Screening and Case-Finding Tools for the Detection of Dementia. Part II: Evidence-Based Meta-Analysis of Single-Domain Tests

Mitchell, Alex J.; Malladi, Srinivasa

doi:10.1097/jgp.0b013e3181cdecd6

Cited by 38 publications

(20 citation statements)

References 69 publications

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“…Our study confirmed the utility of the SMCC as a good 'rule-out' measure in our population. The performance of both the SMC and SMCC in our study was superior to the 43% sensitivity and 85.8% specificity reported in a meta-analysis of SMC [74] . The differing performance between SMC and SMCC highlights the need for a standard definition of subjective memory impairment for research or clinical settings [55] .…”

Section: Discussionmentioning

confidence: 61%

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The Sensitivity and Specificity of Subjective Memory Complaints and the Subjective Memory Rating Scale, Deterioration Cognitive Observee, Mini-Mental State Examination, Six-Item Screener and Clock Drawing Test in Dementia Screening

Ramlall¹,

Chipps²,

Bhigjee³

et al. 2013

Dement Geriatr Cogn Disord

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Background:The effectiveness of dementia screening depends on the availability of suitable screening tools with good sensitivity and specificity to confidently distinguish normal agerelated cognitive decline from dementia. The aim of this study was to evaluate the discriminant validity of 7 screening measures for dementia. Methods: A sample of 140 participants aged ≥60 years living in a residential facility for the aged were assessed clinically and assigned caseness for dementia using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revised diagnostic criteria. Sensitivity and specificity of a selection of the following screening measures were tested using receiver operating characteristic (ROC) analysis for individual and combined tests: the Mini-Mental State Examination (MMSE), Six-Item Screener (SIS), Subjective Memory Complaint, Subjective Memory Complaint Clinical (SMCC), Subjective Memory Rating Scale (SMRS), Deterioration Cognitive Observee (DECO) and the Clock Drawing Test (CDT). Results: Using ROC analyses, the SMCC, MMSE and CDT were found to be 'moderately accurate' in screening for dementia with an area under the curve (AUC) >0.70. The AUCs for the SIS (0.526), SMRS (0.661) and DECO (0.687) classified these measures as being 'less accurate'. At recommended cutoff scores, the SMCC had a sensitivity of 90.9% and specificity of 45.7%; the MMSE had a sensitivity of 63.6% and a specificity of 76.0%, and the CDT had a sensitivity of 44.4% and a specificity of 88.9%. Combining the SMCC and MMSE did not improve their predictive power except for a modest increase when using the sequential rule. Conclusion: The SMCC is composed of valid screening questions that have high sensitivity, are simple to administer and ideal for administration at the community or primary health care level as a first level of 'rule-out' screening. The MMSE can be included at a second stage of screening at the general hospital level and the CDT in specialist clinical settings. Sequential use of the SMCC and MMSE will improve the specificity of the former and the sensitivity of the latter.

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Section: Discussionmentioning

confidence: 61%

“…This is a screening test for dementia [73] that assesses visuospatial, constructional and executive functions and is classified as a single-domain test [74] . In this study, the free-drawing version with the '10 past 11' time setting instruction was used.…”

Section: Screening Measuresmentioning

confidence: 99%

The Sensitivity and Specificity of Subjective Memory Complaints and the Subjective Memory Rating Scale, Deterioration Cognitive Observee, Mini-Mental State Examination, Six-Item Screener and Clock Drawing Test in Dementia Screening

Ramlall¹,

Chipps²,

Bhigjee³

et al. 2013

Dement Geriatr Cogn Disord

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“…Folstein's Mini-Mental State Examination (MMSE) is recognized as a valid measure for detecting and grading dementia and cognitive impairment (Adelman & Daly, 2005;Agrell & Dehlin, 2000;Cummings, 1993;Dubois et al, 2007;Folstein & Whitehouse, 1983;Harvan & Cotter, 2006;McKhann et al, 1984;Mitchell & Malladi, 2010;Perneczky et al, 2006;Soto et al, 2008;Tombaugh & McIntyre, 1992). This test, first introduced by Folstein and colleagues in 1975 (Folstein, Folstein, & McHugh, 1975), has become a standard tool for cognitive assessment in clinical settings (Cummings).…”

Section: Introductionmentioning

confidence: 97%

Is the Folstein's Mini-Mental Test an Aphasia Test?

Vigliecca

Peñalva

Molina

et al. 2012

Applied Neuropsychology: Adult

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The Mini-Mental State Examination (MMSE) is recognized as a valid screening for dementia. It consists of 29 verbal items from a total of 30. The Brief Aphasia Evaluation (BAE) includes 10 aphasia and 12 orientation items, which are similar to most of the MMSE items. It was studied whether those BAE items (MMSE-like): (a) correlate with the rest of the BAE items (BAE-rest), and (b) differentiate patients with left cerebral lesions (LC) from both patients with right cerebral lesions (RC) and healthy participants (HP). A sample of 109 right-handed volunteers (38 HP, 37 LC, and 34 RC) was studied. The three groups were matched according to gender, age, and education. Patients were similar in multiple variables. The correlation between MMSE-like and BAE-rest was .90. MMSE-like showed a sensitivity and specificity of .81 or above to identify the LC from the other two groups. There is a risk for misdiagnosing aphasia as dementia with the MMSE.

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“…2 The MMSE has many shortcomings, but improving upon it requires either greater accuracy or greater acceptability. Brief, effi cient single domain tests like the Digit Span and Clock Drawing Test are an increasingly popular initial screening method for dementia, 3 and their value in delirium is unclear and clarifi cation urgently needed. The overall paucity of short tools with a good evidence base may explain why most clinicians do not routinely test for delirium and why delirium continues to be seriously overlooked in clinical settings.…”

mentioning

confidence: 99%

Confusion Assessment Method is the most appropriate tool to quickly detect delirium in hospitalised patients at the bedside

Mitchell

2011

Evid Based Mental Health

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Screening and Case-Finding Tools for the Detection of Dementia. Part II: Evidence-Based Meta-Analysis of Single-Domain Tests

Cited by 38 publications

References 69 publications

The Sensitivity and Specificity of Subjective Memory Complaints and the Subjective Memory Rating Scale, Deterioration Cognitive Observee, Mini-Mental State Examination, Six-Item Screener and Clock Drawing Test in Dementia Screening

The Sensitivity and Specificity of Subjective Memory Complaints and the Subjective Memory Rating Scale, Deterioration Cognitive Observee, Mini-Mental State Examination, Six-Item Screener and Clock Drawing Test in Dementia Screening

Is the Folstein's Mini-Mental Test an Aphasia Test?

Confusion Assessment Method is the most appropriate tool to quickly detect delirium in hospitalised patients at the bedside

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