Validity and Reliability

The primary validation of the Mini-Cog™ was tested in studies of accuracy in detecting the presence of dementia, now termed major neurocognitive disorder. Most studies included mainly individuals with Alzheimer type and mixed degenerative/vascular dementias.  The recommended cut score for dementia screening (0-2 = positive; 3-5 = negative) was derived empirically to optimize the balance of sensitivity and specificity.  High specificity is usually preferable in screening large populations, such as older adults in health care settings; some studies, seeking higher sensitivity to subtler cognitive impairments, have used 0-3 as “positive”, but this has not been adequately tested against formal cognitive disorder diagnoses.  Individuals with mild cognitive impairment (cognitive impairment/no dementia; mild neurocognitive disorder) are often detected by the Mini-Cog™ using the conventional cut score, but there is insufficient evidence to recommend the Mini-Cog™ as a ‘screen for MCI.’   Studies conducted in primary care settings have shown that non-professionals, including medical assistants, can administer the Mini-Cog™ with high reliability after minimal training and practice.

More information about the validity and reliability of the Mini-Cog™ can be found on the references page of this website.