What are the recommended screening tools for assessing cognitive impairment in older adults during a routine GP visit?

For assessing suspected cognitive impairment in older adults during a routine general practice consultation, several validated brief structured cognitive instruments are recommended for initial assessment in non-specialist settings ³. These include the 10-point cognitive screener (10-CS), the 6-item cognitive impairment test (6CIT), the 6-item screener, the Memory Impairment Screen (MIS), the Mini-Cog, and Test Your Memory (TYM) ³.

It is important to note that dementia should not be ruled out solely based on a normal score from a cognitive instrument ³. When cognitive impairment is suspected, it should be confirmed using a standardised and validated cognitive impairment measure ². Early detection of cognitive impairment in primary care is crucial for improving care for older adults (Fowler et al., 2025).

In addition to cognitive testing, a comprehensive history should be taken from the person with suspected dementia and, if possible, from someone who knows them well, such as a family member ³. This history should cover cognitive, behavioural, and psychological symptoms, as well as their impact on daily life ³. Structured instruments like the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) or the Functional Activities Questionnaire (FAQ) can supplement the history taken from an informant ³. Screening for cognitive impairment is a key aspect of managing Alzheimer's disease and related conditions in older adults (Rogers et al., 2023).

Before referring to a specialist dementia diagnostic service, reversible causes of cognitive decline, such as delirium, depression, sensory impairment (e.g., sight or hearing loss), or cognitive impairment from medicines associated with increased anticholinergic burden, should be investigated ¹. If indicators of delirium are identified, an assessment using the 4AT tool is recommended ². However, single tools like the Mini-Mental State Examination (MMSE) should not be used as the sole basis for assessing mental capacity, although they may provide relevant information ⁴. A systematic review has also explored the diagnostic accuracy of various cognitive screening tools validated for older adults (Kamalzadeh et al., 2024).