a1 Department of Health Sciences, University of Leicester, Leicester , UK
a2 Institute of Psychiatry, Kings College London, London, UK
a3 Department of Psychiatry, Konkuk University Medical Centre, Konkuk University, Seoul, South Korea
a4 Old Age Psychiatry, Sussex Partnership NHS Foundation Trust, Worthing, UK
a5 Leicestershire Partnership NHS Trust, Leicester, UK
a6 Division of Psychiatry, Charles Bell House, University College London, London, UK
Background: As the population ages, it is increasingly important to use effective short cognitive tests for suspected dementia. We aimed to review systematically brief cognitive tests for suspected dementia and report on their validation in different settings, to help clinicians choose rapid and appropriate tests.
Methods: Electronic search for face-to-face sensitive and specific cognitive tests for people with suspected dementia, taking ≤ 20 minutes, providing quantitative psychometric data.
Results: 22 tests fitted criteria. Mini-Mental State Examination (MMSE) and Hopkins Verbal Learning Test (HVLT) had good psychometric properties in primary care. In the secondary care settings, MMSE has considerable data but lacks sensitivity. 6-Item Cognitive Impairment Test (6CIT), Brief Alzheimer's Screen, HVLT, and 7 Minute Screen have good properties for detecting dementia but need further validation. Addenbrooke's Cognitive Examination (ACE) and Montreal Cognitive Assessment are effective to detect dementia with Parkinson's disease and Addenbrooke's Cognitive Examination-Revised (ACE-R) is useful for all dementias when shorter tests are inconclusive. Rowland Universal Dementia Assessment scale (RUDAS) is useful when literacy is low. Tests such as Test for Early Detection of Dementia, Test Your Memory, Cognitive Assessment Screening Test (CAST) and the recently developed ACE-III show promise but need validation in different settings, populations, and dementia subtypes. Validation of tests such as 6CIT, Abbreviated Mental Test is also needed for dementia screening in acute hospital settings.
Conclusions: Practitioners should use tests as appropriate to the setting and individual patient. More validation of available tests is needed rather than development of new ones.
(Received October 16 2013)
(Reviewed November 06 2013)
(Revised February 05 2014)
(Accepted February 10 2014)
(Online publication March 31 2014)
c1 Correspondence should be addressed to: Latha Velayudhan, Senior Clinical Research Fellow, Psychiatry for the Elderly, Academic Department, Leicester General Hospital, Leicester LE5 4PW, UK. Phone: +0116-258-4518; Fax: +0116-273-1115. Email: [email protected].