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Related Experiment Videos

The cognitive assessment screening test (CAST) for dementia

D A Drachman1, J M Swearer, K Kane

  • 1Department of Neurology, University of Massachusetts Medical Center, Wocester 01655, USA.

Journal of Geriatric Psychiatry and Neurology
|October 1, 1996
PubMed
Summary

The Cognitive Assessment. Screening Test (CAST) is a useful dementia screening tool for elderly individuals. It demonstrates high sensitivity and specificity, comparable to established tests, with minimal time and training requirements.

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Area of Science:

  • Gerontology
  • Neurology
  • Cognitive Science

Background:

  • Dementia screening in primary care is crucial for early intervention.
  • Existing cognitive tests may require significant time and expertise.
  • The Cognitive Assessment. Screening Test (CAST) was developed for efficient use in general physician offices.

Purpose of the Study:

  • To evaluate the utility, sensitivity, and specificity of the CAST for screening dementia in the elderly.
  • To compare CAST's performance against the Mini-Mental State Examination (MMSE) and Blessed Dementia Scale cognitive portion (BDS-cog).

Main Methods:

  • Two studies were conducted: one to establish cutoff scores and another in a real-world general medicine clinic setting.
  • CAST (Parts A & B) and other cognitive tests were administered to demented patients, normal controls, and a general elderly population.

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  • A neuropsychological battery served as the gold standard for cognitive impairment assessment.

    • Main Results:

    • In Study 1, CAST achieved 95% sensitivity and 88% specificity, outperforming MMSE (74% sensitivity, 100% specificity) and BDS-cog (100% sensitivity, 96% specificity).
    • In Study 2, CAST demonstrated 88% sensitivity and 100% specificity, significantly better than MMSE (38% sensitivity, 100% specificity) and BDS-cog (50% sensitivity, 94% specificity).
    • Part C of CAST effectively screened for self-reported cognitive concerns.

    Conclusions:

    • CAST is a highly useful and effective dementia screening test for elderly populations.
    • Its performance is comparable or superior to MMSE and BDS-cog.
    • CAST requires minimal examiner time and training, making it suitable for general physician practices.