We have good experience with the MoCa (Montreal Cognitive Assessment).

Stefaan

Hi Paul, we had exactly the same problem in our DARES study and after much angst and searching we ended up having to use the MMSE

I don't really know if this fits your aims and desired outcomes, but perhaps the ECog might be an option. Here's the validity paper:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2877034/pdf/nihms-200864.pdf

MoCa (Montreal Cognitive Assessment) is very nice

The MoCa is certainly being recommended as a replacement for MMSE in light of copyright issues and is my "go to" if completion of an ACE-R is not possible. Failing that you may find something of use here - http://www.dementia-assessment.com.au/

.......particularly in the section for GP assessment where the tools tend to be brief. Good luck with finding a suitable tool.

It depends on your need and condition. Do you want to publish results? Do you have rights? Do you have caregivers or research staff or somebody else? Whats the primary goal - to assess as simply (self administered) as possible, to compare results across similar studies (see used scales), as accurate as possible... Population is slightly impaired (MCI) or? MoCa might be good solution, but ... it depends ...

I can strongly recommend the MoCA. It works better for MCI/mild dementia subjects and also for non-AD dementias. Needs little training and is short.

We tend to use the 3MS

The choice depends on the population to be screened, the severity of dementia to be detected and the skill of the interviewer. Taking this in consideration, we make a proposal to primary care physicians based on several highly practical aspects:

1. Especially short and quick test to apply (

Hi, there.

I would suggest either the MoCA or the SLUMS. Both are available in the public domain and both are better at detecting MCI than the MMSE.

Mini-cog and 6-item are suitable for a brief screening of cognitive functioning in our experience in order to assess cognitive impairment.

For a very brief assessment, you could try word list in Cerad - how many animals can a patient name to you in a minute - this could work also. For further detailing, you of course need longer assessments, but this could work as a good start.

We've used the 6-item Cognitive Impairment Test (6-CIT). It is a quick, easy to use and fairly reliable screening tool for dementia in primary care based mental health services.

MoCA test esta disponible en varios idiomas

ACE-III is a bit longer (15 min) but highly recommended to diagnose early cognitive impairment and dementia. You could find it in the webpage of the authors

http://www.neura.edu.au/frontier/research/test-downloads/

I recommend Montreal cognitive assessment (http://www.mocatest.org/) It takes ten minutes to administer. It has cutoff values for MCI and dementia

Moca

You might also consider the Blessed. It is very short and has decent norms.

I would also recommend the MoCa test ( Montreal Cognitive Assessment). I am working with intellectual disabilities, and I think MoCa test gives a good impression of the persons cognitive abilities. It find it valuable that it contains so many different type of tests. I think it is easy to explain the patients. I recommend you try it. Best regards,..

I would agree with the suggestion of the MoCa because of the intellectual property issues with the Folstein's.

For an ID cohort, kindly consider DMR/DLD.

all relevant tools are reviewed here

http://www.ncbi.nlm.nih.gov/pubmed/20808118 and

http://www.ncbi.nlm.nih.gov/pubmed/20808094

Am J Geriatr Psychiatry. 2010 Sep;18(9):759-82. doi: 10.1097/JGP.0b013e3181cdecb8.

Screening and case finding tools for the detection of dementia. Part I: evidence-based meta-analysis of multidomain tests.

Mitchell AJ, Malladi S.

Source

Department of Liaison Psychiatry, Brandon Unit, Leicester General Hospital, Leicester, UK. [email protected]

Abstract

AIM:

To evaluate the diagnostic accuracy of all brief multidomain alternatives to the Mini-Mental State Examination (MMSE) in the detection of dementia.

METHODS:

A literature search, critical appraisal, and meta-analysis were conducted of robust diagnostic validity studies involving cognitive batteries. Twenty-nine distinct brief batteries were tested in 44 large-scale analyses. Twenty studies took place in specialist settings (11 in memory clinics and 9 in secondary care), ten studies were conducted in primary care, and 14 in the community.

