Morales et al.,5555. Morales JM, Bermejo F, Romero M, Del-Ser T. Screening of dementia in community-dwelling elderly through informant report. Int J Geriatr Psychiatry. 1997;12(8):808-16. PMID: 9283925.1997; Spain |
Cross-sectional |
Urban sample of 97 subjects (48.5% men and 51.5% women); mean age ± SD = 75.2 ± 6.1 years (range 66-92); 17.9% illiterate. Rural sample of 160 subjects (31.9% men and 68.1% women); mean age ±SD = 73.5 ±8.2 years (range 61 -96); 28.2% illiterate. (Community-dwelling elderly people) |
Spanish translation of the Mini-Mental State Examination (MMSE) and Spanish version of the Informant Questionnaire on Cognitive Decline in the Elderly (S-IQCODE) |
MMSE and S-IQCODE |
Eleven subjects in the urban sample were found to be mild dementia cases (prevalence rate 11.3%) and 23 subjects in the rural sample were dementia cases (prevalence rate 14.4%). S-IQCODE had higher accuracy than MMSE, especially when applied to mild dementia cases, and had higher specificity than MMSE when applied to population-based samples. In the urban sample, S-IQCODE had accuracy of 89% (cutoff ≥ 85 points) versus 77% for MMSE (cutoff ≤ 21 points); and sensitivity of 82% (versus 73% for MMSE). In the rural sample, S-IQCODE had accuracy of 83% (cutoff ≥ 86) versus 75% for MMSE (cutoff ≤ 21); sensitivity was 83% in both tests; and S-IQCODE had specificity of 83% (versus 74% for MMSE) |
18 points/18 |
Dartigues et al.,6666. Dartigues JF, Commenges D, Letenneur D, et al. Cognitive predictors of dementia in elderly community residents. Neuroepidemiology. 1997;16(1):29-39. PMID: 8994938; https://doi.org/10.1159/000109668. https://doi.org/https://doi.org/10.1159/...
1997; France |
Prospective cohort study |
2,726 subjects (59.8% women and 40.2% men); mean age 74.8 ± 6.9 years (range 65-101); 4.3% had never gone to school; 61.2% had a grade school level and 5.7% a university level of education. (Community-dwelling elderly people) |
French version of MMSE, Benton's visual retention test (BVRT) and Isaac's set test (1ST) |
MMSE < 24, BVRT < 9 and 1ST < 23. Comparison between expected Alzheimer disease (AD) cases was based on the number of low values among the three tests, thus leading to a score of values 0,1,2 or 3 |
2043 subjects (75%) had at least one complete follow-up screening at 1 or 3 years. At first year of follow-up, 21 subjects were classified as incident cases of dementia (13 as possible or probable Alzheimer's Disease (AD) and 8 as other dementia). At the third year of follow-up, 63 subjects were classified as incident cases of dementia (46 as possible or probable AD and 17 as other dementia). Among the 3 tests (MMSE, BVRT and 1ST), when cutoff level was 1, the sensitivity for diagnosing AD was 90.8% and specificity was 52.2%; When the level was 2, the sensitivity was 81.2% and specificity was 80.4%. When the level was 3, the sensitivity was 52.2% and specificity was 91.3% |
18 points/18 |
Burkart et al.,3535. Paradela EM, Lopes C de S, Lourenço RA. Adaptação para o português do Cambridge Cognitive Examination-Revised aplicado em um ambulatório público de geriatria [Portuguese adaptation of the Cambridge Cognitive Examination-Revised in a public geriatric outpatient clinic]. Cad Saude Publica. 2009;25(12):2562-70. PMID: 20191148; https://doi.org/10.1590/s0102-311x2009001200004. Erratum in: Cad Saude Publica. 2010 Apr;26(4):845-6. https://doi.org/https://doi.org/10.1590/...
2000; Germany |
Cross-sectional |
256 subjects. (Community-dwelling elderly people) |
A modified German version of the selective reminding procedure (SRP), Mini-Mental State Examination (MMSE) and verbal fluency test (VFT) |
MMSE and SRP |
23 (9%) of the 256 probands received the diagnosis of dementia (87% female; mean age 87 ± 7.3 years; mean formal education 9.1 ± 1,7 years). MMSE performed better than all SRP scores in terms of sensitivity and specificity. SRP cannot be recommended for dementia screening. MMSE with cutoff of ≤ 23 had sensitivity of 87% and specificity 99%; with cutoff of ≤ 24, sensitivity was 91% and specificity 97%. SRP score cutoffs with specificity of 95% or above had sensitivities below 50% |
17 points/18 |
Silva et al.,6565. de Silva HA, Gunatilake SB. Mini Mental State Examination in Sinhalese: a sensitive test to screen for dementia in Sri Lanka. Int J Geriatr Psychiatry. 2002;17(2):134-9. PMID: 11813275; https://doi.org/10.1002/gps.541. https://doi.org/https://doi.org/10.1002/...
