Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 8:14:901592.
doi: 10.3389/fnagi.2022.901592. eCollection 2022.

The discriminant validity of single-question assessments of subjective cognitive complaints in an Asian older adult population

Ting Pang  1 , Xuhao Zhao  1 , Xindi He  1 , Cheuk Ni Kan  2 , Narayanaswamy Venketasubramanian  2 , Ching-Yu Cheng  3 , Changzheng Yuan  1 , Christopher Chen  2 , Xin Xu  1   2
Affiliations

The discriminant validity of single-question assessments of subjective cognitive complaints in an Asian older adult population

Ting Pang et al. Front Aging Neurosci. .

Abstract

Objective: To compare the discriminant validity of three different single-question assessments of subjective cognitive complaints (SCC) for dementia in a community-based older adult population in Singapore.

Methods: Eligible older adults aged ≥60 were recruited into phase I for identifying those who require further assessment using the Abbreviated Mental Test (AMT) and progressive forgetfulness question (PFQ). Participants who failed either tests entered phase II and were administered various single-question assessments of SCC, such as the 8th question on the patient Ascertain Dementia 8 (AD8-8pt), informant AD8 (AD8-8info), and the 10th item on the Geriatric Depression Scale (GDS-10), followed by the Montreal Cognitive Assessment (MoCA) and a formal neuropsychological battery to identify the participant's cognitive status by a research diagnosis and DSM-IV criteria. Differences in characteristics among diagnostic groups were compared. All discriminatory indices (sensitivity, specificity, positive, and negative predictive values, overall accuracy) for these single-question assessments and their combinations with the MoCA were calculated and reported to confirm their discriminant validity in identifying the existence of subjective complaints and objective impairment.

Results: A total of 3,780 participants were assessed at phase I, of which 957 entered and completed phase II. Of whom, 911 were dementia-free and 46 had dementia. The MoCA (13/14) displayed good sensitivity (95.6%), specificity (81.5%), and overall accuracy (82.1%) for dementia detection. The GDS-10 and AD8-8pt showed poor discriminant validity, while the AD8-8info had the highest specificity (83.2%) and the greatest overall accuracy (82.5%) for dementia. Compensatory combination of the AD8-8info with MoCA, the sensitivity and positive predictive values were optimized (100%), while the conjunctive combination of two tools achieved excellent specificity (96.3%) and overall accuracy (94.8%) in discriminating dementia patients.

Conclusion and implications: Combining a reliable single-question SCC assessment with an objective tool can efficiently discriminate dementia patients from healthy older adults in the community.

Keywords: cognitive screening; dementia; discriminant validity; single-question assessment; subjective cognitive complaints.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Study recruitment.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. American Psychiatric Association (1994). Diagnostic Criteria From DSM-IV TM; 3rd Print. Washington, DC: American Psychiatric Association.
    1. Brailean A., Steptoe A., Batty G. D., Zaninotto P., Llewellyn D. J. (2019). Are subjective memory complaints indicative of objective cognitive decline or depressive symptoms? Findings from the English Longitudinal Study of Ageing. J. Psych. Res. 110 143–151. 10.1016/j.jpsychires.2018.12.005 - DOI - PubMed
    1. Chan Q. L., Shaik M. A., Xu J., Xu X., Chen C. L.-H., Dong Y. (2016). The Combined Utility of a Brief Functional Measure and Performance-Based Screening Test for Case Finding of Cognitive Impairment in Primary Healthcare. J. Am. Med. Direct. Assoc. 17:372.e9–372.e11. 10.1016/j.jamda.2015.12.095 - DOI - PubMed
    1. Chan Q. L., Xu X., Shaik M. A., Chong S. S. T., Hui R., Chen C. L.-H., et al. (2015). Clinical Utility of the Informant AD8 as a Dementia Case Finding Instrument in Primary Healthcare. J. Alzheimer’s Dis. 49 121–127. 10.3233/jad-150390 - DOI - PubMed
    1. Chong M. S., Chin J. J., Saw S. M., Chan S. P., Venketasubramanian N., Tan L. C. S., et al. (2006). Screening for dementia in the older Chinese with a single question test on progressive forgetfulness. Int. J. Geriatr. Psych. 21 442–448. 10.1002/gps.1488 - DOI - PubMed