Among older adults with a minor decline on a screening test
for cognitive ability, an additional three-minute test of associative memory
can improve identification of patients at increased risk of developing dementia
over the next several years, according to a study published in the May/June
issue of the Annals of Family Medicine.
Susan Jongstra, MD, PhD, from the University of Amsterdam,
and colleagues evaluated whether the Visual Association Test (VAT) in
conjunction with the Mini-Mental State Examination (MMSE) improves the
predictive value for development of dementia among 2690 primary care patients
(aged 70 to 78 years) over the next four to six years.
The researchers found that patients having a decline of two
points or more in total MMSE score over two years had an odds ratio of 3.55 for
developing dementia. When that same decline in MMSE score was considered with
an imperfect VAT score, the odds ratio increased to 9.55 for developing
dementia. For a one-point decline in MMSE score, the odds of dementia increased
only when the VAT score was imperfect. A two- or three-point decline in MMSE
score and a perfect VAT score did not relate to a change in dementia risk
compared to the average risk of the cohort as a whole.
“Administering the VAT in patients with a small decline
on the MMSE over a two-year period has substantial incremental value for
identifying those at elevated risk for developing dementia,” the authors
write. “This simple test may help distinguish older adults who need
further cognitive examination from those in whom a watchful waiting policy is
Jongstra S, et al. Improving Prediction of Dementia in Primary Care. Ann Fam Med, May/June 2018vol. 16 no.
3 206-210. http://www.annfammed.org/content/16/3/206.full