- Email: [email protected]
The neurolinguistic profile of behavioral variant frontotemporal dementia
P710 P3-201
Poster Presentations: P3 POSTERIOR CORTICAL ATROPHY (PCA) AND MENTAL IMAGERY: A PILOT STUDY
Jennifer C. Scuse, Dina I. Drubach, Daniel A. Drubach, Mayo Clinic, Rochester, MN, USA. Contact e-mail: [email protected] Background: Posterior cortical atrophy (PCA) is a syndrome characterized by progressive visual perceptual difficulties often associated with other neurological manifestations including apraxia, aphasia and cognitive symptoms. Because the underlying neuropathology is frequently that of Alzheimer’s Disease, it has become known as the “visual presentation” of this disorder. While patients with PCA have difficulties with extrinsic perception, we do not know whether “intrinsic perception”, including the ability to visualize imagery, is affected. This is an important question taking into account the cognitive value of visual imagery which forms the basis of imagination, which enables a number of cognitive tasks including behavior rehearsal, anxiety reduction, recreation, motor skill enhancement and others. Since visual imagery is a subjective experiential phenomenon, it is difficult to quantify or characterize in a person. The Vividness of Visual Imagery Questionnaire (VVIQ: Marks 1973) is a valid psychometric instrument used for measuring visual imagery differences in individuals (see Richardson, 1994; McKelvie, 1995 for reviews). The questionnaire consists of sixteen items that are each completed twice; once to determine the vividness of several images recalled by the participant when their eyes are open, and then once again for the same images obtained when their eyes are closed. The test uses a self-reported 5 point Likert scale to objectively measure the vividness of each mental image. Methods: The VVIQ was administered to 7 patients with PCA and 8 age matched controls. Results: Although the vividness of mental imagery values for an image obtained with participant’s eyes open did not differ significantly from the values obtained from the typical control group [F(13,14)¼2.1257, p¼ 0.1686] it was shown that when the individuals with PCA ranked the vividness of a mental image obtained with their eyes closed the vividness ranking was statistically lower than those obtained by the control participants [F(13, 14) ¼ 4.7045, p¼0.0492]. Conclusions: The results of this pilot study indicate that participants with PCA maintain their ability to vividly visualize images with eyes open, however they may demonstrate a decrease in their ability to vividly visualize images with eyes closed when compared to their typical peers.
P3-202
SPECT FINDINGS AND NEUROPSYCHOLOGICAL ASSESSMENTS IN OLDER PATIENTS WITH ALZHEIMER’S DISEASE
Hiroyuki Umegaki, Taeko Makino, Madoka Yanagawa, Masafumi Kuzuya, Nagoya University, Nagoya, Japan. Contact e-mail: [email protected] Background: Many studies have demonstrated that older patients who were clinically diagnosed as Alzheimer’s disease (AD) actually have multiple pathologies or pathologies other than AD. SPECT provides useful information of regional blood flow and easy Z score system (eZIS) determine AD-specific pattern of regional blood flow reduction. In the current study we tried to find out the characteristics of patients who were clinically diagnosed as AD but had non-specific pattern of regional blood flow reduction by eZIS in geriatics outpatient settings. Methods: All the Subjects involved were clinically diagnosed as AD according to DSM-IV in an out patient clinic of geriatrics. The number of the subjects was 182 (mean age 77.766.8). We used eZIS version 3.0 for a statistical analysis of SPECT. Three indices (severity, extent, tario) of regional blood flow reduction were used. Those who had all three indices above the threshold were determined as
eZIS+, and those who did not have AD specific pattern of regional blood flow reduction were determined as eZIS-. Then, scores of the neuropsychological assessments and backgrounds were compared between these two groups. Results: The 42.9% of the subjects were eZIS-. Subjects in eZIS+ group were significantly older and milder memory impairment in logical memory 1 and II. Conclusions: eZIS- AD may have multi-pathologies or dementia pathologies other than AD. More details of eZIS-AD will be invetigated P3-203
THE CLOCK DRAWING TEST: A COMPARISON BETWEEN ALZHEIMER’S DISEASE AND FRONTEMPORAL DEMENTIA PATIENTS
