The validity of cognitive testing in screening for dementia

Patricia Stockton*, Jiska Cohen-Mansfield, Nathan Billig

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


The concept of 'cognitive impairment,' as an indicator of dementia, defined in 1980 as a loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning is the model which has been adopted for a condition, which has recently been reclassified from an 'organic' to a 'cognitive disorder.' Data derived from the assessment of a sample of older people demonstrated the extreme sensitivity of a widely employed cognitive assessment instrument to all levels of educational experience, and educational correlates, notably level of physical disability, were identified as other independent predictors of test performance. The analyses raise questions with regard to the reinterpretation of 'lack of education,' from a confounding factor in prevalence estimates of cognitive impairment to a 'risk factor' for dementia, and support those who have questioned the validity of the one-dimensional 'cognitive paradigm,' and the trend to diagnosis based upon objective assessment with standardized instruments.

Original languageEnglish
Pages (from-to)33-41
Number of pages9
JournalJournal of Medical Systems
Issue number1
StatePublished - 1998
Externally publishedYes


  • Cognition screening diagnosis
  • Dementia
  • Education


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