Streit, Sven; Limacher, Andreas; Zeller, Andreas; Bürge, Markus (2015). Detecting dementia in patients with normal neuropsychological screening by Short Smell Test and Palmo-Mental Reflex Test: an observational study. BMC Geriatrics, 15(1), p. 90. BioMed Central 10.1186/s12877-015-0094-0
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BACKGROUND
General practitioners (GPs) are in best position to suspect dementia. Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT) are widely used. Additional neurological tests may increase the accuracy of diagnosis. We aimed to evaluate diagnostic ability to detect dementia with a Short Smell Test (SST) and Palmo-Mental Reflex (PMR) in patients whose MMSE and CDT are normal, but who show signs of cognitive dysfunction.
METHODS
This was a 3.5-year cross-sectional observational study in the Memory Clinic of the University Department of Geriatrics in Bern, Switzerland. Participating patients with normal MMSE (>26 points) and CDT (>5 points) were referred by GPs because they suspected dementia. All were examined according to a standardized protocol. Diagnosis of dementia was based on DSM-IV TR criteria. We used SST and PMR to determine if they accurately detected dementia.
RESULTS
In our cohort, 154 patients suspected of dementia had normal MMSE and CDT test results. Of these, 17 (11 %) were demented. If SST or PMR were abnormal, sensitivity was 71 % (95 % CI 44-90 %), and specificity 64 % (95 % CI 55-72 %) for detecting dementia. If both tests were abnormal, sensitivity was 24 % (95 % CI 7-50 %), but specificity increased to 93 % (95 % CI 88-97 %).
CONCLUSION
Patients suspected of dementia, but with normal MMSE and CDT results, may benefit if SST and PMR are added as diagnostic tools. If both SST and PMR are abnormal, this is a red flag to investigate these patients further, even though their negative neuropsychological screening results.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine 04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM) 04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic 04 Faculty of Medicine > Pre-clinic Human Medicine > Department of Clinical Research (DCR) |
UniBE Contributor: |
Streit, Sven, Limacher, Andreas, Bürge, Markus |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
1471-2318 |
Publisher: |
BioMed Central |
Language: |
English |
Submitter: |
Doris Kopp Heim |
Date Deposited: |
27 Jul 2015 15:52 |
Last Modified: |
20 Feb 2024 14:17 |
Publisher DOI: |
10.1186/s12877-015-0094-0 |
PubMed ID: |
26205974 |
BORIS DOI: |
10.7892/boris.70541 |
URI: |
https://boris.unibe.ch/id/eprint/70541 |
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