ABSTRACT
References 59
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. The 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. Thus, 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. These short cognitive tests are commonly described as ‘screening instruments’, but this is in fact a misnomer. Screening has been defined 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). The US Preventive Services Task Force (2003) has concluded that the evidence is insufficient to recommend for, or against, routine screening for dementia in older adults. In reality, these short cognitive tests are used as a means of case finding in certain clinical situations for which there is a high prior probability of finding individuals with cognitive impairment, usually associated with dementia or in those individuals who are medically unwell, delirium.
