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The validity of cognitive testing in screening for dementia
P Stockton1, J Cohen-Mansfield, N Billig
1Department of Psychiatry, Georgetown University Medical Center, Washington, D.C. 20007, USA.
Journal of Medical Systems
|April 29, 1998
Summary
Lack of education may be a risk factor for dementia, not just a confounding variable. Standardized cognitive tests may overestimate cognitive impairment in older adults.
Area of Science:
- Neurology
- Gerontology
- Psychometrics
Background:
- Cognitive impairment, a dementia indicator, was defined in 1980 as intellectual loss impacting functioning.
- The classification of cognitive disorders has shifted from "organic" to "cognitive."
Purpose of the Study:
- To investigate the influence of educational experience on cognitive assessment outcomes.
- To re-evaluate the role of education in dementia prevalence and risk.
Main Methods:
- Assessment of a sample of older adults using a widely employed cognitive assessment instrument.
- Statistical analysis to identify predictors of test performance, including educational level and physical disability.
Main Results:
- Cognitive assessment instruments showed extreme sensitivity to educational experience levels.
- Educational level and physical disability were identified as independent predictors of test performance.
Conclusions:
- Lack of education may be a risk factor for dementia, challenging its traditional role as a confounding factor.
- The validity of the one-dimensional "cognitive paradigm" and diagnosis via standardized instruments is questioned.