The clinical utility of the Hopkins Verbal Learning Test as a screening test for mild dementia

Objective. The purpose of this study was to determine whether the Hopkins V erbal Learning Test (HVLT) could be used as a valid and reliable screening test for mild dementia in older people, and to compare its performance to t hat of the Mini-Mental State Examination (MMSE). Method. Using a cross-sectional design, we studied three groups of older su bjects recruited from a district geriatric psychiatry service: (1) 26 patie nts with DSM-IV dementia and MMSE scores of 18 or better; (2) 15 patients w ith psychiatric diagnoses other than dementia; and (3) 15 normal controls. The relationship of each potential cutting point on the HVLT and the MMSE w as examined against the independently ascertained DSM-IV diagnoses of demen tia using a Receiver Operating Characteristic (ROC) analysis. Results. The subjects consisted of 21 (37.5%) males and 35 (62.5%) females with a mean age of 74.7 (SD 6.1) years and a mean of 8.5 (SD 1.8) years of formal education. ROC analysis indicated that the optimal cutting point for detecting mild dementia in this group of subjects using the HVLT was 18/19 (sensitivity = 0.96, specificity = 0.80) and using the MMSE was 25/26 (sen sitivity = 0.88, specificity = 0.93). Conclusions. The HVLT can be recommended as a valid and reliable screening test for mild dementia and as an adjunct in the clinical assessment of olde r people. The HVLT had better sensitivity than the MMSE in detecting patien ts with mild dementia, whereas the MMSE had better specificity. Copyright ( C) 2000 John Wiley & Sons, Ltd.