An Investigation and Feasibility Study in Using a Multi-Stage Screening Approach Including Postal Screening for the Early Detection of Mild Cognitive Impairment In a Community Sample
Degree GrantorUniversity of Canterbury
Degree NameDoctor of Philosophy
The early and accurate detection of age-related cognitive declines, such as mild cognitive impairment (MCI), represents an important but elusive research goal. Previous screening techniques have demonstrated only limited effectiveness for identifying older adults with MCI, and these diagnoses have tended to be unreliable over time. Such screening approaches have traditionally either been expensive and time consuming, or brief but inaccurate. The objective of this thesis was to explore the utility of a multi-stage screening approach, including a range of postal screening tools as a novel way of identifying cases of MCI within a community sample of older adults (N = 114). Multi-stage screening was validated through assessing all participants with a neuropsychological testing battery. Cognitive decline was identified by the screening tools at a statistically significant rate, demonstrating the value of self- and informant-reports in the early detection of MCI. The screening measures also demonstrated strong psychometric properties, and validity for use as postal screening measures. Subtypes of MCI were explored, but the reliability of these diagnoses was limited. Instead, generalised cognitive profiles demonstrated that individuals experiencing early cognitive impairment were able to be differentiated from those of cognitively intact older adults. The present results demonstrated the utility of multi-stage cognitive screening for detecting cognitive impairment, and for overcoming previous limitations in this area. Furthermore, conceptualising early cognitive declines generally, rather than focusing on subtypes, was shown to aid diagnostic reliability.