P3–222: Detection of mild cognitive impairment and early‐stage dementia with an audio‐recorded cognitive scale
Year: 2013
Type: article
Study design: Observational Study
Abstract: Primary care physicians often miss a diagnosis of Mild Cognitive Impairment (MCI) or early dementia and screening measures can be insensitive to very mild impairments. Other cognitive assessments may take too much time or be unacceptable or frustrating to seniors. This study examined the ability of an audio-recorded scale, developed in Australia, to detect MCI or mild Alzheimer's disease (AD) and compared cognitive domain specific performance on the audio-recorded scale to the in-person battery and common cognitive screens. Seventy-six subjects from the Mount Sinai Alzheimer's Disease Research Center were recruited. Subjects were 75 years or older, with a clinical diagnosis of AD or MCI (n=51) or normal control (n=25). Participants underwent in-person testing with the neuropsychological testing battery followed within six months by testing with the Audio-recorded Cognitive Screen (ARCS). The ARCS is administered using a compact-disk recorder and headphones, with the subject writing responses in a booklet. The ARCS provided better discrimination between normal and impaired elders than the Mini-Mental Status Exam (MMSE), the clock drawing test or the two combined. The in-person battery and ARCS analogous variables were significantly correlated, most in the .4 to .7 range, including verbal memory, executive function/attention, naming, and verbal fluency. The area under the curve generated from ROC curves indicated high and equivalent diagnostic discrimination for ARCS and the in-person battery (0.972 vs. 0.988; p=0.23). The ARCS demonstrated better discrimination between normal controls and those with mild cognitive deficits than typical screening measures. Performance on cognitive domains within the ARCS was well correlated with the in-person cognitive test battery. Successful completion of the ARCS was accomplished despite mild difficulty hearing the instructions even in very elderly subjects. The ARCS, which can be administered to unsupervised patients by untrained personnel, represents something of a “hybrid” instrument: longer than typical screening measures and shorter than a standard neuropsychological battery, indicating that it may be a useful measure in primary care settings.
Source: Alzheimer s & Dementia
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2320912397