Diagnostic accuracy of brief cognitive screening tools to diagnose vascular cognitive impairment in Peru. (17th March 2021)

• Record Type: Journal Article
• Authors: Custodio, Nilton; Montesinos, Rosa; Alva‐Diaz, Carlos; Pacheco‐Barrios, Kevin; Rodriguez‐Calienes, Aaron; Herrera‐Pérez, Eder; Becerra‐Becerra, Yahaira; Castro‐Suárez, Sheila; Pintado‐Caipa, Maritza; Cruz del Castillo, Rossana; Cuenca, José; Lira, David
• Is Part Of: International journal of geriatric psychiatry. Volume 37:Number 1(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-03-17
• Subjects: brief cognitive tests -- cognitive vascular disorder -- diagnostic accuracy -- vascular dementia; Geriatric psychiatry -- Periodicals; Geriatric Psychiatry -- Periodicals; 618.97689
• DOI: 10.1002/gps.5531
• Languages: English
• ISSNs: 0885-6230

Abstract

Abstract: Introduction: To evaluate the diagnostic accuracy of three brief cognitive screening (BCS) tools, Peruvian version of Addenbrooke's Cognitive Examination (ACE‐Pe), of INECO Frontal Screening (IFS‐Pe) and of the Mini‐Mental State Examination (MMSE‐Pe), for the diagnosis of vascular cognitive impairment (VCI) and its non‐dementia stages (VCI‐ND) and vascular dementia (VD) in patients with cerebral stroke in Lima—Peru. Materials and methods: A cohort analysis to evaluate the diagnostic accuracy of three BCS for VCI. Results: Two hundred and four patients were evaluated: 61% Non‐VCI, 30% VCI‐ND and 9% VD. To discriminate patients with VCI from controls, the area under the curve (AUC) of ACE‐Pe, IFS‐Pe and MMs‐Pe were 0.99 (95% confidence interval [CI] 0.98–0.99), 0.99 (95%CI 0.98–0.99) and 0.87 (95%CI 0.82–0.92), respectively. Of the three BCS, the IFS‐Pe presented a larger AUC to discriminate VCI‐ND from VD (AUC = 0.98 [95%CI 0.95–1]) compared to ACE‐Pe (AUC = 0.84 [95%CI 0.74–0.95]) and MMSE‐Pe (0.92 [95%CI 0.86–0.99]). The IFS‐Pe presented a higher sensitivity (S), specificity (Sp), and positive (+LR) and negative likelihood ratios (−LR) (S = 96.72%, Sp = 89.47%, +LR = 9.1 and −LR = 0.03) than ACE‐Pe (S = 96.72%, Sp = 63.16%, +LR = 2.62 and −LR = 0.05) and MMSE‐Pe (S = 90.16%, Sp = 78.95%, +LR = 4.28 and −LR = 0.12). In the multiple regression analysis, the IFS‐Pe was not affected by age, sex or years of schooling. Conclusion: The IFS‐Pe has the best diagnostic accuracy for detecting VCI and discriminating between pre‐dementia (VCI‐ND) and dementia (VD) stages. Key points: Brief cognitive screening (BCS) tools for the detection of vascular cognitive impairment (VCI) must be adapted and validated for each region and include evaluation of individuals with a low level of education and illiterate subjects from urban and rural settings A diagnostic test design was used to determine the diagnostic accuracy indicators of the three BSC: Peruvian version of Addenbrooke's Cognitive Examination (ACE‐Pe), INECO Frontal Screening (IFS‐Pe) and the Mini‐Mental State Examination (MMSE‐Pe) IFS‐Pe presented a higher sensitivity, specificity, and positive and negative likelihood ratios than ACE‐Pe and MMSE‐Pe IFS‐Pe was more accurate in differentiating pre‐dementia (VCI non‐dementia stage) from dementia stages (vascular dementia) compared to ACE‐Pe and the MMSE‐Pe