HEAD TURNING SIGN FOR DIAGNOSIS OF DEMENTIA AND MILD COGNITIVE IMPAIRMENT: A REVALIDATION

Objective To examine the utility of the head turning sign in the diagnosis of dementia and mild cognitive impairment, and to compare results with a previous report from this clinic (J Neurol Neurosurg Psychiatry 2012;83:852–3). Methods/Setting Prospective observational study, Cognitive Function Clinic. Results Of 191 consecutive new outpatients (M:F=100:91; age range 20–89 years, median 60 years) seen over a 10–month period (February–December 2012), 85 had cognitive impairment (55 with dementia by DSM–IV–TR criteria, 30 with MCI). Considering the whole cohort, presence of the head turning sign (HTS+) had sensitivity 0.61 and specificity 0.98 for the diagnosis of cognitive impairment; these figures were comparable to those (0.60, 0.98 respectively) from the previously examined cohort (January–October 2011). Considering only those patients who attended with an informant (n=113), HTS+ had sensitivity 0.68 and specificity 0.94 for diagnosis of cognitive impairment, again comparable with the previous cohort (0.63, 0.95 respectively). Positive predictive values were high (>0.9) in both cohorts. Conclusions This study confirms that the head turning sign is very specific but not very sensitive for the diagnosis of cognitive impairment in an unselected cognitive clinic cohort, with a high positive predictive value.