Monday October 7, 2024

The Melbourne Adaptive Cognitive Assessment (MACA)

An Eastern Health initiative supported by the Eastern Health Foundation.

Cognitive screening tests are an important component of the clinician assessment of cognitive impairment in adults. Clinician time is limited in clinical consultations, so compromises must be made in the comprehensiveness of the screen.

Current commonly used screens which try to assess various components of cognition, allow only brief glimpses into each of these “domains”. Each has strengths and weaknesses, and often simpler screens are used which have inadequate domain coverage for accurate differentiation of the causes of progressive cognitive impairment, such as those due to Alzheimer disease, frontal or vascular dementia.

To address these limitations, we have created the MACA. This is a novel screening test which covers the cognitive domains comprehensively, with items specifically included which are difficult for patients with the various phenotypes. The MACA has alternate versions for serial assessments. It has been ported to the iPad platform which Eastern Health is using to collect normative data and gain experience in patients with various causes of cognitive impairment.

The iPad system will allow translation into multiple languages to allow testing in non-English speaking patients. This new test will then serve the Eastern Health community more broadly and provide more accurate diagnoses early in cognitive impairment to allow quicker diagnosis and management.