7-Minute Screen Research Articles

The Utility of Cognitive Screeners in the Detection of Dementia Spectrum Disorders in Spanish-Speaking Populations.

Increasing rates of dementia spectrum disorders among Spanish-speaking geriatric populations necessitate the development of culturally appropriate cognitive screening tests that can identify neurodegenerative disorders in their earliest stages when emerging disease-modifying treatments are most likely to be effective. This scoping review identified 26 brief Spanish language cognitive screening tools (<20 minutes) by searching academic databases using a combination of search terms. Results suggest that the Mini-Mental Status Examination and Montreal Cognitive Assessment appear to be less valid than other screeners. Instruments such as the 7-Minute Screen and Mini-Cog evidence higher classification rates of dementia, while Phototest detected mild cognitive impairment at higher rates more consistently than other screeners. Different sensitivity and specificity outcomes and cutoffs were observed when the same cognitive screener was evaluated in different countries. Results indicate that it is imperative to increase nation-specific validation and normative data for these instruments to best serve diverse populations.

Comparison of the Montreal Cognitive Assessment and 7minute Screen Test to Assess Mild Cognitive Impairment Among Geriatric Population

Comparison of the Montreal Cognitive Assessment and 7minute Screen Test to Assess Mild Cognitive Impairment Among Geriatric Population

Screening for Cognitive Impairment in Older Adults: A Systematic Review for the U.S. Preventive Services Task Force

Earlier identification of cognitive impairment may reduce patient and caregiver morbidity. To systematically review the diagnostic accuracy of brief cognitive screening instruments and the benefits and harms of pharmacologic and nonpharmacologic interventions for early cognitive impairment. MEDLINE, PsycINFO, and the Cochrane Central Register of Controlled Trials through December 2012; systematic reviews; clinical trial registries; and experts. English-language studies of fair to good quality, primary care–feasible screening instruments, and treatments aimed at persons with mild cognitive impairment or mild to moderate dementia. Dual quality assessment and abstraction of relevant study details. The Mini-Mental State Examination (k = 25) is the most thoroughly studied instrument but is not available for use without cost. Publicly available instruments with adequate test performance to detect dementia include the Clock Drawing Test (k = 7), Mini-Cog (k = 4), Memory Impairment Screen (k = 5), Abbreviated Mental Test (k = 4), Short Portable Mental Status Questionnaire (k = 4), Free and Cued Selective Reminding Test (k = 2), 7-Minute Screen (k = 2), and Informant Questionnaire on Cognitive Decline in the Elderly (k = 5). Medications approved by the U.S. Food and Drug Administration for Alzheimer disease (k = 58) and caregiver interventions (k = 59) show a small benefit of uncertain clinical importance for patients and their caregivers. Small benefits are also limited by common adverse effects of acetylcholinesterase inhibitors and limited availability of complex caregiver interventions. Although promising, cognitive stimulation (k = 6) and exercise (k = 10) have limited evidence to support their use in persons with mild to moderate dementia or mild cognitive impairment. Limited studies in persons with dementia other than Alzheimer disease and sparse reporting of important health outcomes. Brief instruments to screen for cognitive impairment can adequately detect dementia, but there is no empirical evidence that screening improves decision making. Whether interventions for patients or their caregivers have a clinically significant effect in persons with earlier detected cognitive impairment is still unclear. Agency for Healthcare Research and Quality.

Efficacy of a computerized cognitive training application for older adults with and without memory impairments

It has been shown that cognitive training might help to protect against age-related cognitive decline. Our aim was to evaluate the efficacy of a computerized cognitive training application and its near transfer effects on the cognitive status of older adults. Performance on the 7-Minute Screen at baseline and at the end of the program was analyzed by using a pre-post design. Adults aged 55 and older (n = 101; mean age ± standard deviation: 68.97 ± 5.81 years) with and without memory impairments were trained. Significant improvements after the training program were found in memory, visuo-spatial and verbal fluency abilities, regardless of age, gender or education. Moreover, participants without significant memory impairments and those with Age-Associated Memory Impairment gained from the program more than subjects with mild cognitive impairment. Computerized cognitive training programs, such as Telecognitio®, may be used as a practical and valuable tool in clinic to improve cognitive status.

