3153 Comparison of Free-Cog with the Mini-Mental State Examination and Lawton-Brody functional scales

Abstract Introduction The Free-Cog is a brief cognitive test designed to capture decline in both general cognition and executive function. The Free-Cog has been validated by comparison with the Mini-Addenbrooke Cognitive Examination in a UK secondary care setting. Here, we compare Free-Cog to the routinely-used Mini-Mental State Examination (MMSE) and the Lawton-Brody Instrumental Activities of Daily Living (IADL) and Physical Self-Maintenance Scales (PSMS). Methods Patients from three memory clinics were recruited (n = 298 records). The Free-Cog, MMSE, IADL and PSMS were administered in-person (n = 267), via telephone (n = 17), or virtually using video conferencing (n = 12). The four tests were compared using Pearson correlation and ability to predict dementia diagnosis using binary logistic regression and the area under receiver operator characteristic (AUROC) curves. Preliminary results In-person Free-Cog score correlations ranged from strong (MMSE; r = 0.86, 95% Confidence Interval [CI]: [0.82–0.89], p < 0.001), to moderate (IADL (r = 0.56, 95% CI: [0.46–0.64], p = <0.001) to weak with the PSMS (r = 0.23, 95% CI: [0.10–0.35], p = <0.001). The Telephone Free-Cog only correlated significantly with MMSE (r = 0.73, 95% CI: [0.39–0.90], p < 0.001) and virtual Free-Cog with MMSE (r = 0.92, 95% CI: [0.74–0.98], p < 0.001) and IADL (r = 0.63, 95% CI: [0.09–0.88], p = 0.03). Each 1-point increase in Free-Cog (Odds ratio [OR]: 0.84, 95% CI: [0.76–0.92], p < 0.001) decreased the odds of being diagnosed with dementia, as the MMSE (OR: 0.79, 95%CI: [0.69–0.90], p < 0.001), and IADL (OR: 0.73, 95% CI: [0.58–0.92], p < 0.01). The Free-Cog (AUROC = 0.79) best discriminated between dementia and diagnosed otherwise, followed by MMSE (AUROC = 0.74), and IADL (AUROC = 0.69), whereas the PSMS did not (AUROC = 0.43). Conclusion The Free-Cog appears to be a free-of-cost, valid alternative to the routinely used MMSE, and supplements the IADL scale in capturing cognitive and functional changes associated with neurodegenerative diseases of cognition.