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Age and Ageing Advance Access originally published online on May 19, 2009
Age and Ageing 2009 38(4):455-460; doi:10.1093/ageing/afp068
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© The Author 2009. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Detection of MCI in the clinic: evaluation of the sensitivity and specificity of a computerised test battery, the Hopkins Verbal Learning Test and the MMSE

Celeste A. de Jager1, Anne-Claire M. C. Schrijnemaekers2, Thurza E. M. Honey1 and Marc M. Budge3

1 Oxford Project to Investigate Memory and Ageing (OPTIMA), Department of Physiology, Anatomy and Genetics, University of Oxford, UK
2 Stichting Revalidatie Limburg, Hoensbroeck Revalidatiecentrum, afdeling Niet-Aangeboren Hersenletsel, Hoensbroek, The Netherlands
3 Department of Geriatric Medicine, Australian National University Medical School, Canberra, Australia

Address correspondence to: C. A. de Jager. Tel. (+44) 1865 231460/231270; Fax: (+44) 1865 231154. Email: celeste.de-jager{at}dpag.ox.ac.uk

Introduction: the sensitive detection of mild cognitive impairment (MCI) in older adults is an important problem that requires objective assessment. We evaluated whether the computerised cognitive test battery, CogState, was as sensitive to MCI as two well-validated ‘paper-and-pencil’ tests, the Hopkins Verbal Learning Test (HVLT) and the Mini-Mental Status Examination (MMSE).

Methods: these tests were administered with a subjective memory questionnaire and an ‘Activities of Daily Living’ scale to 21 individuals with MCI and 98 cognitively healthy controls matched for sex, education and IQ levels. The sensitivity and specificity of the tests and their discrimination between groups were determined.

Results: the HVLT had a maximum discrimination between controls and MCI cases of 90%, compared with 86% for CogState and 65% for the MMSE. Only CogState showed correlations with subjective memory complaints (SMC) and activities of daily living for the whole cohort when controlled for age, sex and years of education. Logistic regression analyses showed that diagnosis (control:MCI) was predicted by HVLT and a CogState ratio score. Age was a significant predictor of HVLT performance, while age and SMC predicted CogState performance. The computerised test battery was well tolerated by older adults, but presentation speed was a limiting factor for some participants.

Conclusions: overall, we conclude that the HVLT has better sensitivity for the detection of MCI in older adults than the CogState, but that CogState may enable the identification of cognitive deficits above and beyond impairments in memory.

Keywords: mild cognitive impairment, memory, computerised tests, older adults, HVLT, CogState, Alzheimer’s disease, elderly

Received 23 October 2009; accepted in revised form 19 March 2009.


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