Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline were efficient screening tests for dementia

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Abstract

Objective To compare 3 screening approaches for dementia in a clinical environment: cognitive testing, informant report, and neurovisual assessment. Design A blinded comparison of the results from each of the 3 screening tests with the diagnosis of dementia based on the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R). Setting A university geriatric hospital and memory clinic in Geneva, Switzerland. Patients 76 patients (mean age 82 y, 79% women) who were admitted to the hospital or were attending an outpatient clinic. Patients were excluded if they had no informant; were not fluent in French; or had severe sensorimotor deficit, delirium, or acute physical conditions. Description of tests and diagnostic standard The French-language versions of the Mini-Mental State Examination (MMSE), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), and the Clinical Antisaccadic Eye Movement Test (AEMT) were used according to instructions provided by the test developers. The MMSE was administered by a geriatric registrar, the IQCODE was given to informants by a nurse, and the AEMT was administered by a neuropsychologist. Each test was administered by personnel blinded to the results of the other tests and to the results of the diagnostic standard (diagnoses of dementia and depression were made by senior psychiatrists using a checklist ofDSM-III-R criteria). Main outcome measures Sensitivity, specificity, and likelihood ratios. Main results 33 patients were diagnosed with dementia and 11 with depression; 2 of the latter group also had dementia. The sensitivity and specificity of the MMSE at the 26/27 cut-off point were 91% and 63%, respectively. The corresponding figures for the IQCODE at the cut-off point of 3.277 3.30 were 100% and 42%, respectively. {The likelihood ratio for a positive test (+LR) with the MMSE at the 26/27 cut-off point was 2.46 (10.86 at the 23/24 cut-off) and the likelihood ratio for a negative test (-LR) was 0.14 (0.26 at the 23/24 cut-off). The +LR with the IQCODE at the 3.27/3.30 cut-off point was 1.72 (2.53 at the < 3.6/> 3.6 cut-off) and the -LR was 0(0.34 at the <3.6/> 3.6 cut-off.}* The AEMT did not perform as well as the other 2 tests. Conclusion The Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly were efficient methods of screening for dementia in clinical settings and comparably discriminated between patients with and without dementia.

Original languageEnglish (US)
Pages (from-to)25
Number of pages1
JournalEvidence-Based Medicine
Volume2
Issue number1
StatePublished - 1997

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Dementia
Eye Movements
Diagnostic and Statistical Manual of Mental Disorders
Geriatrics
Depression
Sensitivity and Specificity
Delirium
Ambulatory Care Facilities
Surveys and Questionnaires
Cognitive Dysfunction
Checklist
Switzerland
Routine Diagnostic Tests
Psychiatry
Language
Nurses
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{da10c6733b504c228540f7b173d3c026,
title = "Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline were efficient screening tests for dementia",
abstract = "Objective To compare 3 screening approaches for dementia in a clinical environment: cognitive testing, informant report, and neurovisual assessment. Design A blinded comparison of the results from each of the 3 screening tests with the diagnosis of dementia based on the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R). Setting A university geriatric hospital and memory clinic in Geneva, Switzerland. Patients 76 patients (mean age 82 y, 79{\%} women) who were admitted to the hospital or were attending an outpatient clinic. Patients were excluded if they had no informant; were not fluent in French; or had severe sensorimotor deficit, delirium, or acute physical conditions. Description of tests and diagnostic standard The French-language versions of the Mini-Mental State Examination (MMSE), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), and the Clinical Antisaccadic Eye Movement Test (AEMT) were used according to instructions provided by the test developers. The MMSE was administered by a geriatric registrar, the IQCODE was given to informants by a nurse, and the AEMT was administered by a neuropsychologist. Each test was administered by personnel blinded to the results of the other tests and to the results of the diagnostic standard (diagnoses of dementia and depression were made by senior psychiatrists using a checklist ofDSM-III-R criteria). Main outcome measures Sensitivity, specificity, and likelihood ratios. Main results 33 patients were diagnosed with dementia and 11 with depression; 2 of the latter group also had dementia. The sensitivity and specificity of the MMSE at the 26/27 cut-off point were 91{\%} and 63{\%}, respectively. The corresponding figures for the IQCODE at the cut-off point of 3.277 3.30 were 100{\%} and 42{\%}, respectively. {The likelihood ratio for a positive test (+LR) with the MMSE at the 26/27 cut-off point was 2.46 (10.86 at the 23/24 cut-off) and the likelihood ratio for a negative test (-LR) was 0.14 (0.26 at the 23/24 cut-off). The +LR with the IQCODE at the 3.27/3.30 cut-off point was 1.72 (2.53 at the < 3.6/> 3.6 cut-off) and the -LR was 0(0.34 at the <3.6/> 3.6 cut-off.}* The AEMT did not perform as well as the other 2 tests. Conclusion The Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly were efficient methods of screening for dementia in clinical settings and comparably discriminated between patients with and without dementia.",
author = "Hirsch, {Calvin H}",
year = "1997",
language = "English (US)",
volume = "2",
pages = "25",
journal = "Evidence-Based Medicine",
issn = "1356-5524",
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number = "1",

