VAT score improves predictive value of MMSE for dementia
Susan Jongstra, M.D., Ph.D., from the University of Amsterdam, and colleagues analyzed data from 2,690 primary care patients aged 70 to 78 years. Change in the 30-point MMSE score was assessed over two years, and the VAT score was dichotomized as perfect (6 points) or imperfect (≤5 points) at two years. The predictive value of these tests was assessed in the next four to six years.
The researchers found that patients with a decline of 2 or more points in total MMSE score had an odds ratio of 3.55 for developing dementia over two years. For patients with the same decline in MMSE score plus an imperfect VAT score, the odds ratio for developing dementia was 9.55. The odds of dementia were increased with a 1-point decrease in MMSE score only when the VAT score was imperfect. Patients with a 2- or 3-point decrease in MMSE and a perfect VAT score did not have a significantly different average risk for dementia than the cohort as a whole.
"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 authors write. "This simple test may help distinguish older adults who need further cognitive examination from those in whom a watchful waiting policy is justified."
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