Abstract
BackgroundGeneral practitioners (GPs) are in best position to suspect dementia. Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT) are widely used. Additional neurological tests may increase the accuracy of diagnosis. We aimed to evaluate diagnostic ability to detect dementia with a Short Smell Test (SST) and Palmo-Mental Reflex (PMR) in patients whose MMSE and CDT are normal, but who show signs of cognitive dysfunction.MethodsThis was a 3.5-year cross-sectional observational study in the Memory Clinic of the University Department of Geriatrics in Bern, Switzerland. Participating patients with normal MMSE (>26 points) and CDT (>5 points) were referred by GPs because they suspected dementia. All were examined according to a standardized protocol. Diagnosis of dementia was based on DSM-IV TR criteria. We used SST and PMR to determine if they accurately detected dementia.ResultsIn our cohort, 154 patients suspected of dementia had normal MMSE and CDT test results. Of these, 17 (11 %) were demented. If SST or PMR were abnormal, sensitivity was 71 % (95 % CI 44–90 %), and specificity 64 % (95 % CI 55–72 %) for detecting dementia. If both tests were abnormal, sensitivity was 24 % (95 % CI 7–50 %), but specificity increased to 93 % (95 % CI 88–97 %).ConclusionPatients suspected of dementia, but with normal MMSE and CDT results, may benefit if SST and PMR are added as diagnostic tools. If both SST and PMR are abnormal, this is a red flag to investigate these patients further, even though their negative neuropsychological screening results.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-015-0094-0) contains supplementary material, which is available to authorized users.
Highlights
General practitioners (GPs) are in best position to suspect dementia
Our study focused on patients whose results on the Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT) were negative, but who were admitted to a Swiss Memory Clinic because of suspected dementia
Our findings indicate that both Smell Test (SST) and Palmo-Mental Reflex (PMR) should be validated in a primary care setting that ideally offers other screening tests than MMSE and CDT as well
Summary
General practitioners (GPs) are in best position to suspect dementia. Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT) are widely used. We aimed to evaluate diagnostic ability to detect dementia with a Short Smell Test (SST) and Palmo-Mental Reflex (PMR) in patients whose MMSE and CDT are normal, but who show signs of cognitive dysfunction. General practitioners (GPs) are in a good position to detect dementia early. Cognitive dysfunction may be reported by patients, caregivers, or relatives, or discovered during general screening (e.g. while testing fitness to drive). Detection of dementia can reduce the burden on the caregiver through effective intervention [1], and can delay admission to a nursing home [2], and mitigate. GPs often use the Mini-Mental State Examination (MMSE) and the Clock Drawing Test (CDT) to test for dementia.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
