Abstract
BackgroundScreening for cognitive impairment (CI) is often hampered by lack of consensus as to which screening instrument to use. The aim is to assess the consistence and applicability of different CI screening tools.MethodIn a cross-sectional study from October 2017 to September 2018 in 7 communities in Shanghai, China, elder (≧60) residential volunteers with no history of major cardiovascular diseases, cancers and other comorbidities known to affect cognitive functions were recruited. The participants underwent tests with 7 cognitive function screening instruments. Multivariate linear regressions were performed to test correlations between demographic characteristics, including gender, age, education, and marital status, with cognitive test scores. Mini-Mental State Examination (MMSE) score adjusted according to the correlation coefficients was used to detect CI with a cutoff of 24. Other cognitive function scores were compared between participants with and without CI. In addition, Pearson’s correlation test was used to detect association between different test scores.Results172 participants with relatively low education levels were included. Age and education showed significant association with cognitive test scores. Using adjusted MMSE, 39.6% of participants were identified with CI, while the percentage was 87.2% when adjusted Montreal Cognitive Assessment (MoCA) with cutoff of 26 was used. Analysis of “abnormal” test scores showed that MMSE had the highest percentage of valid data (98.8%). MoCA and Isaacs test of Verbal Fluency (VF) score had correlation with most the other scores, while MMSE only significantly associated with VF and MoCA.ConclusionsMMSE may still present the most applicable tools for quick screen of cognitive functions, especially when environmental conditions may interfere with participants’ attention.
Highlights
Screening for cognitive impairment (CI) is often hampered by lack of consensus as to which screening instrument to use
Using adjusted Mini-Mental State Examination (MMSE), 39.6% of participants were identified with CI, while the percentage was 87.2% when adjusted Montreal Cognitive Assessment (MoCA) with cutoff of 26 was used
Analysis of “abnormal” test scores showed that MMSE had the highest percentage of valid data (98.8%)
Summary
Screening for cognitive impairment (CI) is often hampered by lack of consensus as to which screening instrument to use. Aging was the most important risk factor of dementia and senile cognitive impairment has emerged as one of the major public health challenges [1, 2]. The importance of CI has been well recognized, rarely an accurate estimation of CI prevalence is available in a clinical study. China has the largest population of patients with dementia, there lacks accurate estimation of prevalence and incidence, impeding the effective care [6]. The applicability and accuracy of instruments for screening and diagnosis of CI may be an important cause. Routine screening for cognitive impairment is often hampered by time constraints, poor knowledge of screening instruments and lack of consensus as to which screening tool is best
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