Screening for dementia in "real world" settings: the cognitive assessment screening test: CAST

Among elderly people who do not present with complaints of memory impairment, dementia is often missed by physicians, and time-consuming screening tests requiring expertise to administer and interpret are rarely done. Easily administered, reliable and cost effective dementia screening tests are needed for elderly individuals. The "pencil and paper" Cognitive Assessment Screening Test (CAST) takes minimal examiner time/training, and is both sensitive and specific in discriminating demented patients from healthy controls. The objectives of this study were to: (1) confirm the validity of the CAST in identifying individuals with dementia in a real-world setting (nonassisted living retirement community); (2) compare the sensitivity and specificity with other screening tests and extensive psychometric tests; and (3) assess the reliability of the CAST in test-retest conditions over time. The CAST was both sensitive and specific and showed reliability on retesting. The CAST is both simpler to administer and more accurate than other screening tests for elderly subjects.