Related Experiment Videos
Screening for mild cognitive impairment (MCI) utilizing combined mini-mental-cognitive capacity examinations for
Gelin Xu1, John S Meyer, John Thornby
1Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.
Objective:
To test correctness of results when combining Mini-Mental State Examination (MMSE) and Cognitive Capacity Screening Examination (CCSE) for identifying mild cognitive impairment (MCI) among non-demented elderly subjects at risk for developing dementia.
Methods:
A retrospective study was conducted among consecutively referred volunteers with memory complaints to a research out-patient clinic. Two cognitive screening tests (MMSE and CCSE) were performed according to established protocol. Resulting combined screening test (termed by acronym as CMC) combined the non-overlapping test items derived from both MMSE and CCSE. Conversion to dementia at follow-up served as the 'gold-standard' for evaluating correctness of CMC for identifying MCI.
Results:
Of 351 subjects completing cognitive assessments and meeting requirements for study protocol, 84 (23.9%) developed dementia of different types within 3-6 years (3.89 +/- 2.17) of follow-up. Among these, 47 met criteria for probable Alzheimer disease (AD), 22 for probable vascular dementia (VaD), 12 for mixed AD/VaD and three for probable frontotemporal dementia. When final diagnosis of AD was used as the 'gold standard' for testing correctness of MCI identified by cognitive screening tests, sensitivities of MMSE, CCSE and CMC for identifying MCI were relatively 61.0%, 74.3% and 83.1% with minimum specificity set at 80%. When diagnosis of all types of dementia was used as the standard for testing predictive correctness of MCI, CCSE emerged as an optimal MCI screening test.
Conclusion:
Combining the CCSE and MMSE screening tests resulted in higher sensitivity than was achieved by MMSE alone and maintained specificity at comparable levels for identifying MCI. The results confirmed that CMC has optimal correctness and utility as a brief cognitive test for screening MCI as a prodrome for dementia among non-demented elderly populations.
Insights
Combining the Cognitive Capacity Screening Examination (CCSE) and Mini-Mental State Examination (MMSE) created a combined test (CMC) that accurately identifies mild cognitive impairment (MCI) in elderly individuals at risk for dementia.
Area of Science:
- Neurology
- Geriatrics
- Cognitive Science
Background:
- Mild cognitive impairment (MCI) is an early indicator of dementia in elderly populations.
- Early identification of MCI is crucial for timely intervention and management of dementia progression.
Purpose of the Study:
- To evaluate the accuracy of a combined cognitive screening test (CMC) derived from the Mini-Mental State Examination (MMSE) and Cognitive Capacity Screening Examination (CCSE).
- To assess the CMC's effectiveness in identifying MCI among non-demented elderly individuals at high risk for dementia.
Main Methods:
- A retrospective study analyzed data from 351 elderly volunteers with memory complaints.
- Two cognitive screening tests, MMSE and CCSE, were administered.
- A novel combined screening test (CMC) was developed by integrating non-overlapping items from MMSE and CCSE.
- Conversion to dementia at follow-up served as the gold standard for evaluating MCI identification accuracy.
Main Results:
- Of 351 participants, 84 (23.9%) developed dementia within 3-6 years.
- The combined CMC test demonstrated a sensitivity of 83.1% for identifying MCI when Alzheimer's disease was the gold standard, outperforming MMSE (61.0%) and CCSE (74.3%).
- CCSE emerged as an optimal screening test when all dementia types were considered.
Conclusions:
- The combined CCSE and MMSE (CMC) test offers higher sensitivity for MCI detection compared to MMSE alone, while maintaining comparable specificity.
- The CMC test is a valid and efficient tool for screening MCI as a prodromal stage of dementia in elderly populations.