Choosing a Reliable Cognitive Test for Community Screening of Dementia in Pakistan

Cognitive testing is an essential component of geriatric assessment. No test of memory currently exists in Pakistan that caters to the socio-demographic needs of its people. With growing numbers of elderly, the need to identify an appropriate screening test of cognition becomes necessary. A literature review was conducted to identify existing tests available for screening of dementia in the community. Two tests (The Mini-Cog and 6- CIT) were selected based on their validity for community screening and low dependence on language and education level. 90 consenting participants age 60 and older visiting the out-patient setting of a tertiary care hospital in Karachi were selected through convenience sampling and given both tests. Analysis was done using SPSS 17. Time and rates of completion were calculated and individual tests items were assessed. Reliability was checked for 6-CIT and Mini-Cog using Cronbach’s alpha. Completion rates of the Mini-cog were almost half that of 6-CIT. Dementia rates were found to be 22 % and 26 % respectively for the Mini-Cog (complete group) and 6-CIT. Almost half i.e.48 % of participants were unable to perform the clock draw test in the Mini-Cog. 6-CIT had a 100 % completion rate and was found to be more reliable in our setting with a Cronbach’s Alpha of 0.7 compared to 0.14 for the Mini-Cog test. The 6-CIT is the most reliable test for community screening of dementia in our setting.