Abstract
ObjectivesAs the population of patients with cognitive decline grows, physicians and caregivers need brief screening tools. Comprehensive neurocognitive batteries require special training and time for evaluation. We focused on accessibility and compared the diagnostic power of several easy questions.Design“Attended With” (AW) and “Head-Turning Sign” (HTS) factors and participants’ replies to following questions were recorded: “Do you feel that you have more difficulties in your daily life than you used to?”, [no consciousness (C-) or consciousness+ (C+)], “Could you tell me about your daily pleasures or pastimes?” [no pleasure (P-) or pleasure + (P+)], “What are notable current/recent news/topics?” [no news (N-) or news+ (N+)].SettingThis took place in our Memory Clinic between May 2016 and July 2019.ParticipantsWe enrolled 162 consecutive cases (44 cognitive normal (CN), 55 amnestic mild cognitive impairment (aMCI), and 48 Alzheimer’s disease (AD)).MeasurementsThe sensitivity and specificity of each battery were calculated, and on account of those numbers, the population attributable risk percent % (PAR%) of (AW and HTS+), (C- and P-), (C- and N-), (P- and N-) as analysis of combination of questions, respectively, were calculated.ResultsAW had high sensitivity, 87.4, 95.8% (CN vs aMCI + AD, CN + aMCI vs AD) but the sensitivity of HTS was only 46.4, 57.7%, and HTS showed high specificity, 100.0, 71.8%. C- had high sensitivity, 80.6, 87.5%, whereas P- and N- had high specificity, both 83.9% in CN vs aMCI + AD, 88.1% and 75.9% in CN + aMCI vs AD, respectively. In combination analysis, the PAR% of (C- and N-) were as high as (AW and HTS+).ConclusionsThe combination of (C- and N-) is as powerful as (AW and HTS+) in screening AD. Our findings provide novel insights for screening utility of brief questions “Consciousness of Impairment” and “Recent News.”
Highlights
The rate of memory loss is 41% among people aged 55–64 years and 52% among those aged 70–85 years [1]
Our findings provide novel insights for screening utility of brief questions “Consciousness of Impairment” and “Recent News.”
The Mini Mental State Examination (MMSE) is a brief examination to detect dementia, but it requires as long as ten minutes per patient and is reported to have low sensitivity, that is, a high rate of false negatives [8]
Summary
The rate of memory loss is 41% among people aged 55–64 years and 52% among those aged 70–85 years [1]. As the worldwide population grows older at an unprecedented rate, complaints of memory loss and cognitive disorder will be more and more common [2,3,4,5]. As more and more people develop cognitive dysfunction and most of them are not conscious of the fact that they are developing an illness [9, 10], prompt access to suitable medical care relies on primary physicians or caregivers who consult neurologists or psychiatrists, and more time-saving and easy assessment screening batteries are necessary. Soysal P. et al reported the effectiveness of AW and HTS as a marker of cognitive decline, especially focusing on older populations who are most likely to develop dementia [14]
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