A Brief Dementia Test with Subjective and Objective Measures

• Published in: Dementia and geriatric cognitive disorders extra 2015-09, Vol.5 (3), p.341-349
• Main Authors: Tew, Chee-Wee, Ng, Tze-Pin, Cheong, Chin-Yee, Yap, Philip
• Format: Article
• Language: English
• Subjects: AD8; Cognitive assessment; Dementia; Mini-Mental State Examination; Original; Original Research Article
• ISSN: 1664-5464; 1664-5464
• DOI: 10.1159/000438455

Background: The development of an effective brief dementia test will help in the early identification of dementia. Aim: This study investigates the diagnostic utility of a brief cognitive test for dementia which combines a short subjective informant-rated questionnaire (AD8) with an objective cognitive measure (Mini-Mental State Examination, MMSE) or its subcomponents. Methods: Subjects with mild dementia (Clinical Dementia Rating Scale score ≤1) were matched with community-dwelling, cognitively intact controls. MMSE and Clinical Dementia Rating Scale were administered to all subjects, while AD8 was completed by a reliable informant. Receiver operating characteristics analysis determined the diagnostic accuracies of AD8, MMSE, and AD8 combined with MMSE (AD8+MMSE). Stepwise logistic regression identified the subcomponents of MMSE which, combined with AD8, best discriminated dementia patients from controls. Results: The AD8 (area under the curve [AUC] = 0.92, 95% confidence interval [CI] 0.89-0.95) was superior to the MMSE (AUC = 0.87, 95% CI 0.83-0.92) in discriminating mild dementia patients from controls, and AD8+MMSE (AUC = 0.95, 0.92-0.98) increased its superior discrimination over MMSE alone. AD8 combined with three-item recall and intersecting pentagon copy (AUC = 0.95, 95% CI 0.92-0.97) performed as well as AD8 combined with full MMSE. Conclusion: AD8 combined with the MMSE subcomponents three-item recall and intersecting pentagon copy has excellent diagnostic utility and is a promising brief cognitive test for early dementia.