Luis Jacobo Resendiz-Najera1, Elena Itzel Portillo-Ya~nez1, Gilberto Isaac Acosta-Castillo2, Ana Luisa Sosa-Ortiz2, 1National Institute of Neurology and Neurosurgery “MVS”, Mexico City, Mexico; 2Dementia Laboratory National Institute of Neurology and Neurosurgery, Mexico City, Mexico. Contact e-mail: [email protected] Background: Due to the actual impacts of the dementias, is necessary the use of efficient clinimetric tests that support its early and accurate diagnosis. The clock drawing test (CDT) has been widely use in the assessment of patients with cognitive impartment due to the capacity to asses in a short time several cognitive functions that are affected in different ways along the dementia subtypes. Methods: The objective of our work was to compare the CDT errors between Alzheimer (AD) disease and frontemporal dementia (FTD) patients, using the modified qualitative score of Rouleau and the quantitative CDT score used in the Mini-cog, to analyze if there are specific errors that allow differentiating between these two groups. We use a sample of 90 subjects, 45 with sporadic late onset AD, 20 with FTD behavioral variant and 25 controls without psychiatric or neurological diseases. The CDT with predrawn circle was apply to all the sample and the MMSE was apply to the AD and FTD groups to assess the degree of cognitive impairment. Results: The mean age for the AD, FTD and control groups was 76.3, 65.5 and 63.28 years and the mean education in years was 11.06, 10.55 and 9.92 respectively. The difference in the quantitative CDT score was not statistically significant between the AD and FTD groups but it was between dementia and control groups. In the qualitative score only the conceptual deficit was higher statistically significant between the AD and the control group. Conclusions: We confirmed that the CDT is a useful test for screening dementia, but its utility to differentiate among dementia types is still unclear. In our study we did not find specific errors in the AD and FTD groups that allow us to differentiate between these particular types of dementia, but some limitations in our study can be related to our results, such as: the sample size was small and we did not included patients with FTD others than behavioral variant; we didn’t not take in account the dementia severity and besides, we weren’t able to analyze graphic errors and size of the clock because the predrawn circles.
P3-204
THE NEUROLINGUISTIC PROFILE OF BEHAVIORAL VARIANT FRONTOTEMPORAL DEMENTIA
Chris J. D. Hardy1, Jonathan Rohrer1, Aisling Buckley1, Sebastian J. Crutch1, Laura E. Downey1, Nick C. Fox2, Susie M. Henley1, Manja Lehmann1, Jason D. Warren1, 1University College London, London, United Kingdom; 2UCL Institute of Neurology, London, United Kingdom. Contact e-mail: [email protected] Background: Behavioural variant frontotemporal dementia (bvFTD)
is clinically and pathologically heterogeneous. In contrast to the
Poster Presentations: P3
syndromes of primary progressive aphasia (PPA), language dysfunction is not a defining feature of bvFTD and is generally not emphasised clinically. However, very little information is available concerning neurolinguistic processing in bvFTD. Methods: Key language functions were analysed in a large, comprehensively characterised cohort of patients with bvFTD (n¼25) in relation both to healthy older controls (n¼24) and a cohort of patients representing core PPA syndromes (progressive nonfluent aphasia and semantic dementia; n¼35). Results: Relative to healthy controls, patients with bvFTD showed a profile of neurolinguistic deficits that were less severe than PPA but still extensive, affecting naming, semantic and sentence processing and literacy skills but sparing word repetition. Voxel-based morphometry in the bvFTD cohort revealed a correlated profile of widespread grey matter loss affecting dominant prefrontal, peri-Sylvian and anterior temporal cortices comprising the canonical language network. Conclusions: Language decline may be a significant if under-recognised issue in bvFTD, with implications both for clinical diagnosis and management of these patients and emerging models of language network disintegration in neurodegenerative disease. P3-205
VARIOUS PROGRESSION ACCORDING TO ANATOMIC SUBTYPES OF ALZHEIMER’S DISEASE
Young Noh1, Duk L. Na2, Han Kyu Na3, Dae Ryong Kang4, 1Gachon University Gil Medical Center, Incheon, South Korea; 2Samsung Medical Center, Seoul, South Korea; 3Yonsei University, College of Medicine, Seoul, South Korea; 4Ajou University, Suwon, South Korea. Contact e-mail: [email protected] Background: Recently, we reported Alzheimer’s disease (AD) de-
mentia in the earlier stages can be categorized into various anatomical subtypes with distinct clinical features, using cluster analyses of cortical thickness of the entire brain. The purpose of this study was to examine whether the subtypes of AD dementia had different progression in terms of cognitive function. Methods: A total of one hundred patients with AD dementia who took follow-up neuropsychological tests, among the 152 patients who participated in the previous cluster analysis study were evaluated retrospectively. The primary outcome was change in the neuropsychological test scores from baseline throughout a follow-up period between three subtypes. Results: The mixed model analysis of cognitive function revealed a significant interaction effect between subtypes and time, suggesting that the Parietal dominant subtype had greater decrease in MMSE, CDR sum of box, attention, language function, visuospatial function, verbal memory, and frontal-executive function, compared with the medial temporal dominant subtype or diffuse atrophy subtype. Medial temporal dominant subtype and diffuse atrophy subtype did not show significant difference. Conclusions: Patients with AD dementia may have various progressive courses according to the anatomic subtypes.
