Mapping Cognitive Trajectories and Detecting Early Dementia Using the Mini-Mental State Examination Cognitive Charts: Application to the French Three-City Cohort
Affiliations: [a] Institute for Neurosciences of Montpellier (INM), Inserm, University of Montpellier, Montpellier, France
| [b] Department of Physics, Cégep Limoilou, Québec City, Canada
| [c] INSERM, Bordeaux Population Health Research Center, UMR U1219, University of Bordeaux, Bordeaux, France
| [d] Specialised Geriatric Services, CIUSSS Capitale-Nationale, Québec City, Canada
Correspondence:
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Correspondence to: Joanna Norton, PhD, Inserm U1298, Institute for Neurosciences of Montpellier, 80 Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France. E-mail: joanna.norton@inserm.fr.
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.
Keywords: Age, Alzheimer’s disease, cognitive decline, dementia, early detection, education
