Predicting Risk for Cognitive Impairment Based on Age, Mini-Mental Exam

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Charts that account for patient age and MMSE score may help stratify risk for cognitive impairment.
Charts that account for patient age and MMSE score may help stratify risk for cognitive impairment.

Cognitive charts based on age as well as results of the Mini-Mental State Examination (MMSE) may help stratify risk for long-term cognitive impairment, according to a study published in CMAJ.

A total of 7569 participants aged ≥65 years were included in this analysis. Participants completed the MMSE at baseline, 5 years, and 10 years. Cognitive charts were generated to distinguish participants with dementia from healthy controls. The National Alzheimer's Coordinating Center's Uniform Data Set provided data on 6501 participants that the investigators used to validate their model.

The cognitive charts developed by the investigators demonstrated a sensitivity of 80% (95% CI, 75%-84%) and a specificity of 89% (95% CI, 88%-90%) for differentiating healthy controls from patients with dementia at baseline. The researchers then compared the general trend of cognitive quotient in healthy controls, patients with cognitive impairment and no dementia, and patients with dementia.

Participants in the dementia group experienced significantly greater cognitive decline than healthy controls over time (–8.19 [95% CI, –8.42 to –7.97] vs –5.69 [95% CI, –5.79 to –5.59], respectively; P <.001). However, no differences were observed between the cognitive impairment with no dementia group and healthy controls (–5.77 [95% CI, –5.97 to –5.58] vs –5.69 [95% CI, –5.79 to –5.59], P =.4).

As data were collected from community-dwelling Canadians, the implications associated with the findings may be limited to that patient population.

The use of a risk prediction model similar to the model presented in this study may assist in early detection of cognitive impairment, which “remains our best approach to disease management before irreversible brain damage occurs,” the investigators concluded.

Reference

Bernier PJ, Gourdeau C, Carmichael P-H, et al. Validation and diagnostic accuracy of predictive curves for age-associated longitudinal cognitive decline in older adults. CMAJ. 2017;189(48):E1472-E1480.

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