Validation of the Six-Item Screener to screen for cognitive impairment in primary care settings in China

ABSTRACT

Objectives: This study aimed to examine the reliability and validity of the Six-Item Screener (SIS) in screening cognitive impairment (CI) compared to the Mini-Mental State Examination (MMSE) in primary care settings in China.

Methods: Participants (n = 2556, aged 60 years or older) from 30 primary care settings in Hangzhou, China, were recruited and screened using the SIS. They had a mean age of 71.6 ± 8.7 years, 50% were females, and 73% had education fewer than 5 years. A number of 373 screened participants received the MMSE assessment after the screening.

Results: The correlation coefficients between the six items of the SIS and its total score ranged from 0.17 to 0.78. The correlation between the total score of SIS and MMSE was 0.70. The Cronbach's α coefficient of the SIS was 0.70. The receiver operating characteristic analysis using MMSE as the golden standard had the optimal cut-off score of 3, with sensitivity of 0.86 and specificity of 0.87, and the area under the curve (AUC) was 0.93.

Conclusion: The SIS performs well compared with the MMSE for screening of individuals with CI in primary care settings in China.

KEYWORDS:

• Cognitive impairment
• Six-Item Screener
• validation
• primary care
• China

Acknowledgements

We thank the participants and all who helped us in the study, especially Xinlai Zhao, for contacting with the primary care settings.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The project was supported by Fogarty International Center, the National Institutes of Health of United States of American grant [grant number R01MH100298]. This work was also supported by the Natural Science Foundation of Zhejiang Province [grant number LY16H090011] and the Program for New Century Excellent Talents in University from the Ministry of Education China.