The GPcog for detecting a population with a high risk of dementia

GPcog is a screening tool for dementia in the aged. It consists of nine cognitive items and six items assessing the daily living instrumental activities by an informal carer. This study was aimed to assess the reliability of the French version of the GPcog in a psychogeriatric population. Two hundred and eighty inpatients from a short-term psychogeriatric ward, with or without dementia, were examined. Scores on GPcog, MMSE and on a five-word memory test for screening dementia were compared to the final diagnosis of dementia. The mean age of subjects was 77.8+/-7.0 years for males (n=116), and of 80.3+/-6.6 years for females (n=164). One hundred eighty two patients had dementia, mainly of Alzheimer's type, and 98 had psychiatric disorders but were non demented. GPcog sensitivity for the diagnosis of dementia was 96%, specificity 62%, positive predictive value 83% and negative predictive value 90%. GPcog is an accurate and well-accepted instrument for dementia screening in primary care. French results were similar to those obtained with the English version. It can be easily used by non-specialized carers.     

A comparison of scoring protocols on the Clock Drawing Test in relation to ease of use,diagnostic group,and correlations with Mini-Mental State Examination

OBJECTIVES: To compare five scoring protocols for the Clock Drawing Test (CDT). DESIGN: A retrospective study in which four formal and one informal scoring methods were used to rate clock drawings. Correlations between CDT scores and the abbreviated version of the Mini-Mental State Examination (MMSE-brief) total and memory scores were compared for the total sample and for three diagnostic groups. Protocols were also compared for content and ease of use. SETTING: A comprehensive, community mental health service for older adults. PARTICIPANTS: Sixty-three patients with dementia of the Alzheimer's type, multi-infarct dementia, or a mixed diagnosis. MEASUREMENTS: The CDT, scored under five different scoring protocols, and the MMSE-brief. RESULTS: For the total sample, significant correlations were obtained between all five scoring methods and MMSE scores. Two scoring methods stood out. By diagnostic group, all correlations except one between scoring methods were significant, whereas relationships between the MMSE and the CDT varied. CONCLUSIONS: Deterioration in clock drawing scored under five different scoring protocols correlates with severity of global cognitive impairment, as assessed by the MMSE-brief. Although two scoring methods were easier to use, the type of dementia may dictate which scoring protocol is most suitable. Because clinicians now also use the CDT to screen for executive functioning, future scoring methods may need to be selected in terms of what the CDT is screening.     

血管性认知功能障碍神经心理及事件相关电位的研究

目的探讨非痴呆型血管性认知功能障碍(vascular cognitive impairment no dementia,VCIND)患者神经心理学及事件相关电位P300的特点。方法对64例VCIND患者(VCIND组)及42例其他疾病患者(对照组)行事件相关电位P300检查,使用简易智能状态检查量表(MMSE)、画钟测验(CDT)评定入选者认知功能状态,并进行相关分析。结果与对照组比较,VCIND组患者的CDT、MMSE评分明显降低,差异有统计学意义(P0.01),MMSE评分亚项中的时间定向、地点定向、注意/计算力、短程记忆、言语复述、阅读能力、书写能力、图形描画均明显降低,差异有统计学意义(P0.05,P0.01);P300潜伏期明显延长(P0.01),MMSE评分与P300潜伏期呈负相关(r=-0.615,P0.05)。结论事件相关电位P300检测有助于VCIND的早期诊断。     

Change of Visual Perceptions in Taiwan’s Aged People with Mild Dementia Caused by the Textures of Building Materials

People with dementia can be overstimulated by too many patterns and designs in one space. The purpose of this research was to find the visual perceptions’ changing of the demented elderly related to the textures of building materials, and to inspect what kind of texture might have the possibility of causing demented elders to have visual hallucinations. A total of ten male subjects with mild dementia participated in this experiment. The simulation of visual perception was made using a highly sensitive LCD projector that showed pictures of building materials on a screen. Clock Drawing Test (CDT) was applied to assess the visual perceptions’ changing of the subjects before and after simulation. Based on the results of this experiment, the visual perceptions of the subjects were more changed by character textures and textures of regular shapes than by the other typologies of textures. Some of the subjects have the possibility of visual hallucinations while looking at the textures during the experiment, because they described visual images that did not exist. Data about these building materials can be made available for the reference of building managers and designers, in order to prevent the demented elderly from having behavior problems.     

