title: The Mini-Cog versus the Mini-Mental State Examination and the Clock Drawing Test in daily clinical practice: screening value in a German Memory Clinic.
abstract: BACKGROUND
  The aim of this study was to compare the screening value of the Mini-Cog, Clock Drawing Test (CDT), Mini-Mental State Examination (MMSE) and the algorithm MMSE and/or CDT to separate elderly people with dementia from healthy depending on test time, type and severity of dementia, and demographic variables in a German Memory Clinic.
  
  
  METHODS
  Data from a heterogeneous patient sample and healthy participants (n = 502) were retrospectively analyzed. Of the 438 patients with dementia, 49.1% of the dementia diagnoses were Alzheimer's dementia and 50.9% were non-Alzheimer's dementia. Sixty-four participants were classified as cognitively unimpaired. The CDT and an extraction of the 3-item recall of the MMSE were used to constitute the Mini-Cog algorithm.
  
  
  RESULTS
  Overall, the Mini-Cog showed significantly higher discriminatory power (86.8%) than the MMSE (72.6% at a cut-off ≤ 24 and 79.2% at ≤ 25, respectively) and CDT (78.1%) (each p < 0.01) and did not perform worse than the algorithm MMSE and/or CDT (each p > 0.05). The specificity of the Mini-Cog (100.0%) was similar to that of the MMSE (100.0% for both cut-offs) and CDT (96.9%) (p = 0.154). For all age and educational groups the Mini-Cog outmatched the CDT and MMSE, and was less affected by education than MMSE and less susceptible for the dementia stage than the CDT.
  
  
  CONCLUSIONS
  The Mini-Cog proved to have superior discriminatory power than either CDT or MMSE and is demonstrated to be a valid "short" screening instrument taking 3 to 4 minutes to administer in the geriatric setting.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany. monika.milian@med.uni-tuebingen.de
authors.forename: Monika
authors.initials: M
authors.lastname: Milian
authors.forename: Anna-Maria
authors.initials: AM
authors.lastname: Leiherr
authors.forename: Guido
authors.initials: G
authors.lastname: Straten
authors.forename: Stephan
authors.initials: S
authors.lastname: Müller
authors.forename: Thomas
authors.initials: T
authors.lastname: Leyhe
authors.forename: Gerhard W
authors.initials: GW
authors.lastname: Eschweiler
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology; D016022:Case-Control Studies; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D004522:Educational Status; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis; D008875:Middle Aged; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index