2002; Sri Lanka |
Cross-sectional |
380 subjects of mean age 68.2 (SD = 7,17); 33.1% males and 66.9% females; 54.2% had less than six years of formal education; 11.6% had no formal education; and 5.5% were illiterate. (Community-dwelling elderly people) |
Translated Sinhalese versions of the MMSE and Cambridge Cognitive Examination (CAMCOG) |
MMSE cutoff score ≤ 17 or > 17 points; and CAMCOG |
29 of the 33 subjects who screened positive in MMSE showed evidence of dementia. Among the 24 randomly selected subjects who screened negative in MMSE, 22 showed no evidence of dementia while two scored below cutoff in CAMCOG and showed evidence of dementia. The Sinhalese translation of the MMSE is a useful and sensitive instrument for screening for cognitive impairment in Sri Lanka. MMSE cutoff of 19 points had sensitivity of 100% and specificity 84.6%; with cutoff of 17 points, it had sensitivity of 93.5% and specificity 84.6% |
15 points/18 |
Jeong etal.,6464. Jeong SK, Cho KH, Kim JM. The usefulness of the Korean version of modified Mini-Mental State Examination (K-mMMSE) for dementia screening in community dwelling elderly people. BMC Public Health. 2004;4:31. PMID: 15283869; https://doi.org/10.1186/1471-2458-4-31. https://doi.org/https://doi.org/10.1186/...
2004; South Korea |
Cross-sectional |
235 subjects; mean age 73.5 ± 6.7 years; 50.2% had no formal education; and 66.4% were women. (Community-dwelling elderly people) |
Korean Mini-Mental State Examination (K-MMSE); Korean version of modified Mini-Mental State Examination (K-mMMSE); Korean version of Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), using short form of Samsung Dementia Questionnaire (S-SDQ); Korean Instrumental Activities of Daily Living (K-IADL); and Korean version of Expanded Clinical Dementia Rating (CDR) |
K-MMSE and K-mMMSE |
Among the 235 participants, 46 (19.6%) were classified as having dementia and 54 (22.9%) as having cognitive impairment with no dementia (CIND). K-mMMSE is more sensitive to all levels of CIND and dementia than K-MMSE. At the cutoff of 59/60, K-mMMSE had sensitivity of 0.91 (0.79-0.98) and specificity of 0.78 (0.72-0.84). At the cutoff of 18/19, K-MMSE had sensitivity of 0.91 (0.79-0.98) and specificity of 0.76 (0.69-0.82) to distinguish between demented and normal individuals |
16 points/18 |
Raitetal.,4444. Rait G, Fletcher A, Smeeth L, et al. Prevalence of cognitive impairment: results from the MRC trial of assessment and management of older people in the community. Age Ageing. 2005;34(3):242-8. PMID: 15863409; https://doi.org/10.1093/ageing/afi039. https://doi.org/https://doi.org/10.1093/...
2005; United Kingdom |
Cross-sectional survey as part of a cluster randomized trial |
15,051 subjects; 61.5% were female and 47% were aged between 75 and 79 years. (Community-dwelling elderly people) |
Mini-Mental State Examination (MMSE) |
MMSE at cutoffs of 23/24 and 17/18 |
The prevalence of cognitive impairment was 18.3% at cutoff of 23/24 and 3.3% at 17/18 in MMSE |
18 points/18 |
Laks et al.,6363. Laks J, Batista EM, Guilherme ER, et al. Prevalence of cognitive and functional impairment in community-dwelling elderly: importance of evaluating activities of daily living. Arq Neuropsiquiatr. 2005;63(2A):207-12. PMID: 16100963; https://doi.org/10.1590/s0004-282x2005000200003. https://doi.org/https://doi.org/10.1590/...
