Alabama Brief Cognitive Screener scores correlate proportionally with MoCA and DRS‐2 scores and vary appropriately by diagnosis

Abstract

AbstractBackgroundThe Alabama Brief Cognitive Screener (ABCs) was developed as a nonproprietary replacement for the MMSE (Mini‐Mental State Examination) in order to screen for cognitive deficits. It requires 5‐10 minutes to complete and participants can score up to 30 points.MethodTo assess the clinical correspondence of Alabama Brief Cognitive Screener (ABCs) scores relative to both the Montreal Cognitive Assessment (MoCA) and Dementia Rating Scale (DRS‐2) and also compare score differences by education attainment and the subject’s clinical diagnosis‐ of either Normal Cognition (NC), Mild Cognitive Impairment (MCI), or Dementia. Participants from the UAB Alzheimer’s Disease Center (ADC) from 2018 to 2022 were analyzed retrospectively. The ABCs, MoCA, and DRS‐2 were administered at the initial visit to subjects (n = 116) and their scores were compared to each other using Spearman’s rank correlation along with their clinical diagnosis which included NC (n = 47), MCI (n = 41) and Dementia (n = 28) and their previous education using the Kruskal‐Wallis test.ResultMedian scores for all three assessments were found to be associated with clinical diagnosis (MoCA: χ2 = 62.3, p = <.0001; ABCs: χ2 = 51.3, p = <.0001; DRS‐2: χ2 = 56.5, p = <.0001) and education level (MoCA: χ2 = 24.8 p = <.0001; ABCs: χ2 = 18.1, p = 0.0001; DRS‐2: χ2 = 11.15, p = 0.0038). Cognitive differences observed higher scores in the cognitively unimpaired relative to either MCI or subjects with dementia and in subjects with college or graduate degrees compared to those with only a high school education. Strong correspondence was observed between all assessments with significant correlations for all pairwise comparisons (MoCA v ABCs: ρ = 0.73; MoCA v DRS‐2: ρ = 0.72; ABCs v DRS‐2: ρ = 0.61, p = <.0001). When comparing sub‐types of the ABCs and DRS‐2, significant correlations were observed in the domains of memory (ρ = 0.61, p<0.001), attention (ρ = 0.26, p = 0.0054), construction (ρ = 0.37, p<0.001), and conceptualization (ρ = 0.30, p = 0.011).ConclusionABCs correlates proportionally with MoCA and DRS‐2 scores while also varying appropriately by diagnosis. ABCs shows promise as a non‐proprietary alternative to the MMSE for use as a screening instrument to identify and assess severity of cognitive deficits in medical practice, as well as measure progression of those deficits in patients with neurodegenerative disease.