Screening for Cognitive Impairment with the Quick Memory Check: Validation of a Caregiver Administered Cognitive Screen

Article type: Research Article

Authors: O’Caoimh, Rónán^{a; b; c; *} | Coghlan, Patrick^a | O’Donovan, Mark R^d | Mohd Zaki, Nurzakiah^a | Daly, Brian^a | Gao, Yang^a | Molloy, D. William^a

Affiliations: [a] Department of Gerontology and Rehabilitation, University College Cork, St Finbarr’s hospital, Douglas road, Cork City, Ireland | [b] Health Research Board Clinical Research Facility Galway, National University of Ireland, Galway, Geata an Eolais, University Road, Galway, Ireland | [c] Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, Cork City, Ireland | [d] Health Research Board Clinical Research Facility, University College Cork, Cork City, Ireland

Correspondence: [*] Correspondence to: Dr Rónán O’Caoimh, Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, Cork City, Ireland. Tel.: +353 21 420 5976; E-mail: [email protected].; ORCID: https://orcid.org/0000-0002-1499-673X

Abstract: Background:Self or home-administered cognitive screening instruments (CSIs) can reduce barriers to the early detection of mild cognitive impairment (MCI) and dementia. Objective:To examine the acceptability and diagnostic accuracy of a caregiver-administered CSI, the Quick Memory Check (QMC). Methods:Components of the Quick Mild Cognitive impairment (Qmci) screen (orientation, verbal fluency, and logical memory) were re-weighted to create the QMC, scored out of 100 points. Participants, attending a university hospital memory clinic, were provided administration instructions beforehand. Area under the curve (AUC) scores, adjusted for age and education, were compared with the Qmci screen and Montreal Cognitive Assessment (MoCA). Caregivers or family scored the QMC. Results:In all, 366 participants were recruited; 53 with subjective memory complaints (SMC), 74 with MCI, 193 with dementia, and 46 normal controls. Median QMC scores for controls were 70±13 versus 60±20 for SMC, 52±18 for MCI, and 31±21 for dementia. The QMC had excellent accuracy (AUC 0.97) for cognitive impairment (MCI/dementia from controls), similar to the Qmci screen (AUC 0.98, p = 0.17) and MoCA (AUC 0.95, p = 0.13). At a cut-off of <52/100, the QMC had 83% sensitivity and 100% specificity for cognitive impairment. The QMC had lower accuracy differentiating MCI from SMC (AUC 0.73), albeit similar to the MoCA (AUC 0.70). Conclusion:The QMC, administered by caregivers in advance of clinic, compared favorably to established CSIs scored by trained raters. This caregiver, home-administered CSI is acceptable and can identify cognitive impairment, potentially improving efficiency by reducing testing time and patient stress in busy clinical settings.

Keywords: Caregiver, cognitive screening instrument, dementia, diagnostic accuracy testing, mild cognitive impairment

DOI: 10.3233/JAD-220339

Journal: Journal of Alzheimer's Disease, vol. 90, no. 4, pp. 1417-1427, 2022