Cognitive Assessment Tools for Screening Older Adults With Low Levels of Education: A Critical Review
Frontiers in Psychiatry
Tavares-Junior, J. W. L., de Souza, A. C. C., et al. (2019).
Frontiers in Psychiatry, 10, Article 878.
This review investigates cognitive screening tools for the diagnosis of mild cognitive impairment (MCI) or Alzheimer's disease (AD) in adults (over 55 years old) with limited education levels (four years of education or less). Although speech-language pathologists do not diagnose AD or MCI, findings from this review may be useful for identifying tools for detection of cognitive impairments in these populations.
Not stated
Through July 2019
Cross-sectional studies; prospective cohort studies
36
<p>Of the 44 cognitive screening tools identified in this review, the following five demonstrated some diagnostic accuracy for the diagnosis of MCI and AD in adults with limited educational attainment levels:</p>
<ul>
<li>Mini-Mental State Examination (MMSE);</li>
<li>Montreal Cognitive Assessment (MoCA);</li>
<li>Persian Test of Elderly for Assessment of Cognition and Executive function (PEACE);</li>
<li>Six-Item Screener (SIS); and</li>
<li>Memory Alteration Test (MAT).</li>
</ul>
<p>The MMSE and MoCA were the most frequently used cognitive assessment tools across studies, while the PEACE, SIS, and MAT were each used in one study only. This review found that "the MMSE has low sensitivity for MCI, does not perform well in assessing executive functions, and has limiting floor and ceiling effects" (p. 8), and "MoCA scores are strongly influenced by educational background" (p. 8). The authors conclude that additional tools should be developed for assessing the cognitive abilities of adults with lower educational attainment levels.</p>