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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

Screening for cognitive dysfunction in systemic lupus erythematosus: the Montreal Cognitive Assessment Questionnaire

N E Chalhoub¹, M E Luggen¹

¹Division of Immunology, Allergy, and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, USA.

|November 29, 2018

Abstract

Background:

Cognitive dysfunction (CD) is among the most common neuropsychiatric manifestations of systemic lupus erythematosus (SLE). Traditional neuropsychological testing and the Automated Neuropsychologic Assessment Metrics (ANAM) have been used to assess CD but neither is an ideal screening test. The Montreal Cognitive Assessment Questionnaire (MoCA) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) are brief and inexpensive tests. This study evaluated the MoCA and IQCODE as screening tools.

Methods:

SLE patients fulfilling American College of Rheumatology (ACR) classification criteria were evaluated using the ANAM as the reference standard. The performance characteristics of the MoCA and IQCODE were assessed in comparison with normal controls (NCs) and rheumatoid arthritis (RA) patients. Four different definitions of CD were utilized.

Results:

In total, 78 patients were evaluated. MoCA and ANAM scores were significantly correlated ( r = 0.51, p < 0.001). At the optimal cutoff, the sensitivity of the MoCA was ≥ 90% (depending on definition of CD) vs RA patients and ≥83% vs NCs. ANAM and IQCODE scores did not correlate ( p = 0.8152). IQCODE sensitivities were low for both RA patients and NCs regardless of definition and cutoff used.

Conclusion:

The MoCA appears to be a promising and practical screening tool for identification of patients with SLE at risk for CD.

Keywords:

Informant Questionnaire on Cognitive Decline in the Elderly Montreal Cognitive Assessment Questionnaire Neuropsychiatric lupus cognitive dysfunction systemic lupus erythematosus

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