Dr. Soo Borson is a physician and researcher specializing in dementia. She formerly directed the Memory Disorders Clinic and Dementia Health Services Research Group at the University of Washington (UW), where she was Professor in the School of Medicine and a member of the National Institute on Aging (NIA)-funded Alzheimer's Disease Research Centre.
She created and, with her team at UW, systematically validated the Mini-Cog©, a simple tool to improve detection of cognitive impairment. The Mini-Cog© has been endorsed in a technology assessment by the National Institute on Aging and the Centres for Medicare and Medicaid Services, and is supported by a specific electronic medical record code to facilitate capture of data about cognitive status in administrative health data. The Mini-Cog© has been widely adopted as a preferred measure for detection of cognitive impairment in clinical practice.
Dr. Borson has long been committed to interprofessional mentoring, teaching, and service and to national and international efforts to improve dementia care quality. She is currently Professor Emerita in the School of Medicine, and Affiliate Professor in the School of Nursing, of the University of Washington.
Circunvalación del Hipocampo: Dr. Borson, what is the Mini-Cog©, in short?
Dr. Soo Borson: The Mini-Cog is a very short screening tool developed specifically for use in settings where rapid detection of cognitive impairment is important for clinical care. It was developed by identifying components of more detailed cognitive assessments that were most predictive of dementia in a multi-ethnic sample with varying education levels in the United States.
Circunvalación del Hipocampo: In your opinion, what are the main strengths of this test?
Dr. Soo Borson: The Mini-Cog is very short (under 3 minutes) and requires only brief training to administer reliably. It can be translated on the spot if needed, but multiple language versions are available or in development.
Circunvalación del Hipocampo: Can Mini-Cog© be used free of charge by professionals?
Dr. Soo Borson: Our intent was to offer a reliable, valid screening tool that would be free for broad use. We maintain copyright in order to protect the tool as validated, but will never charge a fee for use by non-commercial clinical or community care providers.
Circunvalación del Hipocampo: In general, in what circumstances should you recommend the use of a brief cognitive test such as Mini-Cog©?
Dr. Soo Borson: Brief cognitive screens are most useful in general primary care practice with older adults and other clinical or research situations where an indicator of cognitive impairment is important but detailed cognitive assessment is not required. Such situations can include identifying individuals at risk for delirium, hospital readmission, or poor outcomes or adherence to medical care.
Circunvalación del Hipocampo: What are the pros in favour of this instrument over other brief cognitive tests?
Dr. Soo Borson: The Mini-Cog is very well accepted by patients in clinical practice and participants in research studies. Compared with other very brief screening tests, the Mini-Cog correlates as well or better with diagnosis of dementia, has been validated in heterogeneous populations, and can be used by non-specialists with minimal exposure to cognitive assessment. Its scoring instructions are simple, empirically validated, and provided on the Mini-Cog form itself.
Circunvalación del Hipocampo: The Mini-Cog© includes an analogue clock drawing section. Do you consider that the progressive use of digital clocks could represent a problem for the use of Mini-Cog© in the near future?
Dr. Soo Borson: This may become a problem! Analog clock drawing is, however, a remarkably (perhaps uniquely) skilled cognitive activity when formally analysed. Critical indicators of impairment in clock drawing are associated with reduced executive function, a core indicator of dementia. Thus far, no comparable short cognitive indicator has been identified. I do note that the Apple watch quickly converts digital to analogue time!
Dr. Borson, thank you very much for accepting this interview our readers will appreciate so much.
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