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GP COG dementia screening test

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • designed as a GP screening tool for dementia (1)

  • there are two components:
    • a cognitive assessment conducted with the patient
      • patient assessment
        • results >8 assumed to be cognitively intact
        • results < 5 assumed to be cognitively impaired
        • if patient scores 5-8, more information required -> informant questionnaire

    • an informant questionnaire (only considered necessary if the results of the cognitive section are equivocal, ie score 5-8 inclusive)

      • informant questionnaire - for patients requiring a informant questionnaire, scores of 3 or less out of 6 in this section indicates cognitive impairment (2)

Click here for an on-line GPCOG calculator.

The elements and procedure for the GPCOG calculation are outlined below.

GPCOG Patient Examination

  • Unless specified, each question should only be asked once

    • Name and address for subsequent recall
      • state to the patient - "I am going to give you a name and address. After I have said it, I want you to repeat it. Remember this name and address because I am going to ask you to tell it to me again in a few minutes: John Brown, 42 West Street, Kensington" ( a maximum of 4 attempts should be allowed but do not score yet)

    • Time Orientation
      • What is the date? (accept exact only)

    • Clock Drawing (visuospatial functioning)
      • use a paper with a printed circle
      • ask the patient to mark in all the numbers to indicate the hours of a clock (correct spacing required)
        • For a correct response (above), the numbers 12, 3, 6, and 9 should be in the correct quadrants of the circle and the other numbers should be approximately correctly placed
      • ask the patient to mark in hands to show 10 minutes past eleven o'clock (11:10)
        • For a correct response (above), the hands should be pointing to the 11 and the 2, but do not penalise if the respondent fails to distinguish the long and short hands

    • Information
      • ask the patient 'can you tell me something that happened in the news recently?' (recently = in the last week)
        • the respondent is not required to provide extensive details, as long as they demonstrate awareness of a recent news story
        • note though that if a general answer is given, such as "war", "a lot of rain", ask for details. If unable to give details, the answer should be scored as incorrect

    • Recall
      • ask the patient 'What was the name and address I asked you to remember?' Score for each of the 5 components -
        • John,
        • Brown,
        • 42,
        • West Street,
        • Kensington
          • all correct - 5 points
          • 1 error - 4 points
          • 2 errors - 3 points
          • 3 errors - 2 points
          • 4 errors - 1 point
          • 5 errors - 0 points

  • GPCOG Patient Score = /9

    • results >8 or < 5 on the GPCOG patient section were assumed to be cognitively intact or impaired, respectively

GPCOG Informant Interview

Ask the informant: "Compared to a few years ago"

  • Does the patient have more trouble remembering things that have happened recently? yes =0; no = 1

  • Does he or she have more trouble recalling conversations a few days later? yes =0; no = 1

  • When speaking, does the patient have more difficulty in finding the right word or tend to use the wrong words more often? yes =0; no = 1

  • Is the patient less able to manage money and financial affairs (e.g., paying bills, budgeting)? yes =0; no = 1

  • Is the patient less able to manage his or her medication independently? yes =0; no = 1

  • Does the patient need more assistance with transport (either private or public)? yes =0; no = 1

  • Score 1 point for each "no" answer

Informant Score = /6

  • if patient scores 0-3, cognitive impairment is indicated

Combined (overall) score = /15

Reference:

  1. Brodaty H, Pond D, Kemp NM, et al; The GPCOG: a new screening test for dementia designed for general practice. J Am Geriatr Soc. 2002 Mar;50(3):530-4.
  2. Brodaty H, Kemp NM, Low L; Characteristics of the GPCOG, a screening tool for cognitive impairment, Int J Geriatr Psychiatry 2004; 19:870-74

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