Review Article| Volume 39, ISSUE 1, P15-25, February 2023

Office- and Bedside-based Screening for Cognitive Impairment and the Dementias

Which Tools to Use, Interpreting the Results, and What Are the Next Steps?
Published:October 18, 2022DOI:


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        • Plassman B.L.
        • Langa K.M.
        • Fisher G.G.
        • et al.
        Prevalence of dementia in the United States: the aging, demographics, and memory study.
        Neuroepidemiology. 2007; 29: 125-132
        • US Preventive Services Task Force
        • Owens D.K.
        • Davidson K.W.
        • et al.
        Screening for cognitive impairment in older adults: US preventive Services task Force recommendation statement.
        JAMA. 2020; 323: 757-763
        • Chodosh J.
        • Petitti D.B.
        • Elliott M.
        • et al.
        Physician recognition of cognitive impairment: evaluating the need for improvement.
        J Am Geriatr Soc. 2004; 52: 1051-1059
        • Folstein M.F.
        • Folstein S.E.
        • McHugh P.R.
        Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.
        J Psychiatr Res. 1975; 12: 189-198
        • Creavin S.T.
        • Wisniewski S.
        • Noel-Storr A.H.
        • et al.
        Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations.
        Cochrane Database Syst Rev. 2016; 2016: CD011145
        • Ciesielska N.
        • Sokołowski R.
        • Mazur E.
        • et al.
        Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis.
        Psychiatr Pol. 2016; 50: 1039-1052
        • Hoops S.
        • Nazem S.
        • Siderowf A.D.
        • et al.
        Validity of the MoCA and MMSE in the detection of MCI and dementia in Parkinson disease.
        Neurology. 2009; 73: 1738-1745
        • Pendlebury S.T.
        • Cuthbertson F.C.
        • Welch S.J.
        • et al.
        Underestimation of cognitive impairment by Mini-Mental State Examination versus the Montreal Cognitive Assessment in patients with transient ischemic attack and stroke: a population-based study.
        Stroke. 2010; 41: 1290-1293
        • Nasreddine Z.S.
        • Phillips N.A.
        • Bédirian V.
        • et al.
        The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment.
        J Am Geriatr Soc. 2005; 53 ([published correction appears in J Am Geriatr Soc. 2019 Sep;67(9):1991]): 695-699
        • Mazancova A.F.
        • Růžička E.
        • Jech R.
        • et al.
        Test the best: classification accuracies of four cognitive rating scales for Parkinson's disease mild cognitive impairment [published online ahead of print, 2020 Jul 17].
        Arch Clin Neuropsychol. 2020; : acaa039
        • Ghafar M.Z.A.A.
        • Miptah H.N.
        • O'Caoimh R.
        Cognitive screening instruments to identify vascular cognitive impairment: a systematic review.
        Int J Geriatr Psychiatry. 2019; 34: 1114-1127
        • Waldron-Perrine B.
        • Axelrod B.N.
        Determining an appropriate cutting score for indication of impairment on the Montreal Cognitive Assessment.
        Int J Geriatr Psychiatry. 2012; 27: 1189-1194
        • Carson N.
        • Leach L.
        • Murphy K.J.
        A re-examination of Montreal cognitive assessment (MoCA) cutoff scores.
        Int J Geriatr Psychiatry. 2018; 33: 379-388
        • Landsheer J.A.
        Impact of the Prevalence of cognitive impairment on the accuracy of the Montreal cognitive assessment: the advantage of using two MoCA thresholds to identify error-prone test scores.
        Alzheimer Dis Assoc Disord. 2020; 34: 248-253
        • Bergeron D.
        • Flynn K.
        • Verret L.
        • et al.
        Multicenter validation of an MMSE-MoCA Conversion table.
        J Am Geriatr Soc. 2017; 65: 1067-1072
        • Borson S.
        • Scanlan J.M.
        • Chen P.
        • et al.
        The Mini-Cog as a screen for dementia: validation in a population-based sample.
        J Am Geriatr Soc. 2003; 51: 1451-1454
        • Seitz D.P.
        • Chan C.C.
        • Newton H.T.
        • et al.
        Mini-Cog for the diagnosis of Alzheimer's disease dementia and other dementias within a primary care setting.
        Cochrane Database Syst Rev. 2018; 2: CD011415
        • Steenland N.K.
        • Auman C.M.
        • Patel P.M.
        • et al.
        Development of a rapid screening instrument for mild cognitive impairment and undiagnosed dementia.
        J Alzheimers Dis. 2008; 15: 419-427
