Could Charting Cognitive Decline Help Identify Dementia?
Using cognitive charts—similar to pediatric growth charts—could be an effective way to determine whether older adults have developed dementia, according to the results of a recent study.
The researchers examined data on 7569 participants in the Canadian Study of Health and Aging for their study. Participants were aged 65 years and older and completed a Mini-Mental State Examination at baseline, 5 years and 10 years. Using linear regression, the researchers generated cognitive charts for the participants, designed to optimize accuracy in distinguishing participants with dementia from healthy controls. The model was validated using data from a separate set of 6501 participants from the National Alzheimer’s Coordinating Center’s Uniform Data Set.
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For baseline measurement, the cognitive charts had a sensitivity and specificity of 80% and 89%, respectively, for distinguishing healthy controls from participants with dementia. Similar sensitivities and specificities were observed for a decline over time greater than 1 percentile zone from the first measurement.
“Similar to the “growth charts” that are used in pediatrics, cognitive charts allow physicians to position any patient based on age, education and Mini-Mental State Examination scores, and simply track the longitudinal profile of cognitive decline over time. This implies an ability to prompt earlier intervention for an older adult who “fell off” the curve,” the researchers concluded.”
—Michael Potts
Reference:
Bernier PJ, Gourdeau C, Carmighael P, et al. Validation and diagnostic accuracy of predictive curves for age-associated longitudinal cognitive decline in older adults [published online December 4, 2017]. CMAJ. https://doi.org/10.1503/cmaj.160792.