Dementia and Geriatric Cognitive Disorders最新文献

{"title":"Feasibility and Psychometric Properties of Integrated Care for Older People Screening Tool for Taiwanese (ICOPES-TW) Cognitive Screening Test.","authors":"Chung-Ying Lin, Hua-Lin Liu, Yi-Ching Yang, Jung-Der Wang, Chung-Yi Li, Mark D Griffiths, Li-Fan Liu","doi":"10.1159/000542272","DOIUrl":"10.1159/000542272","url":null,"abstract":"<p><strong>Background: </strong>Intrinsic capacity, a concept proposed by the World Health Organization, includes multidimensions to better understand older adults' health conditions for successful healthy aging. One of the key dimensions of intrinsic capacity is cognition. The present study aimed to examine if the cognitive test in Integrated Care for Older People Screening Tool for Taiwanese (ICOPES-TW) is a suitable instrument for screening cognition impairment.</p><p><strong>Methods: </strong>Older adults from community or medical center settings in Tainan were recruited (n = 553; mean ± SD age = 75.80 ± 8.32; 60.8% females). All participants were administered the ICOPES-TW cognitive test, the Mini-Mental State Examination (MMSE), Lawton Instrumental Activities of Daily Living (IADL), and Barthel Index (BI) in an in-person interview conducted by a well-trained research assistant.</p><p><strong>Results: </strong>The ICOPES-TW cognitive test was highly correlated with the MMSE total score (r = -0.752) and moderately correlated with IADL (r = -0.426) and BI scores (r = -0.390). When using a cutoff score of 1 for the ICOPES-TW cognitive test, its accuracy to identify cognitive impairment defined by the MMSE was 60% (sensitivity = 0.98, specificity = 0.41). When using cutoff score of 2, the accuracy was 83% (sensitivity = 0.69, specificity = 0.90). Moreover, the ICOPES-TW cognitive test had similar properties to the MMSE in terms of known-group validity (distinguishing different age and educational level groups).</p><p><strong>Conclusions: </strong>Using ICOPES-TW cognitive test with appropriate cutoff point in different healthcare settings could help providers and researchers quickly identify if an older adult has a cognitive impairment. However, the screening ability of ICOPES-TW cognitive test was deemed fair but future studies are recommended to help improve it.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toolkit to Examine Lifelike Language v.2.0: Optimizing Speech Biomarkers of Neurodegeneration.","authors":"Adolfo M García, Franco J Ferrante, Gonzalo Pérez, Joaquín Ponferrada, Alejandro Sosa Welford, Nicolás Pelella, Matías Caccia, Laouen Mayal Louan Belloli, Cecilia Calcaterra, Catalina González Santibáñez, Raúl Echegoyen, Mariano Javier Cerrutti, Fernando Johann, Eugenia Hesse, Facundo Carrillo","doi":"10.1159/000541581","DOIUrl":"10.1159/000541581","url":null,"abstract":"<p><strong>Introduction: </strong>The Toolkit to Examine Lifelike Language (TELL) is a web-based application providing speech biomarkers of neurodegeneration. After deployment of TELL v.1.0 in over 20 sites, we now introduce TELL v.2.0.</p><p><strong>Methods: </strong>First, we describe the app's usability features, including functions for collecting and processing data onsite, offline, and via videoconference. Second, we summarize its clinical survey, tapping on relevant habits (e.g., smoking, sleep) alongside linguistic predictors of performance (language history, use, proficiency, and difficulties). Third, we detail TELL's speech-based assessments, each combining strategic tasks and features capturing diagnostically relevant domains (motor function, semantic memory, episodic memory, and emotional processing). Fourth, we specify the app's new data analysis, visualization, and download options. Finally, we list core challenges and opportunities for development.</p><p><strong>Results: </strong>Overall, TELL v.2.0 offers scalable, objective, and multidimensional insights for the field.</p><p><strong>Conclusion: </strong>Through its technical and scientific breakthroughs, this tool can enhance disease detection, phenotyping, and monitoring.