P3-206
AGE-RELATED CHANGES IN EMOTIONAL MEMORY AND FORGETTING: GIST VERSUS DETAIL
Stephanie L. Leal1,2, Jessica A. Noche2, Michael A. Yassa1,2, 1Johns Hopkins University, Baltimore, MD, USA; 2University of California, Irvine, Irvine, CA, USA. Contact e-mail: [email protected] Background: Changes in memory performance are one of the hallmark cognitive dysfunctions in healthy aging. However, it is not
P711
clear whether there are mechanisms that may allow older adults to compensate for this by activating modulatory systems (i.e. remembering emotional or significant information better). The Logical Memory Subset of the Wechsler Memory Scale (WMS), in which particpants are read two stories and are tested on their memory of the stories immediately and after a delay, does not assess or control for emotional content. It has been suggested that older adults show a “positivity bias,” in which positive information is remembered better (Mather & Carstensen, Trends Cog Sci 2005). We have recently reported also that older adults tend to remember emotional information better over time compared to young adults (Leal and Yassa, Behav Neurosci 2014). Methods: A new emotional version of the logical memory subset of the WMS-IV was developed. Negative, neutral, and positive stories were created to assess and control for emotional content, while all other components were matched (e.g. number to details, sentence structure, etc.). Young (age 18-35) and older (60-85) adults were tested on their memory of the three stories after an immediate, 20 minute, and 1 week delay. Performance on gist and detail information was assessed. Results: Older adults showed increased forgetting for detail information for the negative and neutral stories over time, however, details about the positive story did not change over time. The same was found for memory of the gist, in which there was no loss of gist information for the positive story, but loss of negative and neutral gist information. Conclusions: Not all memories are created equal. Modulatory influences such as emotional content can alter how experiences are remembered, and this modulation changes in the context of healthy normal aging. It is critical to control for the emotional content of stories used in the Logical Memory Test, since older adults remember emotional information differently. These data support the previous findings of a “positivity bias” in older adults.
P3-207
APPLYING ‘GROWTH CURVES’ TO AGEASSOCIATED COGNITIVE DECLINE: AN INNOVATIVE METHOD TO HELP DETERMINE NORMAL VERSUS ABNORMAL LONGITUDINAL COGNITIVE CHANGES IN THE ELDERLY
Patrick J. Bernier1, Christian Gourdeau2, Pierre-Hugues Carmichael3, JeanPierre Beauchemin4, Rene Verreault3,5, Remi W. Bouchard6, Edeltraut Kr€oger3,5, Robert Laforce, Jr.6,7, 1H^opital Christ-Roi du CSSS Vieille-Capitale, Quebec, QC, Canada; 2College Limoilou, Quebec, QC, Canada; 3Centre d’Excellence sur le Vieillissement du CHU de Quebec, Quebec, QC, Canada; 4Institut Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec, QC, Canada; 5Universite Laval, Quebec City, QC, Canada; 6Clinique Interdisciplinaire de memoire du CHU de Quebec, Quebec, QC, Canada; 7Universite Laval, Quebec, QC, Canada. Contact e-mail: [email protected] Background: Worldwide, the Mini-Mental State Examination (MMSE) remains the most widely used screening tool for cognitive impairment. This test is often administered repeatedly to elderly individuals at variable intervals to quantify cognitive functioning over time. Physicians and other health professionals, however, are often at a loss when attempting to determine whether a decline on repeat MMSE is compatible with normal vs. abnormal aging. We aimed to generate simple and ready-to-use cognitive charts for follow-up of age-related cognitive decline. Methods: A total of 7,729 individuals aged 65 years or older from the Canadian Study of Health and Aging completed MMSE at baseline, at 5 and 10 years. Cognitive charts were generated based on two new concepts, the cognitive quotient and age standardized to education.
