Premorbid ability influences measures used to identify dementia

EDITOR,--Alewijn Ott and colleagues identified 474 cases of dementia in a suburb of Rotterdam and report that the prevalence of Alzheimer's disease is inversely related to educational status.1 In an accompanying editorial Martin Orrell and Barbara Sahakian conclude that there may be some truth in the age old saying “use it or lose it” regarding mental skills.2 In Ott and colleagues' study dementia was primarily diagnosed on the basis of poor performance in tests of cognitive efficiency. The first screen consisted of a geriatric mental status examination and the mini mental …