I was interested to learn from the audit of dementia referrals to a later life psychiatry service that only 13.2% of referral letters contained Mini-Mental State Examination (MMSE) results. ^{Reference Hussey, Foy and Meehean1} Findings from a neurology-led dementia service were little better, with around 20% of referrals from primary care containing evidence of cognitive test results, most commonly the MMSE. ^{Reference Fisher and Larner2} These results contrast with those from a postal survey which claimed 79% use of dementia screening tests in three English primary care trusts. ^{Reference Milne, Culverwell, Guss, Tuppen and Whelton3} How can the discrepancy be accounted for?

It would seem unlikely that general practitioners (GPs) would not report MMSE results in a referral letter to a dementia service if the test had been undertaken. More likely, the MMSE is too time consuming in primary care and/or too difficult to interpret. If so, then the use of other, briefer, screening instruments with unambiguous cut-offs, such as Mini-Cog or GP-Cog, ^{Reference Milne, Culverwell, Guss, Tuppen and Whelton3} must be vigorously encouraged in primary care. No example of their use was encountered in the Fisher & Larner study. ^{Reference Fisher and Larner2}

This could form one aspect of the ‘raising awareness’ strand in the implementation of the National Dementia Strategy. ⁴