Objectives: Despite improving recognition of cognitive impairment in elderly population 40-60 % of patients with dementia remain undetected in the community. Therefore short yet reliable instruments are needed to help primary care physicians to diagnose dementia and to distinguish it from other cognitive symptoms. The aim of the study was to evaluate the feasibility of a short neurocognitive battery – 7 Minute Screening test (7 MST) and its psychometric characteristics for diagnosis of Alzheimer’s disease (AD) in Czech sample
Methods: Validation was performed in two steps: 1) translation a back translation of 7 MST and piloting after expertsx consensus 2) validation in a model population of 65 patients with „probable“ AD (mean age 82.8 ± 6.2 yrs, duration of symptoms 3.3± 1.2 yrs) and 72 gender and education matched cognitively intact subjects (mean age 78.6±6.6 yrs) recruited from out-patient psychogeriatric clinic in university hospital.
Results: Both groups differed significantly in total 7 MST score and in all 4 subtests: orientation (OR), memory (M), clock drawing (CD), verbal fluency (VF) (p<0.01). Cronbach α 0.8-0.9 confirm good internal consistency of OR, M and CD scales. Both test-retest (r=0.63-0.96) and interrater reliability (r=0.82-0.96) reached good to very good correlation. Exploratory factor analysis confirmed two distinct components of 7MST: visuospatial (CD) and verbal/memory (OR,M,VF). Binary logistic regression using two models found 94/95% sensitivity and 93/97 % specificity. The ROC area under curve was 0.976 (CI 0.951-1.002). Administration time reached 8.7 min for controls, 11.1 min for AD subjects. Administratorsx and subjectsx acceptance were very good.
Conclusions: 7MST is a rapid, valid and reliable screening instrument for detection of Alzheimer’s disease in busy clinical practice. In a model population it discriminates subjects with dementia from cognitively intact older people. Administration by trained nurse can save physician’s time and identify those who will benefit from further evaluation by the physician. 7MST could be recommended for further testing in elderly.
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