Authors (including presenting author) :
Toh WT(1),Wong YL(1),Chan YMK(1),Lee MSC(1),Chiu KCP(2)
Affiliation :
(1)Department of Occupational Therapy,(2)Department of Medicine, Queen Mary Hospital
Introduction :
Among commonly used cognitive screening instruments, limitations such as literacy level, cultural irrelevancy, long administration time affect its clinical utility for elderly, especially in the acute setting. The Hong Kong Brief Cognitive Test(HKBC) is a locally developed cognitive screening tool for older adults, with a shorter administration time and minimal educational bias. The test includes immediate recall/attention, delayed recall, recent memory, orientation, frontal lobe function test, general knowledge, visuospatial construction, executive function, and language. The total score is 30, with cut-off scores for normal subject, mild and major neurocognitive disorder(NCD). A survey was conducted to explore the applicability of the HKBC for elderly patients in Queen Mary Hospital(QMH).
Objectives :
To evaluate the compatibility of HKBC with Montreal Cognitive Assessment Hong Kong version(HK-MoCA) for elderly patients in acute setting, and to correlate the results of HKBC with actual functional status of elderly.
Methodology :
In March and April 2019, a convenient sample of elderly aged 60 and above admitted to QMH and referred to occupational therapy(OT) for cognitive assessment were tested by HK-MoCA and HKBC within one session.(i)The level of cognitive impairment i.e. normal, mild or major NCD, identified by both tests were reviewed and analysed.(ii)Functional status of 32 patients was also evaluated through basic activities of daily living(BADL) assessment by OT and classified as independent or not, and their HKBC score was compared using the independent t-test.
Result & Outcome :
88 patients completed both HKBC and HK-MoCA during the two-month period with mean age of 76(ranged from 60 to 95), of which 38(40%) aged 80 or above. 70% of the patients rated in the same category (31 normal, 6 mild NCD, 24 major NCD). Of the remaining patients rated in different categories, 13 (half) of them are ≥ 80 years old and the HKBC tended to rate them as being more impaired, which is often more compatible with their clinical presentation. In patients independent in BADL, their mean HKBC score (23.1) is significantly higher than that of patients not independent in BADL (12.8)(p< 0.000). The HKBC can be used as a cognitive screening tool in the acute inpatient setting for older adults aged 60 and above, especially for the oldest old where their performance on the HKBC is more reflective of their actual cognitive function in relation to their functional status.
