SCREENING FOR COGNITIVE IMPAIRMENT IN THE ELDERLY - IMPACT OF PHYSICAL FUNCTION MEASURES ADDED TO COGNITIVE SCREENING INSTRUMENTS

This study examines the relationship between cognitive impairment and impaired physical function to determine if the sensitivity and specifi city of the Modified Mini-Mental State Examination (3MS) can be improv ed by the addition of physical function measures. One hundred and sixt y-two subjects from the Nova Scotia sample of the Canadian Study of He alth and Aging were studied. Subjects were tested using the 3MS and ph ysical function measures prior to undertaking a detailed clinical exam ination. Receiver Operating Characteristic (ROC) curves were construct ed to determine optimal cutpoints for the 3MS and a new 3MS score whic h included physical function measures. While the 3MS distinguished dem ented from unimpaired subjects (.9618), it showed less efficiency for classification of unimpaired subjects and subjects who have cognitive impairment without dementia (.7536). The addition of physical function data increased performance of the 3MS in its ability to discriminate unimpaired from demented subjects (.9854), but not significantly. The relationship between cognitive impairment and functional impairment ne eds clearer definition in cognitively impaired yet non-demented indivi duals. The addition of widely used function measures is inadequate in improving the parameters of the 3MS as a screening instrument.