[Validity of the cognitive screening tests and the mini-mental status examination in a group of elderly hospital patients].

OBJECTIVE

To study the validity of the cognitive screening test (CST) and of the mini-mental state examination (MMS).

DESIGN

Prospective administration of both CST and MMS (in balanced order) by laymen as well as by experienced users, and retrospective comparison of the scores with the clinical diagnosis and with the degree of functioning in activities of everyday life.

SETTING

Clinical and outpatient departments of Geriatrics and Neurology of the Slotervaart Hospital, Amsterdam.

PATIENTS AND METHOD

Ninety-five patients of the clinical and nine patients of the outpatient departments, with an acute somatic diagnostic problem and multiple pathology attending the above-named departments in the period from September 1989 to February 1990: 20 patients (group SOM) were found not to have a dementia syndrome; 25 patients (group DEM) had a dementia syndrome as the main diagnosis; 14 patients (group CVA) had a cerebrovascular accident as the main diagnosis without clinical signs of dementia; 45 patients were excluded from the comparison (30 because of main diagnosis from several groups and 15 because of pathology that might influence the test scores to an unpredictable degree). The data were analysed statistically by means of analyses of confidence and of variance.

RESULTS

The CST was found to be more reliable and less time-consuming than the MMS. The sensitivities of the two tests with regard to the distinction between dementia and somatic pathology were similar (80%). However, specificity of the CST was better than that of the MMS (80% and 60%, respectively).

CONCLUSION

For the screening of older patients for dementia, the CST constitutes a good alternative to the MMS.