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Detecting MCI and dementia in primary care: effectiveness of the MMS, the FAQ and the IQCODE corrected


Cruz-Orduña, Isabel, Bellón, José M., Torrero, Pedro, Aparicio, Esperanza, Sanz, Ana, Mula, Nieves, Marzana, Garbiñe, Begué, Concepción, Cabezón, Dionisio, Olazarán, Javier


Family Practice, Volume: 29, No.: 4, Pages.: 401-406

Year of Publication



Objectives: To study the yield of three instruments for detection of patients with cognitive impairment in primary care. To investigate whether combining tests is better for detecting impairment than applying them separately.; Methods: Seven primary care physicians (PCP) systematically recruited individuals aged over 49 years with a complaint or suspicion of cognitive impairment. The tests administered were the Mini-Mental State Test (MMS), the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and the Pfeffer Functional Activities Questionnaire (FAQ). We calculated sensitivity, specificity and the area under the curve (AUC) and applied logistic regression analysis to determine the yield of the tests in combination. The gold standard was the clinical judgement of a neurologist based on a comprehensive assessment, which included a formal neuropsychological workup.; Results: Of the 160 study patients, 90 (56%) had cognitive impairment (15 of these had dementia). The MMS had a sensitivity of 77% and a specificity of 70% in screening for cognitive impairment, with an AUC of 0.82. Incorporation of the IQCODE increased the AUC to 0.86 (P = 0.01). As for dementia, the FAQ reached a sensitivity of 87% and a specificity of 82%, with an AUC of 0.91. Incorporation of the MMS increased the AUC to 0.95 (P = 0.03).; Conclusions: Cognitive impairment is probably underdiagnosed in primary care. The combination of the FAQ and the MMS had excellent performance for dementia detection; however, no satisfactory instrument or instrument combination could be found for cognitive impairment.;

Bibtex Citation

@article{Cruz_Orduna_2011, doi = {10.1093/fampra/cmr114}, url = {}, year = 2011, month = {nov}, publisher = {Oxford University Press ({OUP})}, volume = {29}, number = {4}, pages = {401--406}, author = {I. Cruz-Orduna and J. M. Bellon and P. Torrero and E. Aparicio and A. Sanz and N. Mula and G. Marzana and C. Begue and D. Cabezon and J. Olazaran}, title = {Detecting {MCI} and dementia in primary care: efficiency of the {MMS}, the {FAQ} and the {IQCODE}}, journal = {Family Practice} }


aged, aged, 80 and over, dementia, diagnosis, female, humans, logistic models, male, middle aged, mild cognitive impairment, primary health care, psychological tests, questionnaires, roc curve, sensitivity and specificity

Countries of Study


Types of Dementia

Mild Cognitive Impairment (MCI)

Types of Study

Instrument development and testing (cross walking of measures, etc.)

Type of Outcomes



Primary Care

Type of Interventions

Diagnostic Target Identification

Diagnostic Targets

Cognition testing (inc. task driven tests such as clock drawing)