Simple new tool may help physicians identify people at risk for Alzheimer disease

A simple new tool that tracks cognitive performance in adults aims to help physicians identify people who may be on the path to Alzheimer disease or another form of dementia. The tool, called the QuoCo (cognitive quotient), is published in CMAJ (Canadian Medical Association Journal).

"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."

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.