Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-18T21:48:41.839Z Has data issue: false hasContentIssue false

Cognitive assessment tools in Asia: a systematic review

Published online by Cambridge University Press:  09 October 2015

Roshaslina Rosli
Affiliation:
Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Maw Pin Tan*
Affiliation:
Ageing and Age-Associated Disorders Research Group, Division of Geriatric Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
William Keith Gray
Affiliation:
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear, UK
Pathmawathi Subramanian
Affiliation:
Department Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Ai-Vyrn Chin
Affiliation:
Ageing and Age-Associated Disorders Research Group, Division of Geriatric Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
*
Correspondence should be addressed to: Dr Maw Pin Tan, Division of Geriatric Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia. Phone: +60-3-79493200. Email: mptan@ummc.edu.my.

Abstract

Background:

The prevalence of dementia is increasing in Asia than in any other continent. However, the applicability of the existing cognitive assessment tools is limited by differences in educational and cultural factors in this setting. We conducted a systematic review of published studies on cognitive assessments tools in Asia. We aimed to rationalize the results of available studies which evaluated the validity of cognitive tools for the detection of cognitive impairment and to identify the issues surrounding the available cognitive impairment screening tools in Asia.

Methods:

Five electronic databases (CINAHL, MEDLINE, Embase, Cochrane Library, and Science Direct) were searched using the keywords dementia Or Alzheimer Or cognitive impairment And screen Or measure Or test Or tool Or instrument Or assessment, and 2,381 articles were obtained.

Results:

Thirty-eight articles, evaluating 28 tools in seven Asian languages, were included. Twenty-nine (76%) of the studies had been conducted in East Asia with only four studies conducted in South Asia and no study from northern, western, or central Asia or Indochina. Local language translations of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were assessed in 15 and six studies respectively. Only three tools (the Korean Dementia Screening Questionnaire, the Picture-based Memory Intelligence Scale, and the revised Hasegawa Dementia Screen) were derived de novo from Asian populations. These tools were assessed in five studies. Highly variable cut-offs were reported for the MMSE (17–29/30) and MoCA (21–26/30), with 13/19 (68%) of studies reporting educational bias.

Conclusions:

Few cognitive assessment tools have been validated in Asia, with no published validation studies for many Asian nations and languages. In addition, many available tools display educational bias. Future research should include concerted efforts to develop culturally appropriate tools with minimal educational bias.

