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Brief cognitive screening instruments: an update
Ismail Z, Rajji TK, Shulman KI.. International journal of geriatric psychiatry, 2010-02-01
Topic: Risk, prevention and care in population studies
Objective To review the recent literature on cognitive screening with a focus on brief screening methods in primary care as well as geriatric services. Design The Medline search engine was utilized using the keyword search terms 'cognitive screening', 'cognitive assessment', and 'dementia screening' limiting articles to those published in English since 1998. Results 679 abstracts were retrieved. Articles focusing on attitudes toward cognitive screening, current screening practices, promising new instruments and more recent updates contributing significant information on established instruments were retrieved and incorporated into this review. Reference lists were reviewed for relevant contributing articles. Instruments recommended from previous reviews of cognitive screening and those identified in surveys as most frequently used in primary care and geriatric settings were emphasized in this review. Conclusions Dementia remains under-diagnosed in the elderly population. Despite significant limitations, the Mini Mental State Exam remains the most frequently used cognitive screening instrument. Its best value in the community and primary care appears to be for the purpose of ruling out a diagnosis of dementia. Instruments such as the Mini-Cog, Memory Impairment Screen (MIS), and the General Practitioner Assessment of Cognition (GPCOG) have consistently been recognized for utility in primary care. The clock drawing test (CDT) and newer instruments such as the Montreal Cognitive Assessment (MoCA) and the Rowland Universal Dementia Assessment Scale (RUDAS) are gaining credibility due to improvements in sensitivity, addressing frontal/executive functioning, and decreasing susceptibility to cultural and educational biases.
Key findings
- Articles focusing on attitudes toward cognitive screening, current screening practices, promising new instruments and more recent updates contributing significant information on established instruments were retrieved and incorporated into this review.
- Despite significant limitations, the Mini Mental State Exam remains the most frequently used cognitive screening instrument.
Why it matters
This 2010 review of the screening literature since 1998 concludes that dementia "remains under-diagnosed" in older people, and that the widely used Mini Mental State Exam is most useful in primary care for "ruling out a diagnosis of dementia". It names the Mini-Cog, Memory Impairment Screen and GPCOG as consistently useful in primary care. It also says the clock drawing test, MoCA and RUDAS were "gaining credibility" because they are more sensitive, test executive function and are less affected by culture and education. It is about screening tools, not treatment, cure or prevention, and it reports no accuracy figures.
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Study details
- Evidence strengthLow
How this study scored 49/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (International journal of geriatric psychiatry) |
| Journal's citation record | 2 / 4 | International Journal of Geriatric Psychiatry: journal h-index 190 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2010 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 438 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 24.3 citations a year over 18 year(s) since 2010 |
| Impact for its field and year | 4 / 6 | Cited 12.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 10 other studies in this library |
| Still being cited | 2 / 4 | Cited 45 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Kenneth I. Shulman: h-index 63 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Toronto: institution h-index 1,923 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 19582756) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 49 / 100 | — |
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Read the original
- DOI: 10.1002/gps.2306
- PubMed: 19582756
- Original source →
- Free full text: International Journal of Geriatric Psychiatry →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Ismail, Z., Rajji, T. K., & Shulman, K. I. (2010). Brief cognitive screening instruments: an update. International journal of geriatric psychiatry. https://doi.org/10.1002/gps.2306
Vancouver
Ismail Z, Rajji TK, Shulman KI. Brief cognitive screening instruments: an update. International journal of geriatric psychiatry. 2010. doi:10.1002/gps.2306. PMID: 19582756.
BibTeX
@article{ismail2010-19582756,
author = {Ismail, Z. and Rajji, T. K. and Shulman, K. I.},
title = {{Brief cognitive screening instruments: an update}},
journal = {International journal of geriatric psychiatry},
year = {2010},
doi = {10.1002/gps.2306},
pmid = {19582756},
url = {https://doi.org/10.1002/gps.2306}
}
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