Author(s): Mitchell Clionsky*,Emily Clionsky
Abstract
Purpose: The Memory Orientation Screening Test (MOST) is compared with standard neuropsychological tests in a sample of elders reflecting the population prevalence of normal cognition, mild cognitive impairment (MCI) and dementia.
Methods: One hundred, forty-eight elders without dementia diagnosis completed neuropsychological tests, the MOST, and MMSE. Neuropsychological results reclassified 37 as having MCI or mild dementia. Clinically diagnosed patients were added, creating a 217-person sample reflecting the population distribution of normal, MCI and dementia.
Results: The MOST correlated highly with diagnostic severity and each neuropsychological test, demonstrating 80% correct diagnostic classification. The MOST showed a stronger relationship with dementia severity and list memory than MMSE. MOST cutting scores provided 88% sensitivity and 83% specificity for identifying MCI and dementia, yielding a PPV of .72 and NPV of .93.
Conclusion: The MOST accurately classifies patients from a diagnostically proportioned sample as normal, MCI, or demented and has high sensitivity and specificity for separating normal from impaired. Providers can use this 5-minute test to accurately identify cognitively impaired patients and to reassure elders with normal cognition, while acknowledging that no single test is adequate for making a definitive diagnosis.
