The Mini-Cog as a screen for dementia: validation in a population-based sample

J Am Geriatr Soc. 2003 Oct;51(10):1451-4. doi: 10.1046/j.1532-5415.2003.51465.x.


Objectives: To test the Mini-Cog, a brief cognitive screening test, in an epidemiological study of dementia in older Americans.

Design: A population-based post hoc examination of the sensitivity and specificity of the Mini-Cog for detecting dementia in an existing data set.

Setting: The Monongahela Valley in Western Pennsylvania.

Participants: A random sample of 1,119 older adults enrolled in the Monongahela Valley Independent Elders Survey (MoVIES).

Measurements: The effectiveness of the Mini-Cog in detecting independently diagnosed dementia was compared with that of the Mini-Mental State Examination (MMSE) and a standardized neuropsychological battery.

Results: The Mini-Cog, scored by an algorithm as "possibly impaired" or "probably normal," and the MMSE, at a cutpoint of 25, had similar sensitivity (76% vs 79%) and specificity (89% vs 88%) for dementia, comparable with that achieved using a conventional neuropsychological battery (75% sensitivity, 90% specificity).

Conclusion: When applied post hoc to an existing population, the Mini-Cog was as effective in detecting dementia as longer screening and assessment instruments. Its brevity is a distinct advantage when the goal is to improve identification of older adults in a population who may be cognitively impaired. Prior evidence of good performance in a multiethnic community-based sample further supports its validity in the ethnolinguistically diverse populations of the United States in which widely used cognitive screens often fail.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Aged
  • Dementia / diagnosis*
  • Dementia / epidemiology
  • Female
  • Humans
  • Male
  • Mass Screening*
  • Mental Recall
  • Neuropsychological Tests*
  • Pennsylvania / epidemiology
  • Psychometrics
  • Sensitivity and Specificity