Abstract
BackgroundCognitive frailty describes cognitive impairment associated with physical decline. Few studies have explored whether short cognitive screens identify frailty. We examined the diagnostic accuracy of the Chinese versions of the Quick Mild Cognitive Impairment (Qmci-CN) screen and Montreal Cognitive Assessment (MoCA-CN) in identifying cognitive frailty.MethodsNinety-five participants with cognitive symptoms [47 with mild cognitive impairment (MCI), 34 with subjective cognitive disorder, and 14 with dementia] were included from two outpatient rehabilitation clinics. Energy (work intensity) and physical activity levels were recorded. Cognitive frailty was diagnosed by an interdisciplinary team using the IANA/IAGG consensus criteria, stratified on the Clinical Frailty Scale (CFS). Instruments were administered sequentially and randomly by trained assessors, blind to the diagnosis.ResultsThe mean age of the sample was 62.6 ± 10.2 years; median CFS score was 4 ± 1 and 36 (38%) were cognitively frail. The Qmci-CN had similar accuracy in differentiating the non-frail from cognitively frail compared to the MoCA-CN, AUC 0.82 versus 0.74, respectively (p = 0.19). At its optimal cut-off (≤55/100), the Qmci-CN provided a sensitivity of 83% and specificity of 67% versus 91% and 51%, respectively, for the MoCA-CN (≤23/30). Neither was accurate in separating MCI from cognitive frailty but both accurately separated cognitive frailty from dementia.ConclusionEstablished short cognitive screens may be useful in identifying cognitive frailty in Chinese adults with cognitive complaints but not in separating MCI from cognitive frailty. The Qmci-CN had similar accuracy to the MoCA-CN and a shorter administration time in this small and under-powered study, necessitating the need for adequately powered studies in different healthcare settings.
Highlights
Cognitive frailty describes cognitive impairment associated with physical decline
We explore the ability of short cognitive screening instruments to identify cognitive frailty as defined by the International Academy on Nutrition and Aging (IANA)/International Association of Gerontology and Geriatrics (IAGG) consensus criteria (Kelaiditi et al, 2013), showing that while both the newly translated Quick Mild Cognitive Impairment (Qmci)-CN and established Montreal Cognitive Assessment (MoCA)-CN are able to differentiate cognitive frailty from nonfrail individuals and those with dementia, neither instrument was accurate in separating mild cognitive impairment (MCI) from cognitive frailty in an outpatient rehabilitation setting in China
We examined the diagnostic accuracy of the Qmci screen (Qmci-CN) against the MoCA-CN in separating those presenting with cognitive complaints, showing that the Qmci-CN’s ability to distinguish MCI from subjective cognitive disorder (SCD) or dementia in this sample was good to excellent but that the time taken to complete it was significantly shorter, which is convenient in a rehabilitation clinic setting
Summary
Cognitive frailty describes cognitive impairment associated with physical decline. The prevalence of cognitive impairment, both mild cognitive impairment (MCI) (Ward et al, 2012) and dementia (Prince et al, 2013), are increasing worldwide and are associated with the clinical syndrome of frailty (Wallace et al, 2019), its physical phenotype (Ma et al, 2019). The International Academy on Nutrition and Aging (IANA) and International Association of Gerontology and Geriatrics (IAGG) recently published consensus criteria identifying cognitive frailty as the presence of physical frailty and cognitive impairment [MCI as defined by a Clinical Dementia Rating scale (CDR) score of 0.5], where dementia has been excluded (Kelaiditi et al, 2013)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
