Cognitive Decline Charts Could Help Flag Whether Patient Has Dementia

By Kelly Young

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

Cognitive charts using percentile curves — similar to pediatric growth charts — could help determine whether a patient has developed dementia, suggests an article in the Canadian Medical Association Journal.

Researchers used a Canadian cohort of over 6000 healthy adults aged 65 and older and 1200 adults with dementia to construct the QuoCo tool. The model considers the patient's age, years of education, and scores on the Mini-Mental State Examination (MMSE) at 0, 5, and 10 years. For identifying patients with dementia in the training sample, the charts had a sensitivity of 80%, a specificity of 89%, and a negative predictive value of 99%, compared with a fixed MMSE cut point for dementia.

A decline in the charts should prompt further clinical evaluation, the authors write.

A commentator cautions: "The widespread benefits derived from cognitive charts for any screening examination [rest] on the assumption that at-risk patients are being screened systematically over time and that results from cognitive tests are communicated to, or can be readily referenced by, physicians. We seem to be some distance away from that reality."