Comparison of the sensitivity of three instruments for the detection of cognitive decline in elderly living at home.

We followed up 181 elderly living at home over 2 years. The changes shown on a brief dementia rating scale (the Abbreviated Mental Test Score (AMTS] were monitored. At follow-up, subjects were classified as organic or non-organic by three potential screening tools-a screening questionnaire (the Psychogeriatric Assessment Schedule), a psychometric test (the Inglis' Paired Associate Learning Test) and a dementia scale (the AMTS). The value of these as screening tools for community samples was considered as a function of their sensitivity to cognitive decline. The classifications made by each were significantly related to previous cognitive change, but all were conservative, missing many subjects who had declined. Of the three, the AMTS appeared the most useful as a predictor of previous change on the AMTS. It remains to be seen whether it is equally useful with different samples and with different measures of outcome.