Enhancing early detection of mild cognitive impairment: Development and validation of a culturally adapted scale for...

Mild cognitive impairment (MCI) scales are crucial for early screening. However, widely used Western MCI scales face cultural barriers in China, potentially compromising assessment accuracy. Culturally adapted MCI scales for Chinese older adults are still lacking. This study aimed to develop and validate a culturally adapted MCI scale for Chinese older adults.

The study comprised two phases. Phase 1 (Scale Development): The Chinese Elderly Mild Cognitive Impairment Assessment Scale (CMCI) was developed by generating an initial item pool via literature review and semi-structured interviews, refining items through two-round Delphi expert consultation, and optimizing the scale via pilot testing. Phase 2 (Scale Validation, n = 2271): Reliability was assessed using internal consistency and test-retest reliability. Validity was evaluated via criterion-related validity (against the Montreal Cognitive Assessment scale) and construct validity. The screening efficacy was examined by constructing the receiver operating characteristic curve.

The final 13-item CMCI, structured into five dimensions, demonstrated strong psychometric properties: internal consistency (Cronbach's α = 0.881), test-retest reliability (r = 0.892, p < 0.01), and criterion-related validity (r = 0.824, p < 0.01). Exploratory factor analysis analyses supported a five-factor model (54.726% variance), with confirmatory factor analysis confirming good fit. The scale showed effective discrimination between MCI and healthy individuals (AUC = 0.83, 95% CI: 0.81-0.85; sensitivity = 69.6%; specificity = 89.6%).

This study provided a culturally adapted scale for Chinese older adults that serves as a reliable and validated scale for screening MCI, facilitating early screening and intervention to promote cognitive health.