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A novel hybrid scale for the assessment of cognitive and executive function: The Free‐Cog
Author(s) -
Burns Alistair,
Harrison Judith R.,
Symonds Catherine,
Morris Julie
Publication year - 2021
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.5454
Subject(s) - cog , montreal cognitive assessment , dementia , cognition , receiver operating characteristic , psychology , scale (ratio) , cognitive test , medicine , clinical psychology , psychiatry , cognitive impairment , computer science , disease , artificial intelligence , physics , quantum mechanics
Abstract Background Scales measuring cognitive and executive functions are integral to the assessment and management of patients with suspected cognitive impairment. Some of the most commonly used cognitive tests are now subject to copyright restrictions. Furthermore, no existing scale assesses both executive and cognitive abilities. Aims We aimed to develop and validate a novel hybrid scale for use in clinical practice which integrate measures of cognition and executive abilities (‘Free‐Cog’). Methods The instrument was devised through a national collaboration including health professionals, those with lived experience of dementia and researchers. Following ethics committee approval, the Free‐Cog was assessed in 25 real‐world clinical settings across England, Wales and Scotland. It was compared to three other cognitive tests routinely administered in clinical practice: the Mini‐Mental State Examination (MMSE), the Montreal Cognitive Assessment (MOCA), and the Addenbrooke's Cognitive Examination (ACE). Results The Free‐Cog was tested in 960 patients with clinical diagnoses of dementia, Mild Cognitive Impairment (MCI), and normal controls. Similar to the MMSE, MOCA and ACE, it discriminated well between the three groups ( p < 0.001). It correlated well with the other instruments. Using a receiver operating characteristic curve analysis, Free‐Cog achieved an Area Under Curve of 0.94 for dementia versus controls, 0.80 for MCI versus controls and 0.77 for dementia versus MCI. A version of the tool adapted for telephone consultation, the Tele Free‐Cog, also discriminated well between patient groups. Conclusions Free‐Cog is a non‐proprietary, empirically derived, concise assessment. Uniquely, it combines cognitive and executive function questions in the one instrument. It could be used to inform the assessment of people presenting with cognitive impairment and is available to anyone interested in trialling it.