Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression
Abstract
:1. Introduction
2. Methods
2.1. Data Collection
2.2. Participants
2.3. Outcome Measures
2.4. Analysis
3. Results
4. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Diagnosis | N = X | Age (Median & IQR) | Education (Median & IQR) | Gender (% Male) | SMMSE (Median & IQR) | Qmci (Median & IQR) | SMMSE AUC NC v CI (95% Confidence Intervals) | Qmci AUC NC v CI (95% Confidence Intervals) | p = x |
---|---|---|---|---|---|---|---|---|---|
Total (All including co-morbid depression & MCI) | 3020 | 77 (81 − 72 = 9) | 12 (14 − 9 = 5) | 1537/2997 * (51%) | 25 (28 − 20 = 8) | 43 (56 − 29 = 27) | 0.87 (0.85–0.88) | 0.93 (0.92–0.94) | z = 11.6 p < 0.001 |
Dementia (All including co-morbid depression) | 2160 | 77 (82 − 73 = 9) | 12 (14 − 9 = 5) | 1087/2145 * (51%) | 23 (26 − 18 = 8) | 38 (50 − 24 = 26) | 0.92 (0.91–0.93) | 0.96 (0.95–0.96) | z = −8.6 p < 0.001 |
Dementia (All excluding co-morbid depression) | 1879 | 78 (82 − 74 = 8) | 11 (14 − 9 = 5) | 971/1864 * (52%) | 23 (26 − 18 = 8) | 37 (49 − 24 = 25) | 0.92 (0.91–0.93) | 0.96 (0.95–0.97) | z = −8.3 p < 0.001 |
AD | 1483 | 78 (83 − 74 = 9) | 12 (14 − 9 = 5) | 651/1475 * (44%) | 23 (25.5 − 18 = 7.5) | 37 (48 − 23 = 25) | 0.94 (0.93–0.95) | 0.97 (0.96–0.97) | z = −5.9 p < 0.001 |
VaD | 130 | 74 (79 − 69 = 10) | 12 (14 − 10 = 4) | 95 (73%) | 27 (29 − 25 = 4) | 53 (64 − 40 = 24) | 0.74 (0.68–0.79) | 0.87 (0.84–0.91) | z = −6.3 p < 0.001 |
Mixed (AD/VaD) | 400 | 77 (81 − 74 = 7) | 11 (13 − 9 = 4) | 256/393 * (65%) | 22 (27 − 19 = 8) | 36 (51 − 23 = 28) | 0.91 (0.89–0.93) | 0.95 (0.94–0.96) | z = −5.7 p < 0.001 |
AD, VaD and Mixed | 2013 | 78 (82 − 74 = 4) | 12 (14 − 9 = 5) | 1002/1998 * (50%) | 23 (26 − 18 = 8) | 38 (50 − 24 = 26) | 0.92 (0.91–0.93) | 0.96 (0.95–0.97) | z = 8.4 p < 0.001 |
FTD | 41 | 69 (71 − 62 = 9) | 12 (14 − 10 = 4) | 25/41 (61%) | 23 (27 − 19 = 8) | 42 (52 − 28 = 24) | 0.90 (0.85–0.96) | 0.96 (0.94–0.98) | z = −2.5 p = 0.01 |
PDD | 41 | 75 (77 − 71 = 6) | 12 (12 − 9.5 = 2.5) | 28/41 (68%) | 26 (29 − 21 = 8) | 46 (61 − 32 = 29) | 0.81 (0.72–0.90) | 0.92 (0.88–0.95) | z = −3.1 p = 0.002 |
