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.