A novel hybrid scale for the assessment of cognitive and executive function: The Free-Cog

Burns, Alistair, Harrison, Judith R. ORCID: https://orcid.org/0000-0002-5775-2524, Symonds, Catherine and Morris, Julie 2021. A novel hybrid scale for the assessment of cognitive and executive function: The Free-Cog. International Journal of Geriatric Psychiatry 36 (4) , pp. 566-572. 10.1002/gps.5454

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Abstract

Background Scales measuring cognitive and executive functions are integral to the assessment and management of patients with suspected cognitive impairment. Some of the most commonly used cognitive tests are now subject to copyright restrictions. Furthermore, no existing scale assesses both executive and cognitive abilities. Aims We aimed to develop and validate a novel hybrid scale for use in clinical practice which integrate measures of cognition and executive abilities (‘Free-Cog’). Methods The instrument was devised through a national collaboration including health professionals, those with lived experience of dementia and researchers. Following ethics committee approval, the Free-Cog was assessed in 25 real-world clinical settings across England, Wales and Scotland. It was compared to three other cognitive tests routinely administered in clinical practice: the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MOCA), and the Addenbrooke's Cognitive Examination (ACE). Results The Free-Cog was tested in 960 patients with clinical diagnoses of dementia, Mild Cognitive Impairment (MCI), and normal controls. Similar to the MMSE, MOCA and ACE, it discriminated well between the three groups (p < 0.001). It correlated well with the other instruments. Using a receiver operating characteristic curve analysis, Free-Cog achieved an Area Under Curve of 0.94 for dementia versus controls, 0.80 for MCI versus controls and 0.77 for dementia versus MCI. A version of the tool adapted for telephone consultation, the Tele Free-Cog, also discriminated well between patient groups. Conclusions Free-Cog is a non-proprietary, empirically derived, concise assessment. Uniquely, it combines cognitive and executive function questions in the one instrument. It could be used to inform the assessment of people presenting with cognitive impairment and is available to anyone interested in trialling it.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Psychology
Additional Information:	This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Publisher:	John Wiley and Sons
ISSN:	0885-6230
Date of First Compliant Deposit:	12 August 2021
Date of Acceptance:	18 October 2020
Last Modified:	10 Jun 2023 16:58
URI:	https://orca.cardiff.ac.uk/id/eprint/143344

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