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The Mini-Cog: receiver operating characteristics with expert and naïve raters
1Alzheimer's Disease Research Center, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195-6560, USA. jscanlan@u.washington.edu
International Journal of Geriatric Psychiatry
|March 10, 2001
Summary
The Mini-Cog is a brief dementia screening tool that is effective even when scored by untrained individuals. Its algorithm demonstrates high sensitivity and specificity for dementia detection in community settings.
Area of Science:
- Gerontology
- Neurology
- Psychometrics
Background:
- Growing elderly populations necessitate accessible dementia detection.
- Current dementia screening tools often require significant time and training.
- The Mini-Cog offers a brief, sensitive, specific, and acceptable alternative.
Purpose of the Study:
- To develop and validate a scoring algorithm for the Mini-Cog dementia screen.
- To evaluate the Mini-Cog's receiver operating characteristics (ROC).
- To assess the generalizability of its clock drawing scoring system.
Main Methods:
- Developed an optimal scoring algorithm combining a three-item recall and clock drawing task (CDT) in 249 multilingual older adults.
- Compared Mini-Cog ROC with MMSE and CASI using expert raters.
- Assessed CDT scoring generalizability with 20 naïve raters on 80 clocks.
Main Results:
- The developed algorithm demonstrated favorable ROC compared to MMSE and CASI.
- Naïve raters achieved >98% concordance with trained raters for most clock severity categories.
- Even when assuming naïve raters misclassified mild impairment, Mini-Cog retained 97% sensitivity and 95% specificity.
Conclusions:
- The Mini-Cog algorithm is effective with simple clock scoring methods.
- The Mini-Cog can be successfully employed by relatively untrained personnel as an initial dementia screen.
- Further research is required to determine its utility in populations with low dementia prevalence.