2005; Brazil |
Cross-sectional |
870 subjects 65.9% were female; 40.1 % were illiterate; 53.4% had 1 -8 years of schooling; 5.3% had 9-11 years of schooling; and 1.2% subjects had more than 12 years of schooling. Mean age 72.14 ±7.26 years. (Community-dwelling elderly people) |
Mini-Mental State Examination (MMSE) and Pfeffer Functional Activity Questionnaire (PFAQ) |
MMSE and PFAQ |
Cognitive and functional impairment was observed in 19.2% of the total sample. Functional impairment without cognitive decline was found in 5.3% of the subjects. Functional impairment was correlated with cognitive impairment. This may be an easier feature for families to recognize and for healthcare professionals to screen for dementia, with assessment of both cognitive and functional status, in combination |
18 points/18 |
Tatsch et al.,6262. Tatsch MF, Bottino CM, Azevedo D, et al. Neuropsychiatric symptoms in Alzheimer disease and cognitively impaired, nondemented elderly from a community-based sample in Brazil: prevalence and relationship with dementia severity. Am J Geriatr Psychiatry. 2006;14(5):438-45. PMID: 16670248; https://doi.org/10.1097/01.JGP.0000218218.47279.db. https://doi.org/https://doi.org/10.1097/...
2006; Brazil |
Cross-sectional |
1,563 subjects. (Community-dwelling elderly people) |
Mini-Mental State Examination (MMSE); Fuld Object Memory Evaluation (FOME); Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE); Activities of Daily Living-International Scale (ADL-IS); Cambridge Examination for Mental Disorders of the Elderly (CAMDEX); Cambridge Cognitive Examination (CAMCOG; cognitive section of CAMDEX); and Clinical Dementia Rating Scale (CDR) |
Combination of screening with MMSE, FOME, IQCODE and ADL-IS was tested prior to diagnostic evaluation with CAMDEX, CAMCOG and CDR |
Prevalence of dementia was 6.8%. Alzheimer disease and CIND were diagnosed in 64 and 25 subjects, respectively |
18 points/18 |
Ortega et al.,6767. Macías Ortega MM, Paguada Canales E, Maradiaga E, Sierra M, Hesse H, Navarro E, et al. Prevalencia de demencia y factores asociados en adultos mayores, Aldea Tablones Arriba, Municipio de Yusguare, Choluteca, mayo 2010 – 2011. Rev Fac Cienc Méd. 2012;9(1):27-33. 2012; Honduras |
Cross-sectional |
50 subjects; 52% were female and 44% were aged between 71 and 80 years. (Community-dwelling elderly people) |
Mini Mental State Examination (MMSE) |
MMSE |
According to MMSE, 18% were classified as possible cases of dementia |
14 points/18 |
Jiang et al.,5353. Jiang C, Xu Y. The association between mild cognitive impairment and doing housework. Aging Ment Health. 2014;18(2):212-6. PMID: 23919266; https://doi.org/10.1080/13607863.2013.823376. https://doi.org/https://doi.org/10.1080/...
2014; China |
Cross-sectional |
1,773 subjects; mean age of participants 72 years; majority female. (Community-dwelling elderly people) |
Montreal Cognitive Assessment (MoCA) |
MoCA |
About 13% (233) of the elderly subjects were identified as having mild cognitive impairment (MCI). The study results suggested that MCI is associated with not doing housework |
17 points/18 |
César et al.,6161. César KG, Brucki SM, Takada LT, et al. Prevalence of Cognitive Impairment Without Dementia and Dementia in Tremembé, Brazil. Alzheimer Dis Assoc Disord. 2016;30(3):264-71. PMID: 26629676; https://doi.org/10.1097/WAD.0000000000000122. https://doi.org/https://doi.org/10.1097/...
2015; Brazil |
Cross-sectional epidemiological study |
630 subjects; mean age of 71.3 years (± 7.99); range 60-98 years; median 70 years; mean education level 4.9 years (±4.54) with median of 4 years; 14% of participants were illiterate and 28.9% had 1-3 years of education. (Community-dwelling elderly people) |
Mini-Mental State Examination (MMSE); Brief Cognitive Screening Battery (BCSB); semantic and phonemic verbal fluency test (VFT); clock drawing test (CDT); Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE); and Pfeffer Functional Activity Questionnaire (PFAQ) |
MMSE; BCSB/VFT/ CDT; IQCODE; and PFAQ |
110 individuals were diagnosed with dementia and 135 individuals were diagnosed with cognitive impairment without dementia (CIND). The prevalence of dementia found in this study was 17.5% and the prevalence of CIND was 19.5% |
18 points/18 |
Hanetal.,6868. Han JW, Kim TH, Kwak KP, et al. Overview of the Korean Longitudinal Study on Cognitive Aging and Dementia. Psychiatry Investig. 2018;15(8):767-74. PMID: 30086611; https://doi.org/10.30773/pi.2018.06.02. https://doi.org/https://doi.org/10.30773...
