Early diagnosis of dementia: Part 2

Even though the MMSE is the current gold standard test for dementia testing, it is not ideal for all dementia and the test is not universally applicable to all patients with dementia.

The current 16-point test is heavily focused on ability to recall skills, verbal memory performance, and orientation issues such as the ability to identify a person, place, time and/or situation. The test is fast and does not involve any writing. When compared with the MMSE, it has been shown to have higher sensitivity in detecting cognitive impairment. However, experts also indicate that the test does give a high rate of false positives.

While no one disagrees for the need of better cognitive test, it is not known if this test will fit the bill. The MMSE is cumbersome, requires writing and it is also difficult to score.

Says Dr Gary J. Kennedy, director of geriatric psychiatry at Montefiore Medical Center in New York City, “I would say that reading this description of the 'Sweet 16,' it sounds like it's much more easily administrated. But still, I'm not convinced this is the answer to the problem. Because diagnosing cognitive impairment is not the same as diagnosing diabetes. It is much more complicated than that. People's cognition varies with life experience. It is not like simply testing for blood sugar levels. There isn't a single diagnostic marker."

Final point:  With early diagnosis of dementia, will that mean doctors will start to prescribe more medications? The point to understand is that the majority of people who have early dementia do not require any treatment and the rates of progression of dementia are very variable.