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Advances in Computerized Cognitive Assessment for Mild Cognitive Impairment and Dementia in Older Adults: A Systematic Review.","authors":"Cornelia Henkel, Susan Seibert, Catherine Nichols Widmann","doi":"10.1159/000541627","DOIUrl":"10.1159/000541627","url":null,"abstract":"<p><strong>Introduction: </strong>Timely detection of cognitive impairment such as mild cognitive impairment (MCI) or dementia is pivotal in initiating early interventions to improve patients' quality of life. Conventional paper-pencil tests, though common, have limited sensitivity in detecting subtle cognitive changes. Computerized assessments offer promising alternatives, overcoming time and manual scoring constraints while potentially providing greater sensitivity.</p><p><strong>Methods: </strong>A literature search yielded 26 eligible articles (2020-2023). The articles were reviewed according to PRISMA guidelines, and the computerized tools were categorized by diagnostic outcome (MCI, dementia, combined).</p><p><strong>Results: </strong>The subjects included in the studies were aged 55-77 years. The overall gender distribution comprised 60% females and 40% males. The sample sizes varied considerably from 22 to 4,486. Convergent validity assessments in 20 studies demonstrated strong positive correlations with traditional tests. Overall classification accuracy in detecting MCI or dementia, distinguishing from normal cognition (NC), reached up to 91%. Impressively, 46% of the studies received high-quality ratings, underscoring the reliability and validity of the findings.</p><p><strong>Conclusion: </strong>The review highlights the advancements in computerized cognitive assessments for assessing MCI and dementia. This shift toward technology-based assessments could enhance detection capabilities and facilitate timely interventions for better patient outcomes.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risperidone for the Treatment of Dementia-Related Psychosis: A Systematic Review and Meta-Analysis.","authors":"Guanghua Zhou, Suna Yin, Shubao Zhang, Fang Hao, Lin Ma","doi":"10.1159/000540689","DOIUrl":"10.1159/000540689","url":null,"abstract":"<p><strong>Introduction: </strong>Risperidone is one of the atypical antipsychotics that has been used for the treatment of dementia-related psychosis (DRP). However, the findings concerning its efficacy and safety in DRP are contradictory.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis to address the effects of risperidone on the alleviation of DRP. We searched Medline via PubMed, Scopus, Web of Science, Google Scholar, and PsychINFO from the inception until May 2024. Appropriate statistical tests were used to test the study hypothesis.</p><p><strong>Results: </strong>The study included 17 articles and 2,311 patients with DRP. Risperidone alleviated DRP with a standardized mean difference (SMD) of 0.355 (95% CI: 0.170-0.541, p = 0.000). The impact of treatment was positively associated with treatment duration (slope p = 0.038) and dose (slope p = 0.000). Six studies (n = 354) reported the data for the effects of risperidone on cognitive function. Analysis showed that risperidone treatment deteriorated cognitive function in DRP patients with an SMD of -0.185 (95% CI: -0.349 to -0.020, p = 0.028). The mean effect size was 0.36 with a 95% CI of 0.17-0.54. However, the true effect size in 95% of all comparable populations fell in the interval of -0.37 to 1.08. This revealed a high heterogeneity among the included publications as the prediction interval showed a wider range of expected treatment effects than CI.</p><p><strong>Conclusion: </strong>Our meta-analysis provides evidence for the effectiveness of risperidone in the management of DRP. However, because of safety concerns and high data heterogeneity, risperidone use should be individualized for each patient.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Item Functioning and Clinical Utility of the Subjective Memory Complaints Questionnaire in a Multi-Ethnic Cohort.","authors":"Andrea Pilar Ochoa Lopez, Joshua M Garcia, Michael W Williams, Luis D Medina","doi":"10.1159/000541236","DOIUrl":"10.1159/000541236","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the psychometric properties of the Subjective Memory Complaints Questionnaire (SMCQ) in a non-Hispanic White (NHW) and Mexican American (MA) sample from Texas in the USA.