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Accuracy of the Cognitive Assessment Battery in a Primary Care Population

机译：初级保健人群中认知评估电池的准确性

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Background: There are several cognitive assessment tools used in primary care, e.g., the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment. The Cognitive Assessment Battery (CAB) was introduced as a sensitive tool to detect cognitive decline in primary care. However, primary care validation is lacking. Therefore, we investigated the accuracy of the CAB in a primary care population. Objective: To investigate the accuracy of the CAB in a primary care population. Methods: Data from 46 individuals with cognitive impairment and 33 individuals who visited the primary care with somatic noncognitive symptoms were analyzed. They were investigated with the MMSE, the CAB, and a battery of neuropsychological tests; they also underwent consultation with a geriatric specialist. The accuracy of the CAB was assessed using c-statistics and the area under the receiver operating characteristic curve (AUC) was used to quantify the binary outcomes (“no cognitive impairment” or “cognitive impairment”). Results: The “cognitive impairment” group was significantly different from the unimpaired group for all the subtests of the CAB. When accuracy was based on binary significant reduction or not in one or several domains of the CAB, the AUC varied between 0.685 and 0.772. However, when a summation or logistic regression of several subcategories was performed, using the numerical values for each subcategory, the AUC was 0.9. For comparison, the AUC for the MMSE was 0.849. Conclusions: The accuracy of the CAB in a primary care population is poor to good when using binary cutoffs. Accuracy can be improved to high when using a summation or logistic regression of the numerical data of the subcategories. Considering CAB time, lack of adequate age norms, and a good accuracy for the MMSE, implementation of the CAB in primary care is not recommended at present based on the results of this study.
机译：背景：基层医疗中使用了几种认知评估工具，例如，迷你精神状态检查（MMSE）和蒙特利尔认知评估。引入认知评估电池（CAB）作为检测初级保健中认知能力下降的敏感工具。但是，缺乏初级保健验证。因此，我们调查了初级保健人群中CAB的准确性。目的：探讨CAB在初级保健人群中的准确性。方法：分析来自46名认知障碍患者和33名因躯体非认知症状而接受初级保健的患者的数据。他们通过MMSE，CAB和一系列神经心理学测试进行了调查。他们还接受了老年病专家的咨询。使用c统计量评估CAB的准确性，并使用受试者工作特征曲线（AUC）下的面积来量化二元结局（“无认知障碍”或“认知障碍”）。结果：对于CAB的所有子测试，“认知障碍”组与未受损组明显不同。当准确性基于CAB的一个或几个域中的二进制显着减少或没有时，AUC在0.685至0.772之间变化。但是，当执行几个子类别的求和或逻辑回归时，使用每个子类别的数值，AUC> 0.9。为了比较，MMSE的AUC为0.849。结论：使用二元临界值时，初级保健人群中CAB的准确性差强人意。使用子类别的数值数据的总和或逻辑回归时，可以将准确性提高到很高。考虑到CAB的时间，缺乏适当的年龄标准以及MMSE的准确性较高，根据本研究的结果，目前不建议在初级保健中实施CAB。

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