The Mini-Cog: A cognitive 'vital signs' measure for dementia screening in multi-lingual elderly

Objectives. The Mini-Cog, a composite of three-item recall and clock drawin g, was developed as a brief test for discriminating demented from non-demen ted persons in a community sample of culturally, linguistically, and educat ionally heterogeneous older adults. Subjects. All 129 who met criteria for probable dementia based on informant interviews and 120 with no history of cognitive decline were included; 124 were non-English speakers. Methods. Sensitivity, specificity, and diagnostic value of the Mini-Cog wer e compared with those of the Mini-Mental State Exam (MMSE) and Cognitive Ab ilities Screening Instrument (CASI). Results. The Mini-Cog had the highest sensitivity (99%) and correctly class ified the greatest percentage (96%) of subjects. Moreover, its diagnostic v alue was not influenced by education or language, while that of the CASI wa s adversely influenced by low education, and both education and language co mpromised the diagnostic value of the MMSE. Administration time for the Min i-Cog was 3 minutes vs 7 minutes for the MMSE. Conclusions. The Mini-Cog required minimal language interpretation and trai ning to administer, and no test forms of scoring modifications were needed to compensate for the extensive linguistic and educational heterogeneity of the sample. Validation in clinical and population-based samples is warrant ed, as its brevity and ease of administration suggest that the Mini-Cog mig ht be readily incorporated into general practice and senior care settings a s a routine 'cognitive vital signs' measure. Copyright (C) 2000 John Wiley & Sons, Ltd.