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What Is the Best Dementia Screening Instrument for General Practitioners to Use?

From the Academic Department for Old Age Psychiatry, Euroa Centre, Prince of Wales Hospital, Randwick, Australia (HB, LG); the School of Psychiatry, University of New South Wales, Sydney, Australia (HB, KB); and Centre for Mental Health Research Building 63, The National University, Canberra, Australia (L-FL).

Objective: The objective of this study was to review existing dementia screening tools with a view to informing and recommending suitable instruments to general practitioners (GPs) based on their performance and practicability for general practice.

Method: A systematic search of pre-MEDLINE, MEDLINE, PsycINFO, and the Cochrane Library Database was undertaken. Only available full-text articles about dementia screening instruments written in English or with an English version were included. Articles using a translation of an English language instrument were excluded unless validated in a general practice, community, or population sample.

Results: The General Practitioner Assessment of Cognition (GPCOG), Mini-Cog, and Memory Impairment Screen (MIS) were chosen as most suitable for routine dementia screening in general practice. The GPCOG, Mini-Cog, and MIS were all validated in community, population, or general practice samples, are easy to administer, and have administration times of 5 minutes or less. They also have negative predictive validity and misclassification rates, which do not differ significantly from those of the Mini-Mental Status Examination.

Conclusions: It is recommended that GPs consider using the GPCOG, Mini-Cog, or MIS when screening for cognitive impairment or for case detection.

Key Words: Diagnosis • dementia • screening • Alzheimer disease • primary care

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