Type
Review Article
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aggarwal, N. T., Tripathi, M., Dodge, H. H., Alladi, S. and Anstey, K. J. (2012). Trends in Alzheimer's disease and dementia in the Asian-Pacific region. International Journal of Alzheimers Disorders, 2012, 171327.Google ScholarPubMed
Ahn, I., Kim, J., Saxton, J. and Kim, D. K. (2007). Reliability and validity of a short form of the Severe Impairment Battery in Korean Alzheimer's disease patients. International Journal of Geriatric Psychiatry, 22, 682687.Google Scholar
Alzheimer's Disease International (2009). World Alzheimer's Report 2009. London, UK: Alzheimer's Disease International.Google Scholar
Catindig, J. A., Venketasubramanian, N., Ikram, M. K. and Chen, C. (2013). Epidemiology of dementia in Asia: insights on prevalence, trends, and novel risk factors. Journal of the Neurological Sciences, 321, 1116.Google Scholar
Chan, S. M. S., Chiu, F. K. H. and Lam, C. W. L. (2006). Correlational study of the Chinese version of the executive interview (C-EXIT25) to other cognitive measures in a psychogeriatric population in Hong Kong Chinese. International Journal of Geriatric Psychiatry, 21, 535541.CrossRefGoogle Scholar
Cho, B. et al. (2002). The validity and reliability of a Computerized Dementia Screening Test developed in Korea. Journal of Neurological Sciences, 203–204, 109114.Google Scholar
Chung, J. C. C. (2009). Clinical validity of Fuld Object Memory Evaluation to screen for dementia in a Chinese society. International Journal of Geriatric Psychiatry, 24, 156162.Google Scholar
de Jager, C. A. et al. (2008). Utility of the Malayalam translation of the 7-minute screen for Alzheimer's disease risk in an Indian community. Neurology India, 56, 161166.Google Scholar
de Silva, H. A. and Gunatilake, S. B. (2002). Mini-Mental State Examination in Sinhalese: a sensitive test to screen for dementia in Sri Lanka. International Journal of Geriatric Psychiatry, 17, 134139.Google Scholar
Dominguez, J. C. et al. (2013). Adaptation of the Montreal Cognitive Assessment for elderly Filipino patients. East Asian Archives of Psychiatry, 23, 8085.Google ScholarPubMed
Dong, Y. et al. (2010). The Montreal Cognitive Assessment (MoCA) is superior to the Mini-Mental State Examination (MMSE) for the detection of vascular cognitive impairment after acute stroke. Journal of Neurological Sciences, 299, 1518.Google Scholar
Duthey, B. (2013). Priority medicines for Europe and the world: a public health approach to innovation. Update on 2004 Background Paper, BP 6.11 Alzheimer Disease.Google Scholar
Fuh, J. L. et al. (1995). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a screening tool for dementia for a predominantly illiterate Chinese population. Neurology, 45, 9296.Google Scholar
Fujiwara, Y. et al. (2010). Brief screening tool for mild cognitive impairment in older Japanese: validation of the Japanese version of the Montreal Cognitive Assessment. Geriatrics & Gerontology International, 10, 225232.Google Scholar
Gao, L. et al. (2014). Validation of the Chinese version of the NUCOG cognitive screening tool in patients with epilepsy, dementia and other neurological disorders. Journal of Clinical Neuroscience, 21, 980987.Google Scholar
Hanyu, H. et al. (2011). Japanese version of the Test Your Memory as a screening test in a Japanese memory clinic. Psychiatry Research, 190, 145148.Google Scholar
Heo, J.-H., Lee, K.-M., Park, T.-H., Ahn, J.-Y. and Kim, M.-K. (2012). Validation of the Korean Addenbrooke's Cognitive Examination for diagnosing Alzheimer's dementia and mild cognitive impairment in the Korean elderly. Applied Neuropsychology Adult, 19, 127131.Google Scholar
Hu, J.-B. et al. (2013). Cross-cultural difference and validation of the Chinese version of Montreal Cognitive Assessment in older adults residing in Eastern China: preliminary findings. Archives of Gerontology and Geriatrics, 56, 3843.Google Scholar
Ibrahim, N. M. et al. (2009). Validation study of the Mini-Mental State Examination in a Malay-speaking elderly population in Malaysia. Dementia and Geriatric Cognitive Disorders, 27, 247253.Google Scholar
Inoue, M., Jimbo, D., Taniguchi, M. and Urakami, K. (2011). Touch panel-type Dementia Assessment Scale: a new computer-based rating scale for Alzheimer's disease. Psychogeriatrics: Official Journal of the Japanese Psychogeriatrics Society, 11, 2833.Google Scholar
Iype, T., Ajitha, B. K., Antony, P., Ajeeth, N. B., Job, S. and Shaji, K. S. (2006). Usefulness of the Rowland Universal Dementia Assessment Scale in South India. Journal of Neurology, Neurosurgery & Psychiatry, 77, 513514.Google Scholar
Jeong, J. W. et al. (2007). A normative study of the Revised Hasegawa Dementia Scale: comparison of demographic influences between the Revised Hasegawa Dementia Scale and the Mini-Mental Status Examination. Dementia and Geriatric Cognitive Disorders, 24, 288293.CrossRefGoogle ScholarPubMed
Kim, H. and Chey, J. (2010). Effects of education, literacy, and dementia on the Clock Drawing Test performance. Journal of the International Neuropsychological Society, 16, 11381146.Google Scholar
Kim, K. W. et al. (2005). Diagnostic accuracy of mini-mental status examination and revised Hasegawa Dementia Scale for Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 19, 324330.Google Scholar
Konagaya, Y. et al. (2007). Validation of the Telephone Interview for Cognitive Status (TICS) in Japanese. International Journal of Geriatric Psychiatry, 22, 695700.CrossRefGoogle ScholarPubMed