RESULTS:

In community settings with a low prevalence of dementia, short screening methods of no more than 10 minutes had an overall sensitivity of 72.0% (95% confidence interval [CI] = 60.4%-82.3%) and a specificity of 88.2% (95% CI = 83.0%-92.5%). The optimal individual tests were the Telephonic interview based on MSQ, Category fluency/Memory impairment screen-Telephonic interview and 6 item Cognitive Impairment Test (6-CIT), but data were limited by the absence of multiple independent confirmation for any individual test. In primary care where the prevalence of dementia is usually modest, the optimal individual tools were the Abbreviated mental test score/Mental status questionnaire (MSQ), and Prueba cognitive de leganes (PCL). Furthermore, the Abbreviated mental test score (AMTS) was superior to the MMSE for case finding, but for screening the MMSE was optimal. If length is not a major consideration, the MMSE may remain the best tool for primary care clinicians who want to rule in and rule out a diagnosis. In specialist settings where the prevalence of dementia is often high, the optimal individual tools were the DEMTECT, Montreal cognitive assessment (MOCA), Memory Alteration test, and MINI-COG. Two tools were potentially superior to the MMSE for rule in and rule out, namely the 6-CIT and MINI-COG. Only four analyses looked specifically at accuracy in early-stage dementia, and each showed at least equivalent diagnostic accuracy, suggesting these methods might be applicable to early identification.

CONCLUSION:

A large number of alternatives to the MMSE have now been validated in large samples with favorable rule-in and rule-out accuracy. Evidence to date suggests for those wishing to use brief battery tests then the original MMSE or the AMTS should be considered in primary care and either the 6-CIT or the MINI-COG should be considered in specialist settings.

Actually, MoCA is more sensitive than MMSE and would be a nice instrument to screening, but it takes a little bit more time to use. Another very simple instrument is the Clocking drawing test (which is not indicated for low schooling populations). You could also consider use informant based measures, like AD-8, what would be useful in this setting as well, even as a complementary data.

A few exist. The Rudas/10mins and the ACE-R /15 mins

I) GPCOG has the same discrimant power as MoCA and is the only one brief ( 3-5 minutes) screening tool built in 2 sections : 1) cognitive assessment 2) informant questionnaire www.gpcog.com.au

II) MoCA takes in account only cogntive performance, requires 8-10 minutes and is more detailed than GPCOG .

GPCOG and MoCA has an higher specificity than MMSE but a more evident "floor effect" in moderate cognitive impairment so it is recommended always the administration of both MMSE plus MOCA (see Geriatric at Your Fingertips - AGS) or GPCOG.

Moreover the specificity of MMSE increases notably if the cut-off adopted is 27 out 30 - as MMSE has been validated in Italy - instead of international cut-off (24-out of 30). For details see "The validation of the Italian version of the GPCOG (GPCOG-It): a contribution to cross-national implementation of a screening test for dementia in general practice .

A. Pirani, H. Brodaty, E. Martini, D. Zaccherini, F. Neviani, M. Neri. International Psychogeriatrics, Volume 22, Issue 01, February 2010, pp 82-90

I would suggest the Addenbrooke's Cognitive Examination (ACE) which has recently been revised (now ACE-III). It follows the same structure and covers the same five cognitive domains as the previous version.

It is easy to administer and well received by participants and can be completed in ~ 15 minutes. The test and instructions can be downloaded freely (http://www.neura.edu.au/frontier/research/test-downloads/) and is available in different languages with a iPad version to be available shortly.

Without any doubt, I recommend the MoCA. Simple, fast, requires minimal training and has application data into multiple populations supporting its reliability and diagnostic validity over other more traditional, such as the MMSE.

You may want to consider the 3MS test (score range 0 - 100). It can be administered in about 10-15 minutes, can provide an estimated MMSE score, provides more information than the MMSE, and has been used in several epidemiological studies (e.g., Lyketsos CG, et al., 2002, JAMA 288, 1475-1483).

The website http://www.dementia-assessment.com.au/ gives a good overview of a number of measures of cognition, function, dementia staging, and psychological symptoms. It includes tests where permission was granted to share the tests for non-commercial use in Australia. It serves as a good resource for those in other countries as well.

How about Rudas?

The Rowland Universal Dementia Assessment Scale (RUDAS) is a short cognitive screening instrument designed to minimise the effects of cultural learning and language diversity on the assessment of baseline cognitive performance.

http://www.health.qld.gov.au/tpch/html/rudas.asp

The Mini-Cog also is one to consider. It uses a three-item recall test , as well as a clock-drawing test. It's easily administered and scored. More details can found at:

http://www.cmecorner.com/macmcm/AAGP/aagp2003_07.htm

http://mcintranet.musc.edu/agingq3/documents/images/MiniCogPDF.pdf

This one is recommended by the German Association of Psychiatrists (DGPPN):

Kalbe E, Kessler J, Calabrese P, et al.: DemTect: a

new, sensitive cognitive screening test to support the

diagnosis of mild cognitive impairment and early dementia.