LBD | 65 | 78 (82 − 73 = 9) | 10 (14 − 8 = 6) | 32/65 (49%) | 24 (27 − 18 = 9) | 37 (54 − 24 = 30) | 0.94 (0.92–0.97) | 0.94 (0.91–0.97) | z = 0.11 p = 0.91 |
MCI | 860 | 75 (80 − 70 = 10) | 12 (14 − 10 = 4) | 450/852 * (53%) | 28 (29 − 25 = 4) | 56 (66 − 46 = 20) | 0.73 (0.71–0.75) | 0.85 (0.83–0.87) | z = −10.8 p < 0.001 |
Co-morbid depression | 281 | 75 (81 − 70 = 11) | 12 (14 − 10 = 4) | 116/281 (41%) | 25 (27 − 21 = 6) | 44 (56 − 30 = 26) | 0.88 (0.86–0.91) | 0.93 (0.91–0.95) | z = −4.2 p < 0.001 |
MCI with co-morbid depression | 94 | 73 (75 − 68 = 7) | 12 (14 − 9 = 5) | 50/92 * (54%) | 26 (29 − 23 = 6) | 52 (62 − 40 = 22) | 0.79 (0.73–0.85) | 0.90 (0.86–0.93) | z = −4.4 p < 0.001 |
MCI without co-morbid depression | 766 | 76 (80 − 70 = 10) | 12 (14 − 10 = 4) | 400/760 * (53%) | 28 (29 − 26 = 3) | 57 (66 − 46 = 20) | 0.72 (0.70–0.75) | 0.84 (0.82–0.86) | z = −10.4 p < 0.001 |
Controls | 875 | 70 (76 − 62 = 14) | 13 (16 − 12 = 4) | 372/875 (43%) | 29 (30 − 28 = 2) | 74 (81 − 66 = 15) | NA | NA | NA |
Diagnosis | N = X | Orientation (Median and IQR) | Registration (Median and IQR) | Clock Drawing (Median and IQR) | Delayed Recall (Median and IQR) | Verbal Fluency (Median and IQR) | Logical Memory (Median and IQR) | Qmci Total (Median and IQR) |
---|---|---|---|---|---|---|---|---|
Total (All) | 3020 | 8 (10 − 6 = 4) | 5 (5 − 4 = 1) | 12 (14 − 5 = 9) | 4 (12 − 0 = 12) | 5 (7 − 3 = 4) | 8 (12 − 4 = 8) | 43 (56 − 29 = 27) |
Dementia (All including co-morbid depression) | 2160 | 7 (9 − 5 = 4) | 5 (5 − 3 = 2) | 11 (14 − 3 = 11) | 4 (8 − 0 = 8) | 5 (7 − 3 = 4) | 8 (12 − 4 = 8) | 38 (50 − 24 = 26) |
Dementia (All excluding co-morbid depression) | 1879 | 7 (9 − 5 = 4) | 5 (5 − 3 = 2) | 11 (13 − 3 = 10) | 0 (8 − 0 = 8) | 4 (6 − 3 = 3) | 8 (12 − 4 = 8) | 37 (49 − 24 = 25) |
AD | 1483 | 7 (9 − 5 = 4) | 5 (5 − 3 = 2) | 11 (13 − 3 = 10) | 0 (8 − 0 = 8) | 4 (6 − 3 = 3) | 8 (12 − 4 = 8) | 37 (48 − 23 = 25) |
VaD | 130 | 9 (10 − 7 = 3) | 5 (5 − 4 = 1) | 14 (15 − 11 = 4) | 8 (12 − 0 = 12) | 7 (9 − 4 = 5) | 10 (14 − 8 = 6) | 53 (64 − 40 = 24) |
Mixed (AD/VaD) | 400 | 7 (10 − 5 = 5) | 5 (5 − 3 = 2) | 10 (14 − 2 = 12) | 0 (8 − 0 = 8) | 5 (7 − 3 = 4) | 8 (12 − 4 = 8) | 35.5 (51 − 23 = 28) |
AD, VaD and Mixed | 2013 | 7 (9 − 5 = 4) | 5 (5 − 3 = 2) | 11 (14 − 3 = 11) | 0 (8 − 0 = 8) | 5 (7 − 3 = 4) | 8 (12 − 4 = 8) | 38 (50 − 24 = 26) |
