Work

Should Cognitive Screening Tests Be Corrected for Age and Education? Insights From a Causal Perspective

Year: 2022

Type: article

Abstract: Cognitive screening tests such as the Mini-Mental State Examination are widely used in clinical routine to predict cognitive impairment. The raw test scores are often corrected for age and education, although documented poorer discrimination performance of corrected scores has challenged this practice. Nonetheless, test correction persists, perhaps due to the seemingly counterintuitive nature of the underlying problem. We used a causal framework to inform the long-standing debate from a more intuitive angle. We illustrate and quantify the consequences of applying the age-education correction of cognitive tests on discrimination performance. In an effort to bridge theory and practical implementation, we computed differences in discrimination performance under plausible causal scenarios using Open Access Series of Imaging Studies (OASIS)-1 data. We show that when age and education are causal risk factors for cognitive impairment and independently also affect the test score, correcting test scores for age and education removes meaningful information, thereby diminishing discrimination performance.

Source: American Journal of Epidemiology

DOI: 10.1093/aje/kwac159

Authors: Marco Piccininni, Jessica L Rohmann, Maximilian Wechsung, Giancarlo Logroscino, Tobias Kurth

Institutions: Center for Stroke Research Berlin, Charité – Universitätsmedizin Berlin, University of Bari Aldo Moro

Language: English

Topic: Dementia and Cognitive Impairment Research

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,450