Study: Lesser Used Test Better at Detecting Cognitive Impairment

Two tests that can be given to patients to detect whether they are experiencing mental decline are currently available, with one currently used more widely than the other.

Researchers at the Mayo Clinic pitted these two tests against each other in a head-to-head comparison and found that the least used test is better, according to a study reported in the December issue of the Archives of Neurology.

The more widely of the two is called the Mini-Mental State Examination, but its sensitivity in detecting mild memory or other cognitive impairments has always been suspect.

The other available brief test is called the Test of Mental Status. It was
specifically developed for use in dementia assessment and was intended to be more sensitive to problems of learning and mental agility that may be seen in mild cognitive impairment.

Mayo Clinic researchers compared these two tests for detecting or predicting mild cognitive impairment. Their study involved four groups of patients: 788 patients with stable normal cognition, 75 patients with normal cognition at the beginning of the study who later developed mild cognitive impairment or Alzheimer’s disease during follow-up, 129 patients with prevalent mild cognitive impairment at the beginning of the study and 235 patients with prevalent mild Alzheimer disease.

The researchers found the Short Test of Mental Status to be slightly more sensitive than the Mini-Mental State Examination in discriminating between patients with stable normal cognition and patients with prevalent mild cognitive impairment.

The Short Test of Mental Status was also found to be superior in detecting deficits in cognition in individuals who had normal cognition at baseline but later developed incident mild cognitive impairment or Alzheimer's disease.

Other sources: Archives of Neurology 2003 Dec;60(12):1777-81.