Cognitive Tests to Detect Mild Cognitive Impairment: A Systematic Review and Meta-analysis
Refereed conference paper presented and published in conference proceedings

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AbstractBackground:
Mild cognitive impairment (MCI) is prevalent and is a syndrome of increased risk for dementia. The Montreal Cognitive Assessment (MoCA) is designed for MCI detection, but many other cognitive tests are available for MCI screening. This study would evaluate the diagnostic performance of different cognitive tests for the detection of MCI.

Methods:
A list of cognitive tests was identified in previous reviews and from the online search engines. Literature searches were performed on each of the cognitive tests in MEDLINE, EMBASE, and PsycINFO from the earliest available dates stated in the individual databases until September 30, 2016. We also extended our search in Google Scholar as a supplementary search. Cross-sectional studies to assess the diagnostic performances of cognitive tests were extracted with the inclusion and exclusion criteria. The test performances were compared with standard diagnostic criteria. Bivariate random-effects models were used to summarize the test performances as a point estimate for sensitivity and specificity, and presented in a summary receiver-operating characteristic curve. Reporting quality and risk of bias were evaluated.

Results:
A total of 97 studies with 21,918 participants were identified to evaluate 9 cognitive tests for detection of MCI. Most studies used the MMSE (n=51) and the MoCA (n=31). The combined performance on MMSE for detection of MCI were 0.71 sensitivity (95% CI: 0.67-0.76) and 0.75 specificity (95% CI: 0.70-0.79). The combined performance on MoCA were 0.83 sensitivity (95% CI: 0.80-0.87) and 0.74 specificity (95% CI: 0.68-0.80). Among the other cognitive tests, the recall tests showed the best diagnostic performances with 0.89 sensitivity (95% CI, 0.84 - 0.93) and 0.83 specificity (95% CI, 0.76 – 0.88) (Figure 1). In subgroup analyses, the long or short delay recall tests are showed to be better than immediate recall tests.

Conclusions:
The MoCA showed better diagnostic performance than the MMSE in the detection of MCI. Although the recall tests only focused on memory functions, they demonstrated better diagnostic performance. Testing for memory functions is the most relevant domain for MCI screening.
All Author(s) ListKelvin Tsoi, Joyce Y. C. Chan, Hoyee W. Hirai, Adrian Wong, Vincent C. T. Mok, Timothy Kwok, Samuel YS. Wong
Name of ConferenceAlzheimer’s Association International Conference (AAIC) 2017
Start Date of Conference16/07/2017
End Date of Conference20/07/2017
Place of ConferenceLondon
Country/Region of ConferenceGreat Britain
Journal nameJAMA internal medicine
Proceedings TitleAlzheimer's & Dementia: The Journal of the Alzheimer's Association - 2017 Abstract Supplement
Series TitlePoster Presentations: Tuesday, July 18, 2017
Number in SeriesP3-298
Year2017
Month7
Volume Number13
Issue Number7 Supplement
PublisherElsevier
Pages1058 - 1058
ISSN2168-6106
LanguagesEnglish-United Kingdom

Last updated on 2020-19-10 at 01:59