Diagnostic Accuracy of Cognitive Screening Tools Validated for Older Adults in Iran: A Systematic Review and Meta-Analysis
BMC Geriatrics
Kamalzadeh, L., Tayyebi, G., et al. (2024).
BMC Geriatrics, 24(1), 428.
<div>This systematic review compares the diagnostic accuracy of validated cognitive screening tools to gold standard tools for cognitive impairment for Iranian adults, 60 years and older.</div>
No funding received
From database inception to March 2023
<div>Cross-sectional studies</div>
17
<div>The authors identified several screening tools suitable for identifying dementia in the primary care setting due to their brevity, user-friendliness, and acceptable diagnostic accuracy. The psychometric characteristics of the tools are as follows:</div>
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<ul>
<li>The Quick Mild Cognitive Impairment (Qmci) screen demonstrated a sensitivity of 88% and specificity of 90% using an optimal cutoff of <38/100 for identifying moderate to severe dementia. </li>
<li>The Persian version of the Rowland Universal Dementia Assessment Scale (RUDAS) demonstrated a sensitivity of 86% and specificity of 79% using a cutoff score of 20 for identifying dementia in older adults with more than six years of formal education.</li>
<li>The Persian version of the Abbreviated Mental Test Score (AMTS) demonstrated a sensitivity of 99% and specificity of 85% using a cutoff score of 6 or lower.</li>
<li>The Persian version of the Short Portable Mental Status Questionnaire (SPMSQ) demonstrated a sensitivity of 86.4% and specificity of 88.2% using a cutoff score of 4 for illiterate, older adults. Using a cutoff score of 3 for literate patients, the SPMSQ demonstrated a sensitivity of 83% and specificity of 93.7%.</li>
<li>The Picture-based Memory Impairment Screen (PMIS) validated in older Iranian adults showed a sensitivity of 60% and specificity of 91% for detecting dementia using a cutoff score of 5.</li>
</ul>
<div>In specialized care settings, the authors identified the following tools for screening older Iranian adults with dementia:</div>
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<ul>
<li>The Addenbrooke's Cognitive Examination (ACE-III) demonstrated a sensitivity of 99% and specificity of 95% using a cutoff score of 78 for older individuals with a minimum of six years of formal education.</li>
<li>The Persian test of the Elderly for Assessment of Cognition and Executive function (PEACE) demonstrated a sensitivity of 75.8% and specificity of 97.4% using a cutoff score of 67.5 for older adults with less education.</li>
</ul>
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<div>Limitations of this review include duplication of included subjects across studies, a lack of research on different disease stages, and a lack of blinding techniques. Additional research is needed to investigate the effects of literacy and age on cognitive performance.</div>
<div>The authors identified several screening tools for mild cognitive impairment (MCI) for older Iranian adults. The psychometric characteristics of the tools are as follows:</div>
<div>
<ul>
<li>The Quick Mild Cognitive Impairment (Qmci) screen demonstrated a sensitivity of 79% and specificity of 80% using a cutoff score of less than 53/100.</li>
<li>The Persian version of the Abbreviated Mental Test Score (AMTS) showed sensitivity ranging from 81 to 96% and specificity ranging from 75 to 86% depending on the cutoff score.</li>
<li>The Addenbrooke's Cognitive Examination (ACE-III) demonstrated a sensitivity of 93% and specificity of 91% using a cutoff score of 84 for MCI.</li>
</ul>
</div>
<div>Limitations of this review include duplication of included subjects across studies, a lack of research on different disease stages, and a lack of blinding techniques. Additional research is needed to investigate the effects of literacy and age on cognitive performance.</div>
