Title | Development and validation of a brief cognitive assessment tool: the sweet 16. |
Publication Type | Journal Article |
Year of Publication | 2011 |
Authors | Fong, TG, Jones, RN, Rudolph, JL, Yang, FMargaret, Tommet, D, Habtemariam, D, Marcantonio, ER, Langa, KM, Inouye, SK |
Journal | Arch Intern Med |
Volume | 171 |
Issue | 5 |
Pagination | 432-7 |
Date Published | 2011 Mar 14 |
ISSN Number | 1538-3679 |
Keywords | Aged, Aged, 80 and over, Cognition Disorders, Cohort Studies, Dementia, Female, Humans, Male, Neuropsychological tests, Surveys and Questionnaires |
Abstract | BACKGROUND: Cognitive impairment is often unrecognized among older adults. Meanwhile, current assessment instruments are underused, lack sensitivity, or may be restricted by copyright laws. To address these limitations, we created a new brief cognitive assessment tool: the Sweet 16. METHODS: The Sweet 16 was developed in a cohort from a large post-acute hospitalization study (n=774) and compared with the Mini-Mental State Examination (MMSE). Equipercentile equating identified Sweet 16 cut points that correlated with widely used MMSE cut points. Sweet 16 performance characteristics were independently validated in a cohort from the Aging, Demographics, and Memory Study (n=709) using clinical consensus diagnosis, the modified Blessed Dementia Rating Scale, and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). RESULTS: The Sweet 16 correlated highly with the MMSE (Spearman r, 0.94; P<.001). Validated against the IQCODE, the area under the curve was 0.84 for the Sweet 16 and 0.81 for the MMSE (P=.06). A Sweet 16 score of less than 14 (approximating an MMSE score <24) demonstrated a sensitivity of 80% and a specificity of 70%, whereas an MMSE score of less than 24 showed a sensitivity of 64% and a specificity of 86% against the IQCODE. When compared with clinical diagnosis, a Sweet 16 score of less than 14 showed a sensitivity of 99% and a specificity of 72% in contrast to an MMSE score with a sensitivity of 87% and a specificity of 89%. For education of 12 years or more, the area under the curve was 0.90 for the Sweet 16 and 0.84 for the MMSE (P=.03). CONCLUSIONS: The Sweet 16 is simple, quick to administer, and will be available open access. The performance of the Sweet 16 is equivalent or superior to that of the MMSE. |
DOI | 10.1001/archinternmed.2010.423 |
User Guide Notes | |
Endnote Keywords | Older people/Cognition/reasoning/Correlation analysis/Medical diagnosis/Dementia/Hospitalization |
Endnote ID | 25220 |
Alternate Journal | Arch Intern Med |
Citation Key | 7529 |
PubMed ID | 21059967 |