Dementia Care Research and Psychosocial Factors

Area of Science:

• Gerontology
• Cognitive Science
• Neurology

Background:

• The Free-Cog is a novel screening tool integrating cognitive and functional measures.
• Previous validation was against the Mini-Addenbrooke Cognitive Examination in UK secondary care.
• This study compares Free-Cog with MMSE and Lawton-Brody scales in Canadian Memory Clinics.

Purpose of the Study:

• To compare the Free-Cog screening tool with the Mini-Mental State Examination (MMSE) and Lawton-Brody Instrumental Activities of Daily Living (IADL) and Physical Self-maintenance Scales (PSMS).
• To assess the validity and reliability of Free-Cog in a Canadian population across different administration methods (in-person, telephone, video call).

Main Methods:

• Data from 308 patient visits in three Canadian Memory Clinics were analyzed.
• Pearson correlation assessed associations between Free-Cog, MMSE, IADL, and PSMS scores.
• Logistic regression and ROC curve analysis (AUROC) evaluated Free-Cog's ability to predict and discriminate dementia.

Main Results:

• Free-Cog scores showed strong correlation with MMSE (r=0.86) and moderate correlation with IADL (r=0.56).
• Free-Cog demonstrated superior discrimination of dementia cases (AUROC=0.86) compared to MMSE (0.73), IADL (0.69), and PSMS (0.59).
• All tested scales, including Free-Cog, were significantly associated with decreased odds of dementia.

Conclusions:

• The Free-Cog test is a valid alternative for dementia screening compared to MMSE and Lawton-Brody scales.
• The study highlights the need for larger sample sizes to confirm the effectiveness of remote Free-Cog administration and explore sex-specific differences.