The "cognitive state" is represented by a single point on the charts without considering its evolution over time.
The patient's cognitive state is considered normal if the QuoCo score is plotted above the cutoff zone, or it is suspect if the point is into that grayed zone.
The "cognitive trajectory" refers to the line traced between the patient's baseline and its most recent QuoCo score.
An interval is the zone between two plain lines of two dotted lines at the bottom of the charts.
If a point is between two lines, You should compute the equivalent of one interval towards the bottom, relatvely to the closest percentile.
A trajectory is suspect when it shows a decline greater than one percentile from the initial measurements, which indicates potential cognitive problems.
(See our video tutorial for more information)
It is mainly to get rid of the decimals. A result on 1000 also prevents confusion with other cognitive tests based on 100 such as 3MS.
The maximum value for the education is fixed at 14 years. You must use 7 years of education to compute the standardized age, even if the real education is higher thatn 14 years.
The cognitive charts were built form a large database of normal patients from which the MMSE, age and education have been analyzed.
Our analysis showed that the MMSE is not favorably influenced over 14 years of education.
Yes. If you have a previous MMSE score where the patient did not have a diagnosis of dementia (Major neurocognitive disorder),
you can use it as a reference point for comparison with the actual MMSE. If you only have an actual MMSE score,
the grayed zone (cut-off) allows you to interpret the cognitive status of the patient.
No. It is acceptable to use another point as the baseline.
For example, if a patient have a better QuoCo score after the baseline, it would be preferable to use that last one.
However, it is not the recommendations from our published study (this notion is currently under investigation by our team).
You probably tried to use data from a patient that does not the have characteristics included in our analysis.
Your patient's age must be between 65 and 95, thus a patient with a standardized age less than 58 years cannot be placed on the QuoCo charts.
Did you make sure to take account of the limit of 14 years of education?
Your patient’s result is exceptionally good and is better than the highest percentile obtained from our statistical analysis. Everything is fine.
It means the patient’s tests performances are increasingly getting better than what is normally expected.
The patient's trajectory is thus very likely normal.
Our analyses have shown that the trajectory is likely suspect as soon as one interval is lost.
However, the larger is the decline, the more suspicious is the trajectory.
When the trajectory goes directly onto the next percentile line, it is theorically still acceptable, but the clinical judgment always prevails.
If you are confident that the previous score was normal for this patient, yes. The grayed zone percentiles will help you measure its trajectory.
Les courbes cognitives ont été développées à partir des scores de MMSE avec "MONDE à l'envers".
It's because the spaces between the percentile lines have been set to maximize the performance of discriminating between
normal decline and the development of a dementia (major neurocognitive disorder).
For the lowest percentiles, the acceptable decline is smaller because previous scores are already low.
Not yet. For now, only the MMSE has been studied.
Download the PDF version of the cognitive chart, or download the QuoCo mobile app now available on iPhone and iPad.