</p><p><strong>Methods: </strong>Data were obtained from the Health and Aging Brain Study - Health Disparities (HABS-HD; N = 1,691, age = 66.5 ± 8.7, education = 12.4 ± 4.8, 60.6% female, 33.2% MA Spanish speaking). Unidimensionality of the SMCQ was evaluated with confirmatory factor analysis. Differential item functioning (DIF) of the SMCQ was assessed across age, sex, education, and ethnicity/language using item response theory/logistic ordinal regression. Associations of the SMCQ in relation to cognitive status, Alzheimer's disease (AD) blood-based biomarkers, and psychological distress were examined.</p><p><strong>Results: </strong>The SMCQ showed excellent fit in a single-factor model (CFI = 0.97, TLI = 0.97, RMSEA [95% CI] = 0.05 [0.04, 0.05], SRMR = 0.07). Significant item-level DIF was detected by education level and ethnicity/language, but not by age or sex; when detected, DIF was not salient (i.e., adverse). The SMCQ was associated with greater psychological distress, worse Clinical Dementia Rating scores, and greater disease burden as measured by total tau and neurofilament light.</p><p><strong>Conclusions: </strong>Practically negligible item-level bias was identified across education and ethnicity/language. Detected DIF can be described as benign, indicating that some items manifested differently between groups but had minimal impact on measurement properties. These results demonstrate that the SMCQ performs appropriately across demographic variables. Our findings also provide support for the associations of SMCQ scores with self-reported mood, cognitive status, and AD blood-based biomarkers.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of acetylcholinesterase inhibitors in the logopenic variant of primary progressive aphasia.","authors":"Julie Carrier-Auclair,Monica Lavoie,Maud Tastevin,Robert Laforce","doi":"10.1159/000540932","DOIUrl":"https://doi.org/10.1159/000540932","url":null,"abstract":"INTRODUCTIONFor over twenty-five years, cholinesterase inhibitors (ChEIs) have been the main symptomatic treatment for Alzheimer's disease (AD). Several meta-analyses have supported their efficacy in various neurocognitive, functional, and behavioral aspects of amnestic AD. Over 86% of cases of the language variant AD are caused by a similar pathologic process than AD, yet no study has examined the efficacy of ChEIs in this AD variant. We aimed to explore the efficacy of ChEIs in the treatment of language AD by comparing their evolution on the MMSE to that of treated amnestic AD patients.METHODSA retrospective chart review was performed in forty-five patients with language AD and fifty-two patients with amnestic AD. Both groups were similar regarding age, level of education, and onset of symptoms. Drug history, MMSE scores, functional and neuropsychiatric symptoms were collected on several time points before and after the introduction of ChEIs. Data was analysed using ANOVA and a generalized linear mixed model.RESULTSPatients with language AD showed a similar trajectory of decline than amnestic AD patients on serial MMSEs up to twenty-four months after the introduction of ChEIs. In language AD patients, ChEIs had a significant impact on activities of daily life (ADLs), but not instrumental activities of daily living (IADLs), and neuropsychiatric symptoms remained stable over time.CONCLUSIONThis study provides preliminary evidence for efficacy of ChEIs in patients with language AD and suggests similar benefits to those seen in amnestic AD patients, hence reassuring patients and their physicians.","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":"13 1","pages":"1-21"},"PeriodicalIF":2.4,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142194182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiles of Met and Unmet Care Needs in the Oldest Old Primary Care Patients with Cognitive Disorders and Dementia: Results of the AgeCoDe and AgeQualiDe Study.","authors":"Sophia Kraake, Alexander Pabst, Horst Bickel, Michael Pentzek, Angela Fuchs, Birgitt Wiese, Anke Oey, Hans-Helmut König, Christian Brettschneider, Martin Scherer, Tina Mallon, Dagmar Lühmann, Wolfgang Maier, Michael Wagner, Kathrin Heser, Siegfried Weyerer, Jochen Werle, Steffi G Riedel-Heller, Janine Stein","doi":"10.1159/000541118","DOIUrl":"10.1159/000541118","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of mild cognitive impairment (MCI) and dementia is increasing as the oldest old population grows, requiring a nuanced understanding of their care needs. Few studies have examined need profiles of oldest old patients with MCI or dementia. Therefore, this study aimed to identify patients' need profiles.