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. 2019 Dec 17;2019(12):CD013282. doi: 10.1002/14651858.CD013282.pub2

Li 2019.

Study characteristics
Patient sampling 176 participants were recruited from the Department of Neurology, Sichuan Provincial People’s Hospital, Chengdu, China. Inclusion criteria were: Chinese speaking, aged over 60 years, reasonable vision, hearing, and ability to communicate. Exclusion criteria were: history of major depression, schizophrenia, epilepsy, significant head injury, substance abuse, alcoholism, or other severe physical disorders. The sampling procedure was not well described and it was unclear if this was a consecutive or random sample.
Patient characteristics and setting This study included 176 Chinese‐speaking participants over the age of 60, who were recruited from the Department of Neurology in Chengdu, China.
The diagnosis of dementia was based upon demographic information, history or informant report, presentation at interview, general and neurological examination, neuropsychological examination, neuroimaging, screening blood tests. Daily and social function was evaluated using the Clinical Dementia Rating Scale. The Common Objects Memory Test was used to assess cognitive deficits. The diagnoses were based on the DSM‐V criteria for dementia, and Petersen criteria for MCI. The healthy group had no memory complaints, and normal activities of daily living.
Diagnoses were made by 1 of 2 neurologists who checked each other's decisions, and disputes were resolved by consensus.
55 participants were healthy, 64 had a diagnosis of MCI, and 57 had a diagnosis of mild dementia.
The prevalence of dementia in the sample was 32.4%, and for MCI 36.4%.
All participants with dementia were classified as mild severity, defined as Clinical Dementia Rating Scale of 1.
The mean age of the MCI and mild dementia groups were significantly older than the healthy participants, and the healthy group had significantly more years of education than the MCI and dementia groups.
The total age of the sample was 74.14 ± 6.68 years; healthy: 72.2 ± 6.48 years, MCI: 75.12 ± 6.41 years, mild dementia: 74.89 ± 6.90 years.
The total sample comprised 55.7% men. 60% of healthy participants were male, 56.3% of the MCI group, and 50.9% of the mild dementia group.
The mean years of education for each of the groups were: healthy: 12.49 ± 4.25 years, MCI: 11.14 ± 3.64 years, mild dementia: 9.68 ± 4.27 years.
The mean ACE‐III scores for each of the groups were: healthy: 90.25 ± 4.74, MCI: 81.98 ± 6.45, mild dementia: 65.18 ± 9.65.
The sources of participants were not specified.
Index tests The index test was the ACE‐III which was translated and adapted culturally for a Chinese‐speaking population using forward and backward translation methods. The translation and adaptation procedures were well described but there was no information on the training or expertise of the assessor. Test thresholds were not pre‐specified, and the authors calculated optimal thresholds based on their study data. The authors also investigate the accuracy of the Chinese versions of the MoCA and MMSE.
Target condition and reference standard(s) Target condition: dementia and MCI
Reference standards: DSM‐V (dementia), Petersen criteria (MCI), NINCDS/ADRDA (Alzheimer's disease), ICD‐10 (vascular dementia), DSM‐V (frontotemporal dementia), Lewy body dementia, and Parkinson's disease dementia.
Flow and timing 176 patients were recruited. Dropout rates were not reported.
The index test was completed within 1 week of the reference standard.
Information on the true positive and negative values were not provided in the original publication and were calculated from sensitivity and specificity data reported in the publication.
Comparative  
Notes  
Methodological quality
Item Authors' judgement Risk of bias Applicability concerns
DOMAIN 1: Patient Selection
Was a consecutive or random sample of patients enrolled? Unclear    
Was a case‐control design avoided? Yes    
Did the study avoid inappropriate exclusions? Yes    
    Unclear Unclear
DOMAIN 2: Index Test All tests
Were the index test results interpreted without knowledge of the results of the reference standard? Yes    
If a threshold was used, was it pre‐specified? No    
Were sufficient data on ACE‐III or mini‐ACE application given for the test to be repeated in an independent study? No    
    High Unclear
DOMAIN 3: Reference Standard
Is the reference standards likely to correctly classify the target condition? Yes    
Were the reference standard results interpreted without knowledge of the results of the index tests? Yes    
Were sufficient information on the method of dementia/MCI assessment given for the assessment to be repeated in an independent study? Yes    
    Low Low
DOMAIN 4: Flow and Timing
Was there an appropriate interval between index test and reference standard? Yes    
Did all patients receive the same reference standard? Yes    
Were all patients included in the analysis? Yes    
Did all patients receive a reference standard? Yes    
    Low