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New Tool for Rapid Screening of Dementia Shows Promise
Date:11/10/2010

MSE, the current gold standard for dementia testing. That test has copyright controls that limit its availability, and the results it provides may be compromised by patients differing educational backgrounds, they noted.

To fashion an alternative screening mechanism, the authors first reviewed data collected from 774 patients who had been screened with the MMSE. Most of the results of that screening were further confirmed by two additional dementia/cognitive decline ranking systems.

Based on these analyses, the authors developed a series of questions focused on recall skills, verbal memory performance, and orientation issues such as the ability to identify a person, place, time and/or situation.

The final test was designed to be simple and fast. The screening involves no pencil or paper and can be completed in an average of two minutes.

When tried out, a score of 14 or less was found to detect 80 percent of cognitive impairment cases, compared with the 64 percent success score logged by the MMSE.

However, the MMSE outperformed the Sweet 16 with respect to correctly identifying patients with no cognitive impairment: 86 percent success vs. 70 percent, respectively.

Nevertheless, when compared with clinician assessments, Sweet 16 scores of 14 or less occurred in 99 percent of the patients diagnosed with cognitive impairment. Scores of 14 or less also occurred in 28 percent of people who were not diagnosed with cognitive impairment, suggesting a potentially high rate of false positives.

Dr. Gary J. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City, said that while better cognitive testing is needed, the jury is still out on whether or not the current innovation will fit the bill.

"Do we need something better than the MMSE?," he asked. "Absolutely. It's cumbersome to use. You need pencils and paper and props to administer it. And there are also a lot of difficulties with how to sco
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