Dementia screening tools for the primary care physician

The prevalence of dementia increases with age and affects approximately 5-8% of individuals over age 65, 15-25% of individuals over age 75, and approximately 25-50% of individuals over age 85. However, dementia is frequently underdiagnosed in the community. The potential harm of not diagnosing dementia in patients includes missed opportunities for the application of available treatments, participation in research, advance care planning, and support of caregivers. This CME article reviews some of the literature and data on four commonly administered neuropsychological tests: the Mini-Mental State Examination, two word list generation tests, and the Clock Drawing Test. The purpose of this article is to provide information on integrating tests into primary care practice, and on interpreting the data obtained from these tests to achieve more targeted clinical decision making for patients with suspected dementia.