- A new tool for evaluation of age-associated cognitive decline has been developed.
- This new tool is a cognitive chart called the QuoCo (cognitive quotient).
- It measures cognitive wellness based on age and education.
A new tool that tracks cognitive performance in adults may help physicians identify people who may be on the path to Alzheimer disease or another form of dementia.
The QuoCo (cognitive quotient)
The tool, called the QuoCo (cognitive quotient), is published in the Canadian Medical Association Journal
‘Early detection of cognitive impairment remains the best approach to disease management before irreversible brain damage occurs.’
"Similar to 'growth charts' used in pediatrics, the QuoCo cognitive charts allow physicians to plot cognitive performance of any patient based on age, education and score on the Mini-Mental State Examination, and track cognitive change over time," says Dr. Robert Laforce Jr., Université Laval and CHU de Québec-Université Laval. "This would allow physicians to intervene and potentially treat an older adult who 'fell off' the curve."
Dementia is a growing problem world-wide with many undiagnosed cases. Although there are no cures, potential treatments are being tested and some risk factors, such as diet and exercise, can be addressed to delay onset.
The authors hope that the QuoCo tool will be used by health care professionals, especially family physicians, to monitor cognitive decline in patients before irreversible damage occurs.
"Dementing illnesses have reached pandemic levels," write the authors. "Early detection of cognitive impairment remains our best approach to disease management before irreversible brain damage occurs. Family physicians are in a key position to contribute to this approach; however, they are ill-equipped."
Limitations of conventional evaluation tools
The authors note that the Mini-Mental State Examination is an imperfect screening measure and has its own limitations, although it is used internationally clinically and in research on dementia and cognitive decline.
In a related commentary, Dr. Andrew Costa, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, writes "the widespread benefits derived from cognitive charts for any screening examination rests on the assumption that at-risk patients are being screened systematically over time and that cognitive test results are communicated, or can be readily referenced by, physicians. We seem to be some distance away from that reality."
He notes that the success of any innovation rests upon training health care professionals to use these tools in clinical practice properly.
- Patrick J. Bernier, Christian Gourdeau et al. Validation and Diagnostic Accuracy of Predictive Curves for Age-Associated Longitudinal Cognitive Decline in Older Adults, Canadian Medical Association Journal DOI: https://doi.org/10.1503/cmaj.160792