Poster Presentations: P3 POSTERIOR CORTICAL ATROPHY (PCA) AND MENTAL IMAGERY: A PILOT STUDY
Jennifer C. Scuse, Dina I. Drubach, Daniel A. Drubach, Mayo Clinic, Rochester, MN, USA. Contact e-mail: [email protected] Background: Posterior cortical atrophy (PCA) is a syndrome characterized by progressive visual perceptual difficulties often associated with other neurological manifestations including apraxia, aphasia and cognitive symptoms. Because the underlying neuropathology is frequently that of Alzheimer’s Disease, it has become known as the “visual presentation” of this disorder. While patients with PCA have difficulties with extrinsic perception, we do not know whether “intrinsic perception”, including the ability to visualize imagery, is affected. This is an important question taking into account the cognitive value of visual imagery which forms the basis of imagination, which enables a number of cognitive tasks including behavior rehearsal, anxiety reduction, recreation, motor skill enhancement and others. Since visual imagery is a subjective experiential phenomenon, it is difficult to quantify or characterize in a person. The Vividness of Visual Imagery Questionnaire (VVIQ: Marks 1973) is a valid psychometric instrument used for measuring visual imagery differences in individuals (see Richardson, 1994; McKelvie, 1995 for reviews). The questionnaire consists of sixteen items that are each completed twice; once to determine the vividness of several images recalled by the participant when their eyes are open, and then once again for the same images obtained when their eyes are closed. The test uses a self-reported 5 point Likert scale to objectively measure the vividness of each mental image. Methods: The VVIQ was administered to 7 patients with PCA and 8 age matched controls. Results: Although the vividness of mental imagery values for an image obtained with participant’s eyes open did not differ significantly from the values obtained from the typical control group [F(13,14)¼2.1257, p¼ 0.1686] it was shown that when the individuals with PCA ranked the vividness of a mental image obtained with their eyes closed the vividness ranking was statistically lower than those obtained by the control participants [F(13, 14) ¼ 4.7045, p¼0.0492]. Conclusions: The results of this pilot study indicate that participants with PCA maintain their ability to vividly visualize images with eyes open, however they may demonstrate a decrease in their ability to vividly visualize images with eyes closed when compared to their typical peers.
P3-202
SPECT FINDINGS AND NEUROPSYCHOLOGICAL ASSESSMENTS IN OLDER PATIENTS WITH ALZHEIMER’S DISEASE
Hiroyuki Umegaki, Taeko Makino, Madoka Yanagawa, Masafumi Kuzuya, Nagoya University, Nagoya, Japan. Contact e-mail: [email protected] Background: Many studies have demonstrated that older patients who were clinically diagnosed as Alzheimer’s disease (AD) actually have multiple pathologies or pathologies other than AD. SPECT provides useful information of regional blood flow and easy Z score system (eZIS) determine AD-specific pattern of regional blood flow reduction. In the current study we tried to find out the characteristics of patients who were clinically diagnosed as AD but had non-specific pattern of regional blood flow reduction by eZIS in geriatics outpatient settings. Methods: All the Subjects involved were clinically diagnosed as AD according to DSM-IV in an out patient clinic of geriatrics. The number of the subjects was 182 (mean age 77.766.8). We used eZIS version 3.0 for a statistical analysis of SPECT. Three indices (severity, extent, tario) of regional blood flow reduction were used. Those who had all three indices above the threshold were determined as
eZIS+, and those who did not have AD specific pattern of regional blood flow reduction were determined as eZIS-. Then, scores of the neuropsychological assessments and backgrounds were compared between these two groups. Results: The 42.9% of the subjects were eZIS-. Subjects in eZIS+ group were significantly older and milder memory impairment in logical memory 1 and II. Conclusions: eZIS- AD may have multi-pathologies or dementia pathologies other than AD. More details of eZIS-AD will be invetigated P3-203
THE CLOCK DRAWING TEST: A COMPARISON BETWEEN ALZHEIMER’S DISEASE AND FRONTEMPORAL DEMENTIA PATIENTS
Luis Jacobo Resendiz-Najera1, Elena Itzel Portillo-Ya~nez1, Gilberto Isaac Acosta-Castillo2, Ana Luisa Sosa-Ortiz2, 1National Institute of Neurology and Neurosurgery “MVS”, Mexico City, Mexico; 2Dementia Laboratory National Institute of Neurology and Neurosurgery, Mexico City, Mexico. Contact e-mail: [email protected] Background: Due to the actual impacts of the dementias, is necessary the use of efficient clinimetric tests that support its early and accurate diagnosis. The clock drawing test (CDT) has been widely use in the assessment of patients with cognitive impartment due to the capacity to asses in a short time several cognitive functions that are affected in different ways along the dementia subtypes. Methods: The objective of our work was to compare the CDT errors between Alzheimer (AD) disease and frontemporal dementia (FTD) patients, using the modified qualitative score of Rouleau and the quantitative CDT score used in the Mini-cog, to analyze if there are specific errors that allow differentiating between these two groups. We use a sample of 90 subjects, 45 with sporadic late onset AD, 20 with FTD behavioral variant and 25 controls without psychiatric or neurological diseases. The CDT with predrawn circle was apply to all the sample and the MMSE was apply to the AD and FTD groups to assess the degree of cognitive impairment. Results: The mean age for the AD, FTD and control groups was 76.3, 65.5 and 63.28 years and the mean education in years was 11.06, 10.55 and 9.92 respectively. The difference in the quantitative CDT score was not statistically significant between the AD and FTD groups but it was between dementia and control groups. In the qualitative score only the conceptual deficit was higher statistically significant between the AD and the control group. Conclusions: We confirmed that the CDT is a useful test for screening dementia, but its utility to differentiate among dementia types is still unclear. In our study we did not find specific errors in the AD and FTD groups that allow us to differentiate between these particular types of dementia, but some limitations in our study can be related to our results, such as: the sample size was small and we did not included patients with FTD others than behavioral variant; we didn’t not take in account the dementia severity and besides, we weren’t able to analyze graphic errors and size of the clock because the predrawn circles.
