The comparative diagnostic accuracy of the Mini Mental State Examination (MMSE) and the General Practitioner assessment of Cognition (GPCOG) for identifying dementia in primary care: a systematic review protocol

Abstract

Background: Improved dementia identification is a global health priority, and general practitioners (GPs) are often the first point of contact for people with concerns about their cognition. However, GPs often express uncertainty in using assessment tools and the evidence based on which tests are most accurate in identifying dementia is unclear. In particular, there is little certainty around how the accuracy of available brief cognitive assessments compares within a clinical family practice setting. Grounded in existing brief cognitive assessment evidence, we will compare the diagnostic test accuracy of the Mini Mental State Examination (MMSE) to the General Practitioner Assessment of Cognition (GPCOG) against the best available reference standard when used within a family practice setting. Methods: We will employ robust systematic review methods to assess studies of diagnostic accuracy where both the MMSE and GPCOG have been evaluated as direct comparisons, i.e. within the same study population. This approach will enable us to minimise between-study heterogeneity, to eliminate the risk of bias due to confounding and increase the opportunity to make clinically useful and useable comparisons of diagnostic accuracy across both the MMSE and GPCOG. This systematic review will be conducted using a pragmatic search strategy, refining searches that build upon studies identified as part of our overview of systematic reviews of the diagnostic accuracy of brief cognitive assessments for identifying dementia in primary care. Discussion: Through this systematic review, we aim to improve existing evidence on how the diagnostic accuracy of MMSE and GPCOG compares when used to identify dementia within the family practice setting. We also aim to make clinical practice recommendations based upon the variations in diagnostic accuracy identified between the MMSE and GPCOG.

Clinical utility of Phototest via teleneuropsychology in Chilean rural older adults

“…Test administration is not standardized for TNP formats in all LA countries, where the cultural, educational, and socioeconomic characteristics of the patient may bias scores 42 . This test does not measure executive function as it can detect only moderate or advance dementia 43 ; and it is also not sensitive to MCI 44,45 , early stages of Alzheimer's-type dementia, and non-Alzheimer's-type dementias 46 . As a pencil and paper task, the MMSE conducted through telehealth means requires the use of complex digital platforms or the user to interact with other systems to complete the assessment 47 .…”

Smart Textiles for Improved Quality of Life and Cognitive Assessment

“…An important subset of e-textiles is those in which the monitoring devices are not only attached to the garment but sensors and electronics are also integrated into the fabric itself [ 9 , 13 , 54 , 55 ], so-called sensorized garments. Because a person wears the garment, for instance, for physiological monitoring, important considerations are the intrinsic rigidity of conductive materials, addressed with flexible electronics, and the mechanical deformations from stretching [ 13 ].…”

“…References [ 54 , 56 ] describe having the actual sensing structures produced in the textiles using processes that are compatible with the textile industry. The basic sensing elements (such as electrodes) need to be an integral part of the textile, utilizing a large area and the properties of the clothing.…”

“…Testing for MCI is an arduous process that requires a physician or psychologist to administer the test to collect data, which introduces bias and increases cost. Previous tools for analyzing cognitive impairment include the Memory Impairment Screen [ 64 , 65 ], the General Practitioner Assessment of Cognition [ 54 ], The Montreal Cognitive Assessment (MoCA) [ 2 ], Mini-mental state [ 55 ], Telephone Interview of Cognitive impairment (TICSm, [ 66 ]), and the CogState Brief Battery [ 56 ]. Prior to the development of these tools the standard way to evaluate if a person had a cognitive impairment was through observation by clinical staff, interviews with specialists, and observation by family or caregivers [ 67 ].…”

Cognitive Impairment and Memory Loss in Diabetes Mellitus: A Systematic Review

“…Diabetes can reduce insulin sensitivity and relative insulin deficiency leading to cognitive decline (6).In diabetes patients, insulin resistance is considered as increased risk factor for cognitive defect. A strong evidence from a study conducted in USA indicated that memory loss may be a slow progressing brain metabolic disease (7).Individuals with Metabolic syndrome and obesity, have a higher risk of developing memory loss leading to Alzheimer's, while Additionally, both primary care physicians and psychiatrists recognised the importance (12). The reason behind is lack of awareness and information about this clinical state and symptoms of decline (15).…”