Caring for a family member with dementia is generally regarded as a chronically stressful process, with potentially negative physical health consequences. However, no quantitative analysis has been conducted on this literature. The authors combined the results of 23 studies to compare the physical health of caregivers with demographically similar noncaregivers. When examined across 11 health categories, caregivers exhibited a slightly greater risk for health problems than did noncaregivers. However, sex and the health category assessed moderated this relationship. Stronger relationships occurred with stress hormones, antibodies, and global reported health. The authors argue that a theoretical model is needed that relates caregiver stressors to illness and proffers moderating roles for vulnerabilities and resources and mediating roles for psychosocial distress and health behaviors.

Objectives. The Mini‐Cog, a composite of three‐item recall and clock drawing, was developed as a brief test for discriminating demented from non‐demented persons in a community sample of culturally, linguistically, and educationally heterogeneous older adults. Subjects. All 129 who met criteria for probable dementia based on informant interviews and 120 with no history of cognitive decline were included; 124 were non‐English speakers. Methods. Sensitivity, specificity, and diagnostic value of the Mini‐Cog were compared with those of the Mini‐Mental State Exam (MMSE) and Cognitive Abilities Screening Instrument (CASI). Results. The Mini‐Cog had the highest sensitivity (99%) and correctly classified the greatest percentage (96%) of subjects. Moreover, its diagnostic value was not influenced by education or language, while that of the CASI was adversely influenced by low education, and both education and language compromised the diagnostic value of the MMSE. Administration time for the Mini‐Cog was 3 minutes vs 7 minutes for the MMSE. Conclusions. The Mini‐Cog required minimal language interpretation and training to administer, and no test forms of scoring modifications were needed to compensate for the extensive linguistic and educational heterogeneity of the sample. Validation in clinical and population‐based samples is warranted, as its brevity and ease of administration suggest that the Mini‐Cog might be readily incorporated into general practice and senior care settings as a routine ‘cognitive vital signs’ measure. Copyright © 2000 John Wiley & Sons, Ltd.

When applied post hoc to an existing population, the Mini-Cog was as effective in detecting dementia as longer screening and assessment instruments. Its brevity is a distinct advantage when the goal is to improve identification of older adults in a population who may be cognitively impaired. Prior evidence of good performance in a multiethnic community-based sample further supports its validity in the ethnolinguistically diverse populations of the United States in which widely used cognitive screens often fail.

In older men, pathways occurred from chronic stress to distress to the metabolic syndrome, which in turn predicted CHD. Older women not using HRT showed fewer pathways than men; however, over time, distress, the MS, and CHD were related. No psychophysiological pathways occurred in older women using HRT.