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The Mini-Cog, Clock Drawing Test, and the Mini-Mental State Examination in a German Memory Clinic: specificity of separation dementia from depression

Published online by Cambridge University Press:  20 August 2012

Monika Milian ,
Anna-Maria Leiherr ,
Guido Straten ,
Stephan Müller ,
Thomas Leyhe  and
Gerhard W. Eschweiler
Monika Milian*
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany Department of Neurosurgery, University of Tuebingen, Tuebingen, Germany
Anna-Maria Leiherr
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
Guido Straten
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
Stephan Müller
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
Thomas Leyhe
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany Geriatric Center at the University Hospital of Tuebingen, Tuebingen, Germany
Gerhard W. Eschweiler
Affiliation:
Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany Geriatric Center at the University Hospital of Tuebingen, Tuebingen, Germany
*
Correspondence should be addressed to: Dr. Monika Milian, Department of Neurosurgery, University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany. Phone: +49-(0)7071-29 81993; Fax: +49-(0)7071-29 4438. Email: monika.milian@med.uni-tuebingen.de.
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Abstract

Background: The aim of this study was to assess the specificities of the Mini-Cog, the Clock Drawing Test (CDT), and the Mini-Mental State Examination (MMSE) against depression and healthy controls in a German Memory Clinic. Furthermore, we analyzed the specificities of all three screening instruments in dependence of actual depression severity.

Methods: Data from 142 depressed elderly, 438 dementia patients, and 64 healthy controls were retrospectively analyzed. The CDT and an extraction of the three-item recall of the MMSE were used to constitute the Mini-Cog algorithm. Depression severity was rated by either the Beck Depression Inventory (BDI) or the Geriatric Depression Scale (GDS) depending on the age of the patients.

Results: The Mini-Cog achieved a specificity of 79.6% against depressed elderly and 100.0% against healthy subjects (p < 0.001). Similarly, the specificities of the CDT (83.8%) and MMSE (92.3% at a cut-off ≤24 and 90.8% at ≤25, respectively) against healthy subjects were significantly higher than the specificities against depressed patients (each p < 0.05). Concerning the depressed patients, the MMSE demonstrated significant higher specificity than the Mini-Cog and the CDT, but also showed the lowest sensitivity for the detection of dementia. Surprisingly, the depression severity had no effect on the specificity of the Mini-Cog and the CDT, only the MMSE was susceptible for the depression severity.

Conclusion: Although the MMSE showed higher specificities, the weighting between the sensitivities and specificities in all tests prove again the Mini-Cog as a short, valid, and sensitive screening tool.

Keywords

dementiaAlzheimer's diseasedepressionMini-Cogmemory clinic
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 1 , January 2013 , pp. 96 - 104
Copyright
Copyright © International Psychogeriatric Association 2012

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