Cognitive assessment tools

A range of cognitive assessment tools are available to support improved screening for dementia in your practice.

General Practitioner Assessment of Cognition (GPCOG)

  • This test was designed as a GP screening tool for dementia
  • There are two components: a cognitive assessment conducted with the patient, and an informant questionnaire (only considered necessary if the results of the cognitive section are equivocal, i.e. score 5-8 inclusive)
  • Results > 8 or < 5 on the GPCOG patient section were assumed to be cognitively intact or impaired, respectively
  • For patients requiring a informant questionnaire, scores of 3 or less out of 6 in this section indicates cognitive impairment
  • View the General Practitioner Assessment of Cognition (GPCOG)

6 Item Cognitive Impairment Test (6CIT)

  • Developed in 1983, 6CIT is relatively unknown, although usage is increasing
  • Recognised by The Royal College of General Practitioners
  • New computerised versions
  • Appears to be culturally and linguistically translatable with good probability statistics
  • More complex scoring system may be a drawback
  • View the 6 Item Cognitive Impairment Test (6CIT)

MiniCog and the Functional Activities Questionnaire

  • For accurately identifying individuals with MCI and undiagnosed dementia, Steenland et al (2008 doc no 17a) argued that a combination of a brief cognitive screening instrument (Mini-Cog) with a functional scale Functional Activities Questionnaire (FAQ) would deliver sensitivity, specificity and positive predictive value were 89%, 90%, and 95%, respectively when normal and abnormal populations were compared
  • The Mini-Cog consists of a clock drawing task and 3-item recall, and takes less than 5 minutes to administer
  • The FAQ is a 30-item questionnaire completed by an informant
  • The FAQ discriminates individuals with MCI from cognitively normal individuals and those with dementia, and its ease of administration makes it an attractive screening instrument to aid detection of cognitive impairment in the elderly
  • The FAQ serves a screening tool for evaluating ADI’s independence. The instrument was intended for community studies of normal aging and moderate senile dementia
  • In order to take the FAQ, a lay informant (i.e. spouse, friend, or relative) must administer it
  • The participant most respond to 10-items pertaining to daily tasks needed when living independently
  • A scale ranging from independence (0) to dependence (3) is used for responses
  • Approximately 10 minutes is required for completion
  • View the Functional Activities Questionnaire
  • Read more about the MinCog and FAQ (External link)

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE)

  • When combined with cognitive tests, such as the Mini Mental State Examination (MMSE), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) provides a useful overview and hence sensitivity and specificity as a screening test can be improved (Steenland et al, 2008)
  • The questionnaire asks how the patient compares today with 10 years ago in various activities, e.g. remembering birthdays and recalling conversations (Jorm, Date)
  • View the Short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE)

Mini Mental State Examination (MMSE)

  • The MMSE was developed by psychiatrists and is widely regarded as the ‘gold standard’ test for dementia
  • However, it is felt that Minicog and FAQ, GPCOG or 6CIT are more appropriate in a primary care setting
  • Download the Mini Mental State Examination (MMSE)

References

  • Steenland et al. Development of a Rapid Screening Instrument for Mild Cognitive Impairment and Undiagnosed Dementia. Journal of Alzheimers Disease 2008 November; 15(3): 419–427. www.ncbi.nlm.nih.gov/pubmed/18997295 View this document
  • Jorm, A. F. (Date) Short Form of the Informant Questionnaire on Cognitive Decline in the Elderly (Short IQCODE). Australia, The Australian National University.