ORIGINAL ARTICLE Validation of the Revised Quick Cognitive Screening Test C. Charles Mate-Kole, PhD, James Conway, PhD, Katherine Catayong, MA, Rachel Bieu, MA, Naa Amerley Sackey, BA, Rebecca Wood, PhD, Robert Fellows, MA ABSTRACT. Mate-Kole CC, Conway J, Catayong K, Bieu R, Sackey NA, Wood R, Fellows R. Validation of the revised Quick Cognitive Screening Test. Arch Phys Med Rehabil 2009;90: 1469-77. Objective: To validate the revised version of the Quick Cognitive Screening Test (QCST). Design: Cross-sectional. Setting: Senior homes; hospital; college campus. Participants: Participants (N=377; 114 men, 263 women) were recruited comprising healthy controls (n=201; 40 men, 161 women), subjects with dementia (n=93; 34 men, 59 women) including Alzheimer disease (n=73) and vascular dementia (n=20); subjects with psychiatric illness (n=35, 15 men, 20 women), specifically schizophrenia or bipolar disor- der; and subjects with other neurologic conditions (n=48, 25 men, 23 women) such as traumatic brain injury (n=12) and cerebrovascular disease (n=31). Diagnoses were confirmed by physicians using appropriate criteria. Recruitment was done in the northeastern region. Interventions: Not applicable. Main Outcome Measures: In an effort to examine the reliability and validity of the revised QCST, participants were administered the revised QCST with a number of standardized measures (ie, Alzheimer’s Disease Assessment Scale-Cogni- tive, Mini-Mental State Examination, Tests of Oral Fluency, Trail-Making Test, and Functional Activities Questionnaire). Results: The results revealed that the revised QCST discrim- inated between healthy controls and the neuropsychiatric par- ticipants. Additionally, the revised QCST significantly corre- lated with other standardized measures, confirming the revised QCST’s reliability and validity as a screening instrument for subjects with cognitive deficits. Conclusions: The revised QCST provides the clinician with a short yet reliable screening instrument in detecting cognitive deficits in subjects with dementia and other neu- rologic conditions. Key Words: Psychometrics; Rehabilitation. © 2009 by the American Congress of Rehabilitation Medicine A S THE ELDERLY POPULATION steadily increases, com- plaints of memory loss and decline in cognitive functions are becoming more common. In 1991, 12.5% of the U.S. population was 65 years old and over. By 2030, the elderly population is estimated to number 65 million, 20% of the population. 1 The early detection of cognitive impairments among the elderly is important in recognizing the cognitive and behavioral changes associated with normal aging, dementias, or other neurologic disorders. Early detection of impairments can aid clinicians in identifying the most appropriate type of care to slow the progression of a neurologic disease. Cognitive impairments may not be evident during routine examination. Boustani et al 2 noted that more than 50% of subjects with dementia, including many with mild and some with moderate dementia, have never received a diagnosis of dementia from a physician. 2,3 Screening for cognitive changes will help primary care phy- sicians be more aware of the possibility of declining cognition in patients and develop appropriate dementia care and a pro- active approach for the care of patients and families. 4 Different screening instruments have been developed to address this issue and are categorized into 3 groups: (1) brief instruments, (2) midrange tests, and (3) computerized tests. Brief Cognitive Screening Instruments Brief screening instruments have been developed to ease the overwhelming and rigorous task of a neuropsychologic battery. These include the MMSE, the Mini-Cog, the Clock Drawing Test, and the CCSE. 5-9 They serve as initial assessment tools in detecting cognitive changes. The most widely used cognitive screening test is the MMSE. 10 Kalbe et al 9 identified patients with MCI and early- stage dementia. Participants with MCI and AD were tested with the DemTect and the MMSE. Results showed the MMSE to be inferior in detecting mild AD and MCI (80% sensitivity) compared with the DemTect (100% sensitivity). Another study From the Department of Psychology, Central Connecticut State University, New Britain, CT (Mate-Kole, Conway, Catayong, Bieu, Wood, Fellows); Olin Neuropsy- chiatry Research Center, The Institute of Living, Hartford, CT (Catayong, Bieu); Department of Public Health, Drexel University, PA (Sackey). Presented to the Canadian Colloquium on Dementia, Vancouver, BC, Canada, October 18 –20, 2007. Supported by the Central Connecticut State University American Association of University Professors. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organi- zation with which the authors are associated. Reprint requests to C. Charles Mate-Kole, PhD, Dept of Psychology, Central Connecticut State University, 1615 Stanley St, New Britain, CT 06050, e-mail: matekolec@ccsu.edu. 0003-9993/09/9009-00872$36.00/0 doi:10.1016/j.apmr.2009.02.007 List of Abbreviations AD Alzheimer disease ADAS Alzheimer’s Disease Assessment Scale ADAS-cog Alzheimer’s Disease Assessment Scale cognitive subscale ANOVA analysis of variance CCSE Cognitive Capacity Screening Examination CNS central nervous system COWAT Controlled Oral Word Association Test CVD cerebrovascular disease FAQ Functional Activities Questionnaire MCI mild cognitive impairment MDRS Mattis Dementia Rating Scale MMSE Mini-Mental State Examination QCST Quick Cognitive Screening Test ROC receiver operating characteristic TMT Trail-Making Test WAIS-R Wechsler Adult Intelligence Scale-Revised 1469 Arch Phys Med Rehabil Vol 90, September 2009