How useful are the MMSE and IQCODE in diagnosing cognitive impairment and dementia in stroke patients

We evaluated the usefulness of two brief cognitive tests in detecting dementia and cognitive impairment not dementia (CIND) in a community-based sample of first-ever stroke patients. The standardized Mini-Mental State Examination (S-MMSE) and the 16-item Informant Questionnaire for Cognitive Decline in Elderly (IQCODE) were administered to 79 patients one year after a first-ever stroke. Dementia and CIND were diagnosed using an independent cognitive battery. The S-MMSE and the IQCODE were extremely poor at detecting CIND individually and in combination. The S-MMSE was insensitive in detecting dementia, and the IQCODE nonspecific. An adequate balance was obtained between specificity and sensitivity for dementia using the a??or rulea?? combination, but with only modest positive predictive value. The results propose that brief cognitive tests cannot adequately replace more comprehensive neuropsychological assessment in stroke patients.