2018; South Korea |
Prospective cohort study |
6,818 subjects; mean age 70.5 ± 7.10 years; 57.5% were women; mean education level was 7.8 ± 5.38 years; illiteracy rate in reading was 4% (n = 275) and illiteracy rate in writing was 4.7% (n = 323). (Community-dwelling elderly people) |
Korean version of Short Informant Questionnaire on Cognitive Decline in the Elderly (SIQCODE); Korean version of Consortium to Establish a Registry for Alzheimer's Disease, neuropsychological assessment package (CERAD-K-N); digit span test (DST); executive clock drawing task (CLOX); Frontal Assessment Battery (FAB); Severe Cognitive Impairment Rating Scale (SCIRS); Disability Assessment for Dementia (DAD); and Clinical Dementia Rating (CDR) |
The baseline evaluation was conducted over two years from November 2010 to October 2012. Follow-up evaluations were conducted every two years from November to October, from 2012 to 2018 |
In the baseline evaluation (November 2010 to October 2012), there were 4572 individuals with normal cognition, 1903 individuals with CIND and 343 individuals with dementia |
18 points/18 |
Vega Alonso et al.,2121. Vega Alonso T, Miralles Espí M, Mangas Reina JM, et al. Prevalence of cognitive impairment in Spain: The Gómez de Caso study in health sentinel networks. Neurologia. 2018;33(8):491-8. PMID: 27939116; https://doi.org/10.1016/j.nrl.2016.10.002. https://doi.org/https://doi.org/10.1016/...
2018; Spain |
Descriptive observational study |
4,624 subjects. (Primary care) |
Mini-Cog; Mini-Mental State Examination (MMSE); and Alzheimer Questionnaire (AQ) |
Mini-Cog screened positive, plus MMSE/AQ |
356 patients (8.2%) had a history of dementia or mild cognitive impairment (MCI). Cognitive impairment was confirmed using MMSE or AQ in 67.2% of the cases in which Mini-Cog screened positive.Total number of known cases plus confirmed cases was 806 (18.5%). Prevalence of cognitive impairment was 21.3% among women and 14.8% among men, and it increased with age, reaching maximum values at ages of 85 years or over |
18 points/18 |
César et al.,3232. Cesar KG, Yassuda MS, Porto FHG, Brucki SMD, Nitrini R. MoCA Test: normative and diagnostic accuracy data for seniors with heterogeneous educational levels in Brazil. Arq Neuropsiquiatr. 2019;77(11):775-81. PMID: 31826133; https://doi.org/10.1590/0004-282X20190130. https://doi.org/https://doi.org/10.1590/...
2019; Brazil |
Cross-sectional epidemiological study |
630 subjects; mean age 71.3 years (± 7.99); range 60-98 years; median 70 years; mean education level was 4.9 years (±4.54) with median of 4 years; 14% of participants were illiterate and 28.9% had 1-3 years of education. (Community-dwelling elderly people) |
Montreal Cognitive Assessment (MoCA); Mini-Mental State Examination (MMSE); Brief Cognitive Screening Battery (BCSB); semantic verbal fluency test (VFT), animal category; clock drawing test (CDT); Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE); Pfeffer Functional Activity Questionnaire (PFAQ); and Clinical Dementia Rating (CDR) |
MoCA and MMSE total scores stratified into educational levels within each age group |
Among the 630 participants, 385 were classified as cognitively normal (CN), 135 as having cognitive impairment with no dementia (CIND) and 110 as having dementia.The MoCA test may not be an adequate tool for identifying individuals with CIND, among those with lower education, but this tool may be used to detect dementia, especially among individuals with more than five years of education, if a lower cutoff score is used, such as 15 points. For MoCA cutoff score 15, CN versus dementia presented sensitivity 90% and specificity 77%; for MoCA cutoff score 19, CN versus CIND presented sensitivity 84% and specificity 49%. |
18 points/18 |