BackgroundThe Clinical Dementia Rating Scale (CDR), the Ascertain Dementia 8 (AD8), the Mini-Cog, the Verbal Fluency Test (VFT), the Community Screener for Dementia (CSI-D), the Rey Auditory Verbal Learning Test (RAVLT), and the Activities of Daily Living Scale (ADL) represent seven commonly employed methods for community cognitive impairment screening in China that have garnered limited attention. This study aimed to assess the discriminatory power of these seven tests when administered concurrently in a single screening to detect cognitive impairment in the absence of a gold standard.MethodsWe conducted a cross-sectional survey among 1,506 elderly people aged 60 and above in the community. The cognitive and social functions of the elderly population were evaluated by using the Seven scales. The characteristics related to demographics and health were collected through questionnaire surveys, and the correlations and consistencies of the Seven scales with cognitive impairment were analyzed respectively. Multifactor logistic regression model was used to analyze the risk factors of cognitive impairment in each scale.ResultsThe positive screening proportions for the seven scales—CDR, ADL, AD8, CSI-D, Mini-Cog, VFT, and RAVLT—were 61.1%, 33.7%, 38.0%, 37.1%, 53.7%, 39.3%, and 52.9%, respectively. Agreement on cognitive impairment risk between each pair of scales was fair-to-moderate (Kappa: 0.32–0.645, all p < 0.001). Screening results differed significantly across the seven scales by age, educational, marital status, epilepsy, cerebral infarction, brain atrophy, and depression (all P < 0.001). Notably, Screen-positive proportions for cognitive impairment rose significantly with increasing age (p < 0.001); the ≥ 80-year-old group showed the highest proportions across scales. Conversely, higher educational attainment was associated with lower risk of screening positive for cognitive impairment (p < 0.001).ConclusionsOur study identified a relatively high screening positivity proportion for cognitive impairment in Chongqing, Age, Sex, Education, Marital status, Brain atrophy, Anxiety, and Depression are risk factors for screening positivity. The identified screening positivity for cognitive impairment varied across different neuropsychological assessment methods, indicating that assessment choice should be tailored to population characteristics rather than applying a one-size-fits-all approach. Selecting the appropriate tool can improve sensitivity and reduce missed diagnoses.
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