Abstract
BackgroundCognitive screeners are imperative for early diagnosis of dementia. The Visual Cognitive Assessment Test (VCAT) is a language-neutral, visual-based test which has proven useful for a multilingual population in a single-center study. However, its performance utility is unknown in a wider and more diverse Southeast Asian cohort.MethodsWe recruited 164 healthy controls (HC) and 120 cognitively impaired (CI) subjects- 47 mild cognitive impairment (MCI) and 73 mild Alzheimer’s disease (AD) dementia participants, from four countries between January 2015 and August 2016 to determine the usefulness of a single version of the VCAT, without translation or adaptation, in a multinational, multilingual population. The VCAT was administered along with established cognitive evaluation.ResultsThe VCAT, without local translation or adaptation, was effective in discriminating between HC and CI subjects (MCI and mild AD dementia). Mean (SD) VCAT scores for HC and CI subjects were 22.48 (3.50) and 14.17 (5.05) respectively. Areas under the curve for Montreal Cognitive Assessment (0.916, 95% CI 0.884–0.948) and the VCAT (0.905, 95% CI 0.870–0.940) in discriminating between HCs and CIs were comparable. The multiple languages used to administer VCAT in four countries did not significantly influence test scores.ConclusionsThe VCAT without the need for language translation or cultural adaptation showed satisfactory discriminative ability and was effective in a multinational, multilingual Southeast Asian population.
Highlights
Cognitive screeners are imperative for early diagnosis of dementia
138 participants were recruited in Singapore from the National Neuroscience Institute Specialist Outpatient Memory Clinic and the Singapore Longitudinal Aging Study, 67 participants were recruited from the memory clinic of Hasan Sadikin Hospital in Indonesia, 40 participants were recruited from the Division of Geriatric Medicine, University of Malaya in Malaysia, and 39 participants were recruited from Asian Hospital & Medical Center and Manila East Medical Center in the Philippines
This study investigated the performance of the Visual Cognitive Assessment Test (VCAT) in a multinational, multilingual Southeast Asian cohort across healthy controls (HC) and cognitively impaired (CI) participants
Summary
Cognitive screeners are imperative for early diagnosis of dementia. The Visual Cognitive Assessment Test (VCAT) is a language-neutral, visual-based test which has proven useful for a multilingual population in a single-center study. Dementia prevalence is estimated to rise considerably across Asia [1,2,3], as the elderly population is projected to increase from the current 10% to 24% of the total Asian population by 2050 [4,5,6,7]. While most cognitive screeners were designed for English language speakers, translation and adaptation of these tools into Asian languages, useful, often result in alteration of their original neuropsychological and psychometric constructs. The lack of standardized cognitive screening tools across Asian countries [20] will prevent meaningful crosscultural comparisons and poses major challenges when conducting international clinical trials with cognition as outcome measures [21]
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