Visual-spatial perception: a comparison between instruments frequently used in the primary care setting and a computerized cognitive assessment battery

Boris Punchik,1–3 Avital Shapovalov,2 Tzvi Dwolatzky,4,5 Yan Press1–3 1Comprehensive Geriatric Assessment Unit, Clalit Health Care Services, Yassky Clinic, 2Sial Center for Research in Family Medicine, Faculty of Health Sciences, 3Community-Based Geriatric Unit, The Division of Community Health, 4Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, 5Geriatric Unit, Rambam Health Care Campus, Haifa, Israel Background: The development of screening instruments will help the primary care team to determine when further comprehensive cognitive assessment is necessary. Design: A retrospective analysis based on medical records. Patients and setting: Patients referred to a comprehensive geriatric assessment unit. Analysis: Cognitive screening and assessment included visual-spatial components: the Mini Mental State Examination, the Clock Drawing Test, the Montreal Cognitive Assessment Test, and the Neurotrax (Mindstreams) computerized cognitive assessment battery. Results: The average age of the 190 eligible patients was 81.09±5.42 years. Comparing the individual tests with that of the visual-spatial index of Neurotrax, we found the Trail Making B test to be most sensitive (72.4%) and the Cube Test to have the highest specificity (72.8%). A combination of tests resulted in higher sensitivity and lower specificity. Conclusion: The use of a combination of visual-spatial tests for screening in neurocognitive disorders should be evaluated in further prospective studies. Keywords: visual-spatial perception, mild cognitive impairment, cognitive assessment, screening tool