Comparative analysis of five diagnostic tools in detecting mild cognitive impairment in older adults

Abstract Background Mild Cognitive Impairment is a critical condition in older adults requiring accurate diagnostic tools for early detection. This study evaluates diagnostic accuracy of five cognitive assessment tools for detecting MCI among older women. Methods A cross-sectional psychometric study...

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Main Authors: Mahdis Ferasat, Bahareh Zeynalzadeh Ghoochani, Mohammad Hossein Kaveh, Tomás Caycho-Rodríguez, Abdolrahim Asadollahi
Format: Article
Language:English
Published: SpringerOpen 2025-05-01
Series:Middle East Current Psychiatry
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Online Access:https://doi.org/10.1186/s43045-025-00534-w
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author Mahdis Ferasat
Bahareh Zeynalzadeh Ghoochani
Mohammad Hossein Kaveh
Tomás Caycho-Rodríguez
Abdolrahim Asadollahi
author_facet Mahdis Ferasat
Bahareh Zeynalzadeh Ghoochani
Mohammad Hossein Kaveh
Tomás Caycho-Rodríguez
Abdolrahim Asadollahi
author_sort Mahdis Ferasat
collection DOAJ
description Abstract Background Mild Cognitive Impairment is a critical condition in older adults requiring accurate diagnostic tools for early detection. This study evaluates diagnostic accuracy of five cognitive assessment tools for detecting MCI among older women. Methods A cross-sectional psychometric study was conducted with 293 women aged ≥ 60 from Women Day Care Centers in Iran. Participants were assessed using the Montreal Cognitive Assessment at two time points, the London Tower Test, the Wisconsin Card Sorting Test, and the Wechsler Memory Scale-Third Edition. Statistical analyses included binomial proportion tests, Bayesian analysis, chi-square tests, and Bland–Altman analysis to assess diagnostic performance, agreement, and reliability. Sensitivity, specificity, and accuracy were calculated using R and JAMOVI softwares. Results The WCST demonstrated the highest specificity (0.850) and strong evidence for detecting cognitive impairments (BF₁₀ = 5.24E + 13, p < 0.001). The WMS-III showed the highest sensitivity (0.700) and accuracy (0.625). MoCA scores improved slightly from T1 (mean = 23.03) to T2 (mean = 24.56), but its reliability varied. The LTT provided moderate evidence for detecting impairments (p = 0.026, BF₁₀ = 0.9778). Socioeconomic status and education significantly influenced cognitive performance, with 46.8% diagnosed with MCI. Agreement between human diagnosis and tool-based assessments was significant (p < 0.001), particularly for WCST and WMS-III. Conclusion The WCST and WMS-III are the most reliable tools for detecting MCI, excelling in specificity and sensitivity, respectively. Combining multiple tests enhances diagnostic accuracy. Future research should explore larger populations and integrate advanced methods like neuroimaging.
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spelling doaj-art-2084f73066fc4bee8ae7229d42dff8022025-08-20T03:27:10ZengSpringerOpenMiddle East Current Psychiatry2090-54162025-05-0132111210.1186/s43045-025-00534-wComparative analysis of five diagnostic tools in detecting mild cognitive impairment in older adultsMahdis Ferasat0Bahareh Zeynalzadeh Ghoochani1Mohammad Hossein Kaveh2Tomás Caycho-Rodríguez3Abdolrahim Asadollahi4Student Research Committee, School of Health, Shiraz University of Medical SciencesDepartment of Occupational Therapy, School of Rehabilitation Sciences, Shiraz University of Medical SciencesDepartment of Health Promotion, School of Health, Shiraz University of Medical SciencesFacultad de Psicología, Universidad Científica del SurDepartment of Gerontology, School of Health, Shiraz University of Medical Sciences,Abstract Background Mild Cognitive Impairment is a critical condition in older adults requiring accurate diagnostic tools for early detection. This study evaluates diagnostic accuracy of five cognitive assessment tools for detecting MCI among older women. Methods A cross-sectional psychometric study was conducted with 293 women aged ≥ 60 from Women Day Care Centers in Iran. Participants were assessed using the Montreal Cognitive Assessment at two time points, the London Tower Test, the Wisconsin Card Sorting Test, and the Wechsler Memory Scale-Third Edition. Statistical analyses included binomial proportion tests, Bayesian analysis, chi-square tests, and Bland–Altman analysis to assess diagnostic performance, agreement, and reliability. Sensitivity, specificity, and accuracy were calculated using R and JAMOVI softwares. Results The WCST demonstrated the highest specificity (0.850) and strong evidence for detecting cognitive impairments (BF₁₀ = 5.24E + 13, p < 0.001). The WMS-III showed the highest sensitivity (0.700) and accuracy (0.625). MoCA scores improved slightly from T1 (mean = 23.03) to T2 (mean = 24.56), but its reliability varied. The LTT provided moderate evidence for detecting impairments (p = 0.026, BF₁₀ = 0.9778). Socioeconomic status and education significantly influenced cognitive performance, with 46.8% diagnosed with MCI. Agreement between human diagnosis and tool-based assessments was significant (p < 0.001), particularly for WCST and WMS-III. Conclusion The WCST and WMS-III are the most reliable tools for detecting MCI, excelling in specificity and sensitivity, respectively. Combining multiple tests enhances diagnostic accuracy. Future research should explore larger populations and integrate advanced methods like neuroimaging.https://doi.org/10.1186/s43045-025-00534-wAccuracyCognitive impairmentCross-sectional studyIranMild cognitive impairmentMontreal cognitive assessment
spellingShingle Mahdis Ferasat
Bahareh Zeynalzadeh Ghoochani
Mohammad Hossein Kaveh
Tomás Caycho-Rodríguez
Abdolrahim Asadollahi
Comparative analysis of five diagnostic tools in detecting mild cognitive impairment in older adults
Middle East Current Psychiatry
Accuracy
Cognitive impairment
Cross-sectional study
Iran
Mild cognitive impairment
Montreal cognitive assessment
title Comparative analysis of five diagnostic tools in detecting mild cognitive impairment in older adults
title_full Comparative analysis of five diagnostic tools in detecting mild cognitive impairment in older adults
title_fullStr Comparative analysis of five diagnostic tools in detecting mild cognitive impairment in older adults
title_full_unstemmed Comparative analysis of five diagnostic tools in detecting mild cognitive impairment in older adults
title_short Comparative analysis of five diagnostic tools in detecting mild cognitive impairment in older adults
title_sort comparative analysis of five diagnostic tools in detecting mild cognitive impairment in older adults
topic Accuracy
Cognitive impairment
Cross-sectional study
Iran
Mild cognitive impairment
Montreal cognitive assessment
url https://doi.org/10.1186/s43045-025-00534-w
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