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J Am Geriatr Soc. 2003 Oct;51(10):1451-4.

The Mini-Cog as a screen for dementia: validation in a population-based sample.

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Department of Psychiatry and Behavioral Sciences and the Alzheimer's Disease Research Center, University of Washington, Seattle, Washington 98195, USA.



To test the Mini-Cog, a brief cognitive screening test, in an epidemiological study of dementia in older Americans.


A population-based post hoc examination of the sensitivity and specificity of the Mini-Cog for detecting dementia in an existing data set.


The Monongahela Valley in Western Pennsylvania.


A random sample of 1,119 older adults enrolled in the Monongahela Valley Independent Elders Survey (MoVIES).


The effectiveness of the Mini-Cog in detecting independently diagnosed dementia was compared with that of the Mini-Mental State Examination (MMSE) and a standardized neuropsychological battery.


The Mini-Cog, scored by an algorithm as "possibly impaired" or "probably normal," and the MMSE, at a cutpoint of 25, had similar sensitivity (76% vs 79%) and specificity (89% vs 88%) for dementia, comparable with that achieved using a conventional neuropsychological battery (75% sensitivity, 90% specificity).


When applied post hoc to an existing population, the Mini-Cog was as effective in detecting dementia as longer screening and assessment instruments. Its brevity is a distinct advantage when the goal is to improve identification of older adults in a population who may be cognitively impaired. Prior evidence of good performance in a multiethnic community-based sample further supports its validity in the ethnolinguistically diverse populations of the United States in which widely used cognitive screens often fail.

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