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| Screening for Mild Cognitive Impairment: The CANS-MCI Study |
| Topic:
Diagnosis and Disease Progression - Clinical |
| Jane B. Tornatore, Emory Hill, Jo Anne Laboff, Brian Fogel, Screen Inc., Seattle, WA, USA. Contact e-mail: jbtornatore@comcast.net |
| Presentation Number: P1-054 |
| Keyword:
screening instrument, early detection, cognition |
| Background: Nearly half of all Alzheimer’s disease (AD) patients are not diagnosed before reaching a degree of decline known as “moderate” dementia, past the time for maximum delay of disease progression. Early identification of the mild cognitive impairments that progress to AD would reduce the rate of disease progression and delay placements in nursing homes. Each year of delayed progression saves thousands in related medical expenses and avoided injuries. Medications that reverse the disease process will markedly increase the demand for early detection. This study examines the predictive validity of a fully self-administered instrument, the Computer-Administered Neuropsychological Screen for Mild Cognitive Impairment (CANS-MCI), which provides screening information about the need for full diagnostic evaluations for dementia. Multiple aspects of three cognitive domains are tested: Memory, Executive Function and Fluency. The CANS-MCI can generate automated graphical reports of longitudinal findings in languages other than those used for test administration. Objective: To derive scoring formulas that discriminate mild cognitive impairment (MCI) from normal functioning. Methods: 90 community-dwelling study participants, enrolled in a 3-year longitudinal study funded by NIA, received full neuropsychological evaluations. Logistic regression and ROC curve analyses were used to determine the CANS-MCI scores that best discriminate between normal and impaired functioning. Groups were divided by level of education for the analyses. Results: Using logistic regression analyses, we correctly classified 100% of participants with a high school degree or less and 88% of those with at least some college. ROC curve analyses on the two educational levels revealed that two cut-points lead to sensitivities of 80% and 78% with corresponding specificities of 75% and 75%. Conclusions: The CANS-MCI is a valid instrument for early cognitive impairment screening. The results are impressive given that: 1) this study used a community sample with a lower incidence of MCI than the clinical samples often used; and 2) the CANS-MCI screens for MCI which is more difficult to detect than diagnosable AD. The CANS-MCI is a valid screening measure to determine the need for further assessment. Early diagnosis can lead to early treatment, when the medications would be most beneficial. |
| Commercial Relationship: J.B. Tornatore, Screen Inc. Full-time/part-time employment. |
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