Standardized Mental Test Schedules: Their Uses and Abuses

Chapter 6 discusses various mental test schedules used over the years, from the 10-item Hodgkinson Mental Test, to the much more complex Dementia Rating Scale (DRS. For practical purposes, however, such tests can be divided into two broad groups: (i) the brief schedules that can easily be used in the clinic, or at the bedside, and do not require specialized equipment or training, and (ii) the more elaborate scales, which are used largely, at least at present, in research studies, and require the purchase of test materials and some training in their administration. The Addenbrooke’s Cognitive Examination (ACE) was developed in an attempt to bridge this divide and to provide a test with greater sensitivity to early cognitive decline than the Mini-Mental State Examination (MMSE) and which could also differentiate between different brain diseases. The remainder of this chapter covers possible alternative cognitive screening instruments. It describes three of the most commonly used brief assessment schedules: the MMSE, the Information–Memory–Concentration (IMC) Test, and the 10-item Hodgkinson Mental Test, which is derived from the IMC Test; plus two longer tests, which are widely used in dementia research: the Mattis Dementia Rating Scale (DRS) and the Cambridge Cognitive Examination—Revised (CAMCOG-R). Finally it also includes a description of the Alzheimer’s Disease Assessment Scale (ADAS-Cog) since it has been used widely in drug evaluation studies.