The Quick Mild Cognitive Impairment (Qmci) screen: developing a new screening test for mild cognitive impairment and dementia

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O'Caoimh, Rónán
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University College Cork
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Introduction: Identifying mild cognitive impairment (MCI) is challenging. Few short instruments have sufficient sensitivity and specificity for use in busy clinical practice. This thesis explores the development, psychometric evaluation and validation of a new short (3–5 min) cognitive screening instrument, designed to screen for MCI and early dementia, called the Quick Mild Cognitive Impairment (Q𝘮𝘤𝘪) screen. Specific aims included assessing 1) content validity, 2) concurrent validity against other short screens, 3) construct validity against detailed global and neuropsychological tests and 4) refining the Q𝘮𝘤𝘪 into a ‘home’-carer administered “Quick Memory Check-QMC”. Methods: A secondary analysis of data from three Canadian databases was conducted to validate the Q𝘮𝘤𝘪. The Q𝘮𝘤𝘪 was then externally validated in different settings (memory clinic, movement disorder clinic, general practice, rehabilitation unit) in Ireland. Translation and external validation in other languages was also begun. Results: The Q𝘮𝘤𝘪 was more accurate than the ABCS 135, 6CIT, GPCOG, SMMSE and had similar sensitivity but greater specificity than the MoCA in differentiating MCI from normal. Cut-off scores using maximal accuracy and Youden’s Index, adjusted for age and education, were produced. The Q𝘮𝘤𝘪 correlated with global functional measures (Lawton-Brody ADL scale and CDR) and the Standardised ADAS-cog. The Q𝘮𝘤𝘪 had excellent inter-rater and test-retest reliability. A shortened Q𝘮𝘤𝘪, administered by caregivers (QMC), was acceptable and had comparable accuracy to a battery of short cognitive screens. Discussion: This thesis presents the development and psychometric evaluation of the Q𝘮𝘤𝘪 screen. It also demonstrates the potential of shortening the instrument to allow caregivers score patients at home in an attempt to reduce performance anxiety. This project also suggests that the Q𝘮𝘤𝘪 could be substituted for more detailed and longer instruments in a wide variety of settings, as a rapid screening test for cognitive impairment, particularly where the suspicion favours the presence of MCI
Cognitive screening , Dementia , Mild cognitive impairment
O'Caoimh, R. 2015. The Quick Mild Cognitive Impairment (Qmci) screen: developing a new screening test for mild cognitive impairment and dementia. PhD Thesis, University College Cork.
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© 2015, Rónán O'Caoimh.