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Evaluation of cognitive impairment in elderly population with hypertension from a low-resource setting: Agreement and bias between screening tools

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dc.contributor.author Lazo-Porras, Maria
dc.contributor.author Pesantes, Maria-A.
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Bernabe-Ortiz, Antonio
dc.date.accessioned 2019-02-06T14:45:36Z
dc.date.available 2019-02-06T14:45:36Z
dc.date.issued 2016
dc.identifier.uri https://hdl.handle.net/20.500.12866/5098
dc.description.abstract INTRODUCTION: The evaluation of cognitive impairment in adulthood merits attention in societies in transition and especially in people with chronic diseases. Screening tools available for clinical practice and epidemiological studies have been designed in high-income but not in resource-constrained settings. The aim of this study was to assess the agreement and bias of three common tools used for screening of cognitive impairment in people with hypertension: the modified Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Leganes Cognitive Test (LCT). METHODS: A cross-sectional study enrolling participants with hypertension from a semi-urban area in Peru was performed. The three screening tools for cognitive impairment were applied on three consecutive days. The prevalence of cognitive impairment was calculated for each test. Pearson's correlation coefficients, Bland-Altman plots, and Kappa statistics were used to assess agreement and bias between screening tools. RESULTS: We evaluated 139 participants, mean age 76.5 years (SD +/- 6.9), 56.1% females. Cognitive impairment was found in 28.1% of individuals using LCT, 63.3% using MMSE, and 100% using MoCA. Correlation coefficients ranged from 0.501 between LCT and MoCA, to 0.698 between MMSE and MoCA. Bland-Altman plots confirmed bias between screening tests. The agreement between MMSE and LCT was 60.4%, between MMSE and MoCA was 63.3%, and between MoCA and LCT was 28.1%. CONCLUSIONS: Three of the most commonly used screening tests to evaluate cognitive impairment showed major discrepancies in a resource-constrained setting, signaling towards a sorely need to develop and validate appropriate tools. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof urn:issn:2405-6502
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Cognitive impairment en_US
dc.subject Hypertension en_US
dc.subject Leganes cognitive test en_US
dc.subject Minimental state examination en_US
dc.subject Montreal cognitive assessment en_US
dc.title Evaluation of cognitive impairment in elderly population with hypertension from a low-resource setting: Agreement and bias between screening tools en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.ensci.2016.11.012


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