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Observational Study
. 2021 Feb;69(2):441-449.
doi: 10.1111/jgs.16898. Epub 2020 Nov 9.

Development of a Brief Screen to Detect Cognitive Impairment in Older Adults: The QuickSort

Amie M Foran  1 , Jane L Mathias  1 , Stephen C Bowden  2
Affiliations
Observational Study

Development of a Brief Screen to Detect Cognitive Impairment in Older Adults: The QuickSort

Amie M Foran et al. J Am Geriatr Soc. 2021 Feb.

Abstract

Background: Sorting tests detect cognitive decline in older adults who have a neurodegenerative disorder, such as Alzheimer's and Parkinson's disease. Although equally effective at detecting impairment as other cognitive screens (e.g. Mini-Mental State Examination (MMSE)), sorting tests are not commonly used in this context. This study examines the QuickSort, which is a new brief sorting test that is designed to screen older adults for cognitive impairment.

Design: Observational cohort study.

Setting: General community and inpatients, Australia.

Participants: Older (≥60 years) community-dwelling adults (n = 187) and inpatients referred for neuropsychological assessment (n = 78). A normative subsample (n = 115), screened for cognitive and psychological disorders, was formed from the community sample.

Measurements: Participants were administered the QuickSort, MMSE, Frontal Assessment Battery (FAB), and Depression Anxiety and Stress Scale-21. The QuickSort requires people to sort nine stimuli by color, shape, and number, and to explain the basis for their correct sorts. Sorting (range = 0-12), Explanation (range = 0-6), and Total (range = 0-18) scores were calculated for the QuickSort.

Results: The Cognitively Healthy subsample completed the QuickSort within 2 minutes, 50% had errorless performance, and 95% had Total scores of 10 or greater. The likelihood of community-dwelling older adults and inpatients (n = 260) being impaired on either the MMSE or FAB, or both, increased by a factor of 3.75 for QuickSort Total scores of less than 10 and reduced by a factor of 0.23 for scores of 10 or greater.

Conclusion: The QuickSort provides a quick, reliable, and valid alternative to lengthier cognitive screens (e.g., MMSE and FAB) when screening older adults for cognitive impairment. The QuickSort performance of an older adult can be compared with a cognitively healthy normative sample and used to estimate the likelihood they will be impaired on either the MMSE or FAB, or both. Clinicians can also use evidence-based modeling to customize the QuickSort for their setting.

Keywords: QuickSort; cognitive impairment; older adult; screening.

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References

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