Validity of screening tools for dementia and mild cognitive impairment among the elderly in primary health care: a systematic review

Abd Razak MA 1 , Ahmad NA 2 , Chan YY 3 , Mohamad Kasim N 4 , Yusof M 5 , Abdul Ghani MKA 6 Show all authors , Omar M 7 , Abd Aziz FA 8 , Jamaluddin R 9

Affiliations 

  • 1 Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia. Electronic address: aznuddin.ar@moh.gov.my
  • 2 Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia. Electronic address: drnoorani@moh.gov.my
  • 3 Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia. Electronic address: chan.yy@moh.gov.my
  • 4 Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia. Electronic address: noraida_kasim@moh.gov.my
  • 5 Women and Child Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Dr Latiff, 50586 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia. Electronic address: muslimah_yusof@moh.gov.my
  • 6 Klinik Rafeeq & Nurul, Sungai Rengit, 81620 Pengerang, Johor, Malaysia. Electronic address: drkamalariff@gmail.com
  • 7 Kuala Selangor Health District, Ministry of Health Malaysia, Jalan Semarak, 45000 Kuala Selangor, Selangor, Malaysia. Electronic address: bentiomarbarawas@gmail.com
  • 8 Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia. Electronic address: Fazlyazry.abdulaziz@moh.gov.my
  • 9 Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia. Electronic address: rasidah.j@moh.gov.my
Public Health, 2019 Apr;169:84-92.
PMID: 30826688 DOI: 10.1016/j.puhe.2019.01.001

Abstract

OBJECTIVES: This systematic review aims to provide updated and comprehensive evidence on the validity and feasibility of screening tools for mild cognitive impairment (MCI) and dementia among the elderly at primary healthcare level.

STUDY DESIGN: A review of articles was performed.

METHODS: A search strategy was used by using electronic bibliographic databases including PubMed, Embase and CENTRAL for published studies and reference list of published studies. The articles were exported to a bibliographic database for further screening process. Two reviewers worked independently to screen results and extract data from the included studies. Any discrepancies were resolved and confirmed by the consensus of all authors.

RESULTS: There were three screening approaches for detecting MCI and dementia - screening by a healthcare provider, screening by a self-administered questionnaire and caretaker informant screening. Montreal Cognitive Assessment (MoCA) was the most common and preferable tool for MCI screening (sensitivity [Sn]: 81-97%; specificity [Sp]: 60-86%), whereas Addenbrooke's Cognitive Examination (ACE) was the preferable tool for dementia screening (Sn: 79-100%; Sp: 86%).

CONCLUSION: This systematic review found that there are three screening approaches for detecting early dementia and MCI at primary health care. ACE and MoCA are recommended tools for screening of dementia and MCI, respectively.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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