Tokyo cognitive assessment for mild cognitive impairment, ToCA-MCI

Validity and utility in elderly Japanese

Kuniaki Otsuka, Yutaka Kubo, Gaku Yamanaka, Junko Sasaki, Tomoko Kikuchi, Toshie Saito, Germaine Cornelissen, Bunpei Uno

Research output: Contribution to journalReview article

Abstract

Objectives: To develop a 20-minute cognitive screening tool of touch-panel type (Tokyo Cognitive Assessment for MCI, ToCA-MCI) to assist paramedical staff and first-line physicians in detecting mild cognitive impairment (MCI), a clinical state that often progresses to dementia, and to assess the reliability and validity of the ToCA-MCI in elderly Japanese subjects. Participants: Subjects were recruited from community-based medical health checks in 2015 and 2016. The ToCA-MCI, the Mini-Mental State Examination (MMSE), the revised version of Hasegawa's Dementia Scale (HDS-R), the Clock Drawing Test (CDT), the Clinical Dementia Rating (CDR) scale, and routine neurophysiological examinations were conducted on 105 elderly subjects. Mild Alzheimer's disease (AD) was found in 5 and MCI in 21 subjects. Among the 79 controls, age-associated cognitive impairment (AACI) affected 22. Measurements: The ToCA-MCI was administered to all participants. Sensitivity and specificity of the ToCA-MCI in detecting MCI were assessed. Results: The ToCA-MCI score was highly correlated with the MMSE (r=0.664, p< 0.0001), HDS-R (r=0.538, p<0.0001), CDT (r=0.437,/p<0.0001), and CDR (r= -0.442, p< 0.0001) scores. The area under the receiver-operator curve (AUC) for predicting MCI by the ToCA-MCI was 0.9581(odds ratio=60.9). Using a cut-off point of 17/18, the ToCA-MCI demonstrated a sensitivity of 92.3% and a specificity of 83.5% in diagnosing MCI. Conclusion: MCI is an evolving and somewhat controversial clinical entity. The ToCA-MCI is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE. The ToCA-MCI could be a useful cognitive test for screening for MCI. It could be recommended for geriatric health screening in the community as a multi-player participation-type screening tool, and for the early detection of MCI in a primary clinical setting.

Original languageEnglish (US)
Pages (from-to)579-621
Number of pages43
JournalTherapeutic Research
Volume38
Issue number6
StatePublished - Jan 1 2017

Fingerprint

Tokyo
Dementia
Cognitive Dysfunction
Sensitivity and Specificity
Health
Touch
Reproducibility of Results
Geriatrics
Area Under Curve
Alzheimer Disease
Reference Values
Odds Ratio
Physicians

Keywords

  • Cognitive screening tool
  • Mild cognitive impairment
  • Multi-player participation-type
  • ToCA-MCI
  • Touch-panel type

Cite this

Otsuka, K., Kubo, Y., Yamanaka, G., Sasaki, J., Kikuchi, T., Saito, T., ... Uno, B. (2017). Tokyo cognitive assessment for mild cognitive impairment, ToCA-MCI: Validity and utility in elderly Japanese. Therapeutic Research, 38(6), 579-621.

Tokyo cognitive assessment for mild cognitive impairment, ToCA-MCI : Validity and utility in elderly Japanese. / Otsuka, Kuniaki; Kubo, Yutaka; Yamanaka, Gaku; Sasaki, Junko; Kikuchi, Tomoko; Saito, Toshie; Cornelissen, Germaine; Uno, Bunpei.

In: Therapeutic Research, Vol. 38, No. 6, 01.01.2017, p. 579-621.

