Simple new tool could help doctors spot dementia

Tuesday, 05 December 2017, 12:54:10 AM. Canadian researchers say they may soon be able to easily identify adults who are on the path to Alzheimer’s disease, using a tool that works in a similar way to a pediatrician’s growth charts.

Canadian researchers say they may soon be able to easily identify adults who are on the path to Alzheimer’s disease, using a tool that works in a similar way to a pediatrician’s growth charts.

The tool, called the QuoCo (a play on the term “cognitive quotient”), allows doctors to test the memory or cognitive performance of any patient and then plot changes over time, to see if those changes fit within the normal range.

“It allows you to track the performance of an individual over time to see if that individual is following the normal cognitive decline associated with normal aging,” neurologist Dr. Robert Laforce Jr. explained to CTV’s Your Morning Monday.

Dr. Laforce said he and his team at the Université Laval helped establish a range of what constitutes “normal cognitive decline” by following 8,000 healthy individuals and tracking their performance using a well-established dementia screening tool called the MMSE, or Mini Mental State Examination.

They were then able to build a cognitive decline chart similar to the growth charts used in pediatrics. Physicians can use the tool to plot an older patient’s cognitive changes over time and determine if they are “falling off” the curve.

A new study of the QuoCo tool, published Monday in CMAJ (Canadian Medical Association Journal), found that it was 80 per cent accurate in correctly identifying those with dementia, and 89 per cent accurate in identifying those without it.

Dr. Laforce noted that the QuoCo looks at more than an individual’s MMSE test score. It also takes into consideration an individual’s age and education level, since research has shown that those with less education, for example, tend to have faster cognitive declines than those with more.

He also noted that the QuoCo would not be “the only part of the equation” in diagnosing dementia, which is why the average family member could not conduct the test on a loved one themselves.

“The interpretation of these screening tests would have to be done with great expertise,” he said, which is why a physician is best suited to use the tool, since they can take a full clinical history, and conduct a physical examination to eliminate other possible causes for cognitive changes.

Although there is no cure for dementia and few medications that can slow the disease, Dr. Laforce believes that new treatments to delay cognitive decline are on the horizon.

“We’re on the verge of vaccines, for instance, for 'prodromal' Alzheimer’s, or early stage Alzheimer’s, that we expect results on in about a year,” he said.

For that reason, he believes it’s important to create tools like QuoCo, to spot the earliest warning signs of the disease.

“When brain damage is advanced -- when there’s irreversible brain damage -- there’s not much we can do. So early screening is the key,” he said.

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