Evaluating the accuracy of brief cognitive assessments for the early detection of cognitive impairment in adults across primary and specialty care settings: A systematic review and meta-analysis.
Jennifer Loveless, Lauren Pilcher, Corey J Bolton et al.
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In 30 seconds
This systematic review and meta-analysis assessed brief, freely available cognitive tests for detecting cognitive impairment, including mild cognitive impairment and dementia, in adults aged 55 years and older in primary and specialty care. It included 47 studies evaluating 10 tests, but accuracy varied widely and pooling was not possible for most analyses. In primary care, sensitivity across tests ranged from 0.17 to 0.98 and specificity from 0.10 to 0.98. The review found no eligible studies of 5-Cog or GPCOG and reports that primary-care evidence informed recommendations in an accompanying clinical practice guideline.
Key findings
- Across tests in primary care, sensitivity ranged from 0.17 to 0.98 and specificity from 0.10 to 0.98.
- In specialty care, assuming the same prevalence, sensitivity ranged from 0.73 to 0.97 and specificity from 0.45 to 0.90.
- Forty-seven studies evaluated 10 tests; accuracy data could not be pooled for most analyses.
- No studies meeting eligibility criteria were identified for 5-Cog or GPCOG.
Why it matters
Brief cognitive tests may support early detection in routine care, but the wide accuracy ranges show that performance is not uniform across tools or settings. The review helps clinicians and guideline developers interpret the available evidence while highlighting that test results should be considered in the context of the specific assessment and care setting.
What to keep in mind
Accuracy varied widely, and data pooling was not possible for most analyses. Evidence for some tests was limited to a single setting, and no eligible studies were found for two tests.