The use of brief screening instruments for age-related cognitive impairment in New Zealand

Abstract

This study aimed to determine which measures are most commonly used to screen for age-related cognitive impairment in New Zealand, to describe how and why they are used, determine the factors clinicians deem most important in the selection of a particular screen and their levels of training and expertise in using particular screens. A web survey was completed by geriatricians, neurologists, psychiatrists, and psychologists (N=82). Cognitive screening measures were selected for the survey based on previous research. According to the sample, the most frequently used screen was the Mini-Mental State Exam (MMSE), followed by the Clock Drawing Test (CDT) and Addenbrooke's Cognitive Examination Revised (ACE-R). Cognitive screening fulfilled a variety of functions in clinical practice and was widely used, especially in services for older people, however formal training was limited. Availability, reliability and validity, and brevity (respectively) were the most important factors clinicians considered when selecting a screening instrument. Respondent comments agreed with current literature that the MMSE is inadequate as a screening instrument for cognitive impairment, and this was reflected in the comments of respondents on the survey questionnaire, yet this was still the most commonly used measure in New Zealand.