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October 1996

Do Long Tests Yield a More Accurate Diagnosis of Dementia Than Short Tests?A Comparison of 5 Neuropsychological Tests

Author Affiliations

From the Rotman Research Institute of Baycrest Centre for Geriatric Care (Drs Stuss and Meiran) and the Departments of Medicine (Neurology) and Psychology (Dr Stuss), University of Toronto, Ontario; the Department of Medicine (Neurology), University of Ottawa, Ontario (Drs Stuss, Guzman, and Willmer); the Memory Disorder Clinic, Elizabeth Bruyere Health Centre, Ottawa (Drs Guzman and Willmer); and the Department of Neuropsychology, New England Sinai Hospital and Rehabilitation Center, Stoughton, Mass (Dr Lafleche).

Arch Neurol. 1996;53(10):1033-1039. doi:10.1001/archneur.1996.00550100119021

Objective:  To provide comparative evidence for a valid and practical measure of mental-status functioning that could be used in dementia clinics.

Design:  Five mental-status neuropsychological tools for dementia screening were administered to patients in a memory disorder clinic. These included the Mini-Mental State Examination, the Dementia Rating Scale, the 6-item derivative of the Orientation-Memory-Concentration Test, a short Mental Status Questionnaire, and a composite tool we labeled the Ottawa Mental Status Examination, which assessed orientation, memory, attention, language, and visual-constructive functioning. The tools were compared using various criteria, including the statistical factors of sensitivity and reliability; effects of gender, native language, and language of testing; the utility of these tests for the differential diagnosis of Alzheimer-type and vascular dementia; and sensitivity to cognitive decline in the entire sample and among patients with severe dementia.

Results:  All of the tests were highly intercorrelated, suggesting that they are interchangeable.

Conclusion:  The comparisons along the various criteria indicate that if the objective is to have a general index of dementia of the Alzheimer type, short tests are at least as good and sometimes better than the longer tests.

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