</p><p><strong>Methods: </strong>The data analysis included cross-sectional baseline data from N = 716 primary care patients without cognitive impairment (n = 575), with MCI (n = 97), and with dementia (n = 44) aged 85+ years from the multicenter cohort AgeQualiDe study \"needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients [85+]\". Patients' needs were assessed using the Camberwell Assessment of Needs for the Elderly (CANE), and latent class analysis identified need profiles. Multinomial logistic regression analyzed the association of MCI and dementia with need profiles, adjusting for sociodemographic factors, social network (Lubben Social Network Scale [LSNS-6]), and frailty (Canadian Study of Health and Aging-Clinical Frailty Scale [CSHA-CFS]).</p><p><strong>Results: </strong>Results indicated three profiles: \"no needs,\" \"met physical and environmental needs,\" and \"unmet physical and environmental needs.\" MCI was associated with the met and unmet physical and environmental needs profiles; dementia was associated with the unmet physical and environmental needs profile. Patients without MCI or dementia had larger social networks (LSNS-6). Frailty was associated with dementia.</p><p><strong>Conclusions: </strong>Integrated care should address the needs of the oldest old and support social networks for people with MCI or dementia. Assessing frailty can help clinicians to identify the most vulnerable patients and develop beneficial interventions for cognitive disorders.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Perceived Stress and Motoric Cognitive Risk Syndrome in an Elderly Population: Rugao Longevity and Aging Study.","authors":"Yuan-Fei Cao, Guo-Ping Shi, Hui Zhang, Meng-Zhen Sun, Zheng-Dong Wang, Xue-Feng Chu, Jiang-Hong Guo, Xiao-Feng Wang","doi":"10.1159/000537937","DOIUrl":"10.1159/000537937","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have indicated a correlation between perceived stress and cognitive decline. However, it remains unknown whether high levels of perceived stress can result in motoric cognitive risk (MCR) syndrome. This study investigated the relationship between perceived stress and MCR in a community-based population.</p><p><strong>Methods: </strong>The study cohort comprised 852 elderly individuals from the Rugao Longitudinal Aging Cohort. Perceived stress was assessed using the 10-item Perceived Stress Scale (PSS-10), while MCR was defined as the coexistence of subjective memory complaints (SMCs) and slow gait speed.</p><p><strong>Results: </strong>The average age of the study participants is 79.84 ± 4.34 years. The mean score of PSS-10 among participants is 10.32 (range = 0-33; [SD] = 5.71), with a median score of 10.00 (6.00, 14.00). The prevalence of MCR is 9.3%. In the logistic regression analysis, for each 1-SD (5.71) increase in the global PSS-10 score, the risk of MCR increased by 40% (95% CI 1.09-1.80). Additionally, in the aspect of two components of MCR, with a 1-SD increase (5.71) in the global PSS-10 score, there was a 50% (95% CI 1.29-1.75) increase in the risk of SMCs and a 27% (95% CI 1.04-1.55) increase in the risk of slow gait speed. In terms of specific walking speed, there was a reverse correlation between the global PSS-10 score and walking speed (r = -0.14, p &lt; 0.001).</p><p><strong>Conclusions: </strong>This study provided preliminary evidence that high levels of perceived stress were associated with the risk of MCR in a community-dwelling population.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"74-82"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of the Case Manager-Centered Collaborative Care Model with Computer-Assisted Assessment on Quality Indicators for the Care of Dementia.","authors":"Yen-Jen Chen, Wen-Fu Wang, Ming-Che Chang, Kai-Ming Jhang","doi":"10.1159/000536646","DOIUrl":"10.1159/000536646","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the influence of case management and its corresponding computer-assisted assessment system on the quality improvement of dementia care.