Research output: Contribution to journalReview article

Otsuka, K, Kubo, Y, Yamanaka, G, Sasaki, J, Kikuchi, T, Saito, T, Cornelissen, G & Uno, B 2017, 'Tokyo cognitive assessment for mild cognitive impairment, ToCA-MCI: Validity and utility in elderly Japanese', Therapeutic Research, vol. 38, no. 6, pp. 579-621.
Otsuka K, Kubo Y, Yamanaka G, Sasaki J, Kikuchi T, Saito T et al. Tokyo cognitive assessment for mild cognitive impairment, ToCA-MCI: Validity and utility in elderly Japanese. Therapeutic Research. 2017 Jan 1;38(6):579-621.
Otsuka, Kuniaki ; Kubo, Yutaka ; Yamanaka, Gaku ; Sasaki, Junko ; Kikuchi, Tomoko ; Saito, Toshie ; Cornelissen, Germaine ; Uno, Bunpei. / Tokyo cognitive assessment for mild cognitive impairment, ToCA-MCI : Validity and utility in elderly Japanese. In: Therapeutic Research. 2017 ; Vol. 38, No. 6. pp. 579-621.
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abstract = "Objectives: To develop a 20-minute cognitive screening tool of touch-panel type (Tokyo Cognitive Assessment for MCI, ToCA-MCI) to assist paramedical staff and first-line physicians in detecting mild cognitive impairment (MCI), a clinical state that often progresses to dementia, and to assess the reliability and validity of the ToCA-MCI in elderly Japanese subjects. Participants: Subjects were recruited from community-based medical health checks in 2015 and 2016. The ToCA-MCI, the Mini-Mental State Examination (MMSE), the revised version of Hasegawa's Dementia Scale (HDS-R), the Clock Drawing Test (CDT), the Clinical Dementia Rating (CDR) scale, and routine neurophysiological examinations were conducted on 105 elderly subjects. Mild Alzheimer's disease (AD) was found in 5 and MCI in 21 subjects. Among the 79 controls, age-associated cognitive impairment (AACI) affected 22. Measurements: The ToCA-MCI was administered to all participants. Sensitivity and specificity of the ToCA-MCI in detecting MCI were assessed. Results: The ToCA-MCI score was highly correlated with the MMSE (r=0.664, p< 0.0001), HDS-R (r=0.538, p<0.0001), CDT (r=0.437,/p<0.0001), and CDR (r= -0.442, p< 0.0001) scores. The area under the receiver-operator curve (AUC) for predicting MCI by the ToCA-MCI was 0.9581(odds ratio=60.9). Using a cut-off point of 17/18, the ToCA-MCI demonstrated a sensitivity of 92.3{\%} and a specificity of 83.5{\%} in diagnosing MCI. Conclusion: MCI is an evolving and somewhat controversial clinical entity. The ToCA-MCI is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE. The ToCA-MCI could be a useful cognitive test for screening for MCI. It could be recommended for geriatric health screening in the community as a multi-player participation-type screening tool, and for the early detection of MCI in a primary clinical setting.",
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AU - Sasaki, Junko

AU - Kikuchi, Tomoko

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AU - Cornelissen, Germaine

AU - Uno, Bunpei

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N2 - Objectives: To develop a 20-minute cognitive screening tool of touch-panel type (Tokyo Cognitive Assessment for MCI, ToCA-MCI) to assist paramedical staff and first-line physicians in detecting mild cognitive impairment (MCI), a clinical state that often progresses to dementia, and to assess the reliability and validity of the ToCA-MCI in elderly Japanese subjects. Participants: Subjects were recruited from community-based medical health checks in 2015 and 2016. The ToCA-MCI, the Mini-Mental State Examination (MMSE), the revised version of Hasegawa's Dementia Scale (HDS-R), the Clock Drawing Test (CDT), the Clinical Dementia Rating (CDR) scale, and routine neurophysiological examinations were conducted on 105 elderly subjects. Mild Alzheimer's disease (AD) was found in 5 and MCI in 21 subjects. Among the 79 controls, age-associated cognitive impairment (AACI) affected 22. Measurements: The ToCA-MCI was administered to all participants. Sensitivity and specificity of the ToCA-MCI in detecting MCI were assessed. Results: The ToCA-MCI score was highly correlated with the MMSE (r=0.664, p< 0.0001), HDS-R (r=0.538, p<0.0001), CDT (r=0.437,/p<0.0001), and CDR (r= -0.442, p< 0.0001) scores. The area under the receiver-operator curve (AUC) for predicting MCI by the ToCA-MCI was 0.9581(odds ratio=60.9). Using a cut-off point of 17/18, the ToCA-MCI demonstrated a sensitivity of 92.3% and a specificity of 83.5% in diagnosing MCI. Conclusion: MCI is an evolving and somewhat controversial clinical entity. The ToCA-MCI is a brief cognitive screening tool with high sensitivity and specificity for detecting MCI as currently conceptualized in patients performing in the normal range on the MMSE. The ToCA-MCI could be a useful cognitive test for screening for MCI. It could be recommended for geriatric health screening in the community as a multi-player participation-type screening tool, and for the early detection of MCI in a primary clinical setting.

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