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vol.3 issue2The Clock Drawing Test A review of its accuracy in screening for dementiaEvaluation of Mini-Mental State Examination scores according to different age and education strata, and sex, in a large Brazilian healthy sample author indexsubject indexarticles search
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Dementia & Neuropsychologia

Print version ISSN 1980-5764

Dement. neuropsychol. vol.3 no.2 São Paulo Apr./June 2009

http://dx.doi.org/10.1590/S1980-57642009DN30200003 

Original Articles

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

Sergio Telles Ribeiro Filho1 

Roberto Alves Lourenço2 

1MD, Laboratório de Pesquisa em Envelhecimento Humano, GeronLab, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

2MD, MPH, PhD, Laboratório de Pesquisa em Envelhecimento Humano, GeronLab, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Internal Medicine Department, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

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 8th to July 15th, 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.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

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Received: February 16, 2009; Accepted: May 21, 2009

Sergio Telles Ribeiro Filho - Rua Visconde de Pirajá, 414 / sala 518 - 2410-002 Rio de Janeiro RJ - Brazil. E-mail: sergiotell@globo.com

Disclosure: The authors report no conflicts of interest.

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