Clinical meaning
Cognitive screening tools are brief, standardized assessments that evaluate multiple cognitive domains to detect impairment. The Montreal Cognitive Assessment (MoCA) evaluates visuospatial/executive function, naming, memory, attention, language, abstraction, delayed recall, and orientation (30 points; <26 suggests MCI). The Mini-Mental State Examination (MMSE) assesses orientation, registration, attention/calculation, recall, and language (30 points; <24 suggests dementia; less sensitive for MCI than MoCA). The Mini-Cog combines 3-word recall with clock drawing (quick 3-minute screen). The Saint Louis University Mental Status (SLUMS) is more sensitive than MMSE for MCI detection. Each tool has different sensitivity/specificity profiles, and selection depends on the clinical setting, time available, and purpose of screening.
Diagnosis & workup
Diagnostics & workup: - MoCA: most sensitive for MCI detection; tests multiple domains; 10-15 minutes; score <26 = abnormal (add 1 point if education ≤12 years); freely available at mocatest.org - MMSE: widely recognized; less sensitive for MCI (ceiling effect in educated patients); tests orientation, memory, calculation, language; copyright-protected - Mini-Cog: 3-minute screen; 3-word registration/recall + clock drawing test; positive if recall ≤2/3 or abnormal clock; best for primary care screening due to speed - SLUMS: 7-minute assessment; more sensitive than MMSE for MCI; scoring adjusts for education level - Clock Drawing Test: screens visuospatial and executive function; ask patient to draw a clock face with all numbers and set hands to '10 after 11' (11:10); errors in number placement, spacing, or hand placement indicate impairment - Trail Making Test (Part B): measures executive function; connect alternating numbers and letters (1-A-2-B-3-C...); time to completion >300 seconds or many errors suggests executive dysfunction