Summary
A Swiss systematic review investigated the diagnostic accuracy and validity of various tools for screening dementia and / or cognitive impairment in hospital patients. The aim was to provide up-to-date evidence for the choice of cognitive tests best suited for use upon elective hospital patients aged 64 years and over.
Diagnostic accuracy of the Six-Item Cognitive Impairment Test, Cognitive Performance Scale, Clock-Drawing Test, Mini-Mental Status Examination, and Time & Change Test were investigated. Clinical and methodological heterogeneity between the studies included in the review prevented the authors from conducting a meta-analysis or recommending one “best” instrument for use in hospitals.
“The lack of evidence is surprising, because despite the wider public interest in dementia and the recent debates about targeted screening initiatives, this review found not one eligible study published after 2013”. p.19.
Reference
Hwang, AB. Boes, S. [and] Nyffeler, T. [et al] (2019). Validity of screening instruments for the detection of dementia and mild cognitive impairment in hospital inpatients: a systematic review of diagnostic accuracy studies. PLoS One. July 25th 2019; Vol.14(7): e0219569.
“Only six studies evaluating five unique screening instruments were found. Four instruments, the Cognitive Performance Scale (CPS), the Mini-Mental Status Examination (MMSE), the Time & Change (T&C), and the Clock Drawing Test (CDT) were investigated as screening tools for detecting dementia; the CPS and the 6-Item Cognitive Impairment Test were investigated as screening tools for unspecified cognitive impairment. Overall, despite a restrictive combination of inclusion criteria, a considerable number of included studies were rated as having a high risk of bias or applicability concerns”. p.17.
