Objective: Early detection of cognitive impairment is critical for patient outcomes, yet cognitive impairment is under identified in primary care settings largely due to time constraints. The Quick Mild Cognitive Impairment (Qmci) screen was developed to address the need for a short cognitive screening instrument (< 5 min) that is sensitive to early cognitive change but has not been validated in the United States (US). The objective of this study was to examine the classification accuracy of the Qmci in participants from two memory specialty (e.g., secondary outpatient) clinics in the US.
Methods: Participants were 152 older adults: 87 participants were cognitively normal (CN), 48 were diagnosed with mild cognitive impairment (MCI) and 17 were diagnosed with mild dementia (DEM). Classification accuracy of the Qmci and Mini Mental State Examination (MMSE) were compared in participants with and without cognitive impairment.
Results: The Qmci demonstrated higher classification accuracy in differentiating CN from cognitively impaired participants (i.e., MCI and DEM) (AUC = 0.82) than the MMSE (AUC = 0.77). The optimal cut-off score for the Qmci was < 67, which achieved a sensitivity of 79% and specificity of 80%. The optimal MMSE cut-off score was < 27, which achieved a sensitivity of 97% and specificity of 43%.
Conclusions: The Qmci is a valid cognitive screening instrument for detecting early stages of cognitive impairment in memory clinic samples in the US. Its short administration time and increased specificity for detecting MCI make it an attractive option for use in primary care settings. Further validation of the Qmci is needed, specifically within primary care settings.
Keywords: cognitive screening; dementia; mild cognitive impairment; older adults; primary care.
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