Mapping Cognitive Trajectories and Detecting Early Dementia Using the Mini-Mental State Examination Cognitive Charts: Application to the French Three-City Cohort

Author:

Norton Joanna1,Gutierrez Laure-Anne1,Gourdeau Christian2,Amieva Hélène3,Bernier Patrick4,Berr Claudine1

Affiliation:

1. Institute for Neurosciences of Montpellier (INM), Inserm, University of Montpellier, Montpellier, France

2. Department of Physics, Cégep Limoilou, Québec City, Canada

3. INSERM, Bordeaux Population Health Research Center, UMR U1219, University of Bordeaux, Bordeaux, France

4. Specialised Geriatric Services, CIUSSS Capitale-Nationale, Québec City, Canada

Abstract

The Cognitive Quotient (QuoCo) classification algorithm monitoring decline on age- and education-adjusted Mini-Mental State Examination (MMSE)-derived cognitive charts has proved superior to the conventionally-used cut-off for identifying incident dementia; however, it remains to be tested in different settings. Data were drawn from the Three-City Cohort to 1) assess the screening accuracy of the QuoCo, and 2) compare its performance to that of serial MMSE tests applying different cut-offs. For the QuoCo, sensitivity was 74.2 (95% CI: 71.4–76.8) and specificity 84.1 (83.6–84.7) and for the MMSE < 24, 64.1 (61.1–67.0) and 94.8 (94.4–95.1), respectively; whereas overall accuracy and sensitivity was highest for MMSE cut-offs <25 and <26. User-friendly charts for mapping cognitive trajectories over visits with an alert for potentially ‘abnormal’ decline can be of practical use and encourage regular monitoring in primary care where the <24 cut-off is still widely used despite its poor sensitivity.

Publisher

IOS Press

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