Cognitive screening test in primary care: cut points for low education

ABSTRACT OBJECTIVE To establish the diagnostic accuracy of the Brazilian version of the General Practitioner Assessment of Cognition (GPCOG-Br) compared to the Mini-Mental State Examination (MMSE) in individuals with low educational level. METHODS Ninety-three patients (≥ 60 years old) from Brazilian primary care units provided sociodemographic, cognitive, and functional data. Receiver operating characteristics, areas under the curve (AUC) and logistic regressions were conducted. RESULTS Sixty-eight patients with 0-4 years of education. Cases (n = 44) were older (p = 0.006) and performed worse than controls (n = 49) on all cognitive or functional measures (p < 0.001). The GPCOG-Br demonstrated similar diagnostic accuracy to the MMSE (AUC = 0.90 and 0.91, respectively) and similar positive and negative predictive values (PPV/NPV, respectively: 0.79/0.86 for GPCOG-Br and 0.79/0.81 for MMSE). Adjusted cut-points displayed high sensitivity (all 86%) and satisfactory specificity (65%-80%). Lower educational level predicted lower cognitive performance. CONCLUSIONS The GPCOG-Br is clinically well-suited for use in primary care.

The Geriatric Anxiety Inventory in primary care: applicability and psychometric characteristics of the original and short form

Abstract Background Generalized anxiety disorder (GAD) has negative implications for people’s lives, but is often underdiagnosed in the elderly. There is a shortage of instruments to assess geriatric anxiety. Objectives To analyze the applicability and psychometric properties of the Portuguese version of the Geriatric Anxiety Inventory (GAI) and its short form (GAI-SF) within primary care. Methods Fifty-five seniors were classified as non-demented by a multidisciplinary panel. The protocol included the GAI, the Self-Reporting Questionnaire (SRQ-20), the Depression Scale D-10, Mini-Mental State Examination (MMSE), Bayer Scale for Activities of Daily Living (B-ADL) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). A sub-sample also completed the Beck Anxiety Inventory (BAI). Results The GAI and GAI-SF showed good internal consistency (0.89; 0.62, respectively) and test-retest stability (0.58, 0.97). The GAI and GAI-SF correlated significantly with the SRQ-20 (0.74, 0.55) and BAI (0.75, 0.58). Discussion The psychometric characteristics of the Brazilian versions of the GAI and GAI-SF suggest these instruments are suitable for application in the Brazilian elderly population within the primary care setting.