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Related Experiment Video

Updated: May 1, 2026

The 4 Mountains Test: A Short Test of Spatial Memory with High Sensitivity for the Diagnosis of Pre-dementia Alzheimer's Disease

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

Does this patient have dementia?

Tracey Holsinger¹, Janie Deveau, Malaz Boustani

¹Department of Psychiatry, Durham VA Medical Center, Durham, NC, USA. tracey.holsinger@va.gov

|June 7, 2007

Summary

This summary is machine-generated.

Brief cognitive screening tests aid dementia diagnosis in primary care. The Memory Impairment Screen and informant reports show promise for detecting cognitive impairment in older adults.

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Area of Science:

Gerontology
Neurology
Primary Care Medicine

Background:

Millions in the US experience dementia or memory complaints.
Early detection of cognitive impairment is crucial for timely dementia diagnosis.
Brief screening tools can assist in primary care settings.

Purpose of the Study:

To review the literature on the practicality and accuracy of brief cognitive screening instruments in primary care.
To update previous reviews on cognitive screening tools for dementia.

Main Methods:

Searched MEDLINE and psycINFO databases (2000-2006).
Included studies of patients aged 60+ with dementia diagnosis confirmation.
Assessed 29 studies using 25 different screening instruments for eligibility and quality.

Main Results:

Evaluated 38 unique instrument/study combinations.
Mini-Mental State Examination (MMSE) showed median likelihood ratios (LRs) of 6.3 (positive) and 0.19 (negative).
Memory Impairment Screen (4 min) had LRs of 33 (positive) and 0.08 (negative); informant reports had LR of 6.5 for dementia.

Conclusions:

Clinicians should choose primary screening tools based on patient population and awareness of demographic scoring effects.
Consider adding secondary tools for specific situations.
Clock drawing tests can be useful but require appropriate scoring and may miss mild impairment.