Journal article
Decline in cognition from mid-life improves specificity of mini-mental state examination: diagnostic test accuracy in Caerphilly Prospective Study (CaPS)
- Abstract:
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Background: The merit of using baseline cognitive assessments in mid-life to help interpret cross-sectional cognitive tests scores in later life is uncertain.
Objective: Evaluate how accuracy for diagnosing dementia is enhanced by comparing cross-sectional results to a midlife measure.
Method: Cohort study of 2,512 men with repeated measures of Mini Mental State Examination (MMSE) over approximately 10 years. Index test MMSE at threshold of 24 indicating normal, as a cross-sectional measure and in combination with decline in MMSE score from mid-life. Reference standard consensus clinical diagnosis of dementia by two clinicians according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).
Results: 1,150 men participated at phase 4 of whom 75 had dementia. A cross-sectional MMSE alone produced a sensitivity of 60% (50% to 70%) and specificity 95% (94% to 97%) with a threshold of ≥ 24 points indicating normal. For lower-scoring men in late life, with cross sectional scores of <22, combining cross-sectional AND a three-point or more decline over time had a sensitivity of 52% (39% to 64%) and specificity 99% (99% to 100%). For higher-scoring men in later life, with cross sectional scores <26 combining cross-sectional OR decline of at least three points had a sensitivity of 98% (92% to 100%) and specificity 38% (32% to 44%).
Conclusion: It may be helpful in practice to formally evaluate cognition in mid-life as a baseline to compare with if problems develop in future, as this may enhance diagnostic accuracy and classification of people in later life.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Accepted manuscript, pdf, 322.4KB, Terms of use)
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- Publisher copy:
- 10.3233/JAD-220345
Authors
- Publisher:
- IOS Press
- Journal:
- Journal of Alzheimer’s Disease More from this journal
- Volume:
- 89
- Issue:
- 4
- Pages:
- 1241-1248
- Publication date:
- 2022-08-18
- Acceptance date:
- 2022-07-25
- DOI:
- EISSN:
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1875-8908
- ISSN:
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1387-2877
- Language:
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English
- Keywords:
- Pubs id:
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1270050
- Local pid:
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pubs:1270050
- Deposit date:
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2022-07-27
Terms of use
- Copyright holder:
- IOS Press
- Copyright date:
- 2022
- Rights statement:
- © 2022 – IOS Press. All rights reserved.
- Notes:
- This is the accepted manuscript version of the article. The final version is available online from IOS Press at: https://doi.org/10.3233/JAD-220345
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