[Case finding in family practice and neuropsychological diagnosis at a memory clinic]

To improve early diagnosis of cognitive impairment in the elderly a case-finding strategy should be adopted: general practitioners should only examine "suspicious" patients with a very efficient tool. The BrainCheck, a new case-finding tool from Switzerland, comprises of three questions for the patient and the clock drawing test. In addition the family member fills out a short questionnaire. In a validation study with 113 patients and 70 cognitively healthy individuals the BrainCheck showed a correct classification rate of 89 % (sensitivity = 97 %; specificity = 82 %). Within the work of a memory clinic the neuropsychological assessment should use appropriately normed cognitive instruments, especially if one is to detect subtle cognitive impairment. DSM-5 proposes to replace the terms mild cognitive impairment and dementia with mild and severe neurocognitive disorder, respectively. A major improvement in DSM-5 is the list of cognitive domains, which need to be examined. However, no standardized or widely accepted tool exists today to assess the domain of social cognition.