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BMC Geriatrics

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Open Access 01-12-2024 | Mild Neurocognitive Disorder | Research

Diagnostic accuracy of cognitive screening tools validated for older adults in Iran: a systematic review and meta-analysis

Authors: Leila Kamalzadeh, Gooya Tayyebi, Behnam Shariati, Mohsen Shati, Vahid Saeedi, Seyed Kazem Malakouti

Published in: BMC Geriatrics | Issue 1/2024

Abstract

Background

This systematic review aims to comprehensively assess the diagnostic accuracy of cognitive screening tools validated for older adults in Iran, providing evidence-based recommendations for clinicians and researchers.

Methods

A comprehensive search in March 2023 across Web of Science, PubMed, Scopus, ScienceDirect, SID, IranMedex, and IranDoc, enhanced by hand-searching references and Google Scholar, identified cross-sectional studies on cognitive screening in Iranian seniors. We assessed diagnostic accuracy, cognitive domains, and test strengths and weaknesses. A bivariate random-effects meta-analysis provided summary estimates and 95% confidence intervals, illustrated in forest plots.

Results

Our review, derived from an initial screening of 38 articles, focused on 17 studies involving 14 cognitive screening tools and participant counts from 60 to 350, mostly from specialized clinics. The MMSE was the only tool examined in at least three studies, prompting a meta-analysis revealing its sensitivity at 0.89 and specificity at 0.77 for dementia detection, albeit amidst significant heterogeneity (I^2 > 80%). ACE-III demonstrated the highest diagnostic accuracy for MCI and dementia, while MoCA’s performance was deemed adequate for MCI and excellent for dementia. High bias risk in studies limits interpretation.

Conclusion

This review identifies key cognitive tools for dementia and MCI in Iranian older adults, tailored to educational levels for use in primary and specialized care. It emphasizes the need for further validation to enhance diagnostic precision across diverse settings, within a concise framework prioritizing brevity and accuracy for clinical applicability.

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Title: Diagnostic accuracy of cognitive screening tools validated for older adults in Iran: a systematic review and meta-analysis
Authors: Leila Kamalzadeh
Gooya Tayyebi
Behnam Shariati
Mohsen Shati
Vahid Saeedi
Seyed Kazem Malakouti
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Mild Neurocognitive Disorder
Dementia
Dementia
Published in: BMC Geriatrics / Issue 1/2024
Electronic ISSN: 1471-2318
DOI: https://doi.org/10.1186/s12877-024-04963-w

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