Mini-Cog versus Codex (cognitive disorders examination) Is there a difference? / Mini-Cog versus Codex (exame de distúrbios cognitivos): existe alguma diferença?

Abstract. Mini-Cog and Codex (cognitive disorders examination) are brief cognitive screening tests incorporating word-recall and clock drawing tests. Objective: To assess and compare the screening accuracy of Mini-Cog and Codex for diagnosis of dementia and mild cognitive impairment (MCI) in patients attending a dedicated cognitive disorders clinic. Methods: Tests were administered to a consecutive cohort of 162 patients, whose reference standard diagnoses based on clinical diagnostic criteria were dementia (44), MCI (26), and subjective memory complaint (92). Results: Both Mini-Cog and Codex had high sensitivity (>0.8) for dementia diagnosis, but Codex was more specific. For diagnosis of MCI, Mini-Cog had better sensitivity than Codex. Weighted comparisons of Mini-Cog and Codex showed only marginal net benefit for Mini-Cog for dementia diagnosis but larger net benefit for MCI diagnosis. Conclusion: In this pragmatic study both Mini-Cog and Codex were accurate brief screening tests for dementia but Mini-Cog was better for identification of MCI.

Resumo. Mini-Cog e Codex são testes breves de triagem cognitiva incorporando testes de recuperação de palavras e desenho de relógio. Objetivo: Avaliar e comparar a precisão da triagem de Mini-Cog e Codex (exame de distúrbios cognitivos) para o diagnóstico de demência e comprometimento cognitivo leve (CCL) em pacientes atendidos em uma clínica dedicada a distúrbios cognitivos. Métodos: Os testes foram administrados a uma coorte consecutiva de 162 pacientes, cujos diagnósticos padrão de referência com base em critérios clínicos de diagnóstico foram demência (44), CCL (26) e queixa subjetiva de memória (92). Resultados: O Mini-Cog e o Codex apresentaram alta sensibilidade (>0,8) para o diagnóstico de demência, mas o Codex foi mais específico. Para o diagnóstico de CCL, o Mini-Cog teve melhor sensibilidade que o Codex. As comparações ponderadas de Mini-Cog e Codex mostraram apenas um benefício líquido marginal para o Mini-Cog para o diagnóstico de demência, mas um benefício líquido maior para o diagnóstico de CCL. Conclusão: Neste estudo pragmático, o Mini-Cog e o Codex foram testes breves de triagem precisos para demência, mas o Mini-Cog foi melhor para a identificação de CCL.

Screening for dementia in older adults using Mini-Cog scale from a rural setting of Kashmir division

Background: Dementia is common in the geriatric population. It has been suggested that early detection leads to benefits for the patient and their family and cuts the costs. The solution to this problem lies in the development of brief and easily applicable tests that are acceptable to patients, their caregivers, and health professionals. The current study was undertaken for screening for dementia using Mini-Cog scale.Methods: Cross sectional study from District Budgam of Kashmir Division done on individuals aged >60 yrs after providing informed consent. All participants underwent comprehensive evaluations using the Mini-Cog scale for Dementia.Results: The overall prevalence of dementia was 57.5%. Majority of the individuals with dementia were illiterate (49.8%) and had completed up to primary education (63.2%). However no statistical significance was seen between marital and educational status with dementia. About 70.8% of the individuals with dementia were not aware of the availability of facilities related to mental issues.Conclusions: Need of the hour is to develop culturally appropriate interventions that could be integrated with dementia services within the primary health care system.