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[O2‐05‐02]: The CANS‐MCI: Self‐administered screening for mild cognitive impairment
Author(s) -
Hill Emory,
Tornatore Jane B.,
Laboff Jo Anne,
Fogel Brian
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.2005.06.359
Subject(s) - confirmatory factor analysis , neuropsychology , usability , psychology , dementia , test (biology) , cognition , clinical psychology , neuropsychological test , cognitive impairment , neuropsychological assessment , medicine , psychiatry , statistics , structural equation modeling , computer science , paleontology , mathematics , disease , human–computer interaction , biology
Background: The Computer-Administered Neuropsychological Screen for Mild Cognitive Impairment (CANS-MCI) was developed to be uniquely usable in clinicians’ offices where staff time is precious, and for a specific purpose--the earliest detection of mild cognitive impairment (MCI). It is fully automated for user-friendly test administration as well as scoring. Objective: To demonstrate the utility and validity of the CANS-MCI as a screening measure for MCI. Methods: 290 elderly community-dwelling volunteers enrolled in a 3-year longitudinal NIA-funded study. Confirmatory factor analysis was performed on a sub-sample of study participants (N 116) as were ROC curve analyses with those who received full neuropsychological evaluations (N 84). Conclusions: The usability and validity of the CANS-MCI were supported. Previous to the test administration, 48% of the usability subjects reported that they were at least “somewhat” afraid of not knowing what to do on the computer. However, prior computer experience bore no relationship to satisfaction scores after test completion. Furthermore, over 96% of the subjects, including those with dementia, completed all tests without assistance of any kind. Factor analysis confirmed a 3-factor model (Fluency, Executive Functioning, and Memory), indicating that the tests measure the intended cognitive dimensions. The factor loadings in the confirmatory analysis were all significant and ranged from .55-.96; goodness of fit indicators were strong (Bentler Comparative Fit Index .99; Root Mean Square Error of Approximation .038). For sensitivity percentages ranging between 82-85%, specificity scores ranged from 73-87%. The CANS-MCI is an easily administered, robust screening tool measuring all cognitive dimensions that predict whether professional testing for early cognitive impairment is recommended. Analyses indicate exceptional usability, respectable levels of validity, and the ability to determine the need for full diagnostic evaluation of cognitive impairment by longitudinally measuring cognitive abilities. Unlike other full testing batteries, the CANS-MCI is brief with respect to all staff time required for administration, scoring, and staff training. The CANS-MCI also considers contextual factors, and will be available in culture-specific versions with translated reports.