Comparison between two common tools for cognitive screening in a sample of illiterate Egyptian seniors

Abstract

Background: Mild cognitive impairment (MCI) and mild dementia are common problems in the elderly that may pass unnoticed till deteriorated or affect elderly's function especially activities of daily living (ADL). MCI is also associated with significant morbidity and mortality. Patients with MCI may develop any type of dementia as Alzheimer's disease (AD), vascular dementia and other types of dementias by rates about 8.1%, 1.9% and 9.6% respectively per year, so early detection and management will benefit both patient and caregiver. Non amnestic MCI is less common to progress to dementia than amnestic type while about 16% of cases may regress to normal. Due to the absence of actual disease-modifying treatment for late dementia, diagnosis and disease involvement at an early stage especially at the MCI stage has been widely accepted as a critical policy in disease management that could consequently affect long-term results and prevent its progression. MCI can be diagnosed using mental status evaluation in addition to other neurological, psychiatric, medical examination, neuroimaging and biological biomarkers. There are a lot of tools that can be used for screening of cognitive impairment of variable degrees of sensitivity and specificity such as Minimental State Examination (MMSE) and Montreal Cognitive Assessment Basic (MoCA-B). The aim of the work is to compare between MMSE and MoCA-B, which are commonly used cognitive screening tools, in illiterate Egyptian seniors. Methods: An observational clinical study was conducted on 100 illiterate Egyptian elderly having variable comorbidities aged ≥ 60 years recruited from the outpatient clinics of Mansoura university hospitals. Full history taking, comprehensive geriatric assessment, Minimental State Examination (MMSE) and Montreal Cognitive Assessment Basic (MoCA-B) were performed for all participants. Results: The current study showed that patients diagnosed as normal by MMSE were graded MCI and mild dementia by MoCA-B and so there was no significant agreement between MoCA-B and MMSE scale grades among the studied cases in illiterate Egyptian seniors ≥ 60 years (p=0.062). Conclusions: No agreement between MoCA-B and MMSE scale grades among the studied cases.