I was interested to learn from the audit of dementia referrals to a later life psychiatry service that only 13.2% of referral letters contained Mini-Mental State Examination (MMSE) results. Reference Hussey, Foy and Meehean1 Findings from a neurology-led dementia service were little better, with around 20% of referrals from primary care containing evidence of cognitive test results, most commonly the MMSE. Reference Fisher and Larner2 These results contrast with those from a postal survey which claimed 79% use of dementia screening tests in three English primary care trusts. Reference Milne, Culverwell, Guss, Tuppen and Whelton3 How can the discrepancy be accounted for?
It would seem unlikely that general practitioners (GPs) would not report MMSE results in a referral letter to a dementia service if the test had been undertaken. More likely, the MMSE is too time consuming in primary care and/or too difficult to interpret. If so, then the use of other, briefer, screening instruments with unambiguous cut-offs, such as Mini-Cog or GP-Cog, Reference Milne, Culverwell, Guss, Tuppen and Whelton3 must be vigorously encouraged in primary care. No example of their use was encountered in the Fisher & Larner study. Reference Fisher and Larner2
This could form one aspect of the ‘raising awareness’ strand in the implementation of the National Dementia Strategy. 4
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