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P3‐250: NORMATIVE DATA ON DEMENTIA SCREENING TESTS IN AN ELDERLY LEBANESE SAMPLE
Author(s) -
Zamrini Edward,
AbouMrad Fadi,
Duff Kevin,
Pasquier Florence,
Kawas Claudia,
Chelune Gordon,
Hayek Maryse,
Fadel Patricia
Publication year - 2014
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.2014.05.1341
Subject(s) - normative , dementia , memory span , verbal fluency test , percentile , cognition , psychology , boston naming test , montreal cognitive assessment , cognitive test , test (biology) , gerontology , audiology , clinical psychology , developmental psychology , medicine , psychiatry , cognitive impairment , disease , neuropsychology , working memory , statistics , paleontology , philosophy , epistemology , biology , mathematics , pathology
Background: Cognitive screening tools are useful in the diagnosis of dementia. Current screening tools are mostly developed in Western countries and are language dependent. Their use in multilingual societies necessitates multiple translations with the risk of altering the original psychometric properties and intent of the tool. Objective: To develop a novel brief visual cognitive screening tool based on visual information for multilingual societies. Methods: The VCAT was developed using a 5 step process. Based on results from 50 healthy elderly controls (HC), unambiguous and culturally neutral pictures were identified from the International Picture Naming Project (IPNP). Shortlisted pictures were then used to construct test items in the 5 cognitive domains. Test items were piloted on 30 HCs and 41 cognitively impaired (CI) subjects. The final test version was developed based on the pilot findings and ratings from subject matter experts (SMEs). A scoring system was developed using statistical weightage and clinical relevance. The final version was piloted on 28 HC and 25 CI subjects. Quantitative and qualitative differences with MMSE and MoCA were investigated. Results: 10 items were chosen from the initial 16 items. In the pilot testing, CI subjects performed significantly worse than HC in episodic memory [mean (SD):11.89 (1.07) vs 8.80 (2.84), p < 0.001]; semantic Language [3.39 (0.50) vs 2.76 (0.72), p1⁄4 0.001], visuospatial [2.82 (0.39) vs 2.12 (0.78), p < 0.001] and executive function [5.07 (1.49) vs 3.88 (1.64), p 1⁄4 0.005]. In the domain of attention/WM, the difference in performance was borderline significant [1.61 (1.10) vs 1.12 (1.27), p1⁄4 0.06]. AUC based on ROC analyses for the VCAT, MoCA and MMSE was 0.865, 0.863 and 0.791 respectively. A VCAT cut off of 22 out of 30 provided a sensitivity of 84.0% and specificity of 82.1%. Subjects’ qualitative responses demonstrated the VCAT to be simpler and friendlier compared to the MoCA. Conclusions: The VCAT, a visual based screening tool is potentially effective for the early diagnosis of dementia. The lack of requirement for translation and higher subjective preference by subjects over existing screening tools are its strengths. Validation in a larger cohort is currently ongoing.