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Validity of a screening tool for detecting subtle cognitive impairment in the middle-aged and elderly

Authors Bruce K, Robinson S, Smith J, Yelland G

Received 24 May 2014

Accepted for publication 12 August 2014

Published 12 December 2014 Volume 2014:9 Pages 2165—2176


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Richard Walker

Kathryn M Bruce,1 Stephen R Robinson,2 Julian A Smith,1 Gregory W Yelland2,3

1Department of Surgery (MMC), Monash University, Clayton, 2School of Health Sciences, RMIT University, Bundoora, 3Central Clinical School, Monash University, Alfred Health, Melbourne, VIC, Australia

Abstract: The present study tested 121 middle-aged and elderly community-dwelling individuals on the computer-based Subtle Cognitive Impairment Test (SCIT) and compared their performance with that on several neuropsychological tests. The SCIT had excellent internal consistency, as demonstrated by a high split-half reliability measure (0.88–0.93). Performance on the SCIT was unaffected by the confounding factors of sex, education level, and mood state. Many participants demonstrated impaired performance on one or more of the neuropsychological tests (Controlled Oral Word Association Task, Rey Auditory and Verbal Learning Task, Grooved Pegboard [GP], Complex Figures). Performance on SCIT subtests correlated significantly with performance on many of the neuropsychological subtests, and the best and worst performing quartiles on the SCIT subtest discriminated between good and poor performers on other subtests, collectively indicating concurrent validity of the SCIT. Principal components analysis indicated that SCIT performance does not cluster with performance on most of the other cognitive tests, and instead is associated with decision-making efficacy, and processing speed and efficiency. Thus, the SCIT is responsive to the processes that underpin multiple cognitive domains, rather than being specific for a single domain. Since the SCIT is quick and easy to administer, and is well tolerated by the elderly, it may have utility as a screening tool for detecting cognitive impairment in middle-aged and elderly populations.

Keywords: aging, mild cognitive impairment, neuropsychological test, Subtle Cognitive Impairment Test, validation, reliability

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