FTD | 41 | 9 (10 − 6 = 4) | 5 (5 − 3 = 2) | 12 (13 − 5 = 8) | 4 (8 − 0 = 8) | 4 (7 − 3 = 4) | 8 (12 − 4 = 8) | 43 (55 − 30 = 25) |
PDD | 41 | 9.5 (10 − 7 = 3) | 5 (5 − 4 = 1) | 12.5 (15 − 7 = 8) | 8 (12 − 0 = 12) | 5.5 (7 − 4 = 3) | 10 (14 − 8 = 6) | 46 (61 − 32 = 29) |
LBD | 65 | 8 (10 − 6 = 4) | 5 (5 − 3 = 2) | 7 (12 − 1 = 11) | 8 (12 − 0 = 12) | 4 (6 − 3 = 3) | 8 (10 − 4 = 6) | 37 (54 − 24 = 30) |
MCI | 860 | 10 (10 − 8 = 2) | 5 (5 − 5 = 0) | 14 (15 − 12 = 3) | 12 (16 − 4 = 12) | 7 (9 − 5 = 4) | 12 (16 − 8 = 8) | 56 (66 − 46 = 20) |
Co-morbid depression | 281 | 8 (10 − 6 = 4) | 5 (5 − 4 = 1) | 11 (14 − 4 = 10) | 4 (12 − 0 = 12) | 6 (8 − 3 = 5) | 10 (14 − 4 = 10) | 44 (56 − 30 = 26) |
MCI with co-morbid depression | 94 | 9 (10 − 7 = 3) | 5 (5 − 4 = 1) | 13 (15 − 10 = 5) | 8 (12 − 4 = 8) | 8 (8 − 4 = 4) | 12 (14 − 8 = 6) | 51.5 (62 − 40 = 22) |
MCI without co-morbid depression | 766 | 10 (10 − 8 = 2) | 5 (5 − 5 = 0) | 14 (15 − 12 = 3) | 12 (16 − 4 = 12) | 7 (9 − 5 = 4) | 12 (16 − 8 = 8) | 57 (66 − 46 = 20) |
Controls | 875 | 10 (10 − 10 = 0) | 5 (5 − 5 = 0) | 15 (15 − 14 = 1) | 16 (20 − 12 = 8) | 10 (13 − 8 = 5) | 18 (22 − 14 = 8) | 74 (81 − 66 = 15) |
Diagnosis | N = X | Orientation AUC (95% CI) | Registration AUC (95% CI) | Clock Drawing AUC (95% CI) | Delayed Recall AUC (95% CI) | Verbal Fluency AUC (95% CI) | Logical Memory AUC (95% CI) | Qmci Total AUC (95% CI) |
---|---|---|---|---|---|---|---|---|
Total (All) | 3020 | 0.81 (0.79–0.82) | 0.62 (0.60–0.64) | 0.80 (0.79–0.82) | 0.86 (0.85–0.87) | 0.85 (0.84–0.87) | 0.87 (0.85–0.88) | 0.93 (0.92–0.94) |
Dementia (All including co-morbid depression) | 2160 | 0.86 (0.85–0.87) | 0.65 (0.63–0.67) | 0.85 (0.83–0.86) | 0.90 (0.89–0.91) | 0.89 (0.88–0.90) | 0.89 (0.88–0.91) | 0.96 (0.95–0.96) |
Dementia (All excluding co-morbid depression) | 1879 | 0.87 (0.85–0.88) | 0.66 (0.64–0.68) | 0.85 (0.84–0.87) | 0.90 (0.89–0.92) | 0.90 (0.88–0.91) | 0.90 (0.89–0.91) | 0.96 (0.95–0.97) |
AD | 1483 | 0.88 (0.87–0.90) | 0.66 (0.64–0.68) | 0.85 (0.84–0.87) | 0.91 (0.90–0.93) | 0.91 (0.89–0.92) | 0.91 (0.89–0.92) | 0.97 (0.96–0.97) |