</p><p><strong>Methods: </strong>This observational study enrolled 2029 patients and their caregivers at Changhua Christian Hospital in Taiwan. Physicians who made the diagnosis of dementia would introduce the patient and caregiver dyad to the case manager-centered collaborative care team after obtaining agreement. The achievement rates of 11 quality indicators (QIs) comprising timely diagnostic evaluations, regular screens of cognition and neuropsychiatric symptoms, caregiver support, and proper medication prescriptions were counted. Different timeframes (≤4 months, 4 months-1 year, 1-2 years, 2-3 years, or ≥3 years) from diagnosis of dementia to collaborative care intervention were compared.</p><p><strong>Results: </strong>A significantly higher attainment rate was achieved for patients with earlier entry into the collaborative team model, including QIs about timely diagnosis and regular screening, and caregiver support. The QIs regarding dementia medication prescriptions and documentation of the risk of antipsychotics remained similar regardless of the time of entry into the model. The completion rates of QIs also improved after the information system was launched.</p><p><strong>Conclusions: </strong>Physician-case manager co-management in the setting of a collaborative care model with a computer-assisted assessment system helps improve QI achievement for dementia care.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"29-36"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Performance of Five Cognitive Screening Tests in a Large Sample of Seniors.","authors":"Jurij Dreo, Jan Jug, Tisa Pavlovčič, Ajda Ogrin, Anita Demšar, Barbara Aljaž, Filip Agatić, Uros Marusic","doi":"10.1159/000540225","DOIUrl":"10.1159/000540225","url":null,"abstract":"<p><strong>Introduction: </strong>Recent introductions of disease-modifying treatments for Alzheimer's disease have re-invigorated the cause of early dementia detection. Cognitive \"paper and pencil\" tests represent the bedrock of clinical assessment, because they are cheap, easy to perform, and do not require brain imaging or biological testing. Cognitive tests vary greatly in duration, complexity, sociolinguistic biases, probed cognitive domains, and their specificity and sensitivity of detecting cognitive impairment (CI). Consequently, an ecologically valid head-to-head comparison seems essential for evidence-based dementia screening.</p><p><strong>Method: </strong>We compared five tests: Montreal cognitive assessment (MoCA), Alzheimer's disease assessment scale-cognitive subscale (ADAS), Addenbrooke's cognitive examination (ACE-III), euro-coin handling test (Eurotest), and image identification test (Phototest) on a large sample of seniors (N = 456, 77.9 ± 8 years, 71% females). Their specificity and sensitivity were estimated in a novel way by contrasting each test's outcome to the majority outcome across the remaining tests (comparative specificity and sensitivity calculation [CSSC]). This obviates the need for an a priori gold standard such as a clinically clear-cut sample of dementia/MCI/controls. We posit that the CSSC results in a more ecologically valid estimation of clinical performance while precluding biases resulting from different dementia/MCI diagnostic criteria and the proficiency in detecting these conditions.</p><p><strong>Results: </strong>There exists a stark trade-off between behavioral test specificity and sensitivity. The test with the highest specificity had the lowest sensitivity, and vice versa. The comparative specificities and sensitivities were, respectively: Phototest (97%, 47%), Eurotest (94%, 55%), ADAS (90%, 68%), ACE-III (72%, 77%), MoCA (55%, 95%).</p><p><strong>Conclusion: </strong>Assuming a CI prevalence of 10%, the shortest (∼3 min) and the simplest instrument, the Phototest, was shown to have the best overall performance (accuracy 92%, PPV 66%, NPV 94%).</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"289-298"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}