Screening for mild cognitive impairment in elderly ambulatory patients with cognitive complaints

BACKGROUND AND AIMS: Identification of patients with Mild Cognitive Impairment (MCI) is strongly recommended because of their increased risk of dementia. Two brief global cognitive instruments, the Mini Mental State Examination (MMSE) and the Clock Drawing Test (CDT), were examined as useful screening methods for MCI. METHODS: The sensitivity and specificity of MMSE and CDT, scored using the Sunderland and Wolf-Klein methods, were evaluated in 113 elderly individuals with three different MCI subtypes: amnestic, multiple domain impairments, and single non-memory domain. Diagnoses were made on the basis of extensive clinical and neuropsychometric assessment. RESULTS: Used alone, MMSE and CDT at standard cut-offs were highly specific (about 0.80) but rather insensitive (less than 0.50) to all MCI subtypes. By contrast, when used in combination, an abnormal result on either MMSE or CDT scored by the Sunderland method had a specificity of 0.69 [0.57-0.81] and a sensitivity of 0.75 [0.64-0.87] for multiple domain impairments MCI. Results were similar for MMSE in combination with CDT scored by the Wolf-Klein method (specificity 0.71 [0.59-0.83]; sensitivity 0.68 [0.56-0.80]). CONCLUSIONS: MMSE and CDT alone are not valid screening methods for MCI detection. In combination, they reach fair sensitivity and specificity for the multiple domain impairment MCI subtype. However, some theoretical concerns relating to this subtype, together with the uncertainty that still lingers about its prognostic value, caution against routine use of MMSE and CDT as MCI screening instruments.     

晚发抑郁患者基线记忆功能与6个月神经认知结局的关系

目的探讨首次发作晚发抑郁(LOD)患者基线记忆功能与6个月神经认知结局的关系。方法选择LOD患者49例,随访6个月,根据认知评分标准,将33例患者分为认知正常组19例和认知障碍组14例。被试基线和随访6个月时,均接受简易智能状态检查量表、认知筛检测验及神经心理成套测验评估。采用3.0 T MRI仪行头颅扫描,液体衰减反转恢复序列采集图像,测量脑白质高密度信号体积;采用聚合酶链反应技术进行载脂蛋白E基因分型。结果与认知正常组比较,认知障碍组患者基线简易智能状态检查量表及认知筛检测验总分、言语记忆和视觉记忆各测验评分、言语流畅性(1 min)、视空间功能评分及定向力均明显降低,差异有统计学意义(P<0.05)。logistic回归分析显示,LOD患者基线物品即刻回忆评分与神经认知结局呈负相关。结论 LOD患者基线即刻回忆能力可预测其认知转归,基线时即刻记忆越差,神经认知恶化的风险越大。     

The Human Figure Drawing test as a screen for dementia in the elderly: a community-based study

The Human Figure Drawing (HFD) test is a non-verbal test, mainly based on visuo-spatial and constructional abilities. In screening for dementia, the HFD test can be hypothesised as a good complement to Mini-Mental State Examination (MMSE), which is inherently limited by its verbal nature. In order to test this hypothesis, both MMSE and HFD tests were administered to 461 individuals recruited from a community-based study of the elderly (the Kungsholmen project). According to the Third Revised Diagnostic and Statistical Manual of Mental Disorders, 95 subjects were affected by dementia and 366 were non-demented. We calculated the sensitivity and specificity of MMSE, the HFD test, and the combination of the two. Results showed that MMSE mean scores were significantly reduced between the non-demented group and groups with different severities of dementia. The mean scores of a short version of 29 HFD body details (HFD29) and seven HFD essential body details (HFDess) showed similar, but weaker trends than MMSE. However, the sensitivity increased by 4.2% when HFD29 and HFDess were added to MMSE, compared to the MMSE test alone. This increase partially derived from the portion of questionable and mild demented subjects. Unfortunately, a high drop-out rate was present in the HFD test. We conclude that the use of HFD test has limitations in this well-educated population, due to a high number of refusals and only a small improvement in detecting mild demented cases. The application of this test in lower educated populations requires further investigation.     

