Rapid Cognitive Assessment Possible With 'Sweet 16'

Sweet 16, a new instrument developed by a research team, can rapidly evaluate the cognitive status in older persons.

Tamara G. Fong of Hebrew SeniorLife, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, and colleagues conducted the study.

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"For many older adults, cognitive impairment contributes to loss of independence, decreased quality of life and increased health care costs," the authors wrote.

"While the public health impact of cognitive impairment is clear, this condition is often under-recognized. A simple, rapid cognitive assessment instrument is therefore a valuable tool for use in both clinical and research settings," he said.

The most widely known and used measure of cognitive impairment is the Mini-Mental State Examination (MMSE); however, scores on this assessment may be influenced by education level, and the copyright limits its widespread availability.

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To develop the questions, the researchers used information from a group of 774 patients who completed the MMSE as part of a screening process for a large randomized trial of a method to decrease delirium.

They then validated their results among 709 participants in another study that also used two different dementia and cognitive decline rating scales.

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The Sweet 16 scale is scored from zero to 16 and includes questions that address orientation ,registration, digit spans (tests of verbal memory) and recall.

When administered to participants in the validation group, a Sweet 16 score of 14 or less correctly identified 80 percent of the individuals with cognitive impairment and correctly identified 70 percent of those who did not have cognitive impairment.

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In the same group, the MMSE correctly identified 64 percent of those with cognitive impairment and correctly identified 86 percent of those who were cognitively normal.

The researchers also compared the Sweet 16 to clinicians' diagnoses of cognitive impairment. Sweet 16 scores of 14 or less occurred in 99 percent of patients diagnosed with cognitive impairment and 28 percent of those without such a diagnosis.

The report posted online today will be published in the March 14 print issue of Archives of Internal Medicine, one of the JAMA/Archives journals. (ANI)

Source-ANI