Dementia Detection Vastly Improved By Administering One Additional Test

Administering the Visual Association Test (VAT) along with the Mini-Mental State Examination (MMSE) may help clinicians better identify patients with an increased risk for dementia, according to a recent study.

For their study, the researchers evaluated data on 2690 primary care patients aged 70 to 78 years who were enrolled in the Prevention of Dementia by Intensive Vascular Care (preDIVA) trial.

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Specifically, the researchers examined changes in the 30-point MMSE score over 2 years and the VAT score at 2 years. On the VAT, 6 points was considered “perfect” and 5 points or less was considered “imperfect.”
 

The predictive value of both tests for a diagnosis of dementia within the following 4 to 6 years was also evaluated, and data were assessed via logistic regression analysis.

Results of the study showed that patients whose total MMSE score declined by at least 2 points over 2 years had an odds ratio (OR) of 3.55 for developing dementia, while patients with the same decline in MMSE score along with an imperfect VAT score had an OR of 9.55.

The researchers found that a 1-point decline in MMSE score in combination with an imperfect VAT score was associated with an increased risk for dementia. However, the average risk for dementia among patients with a 2- or 3-point decrease MMSE score and a perfect VAT score did not differ significantly from that of the overall cohort.

“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,” the researchers concluded. “This simple test may help distinguish older adults who need further cognitive examination from those in whom a watchful waiting policy is justified.”

—Christina Vogt

Reference:

Jongstra S, van Gool WA, Moll van Charante EP, et al. Improving prediction of dementia in primary care. Ann Fam Med. 2018;16(3):206-210. doi:10.1370/afm.2224

SEE ALSO: Dementia: Evaluating, Diagnosing, and Referring Your Patients (Podcast)

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