Ideal combination of dementia screening tests

Abstract

Aim: Although many neuropsychological tests have been developed to evaluate higher brain dysfunction, conducting several tests in daily medical care is very difficult for both the patient and the examiner. We herein reviewed the correlation between the results of 11 neuropsychological tests in order to create a new compact and easily administered combination of screening tests to detect dementia.
Methods: We performed 11 neuropsychological tests in 1,674 outpatients suspected of having cognitive dysfunction and 46 normal control subjects. The 11 tests included the following examinations: the mini mental state examination (MMSE) and Hasegawa dementia rating scale-revised (HDS-R) for the total intelligence function, the frontal assessment battery (FAB) and Montreal cognitive assessment (MoCA) for the frontal lobe function, the neuropsychiatric inventory (NPI) and Abe's behavioral and psychological symptoms of dementia score (ABS) for emotional changes, the geriatric depression scale (GDS) for depressive conditions, the vitality index (VI) and apathy score (AS) for reduced motivation and the clinical dementia rating (CDR) and Alzheimer's disease cooperative study-activities of daily living (ADCS-ADL) scale for ADL's. In order to determine the most compact test series, we compared all test features, correlations between the scores and the time required to complete each test.
Results: Correlations were found between tests of the cognitive function, tests of the cognitive function vs NPI, tests of the cognitive function vs ADL, NPI vs ABS, NPI vs GDS, GDS vs AS, VI vs AS and CDR vs ADCS-ADL. The duration of testing was shorter for the FAB than for the MoCA and for the ABS than for the NPI.
Conclusions: A combination of six tests (MMSE or HDS-R, FAB, ABS, GDS, AS and ADCS-ADL) was found to be useful for screening dementia and reducing the test burden on the patient in daily medical practice.