الفهرس 
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Abstract
MCI is a heterogeneous clinical syndrome that reflects a change in cognitive functions and deficits on neuropsychological testing but relatively intact daily living activities. MCI is a risk state for further functional and cognitive decline with 5-15% of people progressing to dementia per year. However, " ~ "50% remain stable at 5 years, and in a minority, symptoms resolve over time (Dunne et al., 2021)
There is a shortage in the tools detecting MCI in the elderly especially among illiterate population as the MMSE was introduced in 1975 as a bedside cognitive examination tool for psychiatric inpatients. The concept of MCI was not yet formally recognized while the MoCA was designed specifically with more difficult items in mind to increase the sensitivity for MCI in the psychogeriatric clinic setting (Breton et al., 2019). However, it does get influenced by educational level, ethnic diversities and lifestyle factors (Gagnon et al., 2013) (O’Driscoll & Shaikh, 2017).
RUDAS is a brief cognitive test (BCT) developed and validated in Australia. (Storey et al., 2004). It has satisfactory psychometric properties and is not affected by sex, years of education or language (Rowland et al.,2006).
But still a more accurate tool for MCI diagnosis covering various cognitive domains coping with Egyptian culture with high illiteracy level among elderly is needed.
The hypothesis of the current study was based on that ASCA is a valid tool for MCI diagnosis among illiterate Egyptian elderly population. The aim of the current study was to assess the accuracy of ASCA, a newly designed neuropsychological battery to diagnose MCI among Egyptian elderly, in comparison to RUDAS, a well previously validated one.
This study is a comparative cross-sectional study that included 100 elderly subjects both males and females ≥ 60 years classified according to their A-RUDAS score into MCI and non-MCI groups. Participants were recruited from geriatrics outpatients’ clinics at El-Mansoura university hospital in the period of 7 months from August 2020 to March 2021.
All participants were subjected to the following: Comprehensive geriatric assessment, RUDAS test and ASCA battery tests. Participants were considered MCI according to their A-RUDAS score then ASCA was performed. ASCA subdomains scores were evaluated.
The study showed that ASCA total and subdomains scores were statistically significant in MCI diagnosis in comparison to RUDAS except for abstraction and judgment which showed no statistically significant difference between MCI and non-MCI groups.
Also, ASCA Total score at cut off point ≤95 had perfect diagnostic characteristics in distinguishing MCI from normal subjects with sensitivity and specificity 100% (AUC=1.000, 95% CI= 1.000-1.000, P value = <0.001).
In addition, the cut off points between MCI and non-MCI groups for some ASCA subdomains with higher diagnostic accuracy were calculated as follows: ≤ 10, ≤ 39, ≤ 28, ≤ 9, ≤ 6, ≤ 7, ≤ 8, ≤ 8, ≤ 8, and ≤ 5 for semantic fluency test, Verbal Learning and recall total, Verbal Learning and recall total easy, Verbal Learning and recall total hard, Verbal Learning 1st trial total, Verbal Learning 2nd trial total, Verbal Learning 3rd trial total, Distractor interval total, Delayed recall total, and Set shifting lines.