Mini-mental state examination and mental deterioration battery: analysis of the relationship and clinical implications

OBJECTIVES: To explore the associative structure between a screening test for dementia, the Mini-Mental State Examination (MMSE), and a neuropsychological battery for the detection of dementia, the Mental Deterioration Battery (MDB). DESIGN: A retrospective analysis. SETTING: Psychology unit of a general hospital in Rome, Italy. PARTICIPANTS: Three hundred consecutive outpatients and inpatients referred to our hospital on the basis of suspected cognitive impairment and evaluated between January 1999 and March 2000. MEASUREMENTS: MMSE and MDB. RESULTS: Of the 300 subjects evaluated by the MMSE score, 142 (47.3%) were considered to be cognitively healthy, and 116 (38.7%) were mildly and 42 (14.0%) moderately impaired. Factor analysis of MDB extracted three factors able to account for 75% of the total variance: a visuospatial factor, verbal memory ability, and a language skill. Using MMSE as an independent variable, a linear regression model could account for the visuospatial and language factors and a cubic regression model for the verbal memory factor. Within the normal MMSE boundaries (24-30), a dramatic decrease of verbal memory could be documented, whereas the slope is less steep in the mild impairment group (16-23). CONCLUSIONS: Our findings indicate the presence of a warning range within the normal MMSE interval. Thus, the traditional MMSE cutoff values may not be appropriate in detecting early phases of dementia. When patients score about 27 on MMSE, it should be of interest to check whether they fail only on long-term memory tests, because this could be a first signal of a preclinical condition heralding clear dementia (e.g., mild cognitive impairment).     

Serum C-reactive protein and cognitive function in healthy elderly Italian community dwellers

BACKGROUND: Chronic low-grade inflammation, as measured with the peripheral serum marker C-reactive protein (sCRP), may be a risk factor for dementia in elderly persons. METHODS: The relationship between sCRP and score on the Mini-Mental State Examination (MMSE), a commonly used screening cognitive measure, was investigated in 540 well functioning, healthy, and cognitively normal elders (age 73 +/- 6 years). Sociodemographic status, lifestyle, health status, traditional and nontraditional cardiovascular risk factors including plasma total homocysteine (tHcy), and other peripheral blood markers of vascular inflammation (leukocyte count, serum albumin, and plasma fibrinogen) were also assessed. RESULTS: Risk for having sCRP in the highest decile (>0.7 mg/dl) was significantly higher in individuals with MMSE score 24-25 (odds ratio = 3.07, 95% confidence interval, 1.2-7.9) and 26-28 (odds ratio = 2.10, 95% confidence interval, 1.1-3.9) compared with those scoring above 28 (reference group). Results were unaffected by adjustment for all potential confounders. No association was found between MMSE and peripheral markers of vascular inflammation other than sCRP, but lower MMSE scores were also independently associated with hyperhomocysteinemia (plasma tHcy > 15 mmol/L). CONCLUSION: In healthy, cognitively normal elderly community dwellers, increased sCRP levels are associated with concurrent cognitive impairment as measured by MMSE. The association is independent of sociodemographic status, lifestyle, health status, and traditional and nontraditional cardiovascular risk factors including hyperhomocysteinemia. Results support the hypothesis that chronic low-grade inflammation may be involved in age-related cognitive impairment.     

Racial and ethnic disparities in the treatment of dementia among Medicare beneficiaries

OBJECTIVES: Numerous studies have documented disparities in health care utilization between non-Hispanic White and minority elders. We investigated differences in anti-dementia medication use between non-Hispanic White and minority community-dwelling Medicare beneficiaries with dementia. METHODS: Using multivariate analysis with generalized estimating equations, we estimated prevalence ratios (PRs) for anti-dementia medication use by race/ethnicity for 1,120 beneficiaries with dementia from years 2001 through 2003 of the Medicare Current Beneficiary Survey. RESULTS: After adjusting for demographics, socioeconomics, health care access and utilization, comorbidities, and service year, we found that anti-dementia medication use was approximately 30% higher among non-Hispanic Whites compared to other racial/ethnic groups (PR=0.73, 95% confidence interval [CI]=0.59, 0.91). As for individual racial/ethnic groups, prevalence disparities remained significant for non-Hispanic Blacks (PR=0.75, 95% CI=0.57, 0.99) and non-Hispanic others (PR=0.50, 95% CI=0.26, 0.96) but were attenuated for Hispanics (PR=0.84, 95% CI=0.59, 1.20). DISCUSSION: Results provide evidence that racial/ethnic disparities in utilization of drugs used to treat dementia exist and are not accounted for by differences in demographic, economic, health status, or health utilization factors. Findings provide a foundation for further research that should use larger numbers of minority patients and consider dementia type and severity, access to specialty dementia care, and cultural factors.     

