Alzheimer's & dementia (New York, N. Y.) · 2019
Diagnostic accuracy of a global cognitive screen for Māori and non-Māori octogenarians.
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Zawaly Kristina, Moyes Simon A, Wood Phil C, Cheung Gary, Rolleston Anna, Buetow Stephen, Tippett Lynette, Kerse Ngaire
Аннотация
INTRODUCTION: We assessed the sensitivity and specificity of the Modified Mini-Mental State Examination (3MS) in predicting dementia and cognitive impairment in Māori (indigenous people of New Zealand) and non-Māori octogenarians.
METHODS: A subsample of participants from Life and Living in Advanced Age: a Cohort Study in New Zealand were recruited to determine the 3MS diagnostic accuracy compared with the reference standard.
RESULTS: Seventy-three participants (44% Māori) completed the 3MS and reference standard assessments. The 3MS demonstrated strong diagnostic accuracy to detect dementia with areas under the curve of 0.87 for Māori and 0.9 for non-Māori. Our cutoffs displayed ethnic variability and are approximately 5 points greater than those commonly applied. Cognitive impairment yielded low accuracy, and discriminatory power was not established.
DISCUSSION: Cutoffs that are not age or ethnically appropriate may compromise the accuracy of cognitive screens. Consequently, older age and indigeneity increase the risk of mislabeled cognitive status.
METHODS: A subsample of participants from Life and Living in Advanced Age: a Cohort Study in New Zealand were recruited to determine the 3MS diagnostic accuracy compared with the reference standard.
RESULTS: Seventy-three participants (44% Māori) completed the 3MS and reference standard assessments. The 3MS demonstrated strong diagnostic accuracy to detect dementia with areas under the curve of 0.87 for Māori and 0.9 for non-Māori. Our cutoffs displayed ethnic variability and are approximately 5 points greater than those commonly applied. Cognitive impairment yielded low accuracy, and discriminatory power was not established.
DISCUSSION: Cutoffs that are not age or ethnically appropriate may compromise the accuracy of cognitive screens. Consequently, older age and indigeneity increase the risk of mislabeled cognitive status.