Lam, L. C. W., Ho, P., Lui, V. W. C. and Tam, C. W. C. (2006). Reduced semantic fluency as an additional screening tool for subjects with questionable dementia. Dementia and Geriatric Cognitive Disorders, 22, 159164.Google Scholar
Lam, L. C. et al. (1998). Clock-face drawing, reading and setting tests in the screening of dementia in Chinese elderly adults. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 53, P353P357.CrossRefGoogle ScholarPubMed
Li, M., Ng, T. P., Kua, E. H. and Ko, S. M. (2006). Brief informant screening test for mild cognitive impairment and early Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 21, 392402.Google Scholar
Liebig, P. S. and Rajan, S. I. (2013). An Aging India: Perspectives, Prospects, and Policies. Abingdon, UK: Routledge.Google Scholar
Lin, K.-N. et al. (2003). The three-item clock-drawing test: a simplified screening test for Alzheimer's disease. European Neurology, 49, 5358.Google Scholar
Logiudice, D., Haralambous, B., Vrantsidis, F., Lin, X., Tinney, J. D. and Dow, B. (2010). An Education Program to Improve Referral to Memory Services for Older People of Asian Background Living in Melbourne: Dementia Screening Tools. Report No. 24, National Ageing Research Institute, Parkville, Victoria, Australia.Google Scholar
Maki, N. et al. (2000). Validity of the short-memory questionnaire in vascular dementia. International Journal of Geriatric Psychiatry, 15, 11431146.Google Scholar
Mathuranath, P. S., Cherian, J. P., Mathew, R., George, A., Alexander, A. and Sarma, S. P. (2007). Mini-Mental State Examination and the Addenbrooke's cognitive examination: effect of education and norms for a multicultural population. Neurology India, 55, 106110.Google Scholar
Milne, A., Culverwell, A., Guss, R., Tuppen, J. and Whelton, R. (2008). Screening for dementia in primary care: a review of the use, efficacy and quality of measures. International Psychogeriatrics, 20, 911926.Google Scholar
Na, H. R., Lee, S. H., Lee, J. S., Doody, R. S. and Kim, S. Y. (2009). Korean version of the Baylor Profound Mental Status Examination: a brief staging measure for patients with severe Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 27, 6975.Google Scholar
Poon, V. W., Lam, L. C. and Wong, S. Y. (2008). Assessment of the severity of dementia: validity and reliability of the Chinese (Cantonese) version of the Hierarchic Dementia Scale (CV-HDS). International Journal of Geriatric Psychiatry, 23, 909914.Google Scholar
Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W. and Ferri, C. P. (2013). The global prevalence of dementia: a systematic review and meta-analysis. Alzheimer's & Dementia: Journal of Alzheimer's Association, 9, 6375 e2.Google Scholar
Razali, R. et al. (2014). Is the Bahasa Malaysia version of the Montreal Cognitive Assessment (MoCA-BM) a better instrument than the Malay version of the Mini Mental State Examination (M-MMSE) in screening for mild cognitive impairment (MCI) in the elderly? Comprehensive Psychiatry, 55 (Suppl. 1), S70S75.Google Scholar
Ridha, B. and Rossor, M. (2005). The Mini Mental S. Practical Neurology, 5, 298303.Google Scholar
Shi, J., Tian, J., Wei, M., Miao, Y. and Wang, Y. (2012). The utility of the Hopkins Verbal Learning Test (Chinese version) for screening dementia and mild cognitive impairment in a Chinese population. BMC Neurology, 12, 136. doi:10.1186/1471-2377-12-136.Google Scholar
Suh, G.-H. and Kang, C.-J. (2006). Validation of the Severe Impairment Battery for patients with Alzheimer's disease in Korea. International Journal of Geriatric Psychiatry, 21, 626632.Google Scholar
Shin, M. H. et al. (2011). A combination of the Korean version of the Mini-Mental State Examination and Korean Dementia Screening Questionnaire is a good screening tool for dementia in the elderly. Psychiatry Investigation, 8, 348353.Google Scholar
Sosa, A. L. et al. (2012). Prevalence, distribution, and impact of mild cognitive impairment in Latin America, China, and India: a 10/66 population-based study. Plos Medicine, 9, e1001170e1001170.Google Scholar
Tsai, N. and Gao, Z. X. (1989). Validity of Hasegawa's Dementia Scale for screening dementia among aged Chinese. International Psychogeriatrics, 1, 145152.Google Scholar
Verghese, J. et al. (2012). Picture-based memory impairment screen for dementia. Journal of the American Geriatrics Society, 60, 21162120.CrossRefGoogle ScholarPubMed
Whiting, P. F. et al. (2011). QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Annals of Internal Medicine, 155, 529536.Google Scholar
World Health Organization. (2011). Bulletin of the World Health Organization, 89, 161240.Google Scholar
World Health Organization (2012). Dementia: A Public Health Priority Report. Geneva, Switzerland: WHO.Google Scholar
Yang, Y.-H., Lai, C.-L., Lin, R.-T., Tai, C.-T. and Liu, C.-K. (2006). Cut-off values of Blessed Dementia Rating Scale and its clinical application in elderly Taiwanese. Kaohsiung Journal of Medical Sciences, 22, 377384.Google Scholar
Yip, C. K. and Man, D. W. K. (2010). Validation of the Intelligent Cognitive Assessment System (ICAS) for stroke survivors. Brain Injury, 24, 10321038.Google Scholar
Youn, J. C. et al. (2002). Development of the Korean version of Alzheimer's Disease Assessment Scale (ADAS-K). International Journal of Geriatric Psychiatry, 17, 797803.Google Scholar
Yu, J., Li, J. and Huang, X. (2012). The Beijing version of the Montreal Cognitive Assessment as a brief screening tool for mild cognitive impairment: a community-based study. BMC Psychiatry, 12, 156. doi:10.1186/1471-244X-12-156.Google Scholar