Yu, Ruan-Ching;
(2023)
The validation of brief cognitive assessment tools to evaluate suspected dementia in Chinese-speaking populations.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Background Around 20% of individuals living with dementia are from Chinese-speaking populations. Brief cognitive assessments can assist in the diagnosis of dementia, but it is unclear which are best for Chinese-speaking populations. Additionally, there is a pressing need to validate brief cognitive assessments in Taiwan. Aims I aimed, firstly, to critically examine evidence about brief (< 20mins) cognitive assessment tools used to assist in the diagnosis of dementia in Chinese-speaking populations. Secondly, I aimed to identify gaps in such instrument validation for Taiwanese populations and validate a brief cognitive test for use with all patients presenting with suspected dementia. An additional aim was to culturally adapt and test a cognitive assessment battery for acceptability in this group. Methods I conducted a systematic review and meta-analysis of brief cognitive assessments used for suspected dementia and mild cognitive impairment (MCI) among Chinese-speaking populations. I used quality criteria for instruments as > 75% for sensitivity and specificity and < 75% for heterogeneity. I validated the Taiwanese version of the Addenbrooke's Cognitive Examination, ACE-III (T-ACE-III) with 90 participants in a Taiwanese memory clinic. I culturally adapted a brief cognitive assessment battery and determined its acceptability in Taiwan. Results My meta-analysis results found that the ACE-III and ACE-R were the only tests that met quality criteria across clinical populations for dementia and MCI. My empirical study showed that the T-ACE-III detected dementia in a Taiwanese population with a specificity of 100.0%, a sensitivity of 89.5%, and a Youden Index of 0.895, using an optimal cut-off value of 73/74. Conclusions The ACE-III and ACE-R demonstrated satisfactory psychometric properties for suspected dementia and MCI in Chinese-speaking populations. The T-ACE-III is an effective tool to help diagnose dementia in a Taiwanese clinical population. Further Research Building on my thesis publication, further research could examine T-ACE-III in dementia subtypes.
Type: | Thesis (Doctoral) |
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Qualification: | Ph.D |
Title: | The validation of brief cognitive assessment tools to evaluate suspected dementia in Chinese-speaking populations |
Open access status: | An open access version is available from UCL Discovery |
Language: | English |
Additional information: | Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Mental Health of Older People UCL |
URI: | https://discovery.ucl.ac.uk/id/eprint/10175779 |
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