Screening for dementia in community-based memory clinics.
OBJECTIVE
Dementia is a significant public health problem that is underrecognized in primary care settings. This study examined the usefulness of 3 brief screening tests in detecting dementia and mild cognitive impairment (MCI) in persons seeking consultation for memory complaints within a network of memory diagnostic clinics in Wisconsin.


METHODS
This prospective study of consecutive referrals for memory diagnostic evaluation analyzed data for 364 patients > or = 50 years. Scores on 3 cognitive screening measures-the Mini-Mental State Examination (MMSE), Clock Drawing, and Animal Naming--were compared to clinical diagnosis of normal cognitive aging, MCI, or dementia.


RESULTS
Using the standard cut score of <24, the MMSE identified only 60% of persons diagnosed with dementia. By contrast, using a recommended cut score of <14 words per minute, Animal Naming identified 85% of persons with dementia with a relatively low (12%) false positive rate. Clock Drawing was intermediate to the other 2 measures in screening effectiveness.


CONCLUSIONS
Animal Naming was moderately to highly effective in identifying dementia. The naming procedure is easy to administer and may have value as a brief initial dementia screen in busy practice settings. More demanding cognitive measures may be needed to improve screening accuracy for MCI.
Sager
Mark A
MA
Wisconsin Alzheimer's Institute, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53719, USA. masager@wisc.edu
Hermann
Bruce P
BP
La Rue
Asenath
A
Woodard
John L
JL
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003704:Dementia / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008569:Memory Disorders / Q000175:diagnosis*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012372:ROC Curve