To the Editor: The Rational Clinical Examination article on dementia by Dr Holsinger and colleagues1 notes that as many as 76% of cases of dementia may be missed by primary care physicians. In part this may be because deficits in activities of daily living are a criterion for dementia2 but are not routinely assessed during the medical visit. The authors suggest the Mini-Mental State Examination as a screening tool, but note that it has many limitations.
Coto-Yglesias F. Dementia and Activities of Daily Living. JAMA. 2007;298(13):1515-1516. doi:10.1001/jama.298.13.1515-b