Leading dementia screen 'inaccurate'

Researchers urge GPs to switch to more appropriate dementia tools.

A tool that most GPs rely on to diagnose dementia is less accurate than available alternatives, research suggests.

Researchers from the University of Kent carried out a survey of 138 practices in Kent to identify the most commonly used dementia screening tools.

Each practice was asked to mark which tool they used from a list of screening tools that included the mini-mental state examination (MMSE), the memory impairment screen (MIS), the general practitioner assessment of cognition (GPCOG), the abbreviated mental test (AMT) and the 'mini-cog'.

The researchers also conducted a review of literature on dementia tools to examine their accuracy.

Overall, they found that 79 per cent of practices reported using a screening tool, with 80 per cent of those using the MMSE.

But when the researchers evaluated the available evidence on dementia tools, they found that the three most accurate tools were the GPCOG, the mini-cog and the MIS.

The researchers concluded that the GPCOG, mini-cog and MIS tests were 'more robust and more appropriate for routine use in primary care'.

They added that GPs and other primary care staff needed to be given training in screening if the over-reliance on the MMSE was to be addressed.

But Dr Chris Manning, an expert in mental health, said that GPs should be praised for using any kind of tool at all to diagnose dementia.

'Most GPs use the MMSE because that is probably the only tool that they have heard about and it is recommended by colleagues,' Dr Manning said.

The key now is to get hold of the 20 per cent of GPs who are not using a screening tool at all, he added.

sanjay.tanday@haymarket.com

International Psycho-geriatrics 2008; 20: 911-92.

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