Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression
Short but accurate cognitive screening instruments are required in busy clinical practice. Although widely-used, the diagnostic accuracy of the standardised Mini-Mental State Examination (SMMSE) in different dementia subtypes remains poorly characterised. We compared the SMMSE to the Quick Mild Cogn...
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| Format: | Article |
| Language: | English |
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MDPI AG
2019-08-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/9/3/93 |
| _version_ | 1817993583695757312 |
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| author | Rónán O’Caoimh D. William Molloy |
| author_facet | Rónán O’Caoimh D. William Molloy |
| author_sort | Rónán O’Caoimh |
| collection | DOAJ |
| description | Short but accurate cognitive screening instruments are required in busy clinical practice. Although widely-used, the diagnostic accuracy of the standardised Mini-Mental State Examination (SMMSE) in different dementia subtypes remains poorly characterised. We compared the SMMSE to the Quick Mild Cognitive Impairment (Q<i>mci</i>) screen in patients (<i>n</i> = 3020) pooled from three memory clinic databases in Canada including those with mild cognitive impairment (MCI) and Alzheimer’s, vascular, mixed, frontotemporal, Lewy Body and Parkinson’s dementia, with and without co-morbid depression. Caregivers (<i>n</i> = 875) without cognitive symptoms were included as normal controls. The median age of patients was 77 (Interquartile = ±9) years. Both instruments accurately differentiated cognitive impairment (MCI or dementia) from controls. The SMMSE most accurately differentiated Alzheimer’s (AUC 0.94) and Lewy Body dementia (AUC 0.94) and least accurately identified MCI (AUC 0.73), vascular (AUC 0.74), and Parkinson’s dementia (AUC 0.81). The Q<i>mci</i> had statistically similar or greater accuracy in distinguishing all dementia subtypes but particularly MCI (AUC 0.85). Co-morbid depression affected accuracy in those with MCI. The SMMSE and Q<i>mci</i> have good-excellent accuracy in established dementia. The SMMSE is less suitable in MCI, vascular and Parkinson’s dementia, where alternatives including the Q<i>mci</i> screen may be used. The influence of co-morbid depression on scores merits further investigation. |
| first_indexed | 2024-04-14T01:40:48Z |
| format | Article |
| id | doaj.art-e7bbfd79d907437d8549160c1d914b36 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-04-14T01:40:48Z |
| publishDate | 2019-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-e7bbfd79d907437d8549160c1d914b362022-12-22T02:19:45ZengMDPI AGDiagnostics2075-44182019-08-01939310.3390/diagnostics9030093diagnostics9030093Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical DepressionRónán O’Caoimh0D. William Molloy1Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr’s Hospital, Douglas road, T12 XH60 Cork City, IrelandCentre for Gerontology and Rehabilitation, University College Cork, St Finbarr’s Hospital, Douglas road, T12 XH60 Cork City, IrelandShort but accurate cognitive screening instruments are required in busy clinical practice. Although widely-used, the diagnostic accuracy of the standardised Mini-Mental State Examination (SMMSE) in different dementia subtypes remains poorly characterised. We compared the SMMSE to the Quick Mild Cognitive Impairment (Q<i>mci</i>) screen in patients (<i>n</i> = 3020) pooled from three memory clinic databases in Canada including those with mild cognitive impairment (MCI) and Alzheimer’s, vascular, mixed, frontotemporal, Lewy Body and Parkinson’s dementia, with and without co-morbid depression. Caregivers (<i>n</i> = 875) without cognitive symptoms were included as normal controls. The median age of patients was 77 (Interquartile = ±9) years. Both instruments accurately differentiated cognitive impairment (MCI or dementia) from controls. The SMMSE most accurately differentiated Alzheimer’s (AUC 0.94) and Lewy Body dementia (AUC 0.94) and least accurately identified MCI (AUC 0.73), vascular (AUC 0.74), and Parkinson’s dementia (AUC 0.81). The Q<i>mci</i> had statistically similar or greater accuracy in distinguishing all dementia subtypes but particularly MCI (AUC 0.85). Co-morbid depression affected accuracy in those with MCI. The SMMSE and Q<i>mci</i> have good-excellent accuracy in established dementia. The SMMSE is less suitable in MCI, vascular and Parkinson’s dementia, where alternatives including the Q<i>mci</i> screen may be used. The influence of co-morbid depression on scores merits further investigation.https://www.mdpi.com/2075-4418/9/3/93dementiamild cognitive impairmentscreeningaccuracystandardised mini-mental state examinationquick mild cognitive impairment screen |
| spellingShingle | Rónán O’Caoimh D. William Molloy Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression Diagnostics dementia mild cognitive impairment screening accuracy standardised mini-mental state examination quick mild cognitive impairment screen |
| title | Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression |
| title_full | Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression |
| title_fullStr | Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression |
| title_full_unstemmed | Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression |
| title_short | Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression |
| title_sort | comparing the diagnostic accuracy of two cognitive screening instruments in different dementia subtypes and clinical depression |
| topic | dementia mild cognitive impairment screening accuracy standardised mini-mental state examination quick mild cognitive impairment screen |
| url | https://www.mdpi.com/2075-4418/9/3/93 |
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