title: Determining appropriate screening tools and cut-points for cognitive impairment in an elderly Chinese sample.
abstract: The establishment of normative data and screening cut-points for cognitive tasks is important to ensure the effective and timely detection of mild cognitive impairment (MCI) and Alzheimer's disease (AD). These need to be culturally relevant and account for known factors that impact on cognition such as age, education, and gender. In this study, 1,068 elderly Chinese residents of Shanghai completed a comprehensive series of cognitive tasks as part of a community screening study with 1027 meeting criteria for analysis, age M(SD) = 72.54 (8.40). MCI was detected in 267 individuals, AD in 50, and 710 had normal cognition. Receiver Operator Characteristic curve analysis indicated that the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) best differentiated normal cognition from MCI and AD. We present suggested cut-points to differentiate between normal cognition and MCI and AD for the total sample, and when split according to education levels, age, and gender. Trends suggest that the MoCA was better suited to detecting MCI, and the MMSE was better for detecting AD. For younger and more educated participants, only a slight impairment was necessary to meet screening criteria, while a larger impairment was necessary for older and less educated participants. Both tasks had a high negative predictive values for MCI and AD, and variable positive predictive values. The cut-points presented can be used to inform future work using the MMSE and MoCA to screen for MCI and AD in older Chinese people. (PsycINFO Database Record
authors: School of Psychology, Deakin University.
authors: David
authors: D
authors: Mellor
authors: School of Psychology, Deakin University.
authors: Matthew
authors: M
authors: Lewis
authors: Institute for Health & Ageing, Australian Catholic University.
authors: Marita
authors: M
authors: McCabe
authors: School of Psychology, Deakin University.
authors: Linda
authors: L
authors: Byrne
authors: Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine.
authors: Tao
authors: T
authors: Wang
authors: Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine.
authors: Jinghua
authors: J
authors: Wang
authors: Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine.
authors: Minjue
authors: M
authors: Zhu
authors: Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine.
authors: Yan
authors: Y
authors: Cheng
authors: Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine.
authors: Cece
authors: C
authors: Yang
authors: Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine.
authors: Shuhui
authors: S
authors: Dong
authors: Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine.
authors: Shifu
authors: S
authors: Xiao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000208:ethnology; D044466:Asian People; D002681:China; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000208:ethnology; D065246:Culturally Competent Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012372:ROC Curve; D012016:Reference Values; D015203:Reproducibility of Results