A comparative study on the validations of three cognitive screening tests in identifying subtle cognitive decline

Area of Science:

• Neuroscience
• Gerontology
• Cognitive Psychology

Background:

• Subtle cognitive decline (SCD) represents an early stage of cognitive impairment preceding mild cognitive impairment (MCI).
• Early detection of SCD is critical for dementia prevention and therapeutic interventions.
• This study evaluates the efficacy of three cognitive screening tests in identifying SCD.

Purpose of the Study:

• To compare the validation of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment-Chinese Version (MoCA-CV), and Memory and Executive Screening (MES) in detecting subtle cognitive decline.
• To assess the diagnostic accuracy of these screening tests in differentiating individuals with SCD from cognitively normal controls and those with MCI.

Main Methods:

• Recruited 407 participants: 147 cognitively normal (NC), 102 with SCD, and 158 with MCI.
• Administered comprehensive neuropsychological tests and the three screening tests (MMSE, MoCA-CV, MES).
• Utilized Chi-square analysis and Receiver Operating Characteristic (ROC) curves to compare cognitive performance and evaluate test discrimination.

Main Results:

• SCD individuals showed memory decline (AVLT, CFT, PrM), while MCI individuals exhibited decline across all cognitive domains.
• MMSE, MoCA-CV, and MES scores showed a significant progressive decline from NC to SCD to MCI groups.
• MES demonstrated superior performance in discriminating SCD from NC, with an Area Under the Curve (AUC) of 0.738, compared to MMSE (AUC=0.643) and MoCA-CV (AUC=0.644).

Conclusions:

• The Memory and Executive Screening (MES) test is a more efficacious screening tool for identifying subtle cognitive decline compared to MMSE and MoCA-CV.
• MES offers better sensitivity and specificity in distinguishing individuals with early-stage cognitive decline from those who are cognitively normal.
• These findings support the use of MES for early detection of cognitive impairment, facilitating timely intervention for dementia prevention.