Validation of the Brief Assessment of Impaired Cognition and Brief Assessment of Impaired Cognition Questionnaire in a multicultural memory clinic sample across six European countries

Background: With the changing demographic landscape in most countries worldwide, accurate and brief culture-sensitive case-finding instruments are needed to identify patients with possible cognitive disorders. Objective: To investigate the discriminative validity of the Brief Assessment of Impaired Cognition (BASIC) and BASIC Questionnaire (BASIC-Q) in a multicultural memory clinic sample across six European countries. Methods: The study was a European cross-sectional multi-center study. Receiver operating characteristic curve analysis was used to examine discriminative validity of BASIC and BASIC-Q in identifying cognitive impairment (mild cognitive impairment (MCI) or dementia) as compared to specialist diagnosis. Regression analysis was used to assess the influence of sociodemographic variables and assessment in a second language on scores. Results: The study included a total of 479 participants of which 169 (36%) had immigrant background. BASIC and BASIC-Q had high diagnostic accuracy for cognitive impairment (MCI or dementia) with areas under the curve (AUC) of 0.93 and 0.92, respectively. Age had a significant, but small effect on BASIC, while both BASIC and BASIC-Q were unaffected by sex, education, immigrant status, and assessment in a second language. Among patients with affective/anxiety disorder, 80% scored below cutoff for cognitive impairment on BASIC and 94% on BASIC-Q. However, applying an Objective Performance vs. Subjective Complaints ratio to differentiate between patients with cognitive impairment and affective/anxiety disorder resulted in high overall classification accuracies, with AUC values of 0.80 and 0.74, respectively. Conclusions: The present study suggests that BASIC and BASIC-Q are valid brief case-finding instruments for cognitive impairment in a multicultural setting.