Intersecting pentagon copying and clock drawing test in mild and moderate Alzheimer's disease

BackgroundIn Alzheimer's disease (AD) drawing and constructional abilities are impaired and worsen as the disease progresses.PurposeTo examine the feasibility of and develop a method for screening, diagnosis, and staging of dementia that can be quickly administered and interpreted in the clinical setting.MethodsThe study aims to describe a scoring mechanism of the intersecting pentagon copying (IPC) task based on the degree of drawing failure and pitted against the Mini-Mental State Examination (MMSE) and the clock drawing test (CDT), which is probably its most likely competitor for a small measure. This is a prospective cohort study of 91 probable dementia patients of the Alzheimer type referred to the geriatrician over a period of 3 years where the suitability of prescribing acetyl cholinesterase inhibitor is investigated. The patients were categorized as follows: 18 (20%) normal, 31 (34%) mild dementia, and 42 (46%) moderate dementia. The copying of the pentagon was part of the MMSE and these drawings were further scrutinized and a 10-point scoring method developed. Each IPC and CDT was blindly and independently rated by two geriatricians.ResultsThe MMSE and Clinical Dementia Rating were found to have very similar staging results. The IPC had some commonality with these measures for patients defined as normal in that most score 10/10 for the IPC. However, both mild and moderate dementia patients according to other measures have an overlapping range of scores on the IPC scoring method developed. The highest association for the IPC with the CDT was 0.68. IPC had a stronger correlation with the total MMSE than with the two shorter versions.ConclusionThe IPC seems to operate more as a screening tool rather than a dementia staging instrument and assists in identifying normal patients.     

Validation of a telephone version of the mini-mental state examination.

OBJECTIVE: To assess the construct validity of a telephone-administered version of the Mini-Mental State Examination (MMSE). DESIGN: Validity testing by comparing a telephone version of the MMSE administered first to a face-to-face evaluation done several days later. SETTING: Outpatient geriatric assessment center. SUBJECTS: 100 of 175 consecutive referrals. MAIN OUTCOME MEASURES: MMSE and a brief neuropsychological screening test (BNPS) face-to-face and a telephone version of the MMSE as part of the Adult Lifestyles and Function Interview (ALFI-MMSE). RESULTS: Test scores of the two MMSE versions correlated strongly for all subjects (Pearson's r = 0.85, P = 0.001) and remained significant for the cognitively intact (P = 0.02) and questionably (P = 0.002), mildly (P = 0.0001), and moderately (P = 0.003) demented. Comparison of the two versions' equivalent 22 items revealed no significant difference for scores of all subjects (P = 0.07) but with a trend toward higher scores in the original version. Diminished hearing, reported either by the subject (P = 0.003) or by the collateral source (P = 0.02) was associated with lower scores on the telephone version. Five individual test items were biased by the route of test administration. Sensitivity and specificity relative to the BNPS were 67% and 100% for the ALFI-MMSE and 68% and 100% for the MMSE, respectively. CONCLUSION: The scores on the ALFI-MMSE correlated strongly with the scores of the original version given face-to-face in subjects undergoing geriatric assessment. The results indicate that the ALFI-MMSE could be a useful and economical tool to screen for cognitive impairment.     

Subjective memory deterioration and future dementia in people aged 65 and older

OBJECTIVES: To study whether subjective memory deterioration is associated with future dementia in older people. DESIGN: A population-based prospective cohort study begun in 1994 with biennial follow-up interviews. SETTING: Community-based members of Group Health Cooperative, a large health maintenance organization in the Seattle area. PARTICIPANTS: A sample of 1,883 subjects, dementia free, aged 65 and older, who scored 91 or higher on the 100-point Cognitive Ability Screening Instrument (CASI) at study entry. MEASUREMENTS: Subjective memory was assessed by asking whether memory had changed on 5-point Likert scales (e.g., 1=definitely improved, 3=no change, 5=definitely deteriorated) with regard to five items: remembering names, faces, friends, and appointments and judging the time. The items were summed for a possible total score ranging from 5 to 25. Subjective memory deterioration was defined as present if the total score was 20 or above. Cognitive performance was measured using the CASI. Incident dementia cases were identified using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria. RESULTS: Of 1,883 subjects, 126 developed dementia during 5 years of follow-up. Subjective memory deterioration was associated with cognitive decline and incident dementia. Age modified the association between subjective memory deterioration and future dementia. For persons reporting subjective memory deterioration at the ages of 70, 75, and 80, the hazard ratios of developing dementia were 6.0 (95% confidence interval (CI)=2.1-18), 3.2 (95% CI=1.6-6.2) and 1.6 (95% CI=0.86-3.1), respectively. CONCLUSION: Subjective memory deterioration was found to precede the development of dementia in older people with normal cognitive screening results. These findings suggest that a high level of subjective memory deterioration in persons with normal objective cognitive function may identify a subset of individuals at greater risk for developing dementia.     

