Differential Diagnosis of Dementias - Alzheimer's Association

Rapid Brief Cognitive Screens:
Pros and Cons
Screening Test Pros Cons
MMSE 1,2
Widely used, validated, reliable
Adjustments for age, education, and
race may be necessary
Copyright issues
AD8 informant
interview 3
Mini-Cog
assessment 4
MoCA 5,6
SLUMS
examination 7
Reliable, sensitive, specific, rapidly administered
Superior to MMSE in prediction of dementia
status, rapidly administered, produces a visible
performance indicator
Useful in patients with scores >25 on MMSE,
strong executive function component
Potentially superior to MMSE for early detection of
cognitive impairment
Knowledgeable informants may not be
readily available
Clock-drawing test scoring is vulnerable
to varying interpretations
Conclusions regarding validity in PDD
restricted to specialty clinic setting
Research needed to confirm applicability
beyond initial study group
Note: insufficient information is available to determine whether any one screening tool is superior to another. Positive
screening results should be followed by complete neurologic and medical examinations.
1. Folstein MF et al. J Psychiatr Res. 1975;12:189-198. 2. Weiner MF, Garrett MD, Bret ME. Neuropsychiatric Assessment and Diagnosis. In: Weiner
MF, Lipton AM, eds. Textbook of Alzheimer disease and other dementias. Washington, DC: American Psychiatric Pub.; 2009. 3. Galvin JE et al.
Neurology. 2005;65:559-564. 4. Borson S et al. Int J Geriatr Psychiatry. 2000;15:1021-1027. 5. Nasreddine ZS et al. J Am Geriatr Soc. 2005;53:695-
699. 6. Zadikoff C et al. Mov Disord. 2008;23:297-299. 7. Tariq SH et al. Am J Geriatr Psychiatry. 2006;14:900-910.
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