Abstract
This study aims to develop a new evaluation method for quickly and conveniently screening cognitive impairment in the elderly. The five-minute cognitive test (FCT) was designed to capture deficits in five domains of cognitive abilities, including episodic memory, language fluency, time orientation, visuospatial function, and executive function. Subsequently, FCT efficiencies in differentiating normally cognitive ability from cognitive impairment were explored and compared with that of the Mini-Mental Status Evaluation (MMSE). Equipercentile equating method was utilized to create a crosswalk between scores of the FCT and MMSE. Further, the association of scores of the FCT and MMSE with hippocampal volumes was investigated. There were 241 subjects aged 60 years or above enrolled in this study, including 107 adults with cognitive abilities in normal range, 107 patients with mild cognitive impairment (MCI), and 27 patients with mild Alzheimer disease (AD). The AUC of FCT for detection of cognitive impairment (MCI and mild AD) was 0.885 (95% CI 0.838 to 0.922). The sensitivity and specificity of FCT for the diagnosis of cognitive impairment were 80.6% and 84.11 %, respectively. FCT’s diagnostic performance was superior to that of MMSE in the same cohort. Mean completion time of FCT was 339.9 ± 67.7 seconds (5-6 min). In addition, a conversion table between scores on the FCT and MMSE was created. Further, the FCT scores were positively correlated with hippocampal volumes. The FCT is a novel, reliable, and valid cognitive screening test for the detection of dementia at early stages.
Highlights
As old population is dramatically growing, the detection of early cognitive deficit will become increasingly crucial
The cognitive ability in normal range was defined as subjects having total 24 scores or above assayed by Mini-Mental State Examination (MMSE) [5] and 0 score of Clinical Dementia Rating (CDR)[14]
There was a total of 360 subjects, including 226 subjects with normal cognition, 107 subjects with mild cognitive impairment (MCI) and 27 patients with mild Alzheimer’s disease (AD)
Summary
As old population is dramatically growing, the detection of early cognitive deficit will become increasingly crucial. Despite the existence of numerous cognitive screening tools, several limitations need to be remedied [1, 2, 4], including low accuracy for diagnosing mild cognitive deficit [5-7] or a long time consumption [8-10]. Short questionnaires or highly selective tests may take less than 5 minutes to administrate [11, 12], multi-domain tests are the most useful tools for capturing deficits in a variety of cognitive domains, but typically at the cost of long administration time (usually > 10 minutes) [11]. Many screening tools are currently available but no tools meet the four important requirements for widespread use in clinical practice or large-scale epidemiological studies — that is, capture a clinically acceptable range of cognitive domains, take short time to administrate (around 5 minutes), have high accuracy for detecting cognitive impairment, and incorporate visual recall, which is the earliest deficits in Alzheimer’s disease (AD) patients [13]. We investigated the association of the FCT scores with hippocampal volumes in nondemented individuals
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