Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T06:36:01.608Z Has data issue: false hasContentIssue false

Clinical validation of the WMS-IV-NL brief cognitive status exam (BCSE) in older adults with MCI or dementia

Published online by Cambridge University Press:  31 July 2014

Zita Bouman*
Affiliation:
Kempenhaeghe, Expertise Centre for Epileptology, Sleep, Medicine and Neurocogntion, Heeze, the Netherlands Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
Marc P. H. Hendriks
Affiliation:
Kempenhaeghe, Expertise Centre for Epileptology, Sleep, Medicine and Neurocogntion, Heeze, the Netherlands Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
Albert P. Aldenkamp
Affiliation:
Kempenhaeghe, Expertise Centre for Epileptology, Sleep, Medicine and Neurocogntion, Heeze, the Netherlands Maastricht University Medical Centre, Department of Neurology and School for Mental Health and Neuroscience, Maastricht, the Netherlands University Hospital Gent, Department of Neurology, Gent, Belgium Technical University Eindhoven, Faculty of Electrical Engineering, Signal Processing System Group, Eindhoven, the Netherlands
Roy P. C. Kessels
Affiliation:
Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands Radboud University Medical Center, Department of Medical Psychology, Nijmegen, the Netherlands
*
Correspondence should be addressed to: Zita Bouman, MSc Kempenhaeghe Research and Development Sterkselseweg 65 5591 VE Heeze, the Netherlands. Phone: +31402279581. Email: [email protected].

Abstract

Background:

The Brief Cognitive Status Exam (BCSE) is a new, optional subtest of the Wechsler Memory Scale-IV (WMS-IV) developed for rapid detection of cognitive deficits. We examined the clinical validation of the Dutch version of the BCSE in older adults with mild cognitive impairment (MCI) or dementia, comparing it to the Mini-Mental State Examination (MMSE).

Method:

BCSE and MMSE were administered in 39 older adults with MCI, 51 with dementia and 96 matched healthy controls.

Results:

Our results show that the BCSE is a valid screening instrument, with psychometric properties similar to the widely used MMSE. High correlations were found between the BCSE and MMSE (r = 0.79, n = 183, p < 0.001). Furthermore, a BCSE cut-off score ≤ 42 revealed a sensitivity of 96% a specificity of 92%, a positive predictive value of 86% and a negative predictive value of 97%, whereas the MMSE cut-off score of ≤ 24 showed values of 84%, 96%, 91%, and 92%, respectively. Sensitivity, specificity, positive and negative predictive values to detect MCI compared to controls was 81%, 80%, 61%, and 92%, respectively, on the BCSE, with a cut-off score of ≤ 46, and 84%, 76%, 57%, and 92%, respectively, on the MMSE, with a cut-off score of ≤ 27.

Conclusions:

