Selecting a Brief Cognitive Screening Test Based on Patient Profile: It Is Never Too Early to Start.

Area of Science:

• Gerontology
• Pharmacology
• Neurology

Background:

• Cognitive impairment is often underdiagnosed, impacting dementia risk.
• Cardiovascular risk factors (CVR) and anticholinergic burden (ACB) are key contributors to cognitive decline.
• ACB frequently arises from medications for neuropsychiatric conditions.

Purpose of the Study:

• To evaluate cognitive profiles in older adults with subjective memory complaints.
• To analyze the impact of CVR and ACB on cognitive test performance.
• To determine the utility of different brief cognitive tests based on patient characteristics.

Main Methods:

• Cross-sectional study (2019-2023) in Spain involving 172 patients (≥50 years) with memory complaints and CVR.
• Assessed cognitive function using Memory Impairment Screening (MIS), Semantic Verbal Fluency Test, and SPMSQ.
• Quantified CVR using the European SCORE2 table and ACB using the CALS scale.

Main Results:

• 60% of participants failed at least one cognitive test.
• Higher CVR and ACB were associated with more failed cognitive tests.
• MIS test failure correlated with elevated SCORE2 scores; SPMSQ failure correlated with elevated ACB.

Conclusions:

• Brief cognitive tests can be selected based on patient profiles for effective cognitive impairment screening.
• The MIS test is beneficial for patients with cardiovascular risk.
• The SPMSQ test is particularly useful for patients with significant anticholinergic burden.