Screening and Case-Finding Tools for the Detection of Dementia. Part II: Evidence-Based Meta-Analysis of Single-Domain Tests
American Journal of Geriatric Psychiatry
Mitchell, A. J., & Malladi, S. (2010).
American Journal of Geriatric Psychiatry, 18(9), 783-800.
This meta-analysis compares the accuracy of brief single-domain screening measures to validated diagnostic standards for detecting dementia in screened individuals. <span style="color: #6e6259; font-family: urw-geometric, serif; font-size: 12pt;">Although speech-language pathologists do not diagnose dementia, findings may be useful for identifying tools for detection of cognitive impairments in this population.</span>
Not stated
This systematic review is part two of a two part series with the first supporting document listed below:<ul>
<li>Mitchell, A. & Malladi, S. (2010). Screening and Case-Finding Tools for the Detection of Dementia. Part I: Evidence-Based Meta-Analysis of Multi-Domain Tests. American Journal of Geriatric Psychiatry, 18(9), 759-782. doi: 10.1097/JGP.0b013e3181cdecb8</li>
</ul>
Through July 2009
Quantitative studies (not further specified)
Community (13 studies); Primary care (9 studies); Specialist settings (23 studies)
Overall, single-domain tests appear to have inferior sensitivity and specificity when applied in the community, inferior specificity but equal sensitivity when applied in primary care, and equivalent sensitivity and specificity when applied in specialist settings.
<p>Findings demonstrated that the optimal single domain test methods for screening for dementia were the Memory Impairment Screen and verbal fluency-categories for community settings, the Selective Reminding Test and Clock Drawing Test in primary care, and the Memory Alteration Test and word list-immediate recall for specialist settings. In community-based settings, single-domain tests had a sensitivity of 64.2%, specificity of 84.9%, positive predictive value (PPV) of 57.1%, and negative predictive value (NPV) of 88.3%, and were found to be less accurate than the Mini-Mental State Examination (MMSE). In a primary care setting single-domain testing had a sensitivity of 69.%, a specificity of 82.5%,PPV of 36.5%, and NPV of 95.8%, which was found to be less specific but equally as sensitive to the MMSE. Single-domain tests were found to have similar accuracy to the MMSE in specialty settings, with a sensitivity of 76.6%, a specificity of 81.9%, a PPV of 80.8%, and a NPV of 74.9%.</p>