Int J Geriatr Psychiatr

2004; 19:136-143.

DemTect, PANDA, EASY, and MUSIC: cognitive screening tools with age correction and weighting of subtests according to their sensitivity and specificity.

Kalbe E, Calabrese P, Fengler S, Kessler J.

J Alzheimers Dis. 2013 Jan 1;34(4):813-34. doi: 10.3233/JAD-122128.

My proposal is by no meams new; yet may I suggest the "Clock drawing interpretation test" [scored according to Mendes] ?

In my experience, this test is specially valuable in borderline MMSE, and anyway these tests are complementary.

You might find and download from my profile the following article: Clock drawing interpretation scale (CDIS) and neuro-psychological functions in older adults with mild and moderate cognitive impairments.

M Colombo, R Vaccaro, S F Vitali, M Malnati, A Guaita

Archives of gerontology and geriatrics 01/2009; 49 Suppl 1:39-48.

This is an interesting area, and depends on the time and resources available for test administration and scoring. Does anyone have experience of a self-administered test (ie that a subject could complete alone without the need for a researcher to administer the test) eg on an iPad or similar, as a screening test across a range of ages (without too much of a ceiling effect).

Susan, Perhaps we should develop one for the iPad?

I don't have experience with this, but there is a cognitive screen that is administered with an audio device. As I understand it, someone just has to set the participant up with the computer, but can then leave them to complete it. Reference is:

Schofield PW, Lee SJ, Lewin TJ, Lyall G, Moyle J, Attia J, McEvoy M. (2010) The Audio Recorded Cognitive Screen (ARCS): a flexible hybrid cognitive test instrument. J Neurol Neurosurg Psychiatry. 2010 Jun;81(6):602-7.

We have been using the Montreal Cognitive Assessment Scale, in conjunction with the Mini-Mental as a screening tool for cognition in inpatient and outpatient geriatric psychiatry. It is easy to administer, comes in multiple languages and has online instructions. We are still reviewing the data for our population, but they provide references for use in the community setting on their website.

http://www.mocatest.org/

I use ADE-R test at clinic. But for community study we are planning to use one that is recently published by Zurrani Arabi at al from Malaysia Early Dementia Quesionnaire (EDQ) available at BMC Fam Practice.2013: 14 (49). . They have shown EDQ is a promising alternative to MMSE for screening of early dementia in primary care.

It maybe worth a look at website below which gives you an overview of the evidence.

http://www.ncepmaps.org/Dementia-Screening-Instruments.php

thank you to everybody for the hints.

About MOCA [see Crystal Watkins input], let me paste what I've written in another discussion list:

we also proficiently used MOCA in

"Forloni G., Polito L., Davin A., Abbondanza S. ,Vaccaro R., Valle E., Guaita A., Colombo M., Vitali S., Ferretti V.V., Villani S. Cognitive stimulation and APOE genotype in non-demented elderly subjects: a randomized controller study (RCT). JHNA (The Journal of Nutrition, Health & Aging) 16 (9): 841-2, 2012"

Let me allege the conclusions from the abstract:

"These results provide further evidence that CS benefits cognition in elderly non-demented subjects. Moreover, few sessions of CS are potentially more beneficial for subjects without cognitive deficits rather than MCI participants. Follow-up evaluations are necessary to assess the long-term effect of this kind of intervention and potentially to highlight a benefit also for MCI subjects in terms of a slower cognitive decline over time. APOE genotype does not influence the outcome of CS compared to SE. Finally, our data show that APOE genotype impacts on the gain in MOCA score registered by administering the test after a short period of time."

Mauro Colombo

Have you looked at Test My Memory? I've not use it but heard good things about it.

I would add Geriatric Depression Scale to MOCA or any screen test you'd prefer.

Colleagues like Giuseppe Bellelli or Luc de Vreese use & suggest also "Iqcode" [Informant Questionnaire on Cognitive Decline in the Elderly]: see Psychol Med 1994; 24:145-53, & Int Psychogeriatr 2004; 16:275-293 (review)

best regards, Mauro

Depression and anxiety are important factors in cognitive functioning. You might want to consider adding the Geriatric Depression Scale-15 Item (GDS-15) and the Geriatric Anxiety Inventory (GAI) to your study. Both have good reliability and validity, are easy to adminster, and will help you sort out the degree to which affective dsisturbance is influencing cognition in your older adult sample.

just downloaded the alleged file, according to which "To our knowledge, this is the first survey demonstrating that the MMSE is not the most commonly used tool, and other, newer instruments like the MoCA, are gaining prominence." Best regards, Mauro

I thought that controlling pain -related variables might be important (VAS, medication type). Pain is quite common in elderly and together with meds it affects cognition.

