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Improving Prediction of Dementia in Primary Care.
- Source :
- Annals of Family Medicine; May/Jun2018, Vol. 16 Issue 3, p206-210, 5p
- Publication Year :
- 2018
-
Abstract
- <bold>Purpose: </bold>The Mini-Mental State Examination (MMSE) is one of the most widely used instruments to screen for cognitive deficits; however, this instrument alone is not sensitive enough to detect early symptoms of dementia. We aimed to investigate whether additionally using the Visual Association Test (VAT) improves the predictive value of the MMSE score for development of dementia.<bold>Methods: </bold>Analyses were based on data from 2,690 primary care patients aged 70 to 78 years who participated in the Prevention of Dementia by Intensive Vascular Care (preDIVA) trial. We assessed change in the 30-point MMSE score over 2 years and the VAT score at 2 years-dichotomized as perfect (6 points) or imperfect (≤5 points)-and evaluated the predictive values of these tests for a diagnosis of dementia in the subsequent 4 to 6 years. Data were analyzed with logistic regression analysis.<bold>Results: </bold>Patients having a decline of 2 points or more in total MMSE score over 2 years had an odds ratio of 3.55 (95% CI, 2.51-5.00) for developing dementia. Patients having the same decline in MMSE score plus an imperfect VAT score had an odds ratio of 9.55 (95% CI, 5.89-15.41) for developing dementia. A 1-point decline in MMSE score increased odds of dementia only when the VAT score was imperfect. Dementia risk for patients with a 2- or 3-point decrease in MMSE score and a perfect VAT score did not differ significantly from the average risk of the cohort as a whole.<bold>Conclusions: </bold>Administering the VAT in patients with a small decline on the MMSE over a 2-year period has substantial incremental value for identifying those at elevated risk for developing dementia. This simple test may help distinguish older adults who need further cognitive examination from those in whom a watchful waiting policy is justified. [ABSTRACT FROM AUTHOR]
- Subjects :
- DIAGNOSIS of dementia
DEMENTIA prevention
PRIMARY care
EARLY diagnosis
MINI-Mental State Examination
CLINICAL trials
COMPARATIVE studies
LEARNING
LONGITUDINAL method
NEUROPSYCHOLOGICAL tests
RESEARCH methodology
MEDICAL cooperation
MEMORY
PRIMARY health care
PSYCHOLOGICAL tests
PSYCHOMETRICS
RESEARCH
RISK assessment
VISUAL perception
LOGISTIC regression analysis
EVALUATION research
Subjects
Details
- Language :
- English
- ISSN :
- 15441709
- Volume :
- 16
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Annals of Family Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 129518888
- Full Text :
- https://doi.org/10.1370/afm.2224