The Dutch version of the BCSE is a clinically valid screening instrument for the detection of cognitive impairment in patients with dementia. Nevertheless, for distinguishing older adults with MCI from healthy controls both the BCSE and MMSE have limitations.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albert, M. S. et al. (2011). The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the national institute on Aging-Alzheimer's association workgroups on diagnostic guidelines for Alzheimer's disease. Journal of the Alzheimer's Association, 7, 270279. doi: 10.1016/j.jalz.2011.03.008.Google Scholar
Appels, B. A. and Scherder, E. (2010). The diagnostic accuracy of dementia-screening instruments with an administration time of 10 to 45 minutes for use in secondary care: a systematic review. American Journal of Alzheimer's Disease & Other Dementias, 25, 301316. doi: 10.1177/1533317510367485.Google Scholar
Applegate, W. B., Blass, J. P. and Williams, T. F. (1990). Instruments for the functional assessment of older patients. New England Journal of Medicine, 322, 12071214. doi: 10.1056/NEJM199004263221707.Google Scholar
Blake, H., McKinney, M., Treece, K., Lee, E. and Lincoln, N. B. (2002). An evaluation of screening measures for cognitive impairment after stroke. Age and Ageing, 31, 451456.Google Scholar
Centraal Bureau voor Statistiek (CBS) – Statline (2011). Retrieved July 2011 from http://www.cbs.nl.Google Scholar
Cullen, B., O’Neill, B., Evans, J. J., Coen, R. F. and Lawlor, B. A. (2007). A review of screening tests for cognitive impairment. Journal of Neurology, Neurosurgery, and Psychiatry, 78, 790799. doi: 10.1136/jnnp.2006.095414 Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Gifford, D. R. and Cummings, J. L. (1999). Evaluating dementia screening tests: methodologic standards to rate their performance. Neurology, 52, 224227.Google Scholar
Gregory, C. A., Orrell, M., Sahakian, B. and Hodges, J. R. (1997). Can frontotemporal dementia and Alzheimer's disease be differentiated using a brief battery of tests? International Journal of Geriatric Psychiatry, 12, 375383.Google Scholar
Heinik, J., Solomesh, I., Shein, V. and Becker, D. (2002). Clock drawing test in mild and moderate dementia of the Alzheimer's type: a comparative and correlation study. International Journal of Geriatric Psychiatry, 17, 480485. doi: 10.1002/gps.616.Google Scholar
Hendriks, M. P. H., Bouman, Z., Kessels, R. P. C. and Aldenkamp, A. P. (2014). Wechsler Memory Scale-Fourth Edition, Dutch Edition. Manual. Amsterdam: Pearson Assessment.Google Scholar
Ismail, Z., Rajji, T. K. and Shulman, K. I. (2010). Brief cognitive screening instruments: an update. International Journal of Geriatric Psychiatry, 25, 111120. doi: 10.1002/gps.2306.CrossRefGoogle ScholarPubMed
Lezak, M. D., Howieson, D. B.. Bigler, E. D. and Tranel, D. (2012). Neuropsychological Assessment. New York: Oxford University Press.Google Scholar
McKhann, G. M. et al. (2011). The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Journal of the Alzheimer's Association, 7, 263269. doi: 10.1016/j.jalz.2011.03.005.Google Scholar
Milne, A., Culverwell, A., Guss, R., Tuppen, J. and Whelton, R. (2008). Screening for dementia in primary care: a review of the use, efficacy and quality of measures. International Psychogeriatrics, 20, 911926. doi: 10.1017/S1041610208007394.Google Scholar
Mitchell, A. J. (2009). A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. Journal of Psychiatric Research, 43, 411431. doi: 10.1016/j.jpsychires.2008.04.014.Google Scholar
Morris, J. C. (1993). The clinical dementia rating (CDR): current version and scoring rules. Neurology, 43, 24122414.Google Scholar
Nilson, L. N., Bäckman, L., Sällsten, G., Hagberg, S. and Barregård, L. (2003). Dose-related cognitive deficits among floor layers with previous heavy exposure to solvents. Archives of Environmental Health, 58, 208217. doi: 10.3200/AEOH.58.4.208-217.CrossRefGoogle ScholarPubMed
Papagno, C., Allegra, A. and Cardaci, M. (2004). Time estimation in Alzheimer's disease and the role of the central executive. Brain and Cognition, 54, 1823.Google Scholar
Rabin, L. A., Barr, W. B. and Burton, L. A. (2005). Assessment practices of clinical neuropsychologists in the United States and Canada: a survey of INS, NAN, and APA division 40 members. Archives of Clinical Neuropsychology, 20, 3365. doi: 10.1016/j.acn.2004.02.005.Google Scholar
Ritchie, K., Artero, S. and Touchon, J. (2001). Classification criteria for mild cognitive impairment: a population-based validation study. Neurology, 56, 3742.CrossRefGoogle ScholarPubMed
Román, G. C. et al. (1993). Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology, 43, 250260.Google Scholar
Scazufca, M., Almeida, O. P., Vallada, H. P., Tasse, W. A. and Menezes, P. R. (2009). Limitations of the mini-mental state examination for screening dementia in a community with low socioeconomic status: results from the Sao Paulo ageing & health study. European Archives of Psychiatry and Clinical Neuroscience, 259, 815. doi: 10.1007/s00406-008-0827-6.CrossRefGoogle Scholar
Shulman, K. I. (2000). Clock-drawing: is it the ideal cognitive screening test? International Journal of Geriatric Psychiatry, 15, 548561.Google Scholar
Solomon, P. R. and Murphy, C. A. (2005). Should we screen for Alzheimer's disease? A review of the evidence for and against screening Alzheimer's disease in primary care practice. Geriatrics, 60, 2631.Google Scholar
Tombaugh, T. N. (2005). Test-retest reliable coefficients and 5-year change scores for the MMSE and 3 MS. Archives of Clinical Neuropsychology, 20, 485503. doi: 10.1016/j.acn.2004.11.004.Google Scholar
Tombaugh, T. N. and McIntyre, N. J. (1992). The mini-mental state examination: a comprehensive review. Journal of the American Geriatrics Society, 40, 922935.Google Scholar
United Nations Educational, Scientific and Cultural Organisation Institute for Statistics (UNESCO-UIS) (2011). International Standard Classification of Education (ISCED). Montreal, Canada: UNESCO-UIS.Google Scholar
Wechsler, D. (2009). Wechsler Memory Scale – Fourth Edition. San Antonio, TX: Pearson Assessment.Google Scholar
Zhu, J. and Tulsky, D. S. (2000). Co-norming the WAIS-III and WMS-III: Is there a test-order effect on IQ and memory scores? Clinical Neuropsychology, 14, 461467. doi: 10.1076/clin.14.4.461.7197.Google Scholar