Neuropsychological screening tests in African Americans

Neuropsychological tests are instruments used to diagnose a variety of cognitive conditions. This article will review a few of the brief scales commonly used in screening for dementia. It will also discuss the properties of and problems with some of the brief scales that are commonly used to screen African Americans for dementia, highlighting the various biases. The Mini-Mental State Examination (MMSE) is the most widely known and utilized cognitive impairment instrument in the United States. Whether or not it is biased to race after adjusting the scores for educational attainment remains controversial. The Blessed Information-Memory-Concentration Test (BIMC), Blessed Orientation-Memory-Concentration Test (BOMC), Short Portable Mental Status Questionnaire (SPMSQ), and Neurobehavioral Cognitive Status Examination (NCSE) are other screening tests used to diagnose dementia. Some of these tests have been found to misclassify many more African Americans as demented compared to the proportion of whites that are misclassified. The Cambridge Cognitive Examination (CAMCOG) is the only brief neuropsychological scale designed to actually diagnose early dementia, but it is not known if it is biased for African Americans.