Concurrent Validity of the Cognitive Assessment of Minnesota in Older Adults with and without Depressive Symptoms

Cognitive impairment represents a common mental health problem in community-dwelling and institutionalized older adults, and the prevalence increases with age. Multidisciplinary teams are often asked to assess cognitive and functional impairment in this population. The Cognitive Assessment of Minnesota was created by occupational therapists for this purpose and is frequently used, but has not been extensively validated. This study examined the performance of the CAM and compared it to the MMSE with 113 outpatient clinic patients over the age of 60. Subgroups were established based on scores on a depression inventory to determine if the presence of depressed mood altered the relationship between the measures. Both measures demonstrated good internal consistency. The overall correlation between the two measures was high, statistically significant and remained high regardless of depression status. We offer recommendations about the utility of each measure in screening cognitive functioning for older adults. 1. Introduction Cognitive impairment represents a common mental health problem in community dwelling and institutionalized older adults, and the prevalence increases with age [1]. Several measures have been developed to assess cognitive functioning in this population with some measures having a greater emphasis on memory and language functioning in analog conditions and others focusing more on functional adaptive skill use. Occupational therapists often work within multi-disciplinary settings and are frequently asked to assess the functional and cognitive status of their patients. The Cognitive Assessment of Minnesota (CAM) [2] was created for this purpose. The CAM is a standardized assessment of cognitive functioning developed by occupational therapists. The advantage of using a measure like the CAM is that it covers a greater range of cognitive impairment compared to most cognitive screens, making it potentially more useful as a screening measure. In addition to providing a global measure of cognition, the CAM also assesses practical skill domains. For example, the CAM allows for assessments of working memory and simple mathematical ability (e.g., can the person make change) that would allow for specific recommendations (e.g., providing assistance to the affected person in managing finances). The CAM also allows for hierarchical grading of cognitive skills, which may be useful in monitoring change over time. Thus, the CAM may be a promising measure to be used in geriatric settings. Although the CAM is frequently used internationally by OTs in practice