Have you looked at the OASR and OABCL in the Aseba assessment tools. See http://www.aseba.org/olderadults.html

Morris, J.N., Hawes, C., Fries, B.E., Philips, C.D., Mor, V., et al. (1990). Designing the National Assessment Instrument for nursing homes. The Gerontologist, 30, 293-03.

Morris, J.N., Hawes, C., Murphy, K., Nonemaker, S., Phillips, C., Fries, B.E., & Mor, V. (1991). Resident Assessment Instrument training manual and resource guide. Elliot Press, Natick, MA.

Gottfries, C.G., Bråne, G., Gullberg, B., & Steen, G. (1982). A new rating scale for dementia syndromes. Archives of Gerontology and Geriatrics, 11, 311-330.

I would also suggest MOCA, as it is more sensitive to mild impairment than the MMSE. On the other hand it also has lower specificity so you might get some false positives, but balancing sensitivity and specificity is always tricky. CERAD is another alternative, but that takes appr. 30 minutes to administer and was originally developed to identify AD. I'll attach some articles on CERAD, since I've studied it.

Article CERAD test performances in amnestic mild cognitive impairmen...

And the other articles

Article Age, education and test performance on the Finnish CERAD

We use the MOCA a great deal. The Cognistat is also used by some. the other tool is the EXIT, which focuses on executive function, but it does take longer to administer than the MOCA or MMSE. it really depends what you are trying to determine with this - whether there may be some cognitive impairment? are you looking at function related to the impairment - how cognition impacts their function? why in an art museum?

also when you assess someone outside their environment, in an unfamiliar situation, you need to consider their level of anxiety, etc. A quick screen is just that, a quick screen. All these different tools require understanding and interpretation and by themselves should never be used to determine dementia.

I would suggest ACE-III. It is much more comprehensive and would not underestimate cognitive impairment. It addresses memory, language, visuospatial and executive function in a much more detailed manner than MMSE. However, its administration may take 15-40 minutes, depending on the individual tested.

The NIH has come out with a compilation of tests:

www.nia.nih.gov/research/cognitive-instrument

The Alzheimer's Foundation of America has a National Memory Screening Initiative which does something very similar to what you are describing for about 70,000 individuals per year:

http://www.nationalmemoryscreening.org/

http://www.medafile.com/AFA/

There are free computerized tests that can be set up to collect excellent data in 2 minutes that are fun and will draw a crowd at:

http://www.memtrax.org/

This is a rapidly developing cottage industry.

Assessing for depression and pain are also relevant.

But what you probably need is something that takes no more than 8 minutes and gives you a fairly stable measure. 3 MemTrax tests would probably be best..

We use the Elderly Cognitive Assessment Questionnaire (ECAQ) in our community stroke clinic. This is because we run a post stroke service in a primary care facility, and the ECAQ has been validated for use in primary care. For those aged less than 60 years old, we still use the MMSE- which has been validated for our community, with a lower cut off point. Our team is also looking to validate a new tool (Early Dementia Questionnaire) which was designed to detect early signs of dementia at primary care level. Our papers were recently published on BMC Family Practice (i.e. EDQ)- and the primary care driven stroke service -which will be featured in Journal of Neursoscience in Rural Practice. Good luck!

What about TYM test? :) http://www.tymtest.com and http://www.bmj.com/content/338/bmj.b2030

The TYM test is a new cognitive test comprising of 10 tasks presented on 2 sides of a single sheet of soft card. Most people take about 5 minutes to complete the TYM. The test can be completed under supervision from a health professional. The maximum score is 50/50.

another vote for MoCA

In general adult, I use the MOCA: it has basic frontal lobe testing.

In my own practice I would nowadays use the ACE (currently v3) which makes a sensible attempt to address a number of important domains of cognitive function, and lacks the clinically very relevant ceiling effect of the MMSE.

One more for MoCA

Dear Paul and colleagues,

Please try or just take a look in the ACE-R.

In the clinical examination we are using The ACE-R, because we believe it's perform better (more discriminative) than MMSE or MOCA alone (or combined)

Dear Eduardo, I could find ACE-R normative data for people aged 50 to 75 years, in Int J Geriatr Psychiatry 2006; 21: 1078-85. Are there normative references for older people ?

