There were 30.9% elderly with MCI in this study. This prevalence is higher than in previous studies with similar population characteristics. Xu S et al. and Petersen et al. stated that the prevalence of MCI in the elderly 60 years and over ranges from 8.4–25.2%. This difference is probably caused by the low educational background of the research subjects in this study [2, 4].
This study showed that low levels of education were significantly associated with the incidence of MCI. This is consistent with research by Petersen et al. and Xu S et al., which states that the prevalence of MCI will be higher in populations with lower levels of education [2, 4].
This study also showed that the presence of subjective memory complaints was statistically significant with MCI. These results are in line with research by Petersen et al. and Mitchell AJ, which showed that subjective memory complaints were associated with disruption of new long-term memory formation in MCI. [4, 22]. This variable makes sense for inclusion in a brief screening program for MCI, especially when combined with other examinations [19–21].
Research by Radanovic M et al., Mueller KD et al., and Mirandez RM et al. proven that the elderly with MCI had lower verbal fluency test results, primarily semantic fluency. This is consistent with this study's results that showed that an abnormal verbal semantic fluency test was statistically significantly associated with MCI [22–24]. Verbal fluency is a cognitive function that involves executive functioning and language skills in retrieving information from memory stored in the brain. Therefore, to assess executive functioning and language skills, verbal fluency tests can be used. Language skills reflect the left temporal lobe function. Executive function reflects the function of the frontal lobe and left prefrontal, dorsolateral cortex [25, 26].
The elderly with MCI have a risk of developing dementia of about 10–12% per year, whereas the rate of development of dementia in the average elderly population is about 1–2% per year [27, 28]. Elderly with MCI can be prevented from developing dementia if MCI can be detected early and received adequate therapy. Several studies have shown that the percentage conversion of MCI to normal cognitive function in the elderly can range from 25–40% [29, 30]. Therefore, we need a novel and easy yet accurate method for early detection of MCI in the elderly population. It is hoped that neuropsychiatric score can be a suitable method for early detection of MCI in the community. This method is early detection before the further examination to establish a diagnosis of MCI.
The neuropsychiatric score is a simple, early detection method and easy to validate. A combination of verbal semantic fluency test, subjective memory complaints variables, and education level are used to develop a neuropsychiatric score for early detection of the MCI in the community.
The accuracy of the neuropsychiatric score for detecting elderly with MCI in the community was reasonably good. The neuropsychiatric score with a cut-off point of 2 has sensitivity = 91.20% and Specificity = 78.9%.