(other contributors: Pond D, Kemp N, Luscombe G) Early detection and diagnosis of dementia is important in maintaining quality of life, particularly as effective treatments are becoming available. To assist general practitioners (GPs) in the detection of dementia, we designed and tested a brief screening instrument: The General Practitioner Assessment of Cognition (GPCOG). The GPCOG consists of nine cognitive test items and six historical questions to an informant. The validity of the measure was established against the criterion of DSM-IV diagnosis of dementia. Sixty-seven GPs administered the GPCOG to 283 community dwelling patients. Subjects were attendees aged >75 years or 50-74 years old with memory complaints. Subsequently a research psychologist administered measures including The Cambridge Mental Disorder of the Elderly Examination. Consensus DSM diagnoses were established at case conference. A ‘two-stage’ method of administering the GPCOG (cognitive testing followed by informant questions if necessary) had a sensitivity of 0.85 and a specificity of 0.86, a misclassification rate of 14% and positive predictive value of 71.4%. Patient interviews took less than four minutes to administer and informant interviews less than two minutes. Most GPs and patients found assessment acceptable. The GPCOG is a valid, efficient, well-accepted instrument for dementia screening in primary care.
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