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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Validation of the Dutch version of the quick mild cognitive impairment screen (Qmci-D)
Steven Bunt1, Rónán O'Caoimh2,3, Wim P Krijnen4
1Research group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Eyssoniusplein 18, P.O. Box 30030, 9700, RM, Groningen, The Netherlands. s.bunt@pl.hanze.nl.
Background:
Differentiating mild cognitive impairment (MCI) from dementia is important, as treatment options differ. There are few short (<5 min) but accurate screening tools that discriminate between MCI, normal cognition (NC) and dementia, in the Dutch language. The Quick Mild Cognitive Impairment (Qmci) screen is sensitive and specific in differentiating MCI from NC and mild dementia. Given this, we adapted the Qmci for use in Dutch-language countries and validated the Dutch version, the Qmci-D, against the Dutch translation of the Standardised Mini-Mental State Examination (SMMSE-D).
Method:
The Qmci was translated into Dutch with a combined qualitative and quantitative approach. In all, 90 participants were recruited from a hospital geriatric clinic (25 with dementia, 30 with MCI, 35 with NC). The Qmci-D and SMMSE-D were administered sequentially but randomly by the same trained rater, blind to the diagnosis.
Results:
The Qmci-D was more sensitive than the SMMSE-D in discriminating MCI from dementia, with a significant difference in the area under the curve (AUC), 0.73 compared to 0.60 (p = 0.024), respectively, and in discriminating dementia from NC, with an AUC of 0.95 compared to 0.89 (p = 0.006). Both screening instruments discriminated MCI from NC with an AUC of 0.86 (Qmci-D) and 0.84 (SMMSE-D).
Conclusion:
The Qmci-D shows similar,(good) accuracy as the SMMSE-D in separating NC from MCI; greater,(albeit fair), accuracy differentiating MCI from dementia, and significantly greater accuracy in separating dementia from NC. Given its brevity and ease of administration, the Qmci-D seems a useful cognitive screen in a Dutch population. Further study with a suitably powered sample against more sensitive screens is now required.
Insights
The Dutch Quick Mild Cognitive Impairment (Qmci-D) screen effectively differentiates dementia from normal cognition and mild cognitive impairment (MCI). This brief tool shows promise for cognitive screening in Dutch populations.
Area of Science:
- Neurology
- Geriatrics
- Cognitive Science
Background:
- Differentiating mild cognitive impairment (MCI) from dementia is crucial due to differing treatment options.
- Accurate, brief (<5 min) cognitive screening tools are limited in the Dutch language.
- The Quick Mild Cognitive Impairment (Qmci) screen is a validated tool for differentiating MCI from normal cognition (NC) and mild dementia.
Purpose of the Study:
- To adapt and validate the Qmci screen for Dutch-language use (Qmci-D).
- To compare the diagnostic accuracy of the Qmci-D against the Dutch Standardised Mini-Mental State Examination (SMMSE-D).
Main Methods:
- The Qmci was translated into Dutch using a mixed qualitative and quantitative approach.
- 90 participants (25 dementia, 30 MCI, 35 NC) were recruited from a hospital geriatric clinic.
- Qmci-D and SMMSE-D were administered sequentially by a single, trained rater blinded to diagnosis.
Main Results:
- Qmci-D showed significantly higher AUC than SMMSE-D in discriminating MCI from dementia (0.73 vs. 0.60, p=0.024).
- Qmci-D demonstrated significantly greater accuracy than SMMSE-D in differentiating dementia from NC (AUC 0.95 vs. 0.89, p=0.006).
- Both screens showed similar accuracy in discriminating MCI from NC (AUC 0.86 for Qmci-D, 0.84 for SMMSE-D).
Conclusions:
- The Qmci-D exhibits comparable accuracy to SMMSE-D in separating NC from MCI.
- Qmci-D offers greater accuracy in differentiating MCI from dementia and significantly higher accuracy in separating dementia from NC.
- The Qmci-D is a potentially valuable, brief cognitive screening tool for the Dutch population, warranting further investigation.
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