title: Brief informant screening test for mild cognitive impairment and early Alzheimer's disease.
abstract: OBJECTIVE
  Recent research has attempted combinations of instruments to improve screening accuracy for mild cognitive impairment (MCI) and early Alzheimer's disease (AD). We compared Mini-Mental State Examination (MMSE), Immediate and Delayed Recall (Logical Memory I and II; LM-I and LM-II, respectively), a single-item informant report of memory problem (IRMP), and a four-item Instrumental Activities of Daily Living (4IADL) scale, and combinations of these tests.
  
  
  METHODS
  The tests were administered together with Clinical Dementia Rating (CDR) to subjects who were cognitively intact (CDR = 0, n = 88), and with diagnoses of MCI (CDR = 0.5, n = 37) and early AD (CDR = 1-2, n = 19).
  
  
  RESULTS
  Screening accuracy (receiver operating characteristic area under curve, AUC) for identifying MCI or MCI-AD was lowest for MMSE (AUC 67.6% for MCI or 77.9% for MCI-AD), and better for IRMP (79.5 or 83.2%), 4IADL (76.9 or 84.7%), LM-I (81.2 or 87.1%) and LM-II (86.1 or 90.8%). Combining IRMP, 4IADL and LM-II was most accurate (AUC 91.7% for MCI or 94.5% for MCI-AD); sensitivity: 86.5 or 89.3%; specificity: 86.4 or 88.6%. However, combining IRMP and 4IADL gave nearly as good accuracy (AUC 87.2 or 91.6%); sensitivity: 86.5 or 85.7%; specificity: 79.5 or 85.2%.
  
  
  CONCLUSIONS
  A brief instrument combining an IRMP and 4IADL items is potentially useful in screening for MCI and early AD.
authors.affiliation: Gerontological Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore.
authors.forename: Minglei
authors.initials: M
authors.lastname: Li
authors.forename: Tze Pin
authors.initials: TP
authors.lastname: Ng
authors.forename: Ee Heok
authors.initials: EH
authors.lastname: Kua
authors.forename: Soo Meng
authors.initials: SM
authors.lastname: Ko
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology*; D044466:Asian People; D002681:China / Q000208:ethnology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009483:Neuropsychological Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012846:Singapore; D011795:Surveys and Questionnaires