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Updated: Jul 19, 2026

Detection of Architectural Distortion in Prior Mammograms via Analysis of Oriented Patterns
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Digital quantification of the MMSE interlocking pentagon areas: a three-stage algorithm.

Namhee Kim1, Timothy Truty2, S Duke Han3,4,5,6

  • 1Michael Reese Foundation Center for Health Equity Research, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL, 60064, USA. Namhee.Kim@rosalindfranklin.edu.

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Summary

A new algorithm, Quantification of Interlocking Pentagons (QIP), offers a detailed scoring method for the pentagon copying test (PCT). This advanced analysis reveals how age and health factors influence cognitive performance in the PCT.

Keywords:
AgingMini-mental state examinationPentagon copying testPerceptual speed

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Area of Science:

  • Neuroscience
  • Gerontology
  • Cognitive Psychology

Background:

  • The Mini-Mental State Examination (MMSE) is a standard cognitive screening tool.
  • The pentagon copying test (PCT) within the MMSE assesses visuospatial skills.
  • Current PCT scoring is binary, lacking detailed performance assessment.

Purpose of the Study:

  • To introduce a novel algorithm, Quantification of Interlocking Pentagons (QIP), for granular scoring of the PCT.
  • To quantify PCT performance by analyzing pentagon and intersection areas, and their balance ratio.
  • To explore the relationship between QIP-derived metrics and demographic/clinical factors.

Main Methods:

  • Developed a three-stage algorithm: line segment detection, pentagon unraveling, and area quantification.
  • Applied the QIP algorithm to 497 PCTs from 84 participants in the Rush Memory and Aging Project.
  • Analyzed quantified data, including balance ratio, in relation to age, perceptual speed, vascular risk, and medical conditions.

Main Results:

  • A significant inverse relationship was found between age and the balance ratio (p=0.0033).
  • Balance ratio correlated positively with perceptual speed (r=0.71, p=0.0135).
  • Balance ratio was negatively associated with vascular risk factors (p=0.0269) and medical conditions (p=0.0389).

Conclusions:

  • The Quantification of Interlocking Pentagons (QIP) algorithm provides a novel, quantitative method for assessing PCT performance.
  • QIP-derived metrics, particularly balance ratio, are sensitive to age and cognitive-related factors.
  • This algorithm enhances the utility of the PCT for detailed cognitive assessment.