Cognitive screening test in primary care: cut points for low education

Area of Science:

• Gerontology
• Cognitive Neurology
• Primary Care Medicine

Background:

• Cognitive impairment is a significant concern in aging populations.
• Accurate screening tools are crucial for early detection and intervention in primary care settings.
• The General Practitioner Assessment of Cognition (GPCOG) is a widely used cognitive screening tool, with its Brazilian version (GPCOG-Br) requiring validation.

Purpose of the Study:

• To evaluate the diagnostic accuracy of the Brazilian version of the General Practitioner Assessment of Cognition (GPCOG-Br).
• To compare the GPCOG-Br's performance against the Mini-Mental State Examination (MMSE).
• To assess these tools in individuals with low educational levels within Brazilian primary care.

Main Methods:

• A study involving 93 patients aged 60 and above from Brazilian primary care units.
• Data collected included sociodemographic, cognitive, and functional information.
• Statistical analyses employed receiver operating characteristic curves (AUC) and logistic regressions.

Main Results:

• The GPCOG-Br showed diagnostic accuracy comparable to the MMSE (AUC 0.90 vs. 0.91).
• Both tools demonstrated similar positive and negative predictive values.
• Adjusted cut-points yielded high sensitivity (86%) and satisfactory specificity (65%-80%), with lower education predicting poorer cognitive performance.

Conclusions:

• The GPCOG-Br is a clinically effective tool for cognitive assessment in Brazilian primary care.
• Its performance is comparable to the established MMSE, particularly in populations with limited education.
• The findings support the GPCOG-Br's utility for routine screening of cognitive function in primary care settings.