Thank you in advance, Mauro

Dear Mauro,

the ACE-R recently was validated in many countries and for many languages (japanese, spanish, portuguese...Italian:

Italian => https://www.ncbi.nlm.nih.gov/m/pubmed/22262124/?i=5&from=/22068971/related

It's easy to find good papers examining the ACE-R performance in the PUBMED!

Perform well in specificity and sensitivity; with very good accuracy wen used with retests in the follow-up (combined with the clinical examination, and excluding depression - off course).

Some suggested cut-points could vary in older persons; because the normal loss in cognition and because they probably have less formal education.

Best, Eduardo

I use very often Clock Drawing Test which in my opinion is more sensitive in case of dementia! It's also in the public domain. http://www.healthcare.uiowa.edu/igec/tools/cognitive/clockdrawing.pdf

The abbreviated mental test score (AMTS) developed by Hodkinson in 1972 might have less validation data but its advantages are its simplicity and rapidity to use.

An alternative to consider may be the Short Portable Mental Status Questionnaire (SPMSQ). You may also like to read Pfeiffer's (1975) and Kane & Kane's (1981) publications in the 'Journal of the American Geriatrics Society, 23, 433-441' and 'Assessing the Elderly: A practical guider to measurement (book)' respectivley for more details about this tool. There may be more updated publications about it too, e.g. a Chinese version by Chi & Boey (1993) published in Clinical Gerontologist, 13(4), 35-51.

Talk to my scientist Dr.Britton ([email protected]).

She worked in this area

Perhaps not what you are looking for, but the WHO-5 provides a good indication on depression and is widely used. Only 5 items, so it should be brief enough.

I would suggest Mini Cog. It is very fast (3-5 minutes) and at least as sensitive as MiniMental in predicting dementia. The ionly obstacle is the interpretation of clock drawing test that needs to be strict.

Alternatively consider GP COG

this is simple free clinically validated but should only be used by clinicians and I use it as a GP in the UK

http://www.gpcog.com.au

FAQs

Is the GPCOG a recommended screening tool for dementia?

Yes, the GPCOG has been recommended in scientific literature reviews and by evidence based guidelines to be a valid and efficient tool to screen for dementia. We have listed some of the relevant references for you:

Lorentz, W.J., Scanlan, J.M. and Borson, S., Brief screening tests for dementia.. Canadian Journal of Psychiatry - Revue Canadienne de Psychiatrie, 2002. 47(8):723-33.

Milne, A., et al., Screening for dementia in primary care: a review of the use, efficacy and quality of measures. International Psychogeriatrics, 2008. 20(5):911-26.

Brodaty, H., et al., What is the best dementia screening instrument for general practitioners to use? American Journal of Geriatric Psychiatry, 2006. 14(5):391-400.

Bridges-Webb, C. et al ., Care of patients with Dementia in General Practice - Guidelines. NSW Health, 2003 , Bridges-Webb et al 2003, Royal Australian College of General Practitioners (RACGP)

Culverwell, A. et al., Screening for dementia in primary care: how is it measuring up? Quality in Ageing, 2008. 9(3):39-44

Copyright

1. Who can download or use the GPCOG?

The GPCOG can be used by anyone. Having said that, it is important to bear in mind that the GPCOG is a clinical tool and it should not be administered by concerned family members or unexperienced staff. Make sure you read the instructions prior to your first administration of the GPCOG.

If you are not a clinician but concerned about a family member's memory difficulty please ask your family member's GP or your GP to administer the GPCOG to them. The GP might then ask you to take part in the assessment as the informant and provide important information. Top

2. What are the costs for using the GPCOG?

The GPCOG is free for clinicians and researchers. Use of the website or downloading the paper-and-pencil test doesn't cost anything. However, we do ask you not to change any content of the GPCOG and also to have the original reference printed on the worksheets (Brodaty et al, JAGS 2002; 50:530-534). Commercial companies seeking permission to use the GPCOG should write to [email protected]. Top

3. Can I reprint the GPCOG? Yes

Sohrab Panday MRCGP

The DemTect is a valid Screening instrument that takes little time and good reliability and validity values. It only take between 10 to 15 minutes.

You find more about it here:

Int J Geriatr Psychiatry. 2004 Feb;19(2):136-43. DemTect: a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia.Kalbe E, Kessler J, Calabrese P, Smith R, Passmore AP, Brand M, Bullock R.

the MOCA is the assessment i would vote for in this instance

I recommend SCIP, is a brief screening instrument for cognitive impairment (less than 15 minutes) that has been validated in samples of mental disorder but also applicable to dementia or any cognitive impairment.

