Expanding the Applicability of Cognitive Charts to the Entire Age Span

Background/Objectives: We previously developed Cognitive Charts (CCs) for early detection and/or longitudinal evaluation of age-associated cognitive decline on widely used cognitive screening measures such as the Mini-Mental State Examination (CC-MMSE) and the Montreal Cognitive Assessment (CC-MoCA). Similar to growth curves used in Pediatrics, clinicians can quickly interpret an individual's performance on the MMSE or MoCA, track the patient's longitudinal cognitive trajectory, and subsequently intervene earlier based on the findings (see quoco.org). This has proven very helpful to frontline clinicians, particularly in light of the newly approved monoclonal antibodies for treatment of Alzheimer's disease. To this date, however, the CC-MMSE and CC-MoCA only applied to limited age ranges. We validated herein our CCs across the entire age span. Methods: Two datasets were obtained from the National Alzheimer's Coordinating Center, for a total of 32,560 individuals. We examined average MMSE and MoCA scores for younger individuals compared to the current age thresholds and ensured consistency of age-related Cognitive Quotient scores. Results: In this study, both MMSE and MoCA scores show very little variation below the age threshold. If the age is fixed at the threshold in the QuoCo calculation, the resulting score remains constant within this range. Furthermore, CCs performed similar or better in younger individuals. Conclusions: Our findings again emphasize the clinical significance of CCs as a tool for monitoring cognitive changes across the entire age span, hence maximizing early detection and appropriate treatment monitoring.