VaD | 130 | 0.71 (0.66–0.77) | 0.56 (0.50–0.61) | 0.72 (0.67–0.77) | 0.80 (0.75–0.84) | 0.80 (0.77–0.84) | 0.81 (0.77–0.85) | 0.87 (0.84–0.91) |
Mixed (AD/VaD) | 400 | 0.84 (0.82–0.87) | 0.65 (0.61–0.68) | 0.85 (0.82–0.87) | 0.90 (0.88–0.92) | 0.89 (0.87–0.91) | 0.89 (0.87–0.91) | 0.95 (0.94–0.96) |
AD, VaD & Mixed | 2013 | 0.86 (0.85–0.88) | 0.65 (0.63–0.67) | 0.84 (0.83–0.86) | 0.90 (0.89–0.91) | 0.90 (0.88–0.91) | 0.90 (0.88–0.91) | 0.96 (0.95–0.97) |
FTD | 41 | 0.78 (0.69–0.87) | 0.63 (0.53–0.73) | 0.88 (0.81–0.94) | 0.90 (0.87–0.95) | 0.85 (0.78–0.92) | 0.88 (0.83–0.93) | 0.96 (0.94–0.98) |
PDD | 41 | 0.71 (0.61–0.81) | 0.68 (0.58–0.77) | 0.73 (0.63–0.82) | 0.84 (0.77–0.91) | 0.85 (0.79–0.91) | 0.83 (0.77–0.88) | 0.92 (0.88–0.95) |
LBD | 65 | 0.82 (0.74–0.88) | 0.66 (0.58–0.74) | 0.92 (0.87–0.96) | 0.84 (0.79–0.90) | 0.89 (0.85–0.93) | 0.86 (0.81–0.92) | 0.94 (0.91–0.97) |
MCI | 860 | 0.68 (0.65–0.70) | 0.54 (0.51–0.57) | 0.69 (0.67–0.72) | 0.76 (0.74–0.78) | 0.76 (0.74–0.78) | 0.80 (0.77–0.81) | 0.85 (0.83–0.87) |
Co-morbid depression | 281 | 0.80 (0.77–0.84) | 0.62 (0.57–0.66) | 0.81 (0.78–0.84) | 0.86 (0.84–0.89) | 0.84 (0.82–0.87) | 0.84 (0.82–0.87) | 0.93 (0.91–0.95) |
MCI with co-morbid depression | 94 | 0.75 (0.69–0.82) | 0.59 (0.52–0.65) | 0.75 (0.70–0.81) | 0.82 (0.78–0.87) | 0.80 (0.76–0.85) | 0.80 (0.75–0.84) | 0.90 (0.86–0.93) |
MCI without co-morbid depression | 766 | 0.67 (0.64–0.69) | 0.53 (0.50–0.56) | 0.69 (0.66–0.71) | 0.75 (0.73–0.77) | 0.76 (0.73–0.78) | 0.80 (0.76–0.81) | 0.84 (0.82–0.86) |
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O’Caoimh, R.; Molloy, D.W. Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression. Diagnostics 2019, 9, 93. https://doi.org/10.3390/diagnostics9030093
O’Caoimh R, Molloy DW. Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression. Diagnostics. 2019; 9(3):93. https://doi.org/10.3390/diagnostics9030093
Chicago/Turabian StyleO’Caoimh, Rónán, and D. William Molloy. 2019. "Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression" Diagnostics 9, no. 3: 93. https://doi.org/10.3390/diagnostics9030093
APA StyleO’Caoimh, R., & Molloy, D. W. (2019). Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression. Diagnostics, 9(3), 93. https://doi.org/10.3390/diagnostics9030093