Should Older Adults Be Screened for Cognitive Impairment?

Soo Borson, MD


Medscape General Medicine. 2004;6(1):e48 

In This Article

Improving Detection of Dementia in Primary Care: The Value of Screening

Borson and colleagues,[9] in a paper presented at the Annual Meeting of the American Association for Geriatric Psychiatry, compared rates of detection of cognitive impairment by the Mini-Cog with detection by subjects' own physicians in a study of 277 older adults living in the community. Severity of cognitive impairment was classified by the Clinical Dementia Rating scale, a standard staging method. A score of 0 is reserved for individuals thought to be cognitively normal; 0.5 for those with very mild cognitive deficits that minimally impair everyday function, if at all; 1 and 2 for mild and moderate dementia; and 3 and above for severe dementia. The Mini-Cog incorrectly classified as impaired about 10% of nondemented individuals in this culturally, linguistically, educationally, and diagnostically heterogeneous sample, but correctly classified the great majority of demented individuals in stages 1-3+. Mildly impaired, nondemented individuals were recognized as impaired more than half the time. At all stages of impairment except the most severe, the Mini-Cog was significantly superior to spontaneous recognition by doctors.

Improving early recognition: Mini-Cog vs primary physician.