%0 Journal Article %J Arch Intern Med %D 2011 %T Development and validation of a brief cognitive assessment tool: the sweet 16. %A Tamara G Fong %A Richard N Jones %A James L Rudolph %A Frances Margaret Yang %A Tommet, Douglas %A Habtemariam, Daniel %A Edward R Marcantonio %A Kenneth M. Langa %A Sharon K Inouye %K Aged %K Aged, 80 and over %K Cognition Disorders %K Cohort Studies %K Dementia %K Female %K Humans %K Male %K Neuropsychological tests %K Surveys and Questionnaires %X

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.

%B Arch Intern Med %I 171 %V 171 %P 432-7 %8 2011 Mar 14 %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/21059967?dopt=Abstract %3 21059967 %4 Older people/Cognition/reasoning/Correlation analysis/Medical diagnosis/Dementia/Hospitalization %$ 25220 %R 10.1001/archinternmed.2010.423