@article {7529, title = {Development and validation of a brief cognitive assessment tool: the sweet 16.}, journal = {Arch Intern Med}, volume = {171}, year = {2011}, month = {2011 Mar 14}, pages = {432-7}, publisher = {171}, 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.

}, keywords = {Aged, Aged, 80 and over, Cognition Disorders, Cohort Studies, Dementia, Female, Humans, Male, Neuropsychological tests, Surveys and Questionnaires}, issn = {1538-3679}, doi = {10.1001/archinternmed.2010.423}, author = {Tamara G Fong and Richard N Jones and James L Rudolph and Frances Margaret Yang and Tommet, Douglas and Habtemariam, Daniel and Edward R Marcantonio and Kenneth M. Langa and Sharon K Inouye} }