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[Screening for dementia syndromes: the Hungarian experience with the 7-Minute-Test]
János Kálmán1, Krisztina Boda, Zsuzsanna Bende
1Szegedi Tudományegyetem, Altalános Orvostudományi Kar, Szent Györgyi Albert Orvos- és Gyógyszerésztudományi Centrum, Pszichiátriai Klinika. kalmanj@nepsy.szote.u-szeged.hu
Introduction:
The screening and recognition of dementing disorders are considered as important tasks of general practitioners. Despite of the recent progress made in the treatment of cognitive, behavioral symptoms and slowing down the rate of progression, difficulties are still existing in the early detection, and the most frequent dementia forms such as Alzheimer's disease (AD) and vascular dementia (VD) are underdiagnosed in Hungary. Any rapid, easy-to-use dementia screening method therefore could be of great value in the community.
Aims:
The Hungarian standardisation of a new dementia screening tool, the 7 Minute Test (7MT) has been reported here. Accuracy, sensitivity and specificity were calculated. The authors provide new data regarding the discriminative power of this test in a variety of dementing and dementia related conditions.
Methods:
The test results of 339 probands, referred to the local memory clinic, were evaluated in all subtests, where orientation in time, memory, verbal fluency, and visuoconstructive skills are assessed. The patients were clustered into seven groups according to their clinical diagnosis, such as: Control (CNT), Mild Cognitive Impairment (MCI), AD, VD, mixed AD-VD, depression (D) and Organic Amnestic Syndrome (OAS).
Results:
In overall, the test successfully discriminated 77% of the CNT and all disease cases (sensitivity 85%, specificity 55%). When the AD and CNT groups were compared separately, the highest values: 91% sensitivity, 86% specificity have been found. A total score of 139 has been suggested as a cutoff value to separate CNT and dementia cases. These results suggest that the test is suitable to classify CNT and "real" dementia cases (AD, VD, mixed AD-VD), but not valid within the real dementia groups. Furthermore, it is not helpful for the identification of MCI, pseudodementia cases (D) and OAS as well.
Conclusion:
The 7MT could be a valuable dementia screening tool in the primary care, but it is not specific for any form of dementia.
