Dual-stage cognitive assessment: a two-stage screening for cognitive impairment in primary care

BMC Psychiatry

Research

Zhen Zhang¹  Lin Huang¹  Liang Cui¹  Qinjie Li¹  Qi-Hao Guo¹  Yi-Han Guo² 

[1] Department of Gerontology, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, 200233, Shanghai, China;Faculty of Medicine, The University of Queensland, Brisbane, Australia;

关键词: Mild cognitive impairment;    Visual memory;    Auditory memory;    Primary care;    Geriatric assessment;   

DOI  :  10.1186/s12888-023-04883-w

 received in 2023-02-19, accepted in 2023-05-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundAging population has led to an increased proportion of older adults and cognitively impaired. We designed a brief and flexible two-stage cognitive screening scale, the Dual-Stage Cognitive Assessment (DuCA), for cognitive screening in primary care settings.MethodIn total, 1,772 community-dwelling participants were recruited, including those with normal cognition (NC, n = 1,008), mild cognitive impairment (MCI, n = 633), and Alzheimer’s disease (AD, n = 131), and administered a neuropsychological test battery and the DuCA. To improve performance, the DuCA combines visual and auditory memory tests for an enhanced memory function test.ResultsThe correlation coefficient between DuCA-part 1 and DuCA-total was 0.84 (P < 0.001). The correlation coefficients of DuCA-part 1 with Addenbrooke’s Cognitive Examination III (ACE-III) and Montreal Cognitive Assessment Basic (MoCA-B) were 0.66 (P < 0.001) and 0.85 (P < 0.001), respectively. The correlation coefficients of DuCA-total with ACE-III and MoCA-B were 0.78 (P < 0.001) and 0.83 (P < 0.001), respectively. DuCA-Part 1 showed a similar discrimination ability for MCI from NC (area under curve [AUC] = 0.87, 95%CI 0.848–0.883) as ACE III (AUC = 0.86, 95%CI 0.838–0.874) and MoCA-B (AUC = 0.85, 95%CI 0.830–0.868). DuCA-total had a higher AUC (0.93, 95%CI: 0.917–0.942). At different education levels, the AUC was 0.83–0.84 for DuCA-part 1, and 0.89–0.94 for DuCA-total. DuCA-part 1 and DuCA-total’s ability to discriminate AD from MCI was 0.84 and 0.93, respectively.ConclusionDuCA-Part 1 would aid rapid screening and supplemented with the second part for a complete assessment. DuCA is suited for large-scale cognitive screening in primary care, saving time and eliminating the need for extensively training assessors.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 1