chapter  5
Screening and assessment instruments for the detection and measurement of cognitive impairment
ByLeon Flicker
Pages 8

A frequently used method in the ascertainment of dementia in older people is the performance of a short cognitive test to determine the need to perform further testing to establish the diagnosis. e case for detection of milder forms of cognitive impairment has not been established, and therapeutic strategies targeted for patients with conditions such as mild cognitive impairment (MCI) (Petersen et al., 2001) have not been developed. Another use for these tests is to detect changes in cognitive impairments over time. us, the focus of this chapter remains on the use of short cognitive tests to aid in the detection of older people with dementia, and to monitor the progression of cognitive impairment in people with dementia. ese short cognitive tests are commonly described as ‘screening instruments’, but this is in fact a misnomer. Screening has been dened as ‘An organized attempt to detect, among apparently healthy people in the community, disorders or risk factors of which they are unaware’ (Cadman et al., 1984). e U.S. Preventive Services Task Force (Moyer et al., 2014) has concluded yet again that the evidence is insucient to recommend for, or against, routine screening for cognitive impairment in older adults. However, these short cognitive tests are used as a means of case nding in certain clinical situations for which there is a high prior probability of nding individuals with cognitive impairment, usually associated with dementia or in those individuals who are medically unwell, delirium. An example of this situation is acute hospital admission for people over the age of 65 years (Ames and Tuckwell, 1994).