Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Jul 19, 2021; 11(7): 265-270
Published online Jul 19, 2021. doi: 10.5498/wjp.v11.i7.265
Cognitive screening for adult psychiatric outpatients: Comparison of the Cognivue® to the Montreal Cognitive Assessment
Amanda F Rose, Alan F Gilbertson, Constance Cottrell, Rajesh R Tampi
Amanda F Rose, Alan F Gilbertson, Rajesh R Tampi, Department of Psychiatry and Behavioral Sciences, Cleveland Clinic Akron General, Akron, OH 44307, United States
Constance Cottrell, Office of Nursing Research and Innovation, Cleveland Clinic, Cleveland, OH 44106, United States
Author contributions: Rose AF designed the overall project concept and study design, analyzed data, and outlined the manuscript; Gilbertson AF contributed to the content of the research study, interpretation of data, and manuscript; Cottrell C contributed to study design, review of literature, and revising manuscript; Tampi RR contributed to study design and revising manuscript.
Conflict-of-interest statement: There is no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amanda F Rose, PhD, Doctor, Department of Psychiatry and Behavioral Sciences, Cleveland Clinic Akron General, 1 Akron General Blvd., Akron, OH 44307, United States. rosea@ccf.org
Received: December 16, 2020
Peer-review started: December 16, 2020
First decision: April 6, 2021
Revised: May 10, 2021
Accepted: June 28, 2021
Article in press: June 28, 2021
Published online: July 19, 2021

In this editorial we comment on the article by Cahn-Hidalgo D published in a recent issue of the World Journal of Psychiatry 2020; 10(1); 1-11. We focus on the importance of utilizing psychometrically valid cognitive screening tools when assessing for cognitive decline in older adults in a psychiatric outpatient setting. We compared the use of Cognivue® to use of the montreal cognitive assessment (MoCA) as a cognitive screening tool. A total of 58 patients aged 55 and over participated in this comparison study. Patients completed cognitive screening on Cognivue®, a new Food and Drug Administration-cleared computer screening device, and the MoCA. The results of patient performance using these two instruments were analyzed. Sixteen (28%) patients screened negative for cognitive impairment on both assessments. Forty-two (72%) patients screened positive on one or both of the assessments. There was 43% agreement between Cognivue® and the MoCA in identifying patients with cognitive impairment, and individual subtests were weakly correlated. The MoCA was determined to be the preferred instrument due to its high sensitivity and specificity (100% and 87%, respectively) when screening for cognitive impairment. We propose that the use of Cognivue® cognitive screening tool be closely reviewed until more research proves that the test meets the standards for reliability and validity. It is important for clinicians to remember that screeners should not be used to diagnosis patients with neurocognitive disorders; instead, they should be used to determine whether further evaluation is warranted. Additionally, misdiagnosing of neurocognitive disorders can pose unnecessary psychological and emotional harm to patients and their families and also lead to incorrect treatment and undue healthcare costs.

Keywords: Dementia, Cognitive screening test, Cognitive impairment, Psychological assessment, Neurocognitive disorder, Geriatric psychiatry, Cognitive decline

Core Tip: Practicing clinicians should utilize validated measures when screening for cognitive impairment among older adults. Based on their findings they should make recommendations for further evaluation and not use cognitive screening tools as diagnostic tools.