The performance of the Mini-Cog in a sample of low educational level elderly

O desempenho do Mini-Cog em uma amostra de idosos com baixo nível educacional

Abstract

Objectives:

To study the criterion validity of the Mini-Cog in low educational level elderly.

Design:

Cross-sectional and validation design.

Setting:

Policlínica Piquet Carneiro, an outpatient unit of Rio de Janeiro State University Hospital, in Brazil. Participants: A convenient sample consisting of 306 individuals, 65 yrs or older, selected from April 8^th to July 15^th, 2002.

Methods:

All participants underwent comprehensive geriatric evaluations which included the Mini-Mental State Examination (MMSE) and the cognitive part of the Cambridge Examination for Mental Disorders of the Elderly - Revised (CAMCOG-R). They were classified as demented or non-demented (DSM-IV). A post-hoc analysis was performed on the data from the 3 word recall test of the MMSE, and the Clock Drawing Test from the CAMCOG-R, and respective scores were added and interpreted in accordance with the Mini-Cog protocol.

Results:

293 individuals completed all the study steps; 211 had 4 or less years of schooling and were included in the data analysis. 32% had dementia. Mini-Cog sensitivity and specificity was consistently low independently of the different cut-off points considered. The best performance was found at the cut-off point of 2/3 which yielded sensitivity and specificity of 60% and 65%, respectively.

Conclusion:

The Mini-Cog is not a good cognitive screening tool for individuals with less than five years of formal education.

Key words:
neuropsychology; dementia; mass screening; aging; ambulatory care; validity.

Resumo

Estudar a validade de critério do Mini-Cog em idosos com baixo nível educacional.

Desenho:

transversal e de validação.

Cenário:

Policlínica Piquet Carneiro, uma unidade ambulatorial do Hospital da Universidade do Estado do Rio de Janeiro, no Brasil. Participantes: Uma amostra de conveniência constituída de 306 indivíduos, 65 anos ou mais, selecionados entre 8 de abril e 15 de julho de 2002.

Métodos:

Todos foram submetidos a uma avaliação geriátrica abrangente, que incluiu o Mini-Exame do Estado Mental (MEEM) e a parte cognitiva do Cambridge Examination for Mental Disorders of the Elderly - Revised (CAMCOG-R), e foram classificados segundo sua condição de ser ou não portador de demência (DSM-IV). Foi feita uma análise post-hoc dos dados do teste de evocação de três palavras, incluído no MEEM, e do Teste do Desenho do Relógio, incluído no CAMCOG-R. Os resultados de cada teste foram agrupados e interpretados de acordo com o protocolo do Mini-Cog.

Resultados:

293 indivíduos completaram todas as etapas do estudo, e 211 tinham quatro ou menos anos de escolaridade e tiveram seus dados analisados; 32% tinham demência. A sensibilidade e a especificidade do Mini-Cog foram consistentemente baixas, independente do ponto de corte considerado. O melhor desempenho, no ponto de corte 2/3, registrou sensibilidade e especificidade de 60% e 65%, respectivamente.

Conclusão:

O Mini-Cog não é uma boa ferramenta para triagem cognitiva de indivíduos com menos de cinco anos de educação formal.

Palavras-chave:
neuropsicologia; demência; envelhecimento; programas de rastreamento; assistência ambulatorial; validade.

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Publication Dates

• Publication in this collection
  Apr-Jun 2009

History

• Received
  16 Feb 2009
• Accepted
  21 May 2009