{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:04:31Z","timestamp":1777395871473,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2022,10,11]]},"abstract":"<jats:p>Background: The merit of using baseline cognitive assessments in mid-life to help interpret cross-sectional cognitive tests scores in later life is uncertain. Objective: Evaluate how accuracy for diagnosing dementia is enhanced by comparing cross-sectional results to a midlife measure. Methods: Cohort study of 2,512 men with repeated measures of Mini-Mental State Examination (MMSE) over approximately 10 years. Index test MMSE at threshold of 24 indicating normal, as a cross-sectional measure and in combination with decline in MMSE score from mid-life. Reference standard consensus clinical diagnosis of dementia by two clinicians according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Results: 1,150 men participated at phase 4 of whom 75 had dementia. A cross-sectional MMSE alone produced a sensitivity of 60% (50% to 70%) and specificity 95% (94% to 97%) with a threshold of\u226524 points indicating normal. For lower-scoring men in late life, with cross sectional scores of\u200a&lt;\u200a22, combining cross-sectional AND a three-point or more decline over time had a sensitivity of 52% (39% to 64%) and specificity 99% (99% to 100%). For higher-scoring men in later life, with cross sectional scores\u200a&lt;\u200a26 combining cross-sectional OR decline of at least three points had a sensitivity of 98% (92% to 100%) and specificity 38% (32% to 44%). Conclusion: It may be helpful in practice to formally evaluate cognition in mid-life as a baseline to compare with if problems develop in future, as this may enhance diagnostic accuracy and classification of people in later life.<\/jats:p>","DOI":"10.3233\/jad-220345","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T13:28:04Z","timestamp":1660915684000},"page":"1241-1248","source":"Crossref","is-referenced-by-count":0,"title":["Decline in Cognition from Mid-Life Improves Specificity of Mini-Mental State Examination: Diagnostic Test Accuracy in Caerphilly Prospective Study (CaPs)"],"prefix":"10.1177","volume":"89","author":[{"given":"Sam","family":"Creavin","sequence":"first","affiliation":[{"name":"School of Social and Community Medicine, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Fish","sequence":"additional","affiliation":[{"name":"Department of Neurology, Royal Devon and Exeter Hospital, Exeter, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antony","family":"Bayer","sequence":"additional","affiliation":[{"name":"Division of Population Medicine, Cardiff University, Academic Centre, University Hospital Llandough, Cardiff, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Gallacher","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Warneford Hospital, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoav","family":"Ben-Shlomo","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-220345_ref1","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1001\/jamainternmed.2015.2152","article-title":"Cognitive tests to detect dementia: a systematic review and meta-analysis","volume":"175","author":"Tsoi","year":"2015","journal-title":"JAMA Intern Med"},{"key":"10.3233\/JAD-220345_ref2","first-page":"CD011145","article-title":"Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations","volume":"1","author":"Creavin","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"10.3233\/JAD-220345_ref3","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1093\/ageing\/afu205","article-title":"A diagnosis for \u00a355: What is the cost of government initiatives in dementia case finding","volume":"44","author":"Bell","year":"2015","journal-title":"Age Ageing"},{"key":"10.3233\/JAD-220345_ref4","doi-asserted-by":"crossref","first-page":"526","DOI":"10.7861\/clinmedicine.10-5-526","article-title":"Impact of the National Dementia Strategy in a neurology-led memory clinic","volume":"10","author":"Larner","year":"2010","journal-title":"Clin Med (Northfield Il)"},{"key":"10.3233\/JAD-220345_ref5","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1136\/jech.38.3.259","article-title":"Caerphilly and Speedwell collaborative heart disease studies. 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In Cochrane Database of Systematic Reviews, Krogsb\u00f8ll LT, ed. 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