The New and Improved Way to Screen for Dementia in Primary Care

Arefa Cassoobhoy, MD, MPH


June 08, 2018

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Morning Report, our 1-minute news story for primary care.

Screening for dementia is more common in the primary care of older adults. Many clinicians use the Mini Mental State Exam (MMSE) for this purpose, but its sensitivity for early symptoms of cognitive impairment is low.

A recent analysis looked at improving dementia prediction. About 2700 adults, aged 70-78 years, were given the MMSE plus another screening tool called the Visual Association Test (VAT). It's a 3-minute test that uses pictorial cue cards to evaluate associative memory.

Over the next 6-8 years they analyzed the predictive value of both of these tests to diagnose dementia. Patients with a decline in their MMSE and an imperfect VAT score were more likely to be diagnosed with dementia. Those with a slight decline on the MMSE and a perfect VAT score were not at increased risk compared with the entire cohort.

This is a simple test to consider adding to help distinguish older adults who need further cognitive testing from those in whom watchful waiting is justified.

Follow Dr Cassoobhoy on Twitter at @ArefaMD


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