FOTOTRANS Study. Multicentre study on the validity of Fototest under clinical practice conditions

Objective: Fototest is a short simple test, applicable to illiterate subjects and not influenced by educational level. The purpose of this study is to assess its validity for cognitive impairment (CI) and dementia (DEM) under routine clinical practice conditions. Material and methods: A cross-sectional, multicentre and naturalistic study conducted in General Neurology clinics. The subjects were, over 60 years old, with a previously established diagnosis of no cognitive impairment (NoCI), cognitive impairment without dementia (CInoDEM), or dementia (DEM). The discriminant validity was assessed using the area under the ROC curve (AUC), sensitivity (Sn), specificity (Sp), and probability coefficients. Partial corelations were calculated, adjusted for age, sex and education level with Eurotest, verbal fluency test (VFT) and Global Deterioration Scale (GDS) score to evaluate the concurrent and construct validity. Results: Nineteen neurologists included a total of 589 subjects: 361 NoCI, 10 CINoDEM and 122 DEM. The discriminant value was better for DEM (AUC 0.94 +/- 0.02) than for CI (0.86 +/- 0.02). For DEM the best cut-off point was 26/27 (Sn = 0.88 [95% CI, 0.93-0.97], Sp = 0.87 [95% CI, 0.84-0.90)); and for CI, 28/29 (Sn=0.71 [95% CI, 0.65-0.77], Sp = 0.84 [95% Cl, 0.80-088]). Fototest showed a high and significant correlation with Eurotest (r = 0.70 +/- 0.02), VFT (r=0.68 +/- 0.02) and the GDS score (r=-0.77 +/- 0.02). Conclusion: The Fototest showed adequate validity for CI and DEM in general Neurology clinics in an extensive and wide geographical area. (C) 2011 Sociedad Espanola de Neurologia. Published by Elsevier Espana, S.L. All rights reserved.