![]() ![]() Due to subtest differences we predicted that the MoCA would have better sensitivity/specificity for non-amnestic MCI, DLB, and FTLD compared to the STMS. 6 In this current study, we aimed to compare the MoCA and the STMS for detection of MCI, AD, and other forms of dementia in both a community and an academic referral center setting. 14, 15 Our group previously showed STMS was more sensitive and specific in detecting early cognitive deficits than the MMSE. The Short Test of Mental Status (STMS) was developed and validated as a bedside tool that emphasizes brevity and reasonable sensitivity/specificity. 5, 9– 11 The proposed cutoff of 26 has been considered too sensitive in some studies, limiting the specificity of an abnormal score. 7, 8 The Montreal Cognitive Assessment (MoCA) was created specifically to improve the diagnosis of MCI and has shown improved sensitivity in head to head studies with the MMSE in a variety of cognitive impairment settings. 4 The Mini-Mental State Examination (MMSE) is widely used and can be administered relatively quickly, but MMSE scores are not useful for diagnosing MCI, 5, 6 and its licensing fee has made this measure less attractive for clinical use. 3 Most of the existing tools are biased towards detection of amnestic predominant cognitive impairment, with less emphasis on other cognitive domains frequently involved in frontotemporal lobar degeneration or Lewy body disease. However, specialist referral systems, as well as participants, can be overburdened if screening tests are overly sensitive or lack specificity for detecting neurodegenerative diseases.Ī number of tests are being used in clinics across the world, but few have been validated in community settings. Early diagnosis and support helps families plan strategies to minimize the impact and burden of dementia, 2 and will be of increasing importance as disease modifying therapies become a reality. Early and accurate detection of cognitive changes are essential for appropriate referral for more detailed neurocognitive testing and specialist evaluation. 1 Cognitive tests that incorporate brevity and high sensitivity/specificity are required in primary care clinical practice. MCI represents an intermediate clinical stage between stable normal aging and dementia. ![]() Bedside cognitive tests performed by primary care and neurology providers are an important screening tool for mild cognitive impairment (MCI) and dementia. ![]()
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