Sensitivity and specificity of the mini-mental state examination for identifying dementia in the oldest-old: the 90+ study

OBJECTIVES: To evaluate the sensitivity and specificity of the Mini-Mental State Examination (MMSE) in identifying dementia in the oldest-old when stratified by age and education. DESIGN: Cross-sectional. SETTING: Research clinic and in-home visits. PARTICIPANTS: Population-based sample of adults aged 90 and older (n=435) who are enrolled in the 90+ Study, a longitudinal, population-based study. MEASUREMENTS: Neurological examination to determine dementia diagnosis, MMSE, and demographic data. RESULTS: Receiver operating characteristic (ROC) analyses indicated that the MMSE had high diagnostic accuracy for identifying dementia in subjects aged 90 and older across different age and education groups (area under the ROC curve values ranged from 0.82 to 0.98). A range of possible cutoff values and corresponding sensitivity and specificity are provided for the following age groups: 90-93, 94-96, and >or=97. Age groups were subdivided by educational attainment (相似文献   

The influence of dementia on the prevalence of urinary and faecal incontinence in 85-year-old men and women

The influence of dementia on the prevalence of urinary and faecal incontinence was investigated in a random sample (n = 485) of the total population of 85-year-olds from the city of Gothenburg, Sweden. The subjects were assessed by a psychiatric interview, physical examinations, computed tomography of the head and analysis of cerebrospinal fluid. Urinary and faecal incontinence were assessed by a urotherapist. Dementia, urinary and faecal incontinence were defined according to strict, internationally accepted criteria. The prevalences of urinary and faecal incontinence, and dementia were 38%, 17% and 29% respectively. Demented men (50%) and women (60%) were more often urinary incontinent than non-demented men (18%) and women (36%). Faecal incontinence was more prevalent in demented (34.8%) than non-demented subjects (6.7%). Both urinary and faecal incontinence were more prevalent in women (43% and 20% respectively) than men (27% and 11%, respectively). The prevalences of urinary and faecal incontinence, and dementia were higher in residents of a nursing home or hospital (74%, 51% and 92%, respectively) than in subjects living at home (32%, 9% and 18%, respectively). Of the demented subjects resident in an institution, 78% were incontinent compared with 37% living at home. Incontinence aids were used by 18% of the men and 33% of the women, and their use increased with increasing severity of dementia. Dementia influenced the prevalence of urinary incontinence, and both conditions independently of each other strongly influenced the need for institutional care.     

Prevalence of cognitive impairment: results from the MRC trial of assessment and management of older people in the community

BACKGROUND: cognitive impairment is an important part of the diagnostic criteria for dementia. The Mini-Mental State Examination (MMSE) is recommended to test for cognitive impairment and to monitor medication response. OBJECTIVES: we examined the prevalence of cognitive impairment in the UK and assessed associations with cognitive impairment. DESIGN: cross-sectional survey as part of a cluster randomised trial. SUBJECTS: representative sample of people aged 75 years and over. METHODS: all subjects had a detailed baseline health assessment including the MMSE. RESULTS: a total of 15,051 subjects completed the assessment (71.9%). Almost two-thirds of subjects were female (61.5%) and almost half were aged between 75 and 79 years (47.0%). The prevalence of cognitive impairment was 18.3% (95% confidence intervals (CI) = 16.0-20.9) at a cut-off of 23/24, and 3.3% (95% CI = 2.8-4.0) at 17/18. Those with impairment (MMSE 23/24) were significantly more likely to have hearing (odds ratio (OR) 1.7), vision (OR 1.7) and urinary incontinence problems (OR 1.3), have two or more falls in the previous 6 months (OR 1.4), and report poorer health (OR 1.9). Almost half the participants lived alone (n = 7,073; 47.0%) and of these almost one-fifth were impaired (MMSE 23/24; 19.4%). CONCLUSIONS: there was a high prevalence of cognitive impairment. This representative sample demonstrates the potential burden of disease and service demands. It supports the need for a broader assessment of functioning as recommended by the National Service Framework for Older People, particularly in people with cognitive impairment.     

