Brief cognitive screening instruments: an update.
OBJECTIVE
To review the recent literature on cognitive screening with a focus on brief screening methods in primary care as well as geriatric services.


METHODS
The Medline search engine was utilized using the keyword search terms 'cognitive screening', 'cognitive assessment', and 'dementia screening' limiting articles to those published in English since 1998.


RESULTS
679 abstracts were retrieved. Articles focusing on attitudes toward cognitive screening, current screening practices, promising new instruments and more recent updates contributing significant information on established instruments were retrieved and incorporated into this review. Reference lists were reviewed for relevant contributing articles. Instruments recommended from previous reviews of cognitive screening and those identified in surveys as most frequently used in primary care and geriatric settings were emphasized in this review.


CONCLUSIONS
Dementia remains under-diagnosed in the elderly population. Despite significant limitations, the Mini Mental State Exam remains the most frequently used cognitive screening instrument. Its best value in the community and primary care appears to be for the purpose of ruling out a diagnosis of dementia. Instruments such as the Mini-Cog, Memory Impairment Screen (MIS), and the General Practitioner Assessment of Cognition (GPCOG) have consistently been recognized for utility in primary care. The clock drawing test (CDT) and newer instruments such as the Montreal Cognitive Assessment (MoCA) and the Rowland Universal Dementia Assessment Scale (RUDAS) are gaining credibility due to improvements in sensitivity, addressing frontal/executive functioning, and decreasing susceptibility to cultural and educational biases.
Ismail
Zahinoor
Z
Department of Psychiatry, Faculty of Medicine, University of Toronto, Geriatric Mental Health Program, Centre for Addiction and Mental Health, Canada. zahinoor@gmail.com
Rajji
Tarek K
TK
Shulman
Kenneth I
KI
D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D003072:Cognition Disorders / Q000175:diagnosis*; D003704:Dementia / Q000175:diagnosis*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000295:instrumentation / Q000379:methods*; D011320:Primary Health Care; D011594:Psychometrics / Q000379:methods; D006113:United Kingdom