Global Examination of Mental State: An open tool for the brief evaluation of cognition

BACKGROUND: The aim of this paper is to present a freely accessible new instrument for the evaluation of cognition: the Global Examination of Mental State (GEMS). METHODS: It is made up of 11 items tapping into a range of skills, such as Orientation in time and space, Memory, Working memory, Visuo‐spatial, Visuo‐constructional and Planning abilities, Perceptual and visual Attention, Language (Naming, Comprehension, and Verbal fluency), and Pragmatics. RESULTS: The psychometric strengths of this screening are: (1) extensive and updated normative data on the adult Italian population (from 18 to 100 years old); (2) absence of ceiling effect in healthy individuals, which allows to better detect interindividual variability; (3) comparison of the global scores with normative data taking into account Cognitive Reserve rather than only education, thus increasing diagnostic accuracy; (4) thresholds for significant change over time and the possibility to use parallel versions (GEMS‐A/GEMS‐B) for test‐retest; (5) solid psychometric properties and data on discriminant validity; and (6) free access to all materials (record forms, instructions, and cut‐off scores) on the web under a Creative Common License. CONCLUSIONS: With all these characteristics, GEMS could be a very useful paper‐and‐pencil instrument for cognitive screening.