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Sensitivity and specificity for dementia of population-based criteria for cognitive impairment: the MoVIES project
Ganguli M, Belle S, Ratcliff G, Seaberg E, Huff FJ, von der Porten K, Kuller LH.. Journal of gerontology, 1993-07-01
Topic: Risk, prevention and care in population studies
Background Few norms exist for the elderly on the cognitive tests commonly used to screen for dementia; conventional cutpoints used in clinical settings may be of limited value in population screening. A particular problem is posed by elderly populations with low educational levels, as performance on most cognitive tests is affected by education. Thus, a healthy but poorly educated population may obtain test scores in the range considered impaired in the clinical setting. Methods A random sample of 1,367 subjects aged 65+ years was screened for dementia in a rural community in Southwestern Pennsylvania. Two sets of cognitive measures were used: a global cognitive scale (the MMSE) and a brief battery of tests tapping a variety of cognitive domains. Rather than using a priori cutoff scores, we examined the specificity and sensitivity for dementia of two operationally defined levels of cognitive impairment, at the 5th and 10th percentiles of the study sample on each set of measures. Results Results suggest that the screening of multiple cognitive domains at the 10th percentile had significantly greater sensitivity but not lower specificity for definite dementia than did the use of the single global scale. Conclusion Our data support the use of population-based cutpoints over standard cutoff scores, in that the global scale at the conventional cutoff was less sensitive than the battery at the same percentile, and because adequate norms do not exist for tests such as those in the battery.
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APA 7th
Ganguli, M., Belle, S., Ratcliff, G., Seaberg, E., Huff, F. J., von der Porten, K., et al. (1993). Sensitivity and specificity for dementia of population-based criteria for cognitive impairment: the MoVIES project. Journal of gerontology. https://doi.org/10.1093/geronj/48.4.m152
Vancouver
Ganguli M, Belle S, Ratcliff G, Seaberg E, Huff FJ, von der Porten K, et al. Sensitivity and specificity for dementia of population-based criteria for cognitive impairment: the MoVIES project. Journal of gerontology. 1993. doi:10.1093/geronj/48.4.m152. PMID: 8315228.
BibTeX
@article{ganguli1993-8315228,
author = {Ganguli, M. and Belle, S. and Ratcliff, G. and Seaberg, E. and Huff, F. J. and von der Porten, K. and Kuller, L. H.},
title = {{Sensitivity and specificity for dementia of population-based criteria for cognitive impairment: the MoVIES project}},
journal = {Journal of gerontology},
year = {1993},
doi = {10.1093/geronj/48.4.m152},
pmid = {8315228},
url = {https://doi.org/10.1093/geronj/48.4.m152}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Results Results suggest that the screening of multiple cognitive domains at the 10th percentile had significantly greater sensitivity but not lower specificity for definite dementia than did the use of the single global scale.
Why it matters
In 1,367 adults aged 65+ from a rural Pennsylvania community, the researchers set "impaired" as scoring in the lowest 5% or 10% of that same community, not using standard clinical cutoffs, because people with little schooling can score in the "impaired" range while healthy. At the 10th-percentile cut, a short battery covering several thinking skills caught more cases of definite dementia than the MMSE alone, without wrongly flagging more healthy people. This is about choosing fair screening cutoffs where education is low, not about treating, curing or preventing dementia.
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Study details
- Participants1,367
- Evidence strengthLow
How this study scored 48/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of gerontology) |
| Journal's citation record | 2 / 4 | Journal of Gerontology: journal h-index 216 (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 | 1993 — older than 20 years, still counted |
| Sample size | 3 / 4 | 1,367 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 151 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.3 citations a year over 35 year(s) since 1993 |
| Impact for its field and year | 3 / 6 | Cited 4.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 20 other studies in this library |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Lewis H. Kuller: h-index 173 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Pittsburgh: institution h-index 1,470 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 8315228) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 48 / 100 | — |
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