Brief Cognitive Assessment Tool

Older adults (aged 60+): (Mansbach, MacDougall, & Rosenzweig, 2012)

• 44-50 normal cognitive functioning: independent living
• 34-43 MCI: functional decline in instrumental activities of daily living (IADL)
• 25-33 mild dementia: IADL deficits, memory and cognitive decline
• 0-24 moderate to severe dementia: functional deficits, marked decline in memory and executive functions, behavioral and psychological symptoms common (upper end of range); requires complex care, pervasive cognitive deficits (lower end of range)

Community-dwelling: (Mansbach, MacDougall, Clark, & Mace, in press; n = 49; mean age = 69.33 ± 9.27)

• In cognitively normal older adults:
  • Mean (SD) BCAT score = 46.65 (2.35), range = 40-50, median = 47
  • Mean (SD) CMF score = 14.69 (.68), range = 13-15, median = 15
  • Mean (SD) ECFF score = 6.33 (.99), range = 3-7, median = 7

Assisted living facilities: (Mansbach et al., 2012)

• Excellent test-retest reliability (ICC = .99) (average interval = 11.5 days)

Assisted living facilities: (Mansbach et al., 2012)

• Excellent internal consistency (Chronbach’s alpha = .92)

Skilled nursing facilities: (Mansbach, Mace, & Clark, 2014)

• Excellent internal consistency (Chronbach’s alpha = .94)

Community-dwelling adults: (Mansbach et al., in press)

• Adequate internal consistency (Chronbach’s alpha = .76)

Assisted living facilities: (Mansbach et al., 2012)

• Excellent predictive validity of basic and instrumental ADLs, as measured by the PSMS (ß = −.41, p < .001) and the Lawton IADL scale (ß = .63, p < .001).
• Excellent predictive validity of BCAT ECFF (B = −1.92, p < .001), Attentional Capacity (B = −1.64, p < .01), and the CMF(B = –1.67, p < .01) as predictors of diagnostic category (MCI vs dementia).
• Excellent predictive validity for identifying dementia (versus MCI): Area under the Curve = .96; Sensitivity = .99, Specificity = .77 (Positive predictive validity = .91, Negative predictive validity = .69)

Skilled nursing facilities: (Mansbach, Mace, & Clark, 2014)

• Excellent ability to differentiate among five categories of cognitive functioning (normal, MCI, mild dementia, moderate dementia, and severe dementia) (F (4, 186) = 381.0, p = .00)
• Excellent ability to predict cognitive diagnosis accounting for 47% of the variance in Clinical Dementia Rating scores over and above the Brief Interview for Mental Status
• Excellent predictive validity for identifying dementia (versus MCI): Area under the Curve = .99; Sensitivity = .99, Specificity = .81(Positive predictive validity = .89, Negative predictive validity = .98)

Community-dwelling adults: (Mansbach et al., in press)

• Excellent predictive validity to differentiate participants who exhibited cognitive impairment on the Montreal Cognitive Assessment (t(31.11) = 6.10, p < .001, Cohen’s d = 1.62) from participants who were cognitively intact on the Montreal Cognitive Assessment.
• Excellent predictive validity for identifying cognitive impairment (versus no cognitive impairment): Area under the Curve = .90; Sensitivity = .81, Specificity = .80 (Positive predictive validity = .68, Negative predictive validity = .89)

Assisted living facilities: (Mansbach et al., 2012)

• Excellent correlation with Mini-Mental Status Examination (r = 0.88, p < .001)
• Excellent correlation with Short Test of Mental Status (r = 0.80, p < .001)
• Adequate to excellent correlation with Lawton IADL scale (r = 0.66, p < .001)
• Adequate correlation with Lawton IADL scale (r = -.040, p < .001)

Skilled nursing facilities: (Mansbach, Mace, & Clark, 2014)

• Adequate to excellent correlation with Kitchen Picture Test (r = 0.63, p < .001)
• Adequate to excellent correlation with Brief Interview for Mental Status (r = 0.68, p < .001)

Community-dwelling adults: (Mansbach et al., in press)

• Adequate to excellent correlation with Montreal Cognitive Assessment (r = 0.68, p < .001)
• Adequate to excellent correlation with Neuropsychological Assessment Battery – Judgment Subtest (r = 0.55, p < .001)

The tool was developed over an 18-month period. Initially, there were 30 items and nine items were deleted based on feedback from two psychologists trained in neurocognitive assessment. Several of the items were revised to improve their clarity.

Not statistically assessed, however, each item was screened for face validity by two psychologists trained in neurocognitive assessment. The 21 items were pilot tested in various clinical situations.

Not statistically assessed, however, the BCAT may be less sensitive in differentiating between moderate and severe impairment (BCAT < 25)

We recommend using the BCIS when severe cognitive impairment has already been established, or when the patient scores under 25 on the BCAT.