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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 online by Cambridge University Press:  15 December 2011

Monika Milian ,
Anna-Maria Leiherr ,
Guido Straten ,
Stephan Müller ,
Thomas Leyhe  and
Gerhard W. Eschweiler
Monika Milian*
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany Department of Neurosurgery, University of Tübingen, Tübingen, Germany
Anna-Maria Leiherr
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
Guido Straten
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
Stephan Müller
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
Thomas Leyhe
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany Geriatric Center at the University Hospital of Tübingen, Tübingen, Germany
Gerhard W. Eschweiler
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany Geriatric Center at the University Hospital of Tübingen, Tübingen, Germany
*
Correspondence should be addressed to: Dr. Monika Milian, Department of Neurosurgery, University of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany. Phone: +49-(0)7071-29 81993; Fax: +49-(0)7071-29 4438. Email: monika.milian@med.uni-tuebingen.de.
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Abstract

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.

Keywords

dementiaAlzheimer's diseasesensitivityspecificityscreening tools
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 5 , May 2012 , pp. 766 - 774
Copyright
Copyright © International Psychogeriatric Association 2011

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