The Mini-Cog versus the Mini-Mental State Examination and the Clock Drawing Test in daily clinical practice: screening value in a German Memory Clinic

• Published in: International psychogeriatrics Vol. 24; no. 5; pp. 766 - 774
• Main Authors: Milian, Monika, Leiherr, Anna-Maria, Straten, Guido, Müller, Stephan, Leyhe, Thomas, Eschweiler, Gerhard W.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.05.2012; Elsevier Inc
• Subjects: Adult; Adult and adolescent clinical studies; Age Factors; Aged; Aged, 80 and over; Algorithms; Alzheimer Disease - diagnosis; Alzheimer Disease - psychology; Alzheimer's disease; Biological and medical sciences; Case-Control Studies; Clinical medicine; Clock drawing test; Cognition & reasoning; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Dementia - diagnosis; Dementia - psychology; Educational Status; Extraction; Female; Geriatric psychology; Geriatrics; Germany; Humans; Male; Medical diagnosis; Medical sciences; Medical screening; Memory; Memory Disorders - diagnosis; Middle Aged; Mini-Mental State Examination; Neurology; Neuropsychological Tests; Older people; Organic mental disorders. Neuropsychology; Power; Psychological tests; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reproducibility of Results; Retrospective Studies; screening tools; sensitivity; Sensitivity and Specificity; Severity of Illness Index; specificity; Europe; Germany; specificity; dementia; sensitivity; screening tools; Alzheimer's disease; Human; Nervous system diseases; Mini Mental State Examination Folstein et al; Alzheimer disease; Memory; Neuropsychological test; Psychometrics; German; Medical screening; Cerebral disorder; Sensitivity; Specificity; Central nervous system disease; Value; Degenerative disease; Elderly; Comparative study; Tool
• ISSN: 1041-6102; 1741-203X; 1741-203X
• DOI: 10.1017/S1041610211002286

Background: The aim of this study was to compare the screening value of the Mini-Cog, Clock Drawing Test (CDT), Mini-Mental State Examination (MMSE) and the algorithm MMSE and/or CDT to separate elderly people with dementia from healthy depending on test time, type and severity of dementia, and demographic variables in a German Memory Clinic. Methods: Data from a heterogeneous patient sample and healthy participants (n = 502) were retrospectively analyzed. Of the 438 patients with dementia, 49.1% of the dementia diagnoses were Alzheimer's dementia and 50.9% were non-Alzheimer's dementia. Sixty-four participants were classified as cognitively unimpaired. The CDT and an extraction of the 3-item recall of the MMSE were used to constitute the Mini-Cog algorithm. Results: Overall, the Mini-Cog showed significantly higher discriminatory power (86.8%) than the MMSE (72.6% at a cut-off ≤ 24 and 79.2% at ≤ 25, respectively) and CDT (78.1%) (each p < 0.01) and did not perform worse than the algorithm MMSE and/or CDT (each p > 0.05). The specificity of the Mini-Cog (100.0%) was similar to that of the MMSE (100.0% for both cut-offs) and CDT (96.9%) (p = 0.154). For all age and educational groups the Mini-Cog outmatched the CDT and MMSE, and was less affected by education than MMSE and less susceptible for the dementia stage than the CDT. Conclusion: The Mini-Cog proved to have superior discriminatory power than either CDT or MMSE and is demonstrated to be a valid “short” screening instrument taking 3 to 4 minutes to administer in the geriatric setting.