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Updated: Aug 21, 2026
The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease
Published on: October 13, 2016
[Optimised neuro-psychological tests on different stages of dementia diagnostics]
Marinella Damian1, Markus Kreis, Bertram Krumm
1Abteilung Neuroradiologie und Gedächtnisambulanz, Zentralinstitut für seelische Gesundheit, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg. damian@zi-mannheim.de
Objective:
We postulated three level of dementia diagnostics: the general practitioner, the neuro-psychiatrist and the memory clinic. For each level, definite diagnostic questions were defined as the main diagnostic focus. The aim was to establish a staged process in dementia diagnostics, proposing for each diagnostic level a specific test battery suitable for the respective diagnostic focus. On each level, the test battery can be supplemented by other tests proposed on the subsequent diagnostic level.
Method:
159 patients were examined clinically, neuropsychologically, and neuroradiologically. Discriminant analyses were computed to find out which tests out of a comprehensive test battery are most suitable in differentiating between several diagnostic groups.
Results:
The diagnostic accuracy of the test batteries proposed for general practitioners and neuro-psychiatrists were maximally 3 % below that of the complete test battery which we suggest for memory clinics.
Conclusion:
Depending on the diagnostic level, a definite short form of a comprehensive test battery can be implemented without unacceptably reducing diagnostic accuracy.
