Abstract
Aim: To develop an ultra-brief test (the Imon Cognitive Impairment Screening Test: ICIS) to screen for mild cognitive impairment (MCI) or dementia.
Methods: The ICIS consists of four subtests exploring the following: time orientation (year, month, day, day of week, each assigned one point, for a total of four points), finger construction of a fox and pigeon (fox successfully made with both hands: 1 point, only one hand: 0.5 point, pigeon made smoothly: 1 point, succeeded after trial and error: 0.5 point, failure: 0 point, total 2 points), letter fluency (subjects need to recall as many words as they can beginning with a given letter in a one-minute trial. 0-2 words: 0 point, 3-5 words: 1 point, 6-9 words: 2 points, 10 words or more: 3 points), and delayed free verbal recall (1 point each, total 3 points), so a perfect score is 12 points. The test takes less than three minutes to administer. The authors studied 76 patients with dementia (51 mild, 18 moderate and seven severe cases), 30 normal elderly controls (C) and 34 patients with mild cognitive impairment (MCI).
Results: The mean scores on the ICIS were 5.5 for the mild, 3.0 for the moderate and 0.7 for the severe dementia patients, 8.3 for those with MCI and 10.5 for the C group. Using a cut-off value of 9/9.5, the ICIS had a sensitivity of 94% for MCI or dementia, and a specificity of 93%. The positive likelihood ratio for MCI or dementia was 14.0, and the negative likelihood ratio was 0.07. The ICIS scores correlated with the Mini-Mental State Examination scores (r=0.82, p<0.0001).
Conclusions: The ICIS has the potential to identify patients who warrant further cognitive evaluation for MCI or dementia.