        • Mioshi E.
        • Dawson K.
        • Mitchell J.
        • et al.
        The Addenbrooke's Cognitive Examination Revised (ACE-R): a brief cognitive test battery for dementia screening.
        Int J Geriatr Psychiatry. 2006; 21: 1078-1085
        • Buschke H.
        • Kuslansky G.
        • Katz M.
        • et al.
        Screening for dementia with the memory impairment screen.
        Neurology. 1999; 52: 231-238
        • Brodaty H.
        • Pond D.
        • Kemp N.M.
        • et al.
        The GPCOG: a new screening test for dementia designed for general practice.
        J Am Geriatr Soc. 2002; 50: 530-534
        • Ylikoski R.
        • Erkinjuntti T.
        • Sulkava R.
        • et al.
        Correction for age, education and other demographic variables in the use of the Mini Mental State Examination in Finland.
        Acta Neurol Scand. 1992; 85: 391-396
        • Rossetti H.C.
        • Lacritz L.H.
        • Cullum C.M.
        • et al.
        Normative data for the Montreal cognitive assessment (MoCA) in a population-based sample.
        Neurology. 2011; 77: 1272-1275
        • Malek-Ahmadi M.
        • Powell J.J.
        • Belden C.M.
        • et al.
        Age- and education-adjusted normative data for the Montreal Cognitive Assessment (MoCA) in older adults age 70-99.
        Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2015; 22: 755-761
        • Mantri S.
        • Nwadiogbu C.
        • Fitts W.
        • et al.
        Quality of education impacts late-life cognition.
        Int J Geriatr Psychiatry. 2019; 34: 855-862
        • Harada C.N.
        • Natelson Love M.C.
        • Triebel K.L.
        Normal cognitive aging.
        Clin Geriatr Med. 2013; 29: 737-752
        • Stern Y.
        Cognitive reserve in ageing and Alzheimer's disease.
        Lancet Neurol. 2012; 11: 1006-1012
        • Del Brutto O.H.
        • Mera R.M.
        • Del Brutto V.J.
        • et al.
        Influence of depression, anxiety and stress on cognitive performance in community-dwelling older adults living in rural Ecuador: results of the Atahualpa Project.
        Geriatr Gerontol Int. 2015; 15: 508-514
        • Lin K.
        • Xu G.
        • Lu W.
        • et al.
        Neuropsychological performance in melancholic, atypical and undifferentiated major depression during depressed and remitted states: a prospective longitudinal study.
        J Affect Disord. 2014; 168: 184-191
        • Musso M.W.
        • Cohen A.S.
        • Auster T.L.
        • et al.
        Investigation of the Montreal Cognitive Assessment (MoCA) as a cognitive screener in severe mental illness.
        Psychiatry Res. 2014; 220: 664-668
        • Obbels J.
        • Vansteelandt K.
        • Verwijk E.
        • et al.
        MMSE changes during and after ECT in late-life depression: a prospective study.
        Am J Geriatr Psychiatry. 2019; 27: 934-944
        • Dybjer E.
        • Nilsson P.M.
        • Engström G.
        • et al.
        Pre-diabetes and diabetes are independently associated with adverse cognitive test results: a cross-sectional, population-based study.
        BMC Endocr Disord. 2018; 18: 91
        • Zhao L.
        • Han C.
        • Zheng Z.
        • et al.
        Risk of mini-mental state examination (MMSE) decline in the elderly with type 2 diabetes: a Chinese community-based cohort study.
        BMC Endocr Disord. 2020; 20: 129
        • Aggarwal H.K.
        • Jain D.
        • Bhavikatti A.
        Cognitive Dysfunction in patients with chronic kidney disease.
        Saudi J Kidney Dis Transpl. 2020; 31: 796-804
        • Potter E.L.
        • Ramkumar S.
        • Wright L.
        • et al.
        Associations of subclinical heart failure and atrial fibrillation with mild cognitive impairment: a cross-sectional study in a subclinical heart failure screening programme.
        BMJ Open. 2021; 11: e045896
        • Pierobon A.
        • Ranzini L.
        • Torlaschi V.
        • et al.
        Screening for neuropsychological impairment in COPD patients undergoing rehabilitation.
        PLoS One. 2018; 13: e0199736
        • Bair M.J.
        • Krebs E.E.
        Fibromyalgia Ann Intern Med. 2020; 172: ITC33-ITC48
        • Nielsen T.R.
        • Jørgensen K.
        Visuoconstructional abilities in cognitively healthy illiterate Turkish immigrants: a quantitative and qualitative investigation.
        Clin Neuropsychol. 2013; 27: 681-692