[Mini-Cog: a simple method for very brief screening of mental decline].
BACKGROUND
Physicians do not detect majority of the demented people, and many patients appear only in an advanced stage of their mental decline at the first medical visit. Role of general practitioner is crucial; a brief and effective screening method can basically change the present situation. Borson et al (2000) has investigated a new, very brief method named Mini-Cog that consists of the combination of the 3-word recall and the clock-drawing test.


OBJECTIVE
of the present study was to evaluate this method in Hungarian patient population.


METHODS
Authors have analysed the charts of patients examined by the first author in the outpatient part of the Memory clinic of the National Institute of Psychiatry and Neurology in a 2-year interval (between 11.01. 1999 and 31.10.2001). Data of 186 patients were analysed. From the Mini-Mental State the total score, score of three-word recall (possible scores between 0-3), serial counting backward with 7 from 100 were taken into consideration; the clock-drawing test was analysed quantitatively (1 = failure, 2 = borderland, 3 = acceptable solution).


RESULTS
The algorithm which considers the patient demented if she or he does not remember of any word, or remembers only of 1-2 and the clock-drawing is pathologic, has a high sensitivity (100%) and specificity (80.9%) in cases using the < or = 24 Mini-Mental State value, while the sensitivity and specificity is 98.8% and 88.0% respectively if drawing the limit at < or = 26 points. Combination of the two tests (word-recall, clock drawing) gives a better value than either of them alone. Based on their experiences they propose to apply in a short test the serial backwards with seven from 100 too, while patients with very high Mini-Mental State scores (29-30) not infrequently can not perfectly solve this subtest (7/11 = 64 p.c.).


CONCLUSIONS
In agreement with the Hungarian Protocol for diagnosing and treating dementias (1999) authors stress the importance of the consultation with a specialist (neurologist or psychiatrist) in cases of suspected dementia to reveal the underlying disease.
Tariska
Péter
P
Országos Pszichiátriai és Neurológiai Intézet, Memória Klinika, Budapest.
Paksy
András
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis; D003663:Decision Trees; D003704:Dementia / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales