title: A score based on screening tests to differentiate mild cognitive impairment from subjective memory complaints.
abstract: It is not easy to differentiate patients with mild cognitive impairment (MCI) from subjective memory complainers (SMC). Assessments with screening cognitive tools are essential, particularly in primary care where most patients are seen. The objective of this study was to evaluate the diagnostic accuracy of screening cognitive tests and to propose a score derived from screening tests. Elderly subjects with memory complaints were evaluated using the Mini Mental State Examination (MMSE) and the Brief Cognitive Battery (BCB). We added two delayed recalls in the MMSE (a delayed recall and a late-delayed recall, LDR), and also a phonemic fluency test of letter P fluency (LPF). A score was created based on these tests. The diagnoses were made on the basis of clinical consensus and neuropsychological testing. Receiver operating characteristic curve analyses were used to determine area under the curve (AUC), the sensitivity and specificity for each test separately and for the final proposed score. MMSE, LDR, LPF and delayed recall of BCB scores reach statistically significant differences between groups (P=0.000, 0.03, 0.001 and 0.01, respectively). Sensitivity, specificity and AUC were MMSE: 64%, 79% and 0.75 (cut off <29); LDR: 56%, 62% and 0.62 (cut off <3); LPF: 71%, 71% and 0.71 (cut off <14); delayed recall of BCB: 56%, 82% and 0.68 (cut off <9). The proposed score reached a sensitivity of 88% and 76% and specificity of 62% and 75% for cut off over 1 and over 2, respectively. AUC were 0.81. In conclusion, a score created from screening tests is capable of discriminating MCI from SMC with moderate to good accurancy.
authors.affiliation: Behavioral and Cognitive Neurology Unit, Department of Neurology, Cognitive Disorders Reference Center, das Clínicas Hospital, University of São Paulo.
authors.forename: Fábio Henrique
authors.initials: FH
authors.lastname: de Gobbi Porto
authors.forename: Lívia
authors.initials: L
authors.lastname: Spíndola
authors.forename: Maira Okada
authors.initials: MO
authors.lastname: de Oliveira
authors.forename: Patrícia Helena
authors.initials: PH
authors.lastname: Figuerêdo do Vale
authors.forename: Marco
authors.initials: M
authors.lastname: Orsini
authors.forename: Ricardo
authors.initials: R
authors.lastname: Nitrini
authors.forename: Sonia Maria
authors.initials: SM
authors.lastname: Dozzi Brucki
keywords: diagnostic score; mild cognitive impairment; screening cognitive test; subjective memory complaints