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[O1‐05‐06]: The Q&E is more sensitive than the clock draw, mini‐cog, and 6‐item screener in the detection of mild Alzheimer s disease (AD)
Author(s) -
Dash Paul,
Troupin Allan,
Thomsen Jessica,
Knowlton Mary
Publication year - 2005
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2005.06.313
Subject(s) - mcnemar's test , dementia , medicine , audiology , cognitive impairment , alzheimer's disease , psychology , disease , statistics , mathematics
Background: Numerous micro-mental dementia screening tests, which take less than 5 minutes to administer, have been proposed as superior to the MMSE, but have never been directly compared for sensitivity in detecting mild AD. Examples include the mini-cog, 6-item screener, and clock draw tests. The Q&E, developed by Dr. Dash, is a 2-minute test that scores encoding, temporal orientation, category fluency, and recall. Objective(s): To compare the sensitivity of the Q&E to several other microscreening tests for detecting mild AD. Methods: In a convenience sample of 256 consecutive patients evaluated in Dr. Troupin’s memory clinic, the Q&E was administered along with the ACE (Addenbrooke’s Cognitive Examination). The MMSE, mini-cog, clock draw, and 6-item screener results can be extracted from the ACE. Patients were clinically diagnosed by Dr. Troupin as Alzheimer’s disease (AD), other dementia (OD), Mild cognitive impairment (MCI) or normal. AD patients were stratified by MMSE scores into Very Mild (27-30), Mild (21-26) and Overall Mild (21-30) categories. The sensitivities of the micro tests for detecting AD were compared using McNemar s test. Results: 109 Overall Mild AD patients (73 Mild, 36 Very Mild) were detected. The Q&E’s sensitivity (using a cut score of 3) was statistically superior to the other tests in the Overall Mild and Very Mild categories (Table 1). The Q&E’s superiority was particularly evident in the Very Mild category, i.e. those with normal MMSE scores. Because there were too few normal patients in this population, specificities could not be calculated, However, previous studies by Dr. Dash revealed an approximate 95% specificity in normal elderly using this Q&E cut score. In patients with OD and MCI, the Q&E was the most sensitive test, although the sample sizes were too small to reach statistical significance. There was a strong trend for the Q&E to be superior to the category fluency test (animals-in-a-minute) alone in the Overall and Very Mild groups. Conclusions: The Q&E has greater sensitivity than the other micro-screening tests for detecting AD in the earliest stages, when the MMSE is still normal. Additional studies to compare the Q&E to other screening tests are warranted.