’s. All participants underwent standardized comprehensive neuropsychological tests and the three cognitive screening tests. Chi-square analysis was used to compare the cognitive performance among the groups of NC, SCD and MCI. Receiver operating characteristic (ROC) curves were used to evaluate the abilities of MMSE, MoCA-CV and MES in discriminating NC, SCD and MCI.

Results

Compared with NC, SCD showed a significant decline only in the tests of memory, such as Auditory Verbal Learning Test (AVLT), Rey-Osterrieth Complex Figure Test (CFT) and Prospective Memory Test (PrM) (P < 0.01). However, MCI showed significant decline in all cognitive performances (P < 0.01). The scores of MMSE, MoCA-CV and MES all showed a progressive downward trend within the groups of NC, SCD and MCI (P < 0.001). In ROC Analyses for discriminating individuals with SCD from NC, the most appropriate MES cutoff was 84, with a sensitivity of 74.3%, a specificity of 60.8% and 0.738 for AUC (95%CI, 0.675–0.801). By contrast, MMSE and MOCA-CV had poor sensitivity (67.4 and 70.8%, respectively) and specificity (51.0 and 52.9%, respectively), and smaller AUCs (0.643 and 0.644, respectively) than the MES.

Conclusion

As a screening test, MES is more efficacious in identifying SCD from normal controls than MMSE and MoCA-CV.

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Title: A comparative study on the validations of three cognitive screening tests in identifying subtle cognitive decline
Authors: Feng-Feng Pan
Lin Huang
Ke-liang Chen
Qian-hua Zhao
Qi-hao Guo
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Alzheimer's Disease
Dementia
Alzheimer's Disease
Dementia
Mild Neurocognitive Disorder
Published in: BMC Neurology / Issue 1/2020
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-020-01657-9

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A comparative study on the validations of three cognitive screening tests in identifying subtle cognitive decline

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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