We performed a two-stage survey on the prevalence of dementia among pe
ople aged over 74 in Troina, northern Sicily, Italy. During the first
stage people were screened by the Mini Mental Status Examination (MMSE
), previously validated in our population for the cut-off score with 1
00% sensitivity and the best specificity to diagnose dementia. During
the second stage people scoring 19 or less at the MMSE test were invit
ed to be examined by a neurologist who diagnosed dementia according to
DSM-III R. Out of 365 subjects of the initial sample 347 were screene
d by MMSE test and 163 scored 19 or less. Of these, 135 were neurologi
cally and neuropsychologically examined in the second stage, and 80 pr
oved to be demented. The minimal estimate of prevalence of dementia in
our sample was 21.9% (21.9% men, 21.8% women). The poor education and
psychosocial life may be the underlying condition favoring dementia i
n this sample of elderly people.