Disturbed visuo-spatial orientation in the early stage of Alzheimer's dementia

A pilot study was conducted to assess previously unrecognized visuo-spatial disturbances in 45 Alzheimer's demented (AD) patients and 59 control persons all over the age of 65 years, living in the community. The results of the Clock Drawing Test (CDT) revealed high frequency (78%) of deficient performative visuo-spatial skills of mild and moderate demented AD patients. The severity of dementia was found to be a good predictor of the deficit in visuoconstructive performance. The most frequent drawing mistakes were the misplacement of numbers and clock hands, which may relate to dysfunctions of the right inferior parietal cortex. The right-left orientation (RLO) for the own body was not deteriorated in AD patients. However, significantly lower scores for RLO in the mental rotation subtest were found in mild and moderate AD groups. There were large inter-individual differences in the test scores of both demented groups. Thirty-one percent and 49% of the AD patients scored 0 points or within the normal range (more than 4 points), respectively, indicating a pseudofocal onset pattern of the dementia. The results of the CDT and Right-Left Orientation Test (RLOT) with Mental rotation showed significant positive correlation with other cognitive functions of Mini Mental State Exam, such as attention-calculation, recall and writing, and indicate that the visuo-spatial orientation (VSO) is a composite of different cognitive skills. The CDT and RLOT appears to be a useful tool for screening the elderly for disturbed VSO.     

Sleep-related respiratory disturbance and dementia in elderly females

Sleep-related respiratory disturbance was studied with a microprocessor-based portable monitoring system in female residents of a retirement village aged greater than or equal to 75 years. Comparisons were made between 29 demented subjects Mini-Mental State Examination Score (MMSE) less than 21 and 48 controls (MMSE greater than 25). Respiratory disturbance index (RDI, the number of episodes of apnea and hypopnea/hour of total sleep time) was higher in the demented subjects: mean RDI (+/- SD) 18.5 +/- 18.6 vs 7.3 +/- 10.8, p = .004. The number of minutes per hour of sleep spent with disturbed breathing was greater in demented subjects than in controls (p = .01). These differences between demented subjects and controls persisted after adjustment for age and relevant medical history. Other possible confounders, namely body mass index and use of sedatives, were not significant. We conclude that respiratory disturbance during sleep is more prevalent in elderly demented females than in controls.     

Misclassification of dementia by the mini-mental state examination--are education and social class the only factors?

The 1988 Melton Mowbray Study of the Elderly comprised an initial screen with the Mini-Mental State Examination (MMSE) followed by a detailed clinical assessment using the Cambridge Mental Disorders of the Elderly Examination (CAMDEX) for all those scoring 21 and under on the MMSE, a one in two sample of those scoring 22 or 23 and a one in ten of the remainder. A total of 1579 subjects completed the initial screen with 438 subjects undergoing the CAMDEX assessment. Analysis of those subjects who were found to be free of dementia at the clinical assessment (n = 155) demonstrated that the very elderly, those from the manual social classes and subjects with visual impairments had an increased chance of being misclassified as demented by the MMSE. Low educational level and various measures of physical disability also showed a tendency to result in misclassification as falsely positive by the MMSE when viewed alone but these effects appeared to be due solely to their association with extreme age and/or manual social class.     

Examining the reliability and validity of the Hebrew version of the Mini Mental State Examination

The Mini Mental State Examination is used worldwide for the screening and diagnosis of dementia. The aim of the present study was to examine the reliability and validity of the Hebrew version of the Mini Mental State Examination. The Hebrew version of the Mini Mental State Examination was administered to 36 demented and 19 non-demented elderly persons. Test-retest reliability scores were calculated as exact agreement rates, and ranged from good to excellent for all the items. Strong convergent validity, as measured by the correlation between the MMSE and the CAM-COG (r = 0.94), was found. Good predictive value was observed as over three-quarters of the participants were correctly classified as demented or non-demented. The Hebrew version of the MMSE was found to be a useful and valid instrument for the determination of dementia in the elderly population.