Validation of the cognitive abilities screening instrument (CASI) with cognitively impaired and cognitively intact Chinese elderly.

摘要

Background. The Cognitive Abilities Screening Instrument (CASI) has been widely used in epidemiological studies in the United States and abroad. Because of the increase in the Chinese population in the San Francisco bay area, and because many Chinese elderly are not properly diagnosed and treated for cognitive disorders, an effective clinical tool is needed to identify and screen for illness. This study examines its usefulness with Chinese living in the San Francisco bay area. Objective. To determine the sensitivity and specificity levels of the instrument when administered to cognitively intact and cognitively impaired participants, and to examine the correlation between the CASI and other existing screening instruments. Methods. Four cognitive screens (CASI, MMSE, Clock Drawing test, and Color Trails 1 & 2) were administered to two groups of participants-cognitively intact and impaired. The screens were administered in the preferred language of the participant, specifically English, Mandarin, or Cantonese. The groups were then matched in age, education, and gender, and their performances were examined for each screen. Results. At a cut-off score of 78, the CASI achieved levels of sensitivity and specificity of 87.9% and 85.7%, respectively. The CASI was significantly correlated with the MMSE ( r = 0.952, p 0.005), the Clock Drawing test (r = 0.860, p 0.005), and the Color Trails (r = 0.443, p 0.005). Conclusion. The CASI was an effective tool in screening for cognitive impairment in Chinese elderly. Its high correlation with the MMSE, combined with its ease of administration, higher scoring range, and relatively high levels of sensitivity and specificity suggest that it may have utility as a clinical screening tool.