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TY - JOUR

T1 - Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline were efficient screening tests for dementia

AU - Hirsch, Calvin H

PY - 1997

Y1 - 1997

N2 - Objective To compare 3 screening approaches for dementia in a clinical environment: cognitive testing, informant report, and neurovisual assessment. Design A blinded comparison of the results from each of the 3 screening tests with the diagnosis of dementia based on the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R). Setting A university geriatric hospital and memory clinic in Geneva, Switzerland. Patients 76 patients (mean age 82 y, 79% women) who were admitted to the hospital or were attending an outpatient clinic. Patients were excluded if they had no informant; were not fluent in French; or had severe sensorimotor deficit, delirium, or acute physical conditions. Description of tests and diagnostic standard The French-language versions of the Mini-Mental State Examination (MMSE), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), and the Clinical Antisaccadic Eye Movement Test (AEMT) were used according to instructions provided by the test developers. The MMSE was administered by a geriatric registrar, the IQCODE was given to informants by a nurse, and the AEMT was administered by a neuropsychologist. Each test was administered by personnel blinded to the results of the other tests and to the results of the diagnostic standard (diagnoses of dementia and depression were made by senior psychiatrists using a checklist ofDSM-III-R criteria). Main outcome measures Sensitivity, specificity, and likelihood ratios. Main results 33 patients were diagnosed with dementia and 11 with depression; 2 of the latter group also had dementia. The sensitivity and specificity of the MMSE at the 26/27 cut-off point were 91% and 63%, respectively. The corresponding figures for the IQCODE at the cut-off point of 3.277 3.30 were 100% and 42%, respectively. {The likelihood ratio for a positive test (+LR) with the MMSE at the 26/27 cut-off point was 2.46 (10.86 at the 23/24 cut-off) and the likelihood ratio for a negative test (-LR) was 0.14 (0.26 at the 23/24 cut-off). The +LR with the IQCODE at the 3.27/3.30 cut-off point was 1.72 (2.53 at the < 3.6/> 3.6 cut-off) and the -LR was 0(0.34 at the <3.6/> 3.6 cut-off.}* The AEMT did not perform as well as the other 2 tests. Conclusion The Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly were efficient methods of screening for dementia in clinical settings and comparably discriminated between patients with and without dementia.

AB - Objective To compare 3 screening approaches for dementia in a clinical environment: cognitive testing, informant report, and neurovisual assessment. Design A blinded comparison of the results from each of the 3 screening tests with the diagnosis of dementia based on the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R). Setting A university geriatric hospital and memory clinic in Geneva, Switzerland. Patients 76 patients (mean age 82 y, 79% women) who were admitted to the hospital or were attending an outpatient clinic. Patients were excluded if they had no informant; were not fluent in French; or had severe sensorimotor deficit, delirium, or acute physical conditions. Description of tests and diagnostic standard The French-language versions of the Mini-Mental State Examination (MMSE), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), and the Clinical Antisaccadic Eye Movement Test (AEMT) were used according to instructions provided by the test developers. The MMSE was administered by a geriatric registrar, the IQCODE was given to informants by a nurse, and the AEMT was administered by a neuropsychologist. Each test was administered by personnel blinded to the results of the other tests and to the results of the diagnostic standard (diagnoses of dementia and depression were made by senior psychiatrists using a checklist ofDSM-III-R criteria). Main outcome measures Sensitivity, specificity, and likelihood ratios. Main results 33 patients were diagnosed with dementia and 11 with depression; 2 of the latter group also had dementia. The sensitivity and specificity of the MMSE at the 26/27 cut-off point were 91% and 63%, respectively. The corresponding figures for the IQCODE at the cut-off point of 3.277 3.30 were 100% and 42%, respectively. {The likelihood ratio for a positive test (+LR) with the MMSE at the 26/27 cut-off point was 2.46 (10.86 at the 23/24 cut-off) and the likelihood ratio for a negative test (-LR) was 0.14 (0.26 at the 23/24 cut-off). The +LR with the IQCODE at the 3.27/3.30 cut-off point was 1.72 (2.53 at the < 3.6/> 3.6 cut-off) and the -LR was 0(0.34 at the <3.6/> 3.6 cut-off.}* The AEMT did not perform as well as the other 2 tests. Conclusion The Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly were efficient methods of screening for dementia in clinical settings and comparably discriminated between patients with and without dementia.

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