Validation of the 7-Minute Screen for the Detection of Early-Stage Alzheimer’s Disease

Background/Aims: The 7-Minute Screen (7MS) is a screening battery to identify individuals with a high probability of Alzheimer’s disease (AD). The 7MS consists of four subtests (Temporal Orientation, Enhanced Cued Recall, Clock Drawing, and Verbal Fluency), each measuring a different aspect of cognition. The present study is designed to examine the predictive validity of the 7MS to distinguish between patients with early-stage AD and healthy control subjects. Methods: Sixty-three patients who were diagnosed as having probable or possible AD and 91 community-dwelling elderly individuals of comparable age, sex distribution, and education were administered the 7MS (paper-and-pencil version) and other screening batteries. All patients were rated Clinical Dementia Rating (CDR) 0.5–1, categorized as early-stage AD, and all participants obtained a score of less than 6 for the Geriatric Depression Scale (15-item version). Results: Mean scores for patients and controls on all the four subtests were significantly different. When using the total score of the 7MS, which was calculated by the original logistic regression formula based on all of the four subtests, the sensitivity for early-stage AD was 90.5% with a specificity of 92.3%. Correlation analysis indicated high concurrent validity between the 7MS and existing standard cognitive screening batteries (e.g., MMSE, HDS-R). In correlation analysis and multiple regression analysis, demographic effects (age, sex, and education) were not significantly associated with the total score of the 7MS in controls. Conclusions: The results showed that the 7MS had a high level of sensitivity and specificity. We also found that the 7MS was not affected by demographic characteristics. These findings demonstrated that the 7MS is a useful screening tool for discriminating patients with early-stage AD from intact individuals.

Utility of the Malayalam translation of the 7- minute screen for &lt;i&gt;Alzheimer's disease&lt;/i&gt; risk in an Indian community

Alzheimer's disease (AD) is suspected to be currently under-diagnosed in India, thus the need for a brief, effective screening test for the condition. We aimed to test the Malayalam translation of the 7-Minute Screen (7MS) for detecting those at high risk for AD and to report on the subscores used to derive the Alzheimer's risk score. This study was performed in Kerala State amongst young university students and elders in residential care homes. Two hundred and eighty-two volunteers were tested, 178 young controls (aged 20-29) and 104 literate elders, (55-92 years). None were clinically diagnosed with AD. Elders and controls were assessed as High or Low AD Risk with the published 7MS algorithm. Performance was compared between groups with ANOVA. The algorithm estimated high (n=61/104) or low (n=40/104) AD risk in the elderly. Significant differences were found between controls, low- and high-risk groups on all four components of the screen (Orientation: F=131.1, Enhanced Cued Recall: F=23.4, Clock Drawing: F=65.1, Verbal Fluency: F=15.7, P<0.0001 for all) and in the risk scores (F=144.7, P<0.0001). Age and gender affected verbal fluency, orientation and clock drawing performance. The high-risk group had worse scores for orientation and better scores for memory than previously reported for AD cases in other populations. The 7MS may be a useful screening test for cognitive impairment in India. Suggestions are given for revising the 'risk algorithm' for more appropriate AD risk assessment in this population.

Is large-scale community memory screening feasible? Experience from a regional memory-screening day.

To investigate whether a large-scale memory-screening program for community-dwelling elders would be successful in identifying individuals with a high probability of dementia in need of further assessment that would result in the earlier diagnosis of dementia. A descriptive study of experience with a volunteer sample. Ten sites (e.g., senior centers, churches, clinics) throughout New England on October 29, 1999. Trained volunteer clinicians evaluated 497 community-dwelling individuals on the screening day. An additional 162 subjects who could not be accommodated on that day were subsequently screened at local sites by appointment during the following month. Subjects participated in a standardized format consisting of an educational lecture, followed by individual screenings with the 7-minute screen (7MS) with locally trained staff. Subjects were informed immediately of test results and counseled regarding follow-up options. A survey was conducted with these subjects and their primary care physicians over the following year. Because the groups tested at different times were not statistically different in terms of demographics, they were combined in the analysis. One hundred ten (16.7% of all screened) individuals received high/retest scores on the 7MS. They were advised to seek diagnostic evaluation and encouraged to have results sent to their primary care physicians (PCPs). Of those followed up, 64% reported that they followed up the screening results with their PCP. More than one-third (38%) of participants with a high/retest score on the 7MS had inconclusive findings on follow-up or were awaiting further diagnostic evaluation. Of those for whom follow-up data were available, 10 (9%) were diagnosed with probable Alzheimer's disease (AD), and an additional nine (8%) who had previous diagnoses of AD were correctly identified by the 7MS. Anecdotally, feedback from participants indicated a high level of satisfaction with the process. Participants reported that the educational talk and the possibility of early detection were the most helpful components of the screening program. Moreover, most individuals surveyed in follow-up would recommend the program to a friend or family member. A follow-up survey of participants and their physicians supported the conclusion that a community memory-screening program might detect individuals who were previously unknown to have cognitive problems. Furthermore, such a program was highly acceptable to participants. The small number of individuals diagnosed with dementia as a result of the screening program indicates that this form of screening may be inefficient as performed. Multiple obstacles to seeking follow-up care were identified and would need to be addressed in larger-scale programs to make this a worthwhile endeavor. The experience gained in this memory screening program might aid in the planning of better programs, which will be essential if early diagnosis is to keep pace with the growth of treatments for dementia.

