Benefits of the CANS-MCI

The Computer-Administered Neuropsychological Screen for Mild Cognitive Impairments (CANS-MCI) is a screening device that requires few clinical resources but contributes significantly to the accurate early identification of those mild cognitive impairments most predictive of Alzheimer's Disease (AD). The CANS-MCI signals the need for a full neuropsychological evaluation early enough in the pre-clinical phase of the disease to enhance the effectiveness of treatments.

EASE OF USE: The tests are entirely self-administered by patients, including many with mild AD; minor assistance, usually in the form of reassurance by general staff or a relative, is necessary to guarantee test validity when the tests are used to track the efficacy of treatment in patients who already have mild dementia.

PRECEDENTS FOR THE CANS-MCI: The CANS-MCI tests were based upon findings of previous neuropsychological research studies concerning the cognitive dimensions that are most predictive of AD. Previous studies found that by combining several of these cognitive dimensions into a single test battery (to account for the variety of distinct, early cognitive deficits associated with AD), predictive validity can be enhanced.

PSYCHOMETRIC BENEFITS: Repeated administration of the CANS-MCI battery is likely to increase the precise predictive sensitivity and specificity. Touch screen automated test administration provides improved objectivity through the elimination of inter-tester variation. The predictive ability of the test scores is enhanced by the precise measurement of single-item response latencies, allowing several tests to be scored with respect to both accuracy and reaction time. Longitudinal comparison of scalable test scores is likely to substantially reduce the problem of false negatives. For example, highly educated people often compensate for subtle brain changes in a manner that masks deterioration and the need for treatment. By comparing highly educated persons against their own previous scores, the CANS-MCI detects the insidious progression of pre-dementia changes long before the diagnosis of MCI or AD would otherwise be investigated.

CLINICAL BENEFITS: Compared to current practices, the primary decision - whether or not a full neuropsychological and/or imaging assessment is needed for the detection of AD - is made with greater accuracy because of longitudinal tracking of individual patients. The test results are returned to the office where testing is performed and where supportive disclosure of results can be controlled and follow-up evaluations can be immediately arranged. The design of the CANS-MCI allows the clinician to accurately concentrate on the patients for whom further assessment is indicated; it reduces unnecessary referrals of the patients who do not demonstrate absolute or change scores on the several test dimensions indicative of mild cognitive impairment and predictive of deterioration. After professional evaluation, continued testing during routine office visits improves the physician's ability to assess the rate of disease progression or assess the effects of medication trials. Results are reported within the context of known risk and prevention factors, educational background, mood state, alcohol abuse, and medication use, enhancing their clinical value.

AUTOMATION BENEFITS: Automated administration and scoring reduce staff time and costs in doctors' offices or other institutions where the CANS-MCI is administered. Automated test administration can also reduce patient defensiveness about displaying limitations in front of others while still providing the information needed by caretakers, patients and physicians. The CANS-MCI is by far the most economical computerized battery with respect to staff time. It is also the most pleasant for patients. The scores are stored immediately and securely in a central data facility, thus reducing the need for in-house data storage and maintenance of data integrity. The CANS-MCI research pshychologists apply thoroughly researched decision rules for descriptive and graphical interpretation of the test scores. These decision rules can be refined and applied to all earlier test results as longitudinal research clarifies even more predictive scoring methods. Graphical displays and descriptive reports are immediately generated, again, without using your staff time and without your staff's errors or bias.

LANGUAGE BENEFITS: Currently available in spoken and silent versions with American English, American Spanish, South American Spanish, Portuguese for Brazil, Nederlands for Europe, and country-specific English versions that eliminate American cultural bias.

COST BENEFITS: As a fee-based service, each screening test is relatively inexpensive ($40,with discounts for advance bulk purchases). Reduced costs result in a clear economic benefit to patients, physicians' offices, government agencies, and insurance companies. Discounts are negotiated for volume of reports and for research application of the tests.

SUMMARY: There are medical needs (likely to expand as treatments become more effective) and a social pressure (likely to grow as the proportion of the aging population increases) for an economical tool that:
(1) is predictive of the earliest signs of MCI and AD;
(2) can be easily and efficiently administered at regular intervals;
(3) provides a way to track treatment effectiveness;
(4) includes the context of an individual's background, mood state, and risk factors; and
(5) gives immediate results to the physician responsible for supportive disclosure and follow-up clinical intervention.
The CANS-MCI addresses all of these needs.