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Sensitivity and specificity of standardized screens of cognitive impairment and dementia among elderly black and white community residents
Fillenbaum G, Heyman A, Williams K, Prosnitz B, Burchett B.. Journal of clinical epidemiology, 1990-01-01
Topic: Risk, prevention and care in population studies
Six standardized published measures of cognitive function were evaluated as screens of dementia in a sample of 164 (83 black, 81 white) community residents aged 65 and over selected from the Duke University EPESE (Established Populations for Epidemiologic Studies of the Elderly), a biracial cohort of 4164 residents in a five county area of piedmont North Carolina. Of these 164 persons, 26 were subsequently diagnosed as demented. The weighted data from this sample represent the estimated performance of these measures among elderly blacks and whites in a five county area. The 6 measures evaluated in this study (specificity figures for blacks precede those for whites) were (1) Orientation-Memory-Concentration Test (38%, 79%), (2) Mental Status Questionnaire (71%, 96%), (3) Mini-Mental State (58%, 94%), (4) Storandt et al. Battery (42%, 69%), (5) Iowa Battery (26%, 69%) and (6) Kendrick Cognitive Tests (92%, 97%). All but the Kendrick Cognitive Tests showed substantial sensitivity (90-100%) in detecting the presence of dementia. The specificity of the tests was particularly poor for blacks. The briefer, simpler measures tended to have greater accuracy than the longer and more complex measures. With rare exceptions, the scores obtained on these screens correlated with race and education.
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APA 7th
Fillenbaum, G., Heyman, A., Williams, K., Prosnitz, B., & Burchett, B. (1990). Sensitivity and specificity of standardized screens of cognitive impairment and dementia among elderly black and white community residents. Journal of clinical epidemiology. https://doi.org/10.1016/0895-4356(90)90035-n
Vancouver
Fillenbaum G, Heyman A, Williams K, Prosnitz B, Burchett B. Sensitivity and specificity of standardized screens of cognitive impairment and dementia among elderly black and white community residents. Journal of clinical epidemiology. 1990. doi:10.1016/0895-4356(90)90035-n. PMID: 2370572.
BibTeX
@article{fillenbaum1990-2370572,
author = {Fillenbaum, G. and Heyman, A. and Williams, K. and Prosnitz, B. and Burchett, B.},
title = {{Sensitivity and specificity of standardized screens of cognitive impairment and dementia among elderly black and white community residents}},
journal = {Journal of clinical epidemiology},
year = {1990},
doi = {10.1016/0895-4356(90)90035-n},
pmid = {2370572},
url = {https://doi.org/10.1016/0895-4356(90)90035-n}
}
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Key findings
- Battery (42%, 69%), (5) Iowa Battery (26%, 69%) and (6) Kendrick Cognitive Tests (92%, 97%).
- All but the Kendrick Cognitive Tests showed substantial sensitivity (90-100%) in detecting the presence of dementia.
- The specificity of the tests was particularly poor for blacks.
- The briefer, simpler measures tended to have greater accuracy than the longer and more complex measures.
- With rare exceptions, the scores obtained on these screens correlated with race and education.
Why it matters
This study evaluated six standardized cognitive tests as screens for dementia in a community sample of black and white elderly residents. It found that while most tests were good at detecting dementia, their specificity was particularly poor for black participants, and that scores on these tests correlated with race and education.
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Study details
- Participants164
- Evidence strengthModerate
How this study scored 50/100
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 clinical epidemiology) |
| Journal's citation record | 3 / 4 | Journal of Clinical Epidemiology: journal h-index 339 (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 | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1990 — older than 20 years, still counted |
| Sample size | 2 / 4 | 164 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 241 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.3 citations a year over 38 year(s) since 1990 |
| Impact for its field and year | 3 / 6 | Cited 5.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 22 other studies in this library |
| Still being cited | 1 / 4 | Cited 3 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Bruce M. Burchett: h-index 28 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Duke University: institution h-index 1,541 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 2370572) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 50 / 100 | — |
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