Diagnosing and treating Alzheimer's disease: a practitioner's overview.

To provide an overview of current diagnostic protocols of Alzheimer's disease (AD), screening techniques, tests, and a review of standard and new treatments. Selected articles from the scientific literature, online sources, and standard texts were examined. Standard tools, such as the Geriatric Depression Scale, the Mini Mental State Evaluation, and the 7-Minute Screen, are useful in the primary care setting for screening elderly patients. Other tools, such as the Clinical Dementia Rating (CDR) and the Global Deterioration Scale, are useful for staging and monitoring progression of disease and response to treatment. Clinical diagnostic testing is still in developmental stages, but the hope is to have a reliable and objective diagnostic tool in order to diagnose AD in the earliest stages. The diagnosis and treatment of AD is becoming a more frequent challenge in the primary care office. Clinicians must keep abreast of the rapid changes in new technologies in order to make informed diagnostic and therapeutic decisions.

Clues to early Alzheimer dementia in the outpatient setting.

As the elderly population booms and the prevalence of dementia soars, it becomes imperative that primary care physicians recognize early dementia within their own practices. Early recognition and diagnosis of dementia will allow appropriate intervention and treatment to improve morbidity. To examine the most common symptoms associated with early Alzheimer disease (AD), as presented by patients and their families, and to compare these with the recommendations of the "7-Minute Screen" by Solomon et al for the identification of AD and the recommendations of the Agency for Health Care Policy and Research (AHCPR) for the early recognition of dementia. A retrospective medical record review was conducted in an outpatient referral population within 2 geriatric evaluation centers. Patient medical record selection was based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for AD, a Mini-Mental State Examination (MMSE) score of 23 or higher, a Geriatric Depression Scale score of less than 5, age above 60 years, and at least an eighth-grade level of education. From 1025 medical records reviewed, 50 patients were chosen who fulfilled all inclusion criteria. Forty patients (80%) missed at least 2, if not all 3, recall items on the MMSE. Thirty patients (60%) had difficulty managing finances and/or balancing a checkbook; 16 (32%) frequently repeated stories and statements; 15 (30%) became lost while driving; 10 (20%) frequently forgot the names of relatives; and 10 (20%) had poor judgment. These results demonstrated a high correlation with recall as a diagnostic factor in diagnosing early AD as found in the 7-Minute Screen. Moreover, these "clues" correlated well with the AHCPR's symptoms that indicate dementia. The symptoms specifically overlapped in the areas of learning and retaining new information (repetition), handling complex tasks (calculation), reasoning ability (judgment), and spatial ability and orientation (driving). There may be a constellation of symptoms associated with early AD. This constellation includes missing recall items on the MMSE, difficulty in calculation, repetition, getting lost while driving, forgetting the names of relatives, and having poor judgment. Recall is the symptom most consistent with the findings of the 7-Minute Screen in diagnosing AD. However, repetition, calculation, judgment, and driving highly correlate with the AHCPR's dementia symptom checklist. Therefore, if primary care physicians keep this constellation of symptoms in mind while evaluating their geriatric population, they will have greater ability to suspect, diagnose, and treat AD at an early stage. Arch Fam Med. 2000;9:1066-1070