title: Feasibility and validity of the self-administered computerized assessment of mild cognitive impairment with older primary care patients.
abstract: We investigated whether a validated computerized cognitive test, the Computerized Assessment of Mild Cognitive Impairment (CAMCI), could be independently completed by older primary care patients. We also determined the optimal cut-off for the CAMCI global risk score for mild cognitive impairment against an independent neuropsychological reference standard. All eligible patients aged 65 years and older, seen consecutively over 2 months by 1 family practice of 13 primary care physicians, were invited to participate. Patients with a diagnosis or previous work-up for dementia were excluded. Primary care physicians indicated whether they, the patient, or family had concerns about each patient's cognition. A total of 130 patients with cognitive concerns and a matched sample of 133 without cognitive concerns were enrolled. The CAMCI was individually administered after instructions to work independently. Comments were recorded verbatim. A total of 259 (98.5%) completed the entire CAMCI. Two hundred and forty-one (91.6%) completed it without any questions or after simple acknowledgment of their question. Lack of computer experience was the only patient characteristic that decreased the odds of independent CAMCI completion. These results support the feasibility of using self-administered computerized cognitive tests with older primary care patients, given the increasing reliance on computers by people of all ages. The optimal cut-off score had a sensitivity of 80% and specificity of 74%.
authors.affiliation: Departments of *Family and Community Medicine ∥Medicine and Institute of Health Policy, Management and Evaluation †Primary Care Research Unit, Sunnybrook Health Sciences Centre, University of Toronto ‡Department of Medicine and Rotman Research institute, Baycrest Health Sciences §Research Department, Toronto Rehabilitation Institute, University Health Network ¶Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Tierney
authors.forename: Gary
authors.initials: G
authors.lastname: Naglie
authors.forename: Ross
authors.initials: R
authors.lastname: Upshur
authors.forename: Rahim
authors.initials: R
authors.lastname: Moineddin
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Charles
authors.forename: R Liisa
authors.initials: RL
authors.lastname: Jaakkimainen
mesh_terms: D000368:Aged; D002170:Canada; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards; D011320:Primary Health Care; D015203:Reproducibility of Results