Optimal cut-off score on the Chinese version of executive interview (C-EXIT25) in a Hong Kong Chinese population

Abstract

Objectives: To determine the optimal cut-off score on the Chinese version of the Executive Interview to discriminate all-cause dementia patients from non-dementia subjects. Participants and Methods: A total of 141 community-dwelling elders were assessed with the Chinese version of the Executive Interview, the Cantonese version of the Mini-Mental State Examination, and Nelson's Modified Card Sorting Test. Severity of dementia was determined using the Clinical Dementia Rating Scale. Results: Higher total scores on the Chinese version of Executive Interview (greater impairment) yielded a statistically significant negative correlation with Nelson's Modified Card Sorting Test's 'Number of categories', but positive correlations with the test's 'Errors', 'Perseverative errors', 'Non-perseverative errors', and 'Percentage of perseverative errors'. The sensitivity and specificity at different cut-off values on the Chinese version of the Executive Interview used to plot the receiver operating characteristic curve gave an area under the curve of 0.97 (95% confidence interval, 0.94-0.99; p ≤ 0.01). The cut-off value of 15 best distinguished Clinical Dementia Rating 0 and 0.5 from Clinical Dementia Rating 1 and 2 (sensitivity = 90.7%; specificity = 87.2%). Conclusions: The results of the current study and the previous pilot study support that the Chinese version of the Executive Interview as a potentially useful bedside tool for executive functional assessment in Chinese elders, by virtue of good internal consistency, inter-rater reliability, concurrent validity and discriminatory power. © 2009 Hong Kong College of Psychiatrists.