Cognitive impairment in medical inpatients .1. Screening for dementia - Is history better than mental state?

Background: evaluation of the short version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and the Abbreviated Mental Test (AMT) as screening tools for dementia in medical inpatients. Methods: 201 patients over 65 were assessed. Assessment included administration of the AMT, a delirium screening instrument and a brief psychiatric interview Relatives were interviewed and the IQCODE administered. Diagnostic and Statistical Manual (DSM) IIIR diagnoses of various causes of cognitive impairment were made. Sensitivity and specificity values of the screening tests for a DSM IIIR diagnosis of dementia were calculated. Results: our study suggests that the IQCODE is more accurate than the AMT as a screening instrument for dementia. Using a cut-off point of >3.44, sensitivity and specificity of the IQCODE for diagnosing dementia were 100 and 86% respectively. Equivalent values for the AMT (cut-off point <8) were 96 and 73%. It was possible to use the IQCODE in eight of the 10 patients unable to complete the AMT. Conclusion: using both the IQCODE and a brief cognitive function test when screening for dementia in medical inpatients will maximize the number of patients who can be screened.