Development and Validation of the Memory Orientation Screening Test (MOST™): A Better Screening Test for Dementia

Abstract

Objectives: Accurate, economical identification of cognitive impairment would increase dementia detection and improve care of older patients. Design: Analysis of archival neuropsychological data combined 3-word recall, time orientation, list memory, and clock drawing into the Memory Orientation Screening Test (MOST ™). The MOST was compared with Folstein Mini Mental State Examination (MMSE) and Mini-Cog to detect dementia presence and severity, and convergence with standardized neuropsychological tests. Internal consistency, retest reliabilities, completion likelihood, and time costs were calculated. Results: The MOST was significantly more sensitive than MMSE or Mini-Cog, twice as accurate as MMSE for identifying mild dementia, better correlated with standardized memory tests, more reliable over time, and minimally related to depression. Conclusions: The MOST is routinely administered in less than 5 minutes by a medical assistant, more accurately identifies dementia and severity than current screening tests, and emulates longer memory testing, making it valuable for Annual Wellness Visits and many applied clinical settings.