Is the 7 Minute Screen an Accurate Test for Dementia?

Can You Test for Dementia in 7 Minutes?
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What Is the 7 Minute Screen?

The 7 minute screen (7MS) is a test designed to identify mild cognitive impairment and the early stages of Alzheimer's disease. Prior the the development of this screen, clinicians were finding that other types of common cognitive tests were not sensitive enough to detect more mild cognitive declines. It's also been agreed that early detection is generally beneficial for treatment and decision-making.

Thus, PR Solomon, along with others, developed the 7MS and then tested it to determine if it was able to increase the accuracy in identifying early dementia.

What Does the 7MS Include?

The 7MS includes four different tests:

1. Enhanced Cued Recall

The enhanced cued recall test assesses memory and learning by presenting a series of 16 pictures of familiar items. The ability to identify and remember those items- both with cues such as, "type of fruit," and without any cues- is tested. 

After going through all of the pictures, a distracting task such as listing the months of the year in both a forward and backward order is assigned, and then the person is asked again to recall the 16 items above, providing the cue if necessary.

2. Temporal Orientation

This section of the 7MS addresses orientation through the use of the Benton Temporal Orientation Test. It asks the person to identify the correct day, month, year, date, time of day.

Other screening tests for dementia may ask similar orientation questions, but this test adjusts the scoring for answers that are close to the correct answer. Other orientation tests often do not factor in an "almost correct" answer, only giving credit for a correct answer and no points for an incorrect answer.

3. Verbal Fluency

The verbal fluency test involves asking the person to name as many animals as she can in 60 seconds.

4. Clock Drawing

The clock drawing test is a frequently used test where the person is asked to draw a clock and set the hands of the clock at a certain time.

How Accurate is the 7MS?

The 7MS has been shown to be very effective at identifying multiple types of dementia such as Alzheimer's, vascular, Lewy body dementia, frontotemporal dementia and decreased cognitive functioning related to diabetes. Several studies have shown that the 7MS consistently can discriminate between someone whose cognition is intact and someone who is experiencing cognitive impairments. As noted above, this test also can also detect mild cognitive impairment, a condition that sometimes but not always progresses to Alzheimer's disease.

The accuracy of the 7MS was shown to not be affected by age, sex or education levels.

Benefits of the 7MS

In addition to its ability to detect cognitive impairment in its earlier stages, the 7MS takes between seven and eight minutes on average to administer, thus offering an effective way to screen for early dementia symptoms in a time-sensitive manner.

It also requires little training for the test administrators.

Limits of the 7MS

As with other cognitive tests, the 7MS should be accompanied by other testing by a physician. Diagnosing dementia involves multiple steps, including ruling out other causes of cognitive decline that could be appropriately treated and potentially reversed.

Diagnosing Dementia

Sources:

Annals of Internal Medicine. 2014;160(11):791-797. Screening for Cognitive Impairment in Older Adults: U.S. Preventive Services Task Force Recommendation Statement. http://annals.org/article.aspx?articleid=1850963&resultClick=3

Archives of Neurology. 1998 Mar;55(3):349-55. A 7 minute neurocognitive screening battery highly sensitive to Alzheimer's disease. http://www.ncbi.nlm.nih.gov/pubmed/9520009

Brown University. Medicine and Health. January 2005. 88 (1). Cognitive Screening of Older Adults. http://med.brown.edu/neurology/articles/jg805.pdf

Dementia and Geriatric Cognitive Disorders. 2008;25(3):248-55. Validation of the 7-Minute Screen for the detection of early-stage Alzheimer's disease. http://www.ncbi.nlm.nih.gov/pubmed/18270487

Journal of Neurology, Neurosurgery and Psychiatry. May 2004; 75(5): 700–705. The seven-minute screen: a neurocognitive screening test highly sensitive to various types of dementia. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1763549/

Trushna, T., Mohan, DS, Nair, S., & Manjunatha, S. A simple screening test with a potential to detect diabetic cognitive impairment in the geriatric population: a preliminary study. http://www.med.cmb.ac.lk/SMJ/VOLUME 3 DOWNLOADS/Page 17-21 - A simple screening test with a potential to detect diabetic cognitive impairment in the geriatric population: a preliminary study

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