How Accurate are Cognitive Self-Assessment Screening Instruments?
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We have often been asked about the accuracy of cognitive self-assessment screening instruments.  The answer to this question is complicated, and might best be considered by first asking a different question – For what purposes are cognitive self-assessment screening instruments best applied?  In our view, having reviewed numerous self-assessments, and having developed the Self-Assessment of Cognition (SAC) screener, self-assessments are most helpful in identifying possible cognitive deficits and guiding the user to a professional when a more comprehensive evaluation is indicated.  Cognitive self-assessment instruments are not intended as diagnostic tools, nor are they adequate replacements for professional evaluations. 

With these caveats in mind, how can you determine if a specific cognitive self-assessment screener is accurate? Your selection of an instrument should be guided by these questions:

  • How robust are the instrument psychometrics?  That is, how valid and reliable is it?
  • How sensitive is the instrument in detecting mild cognitive problems, as well as possible dementia?
  • Does the instrument do more than identify memory problems?
  • Has it be shown to predict functional issues, such as one’s ability to manage medications, transportation, or finances?
  • Is the instrument an online screener with automatic scoring?
  • Does it provide a written report, and if so, is the report helpful?

Clearly, not all cognitive self-assessment instruments are equal or interchangeable, and one should be careful before choosing to use one.  The BCAT® Research Center developed the SAC, with the above questions in mind.  Our aim in creating the SAC was to help older adults and adults: (1) self-identify possible cognitive problems they may have, (2) bring information about possible cognitive deficits to the attention of a healthcare professional (through the SAC report) in order to develop appropriate evaluation and treatment strategies; and (3) use, from the privacy of their homes, an on-demand cognitive screener via the internet. 

The SAC can be used as a low-cost, 3-minute tool for identifying possible cognitive problems, and can indicate when one should seek advice from a healthcare professional. To find out more about the SAC, visit here. One can also access it either through the ENRICH® program website

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