Adaptation and validation of Malay six-item cognitive impairment test in screening for cognitive impairment among elderly outpatients in Hospital Tengku Ampuan Afzan
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Date
2017
Authors
Idris, Umi Kalsom Mohd
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia
Abstract
The usage of a valid and reliable tool is crucial in order to improve the detection of
cognitive impairments among elderly patients in hospital settings. Six-Item Cognitive
Impairment Test (6-CIT) a potential screening tool because it is concise, fast, and easy
to administer verbally. It has excellent sensitivity, specificity, and correlates well with
the Mini-Mental State Examination (MMSE). To date, the instrument‟s adaptability and
performance have yet established upon the local population. This study aimed to
validate the Malay version of 6-CIT as well as determining its psychometric properties,
and correlation with the gold standard as a screening tool for cognitive impairment in
Malay speaking elderly outpatients in local hospital settings. This cross-sectional study
conducted between August to November 2016 at the Orthopaedics and Medical
Outpatient Clinics Hospital Tengku Ampuan Afzan. The study divided into two phases
and the sampling method done by a convenient sampling. Phase 1 involved translation
process of instrument and pilot study upon 24 Malay speaking elderly. Two hundred
and thirty four Malay speaking aged 60 and above elderly, who was not involved in
Phase 1 study, not deaf, and not too ill approached for Phase 2. The data then analysed
for descriptive, exploratory and confirmatory factor analyses, the standard measures of
diagnostic test at two cut-offs (7/8 and 10/11) and analysis of correlations compared to
gold standard. From the factor analyses, orientation and attention-memory with goodinternal consistency (Cronbach's alpha = 0.819 and 0.708) extracted. The overall
performance of the Malay 6-CIT was excellent. At two cut-offs (7/8 and 10/11) the
sensitivity were 95%, while the specificity ranged from 85% to 97% compared to
MMSE-M. When compared to Elderly Cognitive Assessment Questionnaire (ECAQ
Malay), the sensitivity = 100% and specificity = 84%. Significant negative correlation
between total and each factor of the Malay 6-CIT with gold standard obtained. In
conclusion, the translation process of this tool was easy. The administration was quick
and favorable in busy settings. Orientation and attention-memory model concluded from
the factor analyses proved to be valid and reliable in detecting cognitive impairment,
consistent with previous studies. The results of the present research provide evidence
for the Malay 6-CIT used as an alternative screening instrument for cognitive
impairment in future.
Description
Keywords
Cognition disorders