GPCOG

Last reviewed 08/2023

• 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:

• 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.
• Brodaty H, Kemp NM, Low L; Characteristics of the GPCOG, a screening tool for cognitive impairment, Int J Geriatr Psychiatry 2004; 19:870-74