Instrument Development

The Mini-Cog© was developed to help identify, in non-specialist settings, individuals likely to have clinically important cognitive impairment. The initial proof of concept came from a community study of older adults with no exposure to neurocognitive specialty providers, about half of whom were late-life immigrants of widely varying educational and ethnolinguistic backgrounds (many non-English speakers). Evidence of cognitive impairment was based on the Clinical Dementia Rating (CDR), a widely-used multi-domain assessment completed primarily as an interview with a knowledgeable partner (family or friend) and used to stage cognitive status from normal through advanced dementia.  The  Mini-Cog© was constructed from 3-word recall, a common element in many cognitive screening tests and the earliest to decline impairment in common dementias such as Alzheimer’s disease, and a clock drawing task included as an executive/cognitive composite.  The initial visual algorithm for scoring, validated by receiver operating characteristics, was later replaced with an equivalent numerical system and evaluated in two population studies.

 

Soo Borson, Developer of the Mini-Cog©

Soo Borson MD is a physician and researcher specializing in dementia. She is currently co-lead of the Building Our Largest Dementia (BOLD) Center for Early Detection of Dementia, an initiative funded by the Centers for Disease Control (CDC) and housed at New York University (NYU Langone). She also holds a faculty position as Professor of Clinical Family Medicine in the Keck School of Medicine at the University of Southern California.

She formerly directed the Memory Disorders Clinic and Dementia Health Services Research Group at the University of Washington, where she was a Professor in the School of Medicine and a member of the National Institute on Aging-funded Alzheimer’s Disease Research Center. It was during her time there that she recognized the need for easily
developing a population-based approach to dementia care and realizing a fundamental aim of the U.S. National Plan for Alzheimer’s Disease.

Mini-Cog© was developed to help clinicians more easily identify people who might have clinically important, but unrecognized, cognitive impairment. Clinicians asked for quicker, simpler ways to screen that would fit into short primary care visits.

The initial Mini-Cog© proof of concept came from a University of Washington community study of older adults with no exposure to neurocognitive specialty providers, about half of whom were late-life immigrants of widely varying educational and ethnolinguistic backgrounds (many non-English speakers). Evidence of cognitive impairment was based on the Clinical Dementia Rating (CDR), a widely-used multi-domain assessment completed primarily as an interview accessible, simple and valid screening tools to make detecting possible dementia easier in diverse settings. She and her team at University of Washington created and systematically validated the Mini-Cog© as a simple tool to improve detection of cognitive impairment.

Since then, she has worked with many organizations such as the Alzheimer’s Association, Alzheimer’s Foundation of America, Allina Health, Intermountain Health, Health Partners, Kaiser Permanente and the Billings Clinic, and continues to collaborate widely on research and development projects involving dementia detection and cognitive care. She received her medical degree from Stanford University School of Medicine and is licensed by the American Board of Neurology and Psychiatry.

In addition to her research and scholarly work, Dr. Borson has long been committed to person- and family-centered patient care and interprofessional mentoring, teaching and service, with a focus on national and international efforts to improve dementia care quality.