ArticleJournal of the American Medical Directors Association2019
A 4-Item Case-Finding Tool to Detect Dementia in Older Persons.
Article in Journal of the American Medical Directors Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2020Guideline
- An Ultra-Brief Informant Questionnaire for Case Finding of Cognitive Impairment Across Diverse Literacy: Diagnostic Accuracy Study.JMIR aging · 2026Article
- A normative calculator for MoCA domain scores: proxy for Z-scores of conventional neuropsychological tests.Alzheimer's research & therapy · 2025Article
- PENSIEVE-AI a brief cognitive test to detect cognitive impairment across diverse literacy.Nature communications · 2025Article
- Neuropsychiatric symptoms in early stage of Alzheimer's and non-Alzheimer's dementia, and the risk of progression to severe dementia.Age and ageing · 2021Article
- Trajectories of subjective cognitive decline, and the risk of mild cognitive impairment and dementia.Alzheimer's research & therapy · 2020Article
- Active case finding of dementia in ambulatory care settings: a comparison of three strategies.European journal of neurology · 2020Article
- Subjective cognitive decline, anxiety symptoms, and the risk of mild cognitive impairment and dementia.Alzheimer's research & therapy · 2020Article
- Neuropsychiatric symptoms in cognitively normal older persons, and the association with Alzheimer's and non-Alzheimer's dementia.Alzheimer's research & therapy · 2020Article
- Comparative Study of Two Short-Form Versions of the Montreal Cognitive Assessment for Screening of Post-Stroke Cognitive Impairment in a Chinese Population.Clinical interventions in aging · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
Abstract
objectivesBrief cognitive tests are recommended in clinical services outside of specialized memory clinics as case-finding tools to reduce the diagnostic gap of dementia. Although the Montreal Cognitive Assessment (MoCA) is among the most widely used brief tests in specialized memory clinics, its length precludes routine use in nonspecialty clinics. This study investigated whether a small subset of MoCA would suffice to match the performance of the full MoCA in detecting dementia and, hence, be useful in nonspecialty clinics.
designCross-sectional test research.
settingAlzheimer's Disease Centers across the United States.
participantsParticipants age ≥65 years (n = 8773). MEASURES: Participants completed MoCA and were evaluated for dementia. The study sample was split into 2: the derivation sample (n = 4386) was used to develop a short variant of MoCA that best distinguish dementia (using the best-subset-approach with 10-fold cross-validation), while the validation sample (n = 4387) verified its actual performance using area under the receiver operating characteristic-curve (AUC).
resultsA 4-item cognitive test was identified, comprising Clock-drawing, Tap-at-letter-A, Orientation, and Delayed-recall. It demonstrated excellent performance in distinguishing dementia from nondementia (AUC 94.2%) and was comparable to that of MoCA (AUC 93.8%), even across education subgroups. It explained 85.9% of the variability in MoCA and had scores that could be mapped to MoCA with reasonable precision. At the optimal cut-off score of <10, it demonstrated 87.9% sensitivity and 87.6% specificity in detecting dementia. CONCLUSIONS AND IMPLICATIONS: Using rigorous methods, this study developed a brief cognitive test that is free of charge, takes <5 minutes to complete, covers the key cognitive domains, and has standardized instructions to allow its administration even by nonphysicians. This brief test is well suited as a case-finding tool in nonspecialty clinics (such as in primary care and geriatric clinics) and may improve care-integration with specialized memory clinics that utilize MoCA.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.