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The Mini-Cog as a Screen for Dementia: Validation in a Population-Based Sample

Authors

  • Soo Borson MD,

    1. From the Department of Psychiatry and Behavioral Sciences and the Alzheimer's Disease Research Center, University of Washington, Seattle, Washington
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  • James M. Scanlan PhD,

    1. From the Department of Psychiatry and Behavioral Sciences and the Alzheimer's Disease Research Center, University of Washington, Seattle, Washington
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  • Peijun Chen MD, PhD,

    1. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
    2. Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
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  • Mary Ganguli MD, MPH

    1. Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
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  • Supported by grants from the National Institute on Aging (AG-05136, Drs. Borson and Scanlan; AG-7562, Drs. Ganguli and Chen). Abstract presented in part at the annual meeting of the American Association for Geriatric Psychiatry, February 2001.

Address correspondence Soo Borson, MD, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356560, Seattle, WA 98195. E-mail: soob@u.washington.edu

Abstract

Objectives: To test the Mini-Cog, a brief cognitive screening test, in an epidemiological study of dementia in older Americans.

Design: A population-based post hoc examination of the sensitivity and specificity of the Mini-Cog for detecting dementia in an existing data set.

Setting: The Monongahela Valley in Western Pennsylvania.

Participants: A random sample of 1,119 older adults enrolled in the Monongahela Valley Independent Elders Survey (MoVIES).

Measurements: The effectiveness of the Mini-Cog in detecting independently diagnosed dementia was compared with that of the Mini-Mental State Examination (MMSE) and a standardized neuropsychological battery.

Results: The Mini-Cog, scored by an algorithm as “possibly impaired” or “probably normal,” and the MMSE, at a cutpoint of 25, had similar sensitivity (76% vs 79%) and specificity (89% vs 88%) for dementia, comparable with that achieved using a conventional neuropsychological battery (75% sensitivity, 90% specificity).

Conclusion: When applied post hoc to an existing population, the Mini-Cog was as effective in detecting dementia as longer screening and assessment instruments. Its brevity is a distinct advantage when the goal is to improve identification of older adults in a population who may be cognitively impaired. Prior evidence of good performance in a multiethnic community-based sample further supports its validity in the ethnolinguistically diverse populations of the United States in which widely used cognitive screens often fail.

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