Validation of the Seven Minute Screen and Syndrom Kurztest among elderly Norwegian outpatients
ABSTRACT Brief cognitive tests represent a first step in the assessment of elderly people referred to outpatient clinics because of cognitive impairment. The aim of this study is to determine sensitivity, specificity and likelihood ratio for a positive result (LR+) for the brief cognitive tests Seven Minute Screen (7MS) and Syndrom Kurztest (SKT) in an outpatient sample of elderly patients with no dementia or mild dementia.
Ninety-five patients aged 65 years or more from 10 Norwegian geriatric and psychogeriatric outpatient clinics were included in the study. All the subjects had a Mini-mental State Examination score of 22-30. A consensus diagnosis of dementia according to ICD-10 was established by an expert panel that considered data from a standardized assessment protocol blinded for 7MS and SKT results.
Subjects were diagnosed with mild dementia (n = 69) or no dementia (n = 26). Sensitivity for 7MS was 71%, specificity 73% and LR+ was 2.6. Sensitivity for SKT was 65%, specificity 65% and LR+ was 1.9.
Sensitivity, specificity and LR+ for 7MS and SKT were unacceptably low in this outpatient sample.
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ABSTRACT: Early screening for dementia is crucial for identifying reversible causes as well as managing, counseling, and other therapeutic interventions. Many reviews have compared the suitability of very brief screening instruments for use in primary care, but reviews on more extensive instruments in secondary care are scarce. In addition, results on diagnostic accuracy are often biased due to methodological shortcomings, differences in the spectrum of patients or reporting. This systematic review reports the diagnostic accuracy of dementia-screening instruments with an administration time of 10 to 45 minutes, validated in secondary care, restricted to mild dementia and validation studies of ''high quality.'' Characteristics such as cognitive domains and reliability figures are also highlighted.American Journal of Alzheimer s Disease and Other Dementias 06/2010; 25(4):301-16. DOI:10.1177/1533317510367485 · 1.43 Impact Factor
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ABSTRACT: Background: To describe how dementia assessment could be organized in primary health care and how it works. Methods: The project had two phases. In phase one 104 elderly patients were assessed by a local authority dementia team that used a standardized examination protocol, which enabled the family doctors to establish a dementia diagnosis. After evaluation and adjustments the model was extended to 31 local authorities and 474 patients were assessed. Results: The mean age of the patients was 84.4 (SD 5.6) and 81.8 (SD 7.8) years, respectively; 81 and 67% were women, respectively. The mean Mini Mental State Examination scores were 21.1 (SD 5.0) and 19.2 (SD 5.1), respectively. All patients in phase one and 70% in phase two were diagnosed with dementia. In 15 local authorities a specially assigned family doctor assisted in establishing diagnoses. In these local authorities 80% of the patients were diagnosed. Conclusion: A local authority dementia team can collect the information required to enable a family doctor to establish a dementia diagnosis. Ideally, such teams should be assisted by a family doctor interested in dementia diagnostics.Dementia and Geriatric Cognitive Disorders 11/2012; 34(5-6):263-270. DOI:10.1159/000345435 · 2.81 Impact Factor
International Psychogeriatrics 09/2009; 21(6):1031-6. DOI:10.1017/S1041610209990913 · 1.89 Impact Factor