Rojo et al. (2010) Neurocognitive diagnosis and cut-off scores of the Screen for Cognitive Impairment in Psychiatry (SCIP-S). Schizophrenia Research 116, 243–251.

Try using the Montreal Cognitive assessment tool. It screens frontal executive function as well as memory. I have attached the link to their web site where you can down load the tools and permission to use them.

Cheers, Fran http://www.mocatest.org/

For a quick, fun, free assessment, try: www.memtrax.com

This test is easy to administer if you have a computer available and takes less than 3 minutes. Further, it can be repeated frequently, and it provides an indication of change. It would be easy to set up in a museum and much appreciated.

Very interesting! Thank you for this. Could you please send any references to its reliability/validity? The link on the website was not working.

The upgraded website went live yesterday, hopefully the links will work soon. In the interim, see: http://www.medafile.com/JWA-JAD-CRT-2011.pdf

There are data on over 20,000 individuals who have taken the test, but the primary focus during development has been usability and stability of the test. I think too many tests are based solely on my 1989 paper on the MMSE and are locked-down on meaningless squabbles about reliability, validity, sensitivity, and specificity. See my discussion at: http://www.medafile.com/jwa/Ashford_AH08.pdf

All comments are greatly appreciated.

Very interesting but the downloads from website www.medafile.com don't work even going on the website. Thank you.

The links seems to work entering them into Firefox. I have sent you another note and I can send the articles as PDFs if you cannot download them.

Thank you for your interest.

Thanks for the article and the website. Very cool.

There is a study recently published in BMC Geriatrics, using a short form of MMSE for the screening of dementia in older adults with a memory complaint in the community. It may be useful:

http://www.biomedcentral.com/1471-2318/11/59/

We are doing a community study with MINICOG ,hope it keeps it's promise of cross cultural sensitivity in detecting dementia

The MMSE won't be useful for differential dementia diagnosis (e.g., it won't discriminate between Alzheimer's disease and Semantic dementia very well), and it is only useful for detecting very impaired people, with at least moderate stage dementia. Therefore, it is likely that individuals with early stages of dementia will go undetected, and the measure won't be sensitive to subtle declines in cognition. Of course, what you use to screen for dementia depends on your research question. Keep in mind though, that the MMSE, the MoCA, or any other screening tool, are not designed to diagnose dementia. For dementia diagnosis, a more comprehensive neuropsychological assessment is required. For this reason I would suggest using comprehensive neuropsychological assessment.

For community screening, Jody is correct, the MMSE is not a good choice. The Mini-Cog and GP-Cog are popular, but require clock-drawing which requires more time. Best to review this website:

http://www.nia.nih.gov/research/cognitive-instrument

The issue in screening is to set a low threshold for detecting any problem as quickly and efficiently as possible, then advance to a secondary assessment before proceeding to a full neuropsych battery.

I continue to recommend: www.memtrax.com - it is not language or culture dependent, so can be used around the world.

As described on the NIH site under "continuous performance test", it is a lot of fun to give this screening test an audience between 5 and 150 people.

Note that continuous performance tests are what are used by the leading memory researchers to detect the subtle memory problems typical of Alzheimer's disease.

I think that Addenbrooke's cognitive examination is very useful! It includes MMSE although it's even more accurate and specific for elders' brief cognitive examination!

We have positive experience with the MoCa:

Stroke. 2011 Apr 7. [Epub ahead of print]

Is the Montreal Cognitive Assessment Superior to the Mini-Mental State Examination to Detect Poststroke Cognitive Impairment?: A Study With Neuropsychological Evaluation.

Godefroy O, Fickl A, Roussel M, Auribault C, Bugnicourt JM, Lamy C, Canaple S, Petitnicolas G.

We olso have (limited but positive) experience with the SLUMS and with te Scopa-Cog (in a Parkinson-population).

Yours,

Stefaan

I further support the Montreal Cognitive Assessment (MoCA). It has been validated in many clinical settings and is available in many languages.

Why you don't try to create a protocol of screenings that can give you the data you seek for! Rather following one scale, that probably will narrow your collection of data! I can supply you more details from my own experience since my phd is on dementia! Thank you in advance for sharing your concerns with us

I think the mini-Cog would work well in the art museum setting. It is short and easy to do, and has excellent face validity for subjects.