Development and validation of the short form of the Brief Cognitive Assessment Tool (BCAT-SF)

Abstract

This article describes the development and validation of a short form of the Brief Cognitive Assessment Tool (BCAT), the BCAT-SF. Frontline providers and many specialists report having little time to assess cognitive functioning, despite recognizing the utility of doing so. Many of the screening tools now available are judged to require too much time to administer. With this in mind, our intent was to design a very brief measure that retained much of the excellent psychometric properties of the original 21-item BCAT. We present a comparison of the evidence for the reliability and validity of the scores from the original and short forms of the BCAT. One hundred four older adults referred for neuropsychological evaluation participated in the study. We used a rational approach to select items from the original BCAT to create the BCAT-SF. To ensure content validity, the six items selected represented the cognitive domains of contextual memory, executive functioning, and attention. Psychometric analyses confirmed strong evidence of reliability, construct validity, and predictive validity. The BCAT-SF differentiated between mild cognitive impairment and dementia with a sensitivity of 0.90, a specificity of 0.81, and an area under the receiver operating characteristic curve of 0.93. Furthermore, the BCAT-SF predicted instrumental and basic activities of daily living. The BCAT-SF can be administered in three to four minutes, is easily administered (by provider or technician), and is cost-effective. In addition, preliminary evidence finds the BCAT-SF to be psychometrically robust.

Keywords:

• reliability
• validity
• screening
• dementia
• mild cognitive impairment