P3-204
THE NEUROLINGUISTIC PROFILE OF BEHAVIORAL VARIANT FRONTOTEMPORAL DEMENTIA
Chris J. D. Hardy1, Jonathan Rohrer1, Aisling Buckley1, Sebastian J. Crutch1, Laura E. Downey1, Nick C. Fox2, Susie M. Henley1, Manja Lehmann1, Jason D. Warren1, 1University College London, London, United Kingdom; 2UCL Institute of Neurology, London, United Kingdom. Contact e-mail: [email protected] Background: Behavioural variant frontotemporal dementia (bvFTD)
is clinically and pathologically heterogeneous. In contrast to the
Poster Presentations: P3
syndromes of primary progressive aphasia (PPA), language dysfunction is not a defining feature of bvFTD and is generally not emphasised clinically. However, very little information is available concerning neurolinguistic processing in bvFTD. Methods: Key language functions were analysed in a large, comprehensively characterised cohort of patients with bvFTD (n¼25) in relation both to healthy older controls (n¼24) and a cohort of patients representing core PPA syndromes (progressive nonfluent aphasia and semantic dementia; n¼35). Results: Relative to healthy controls, patients with bvFTD showed a profile of neurolinguistic deficits that were less severe than PPA but still extensive, affecting naming, semantic and sentence processing and literacy skills but sparing word repetition. Voxel-based morphometry in the bvFTD cohort revealed a correlated profile of widespread grey matter loss affecting dominant prefrontal, peri-Sylvian and anterior temporal cortices comprising the canonical language network. Conclusions: Language decline may be a significant if under-recognised issue in bvFTD, with implications both for clinical diagnosis and management of these patients and emerging models of language network disintegration in neurodegenerative disease. P3-205
VARIOUS PROGRESSION ACCORDING TO ANATOMIC SUBTYPES OF ALZHEIMER’S DISEASE
Young Noh1, Duk L. Na2, Han Kyu Na3, Dae Ryong Kang4, 1Gachon University Gil Medical Center, Incheon, South Korea; 2Samsung Medical Center, Seoul, South Korea; 3Yonsei University, College of Medicine, Seoul, South Korea; 4Ajou University, Suwon, South Korea. Contact e-mail: [email protected] Background: Recently, we reported Alzheimer’s disease (AD) de-
mentia in the earlier stages can be categorized into various anatomical subtypes with distinct clinical features, using cluster analyses of cortical thickness of the entire brain. The purpose of this study was to examine whether the subtypes of AD dementia had different progression in terms of cognitive function. Methods: A total of one hundred patients with AD dementia who took follow-up neuropsychological tests, among the 152 patients who participated in the previous cluster analysis study were evaluated retrospectively. The primary outcome was change in the neuropsychological test scores from baseline throughout a follow-up period between three subtypes. Results: The mixed model analysis of cognitive function revealed a significant interaction effect between subtypes and time, suggesting that the Parietal dominant subtype had greater decrease in MMSE, CDR sum of box, attention, language function, visuospatial function, verbal memory, and frontal-executive function, compared with the medial temporal dominant subtype or diffuse atrophy subtype. Medial temporal dominant subtype and diffuse atrophy subtype did not show significant difference. Conclusions: Patients with AD dementia may have various progressive courses according to the anatomic subtypes.
P3-206
AGE-RELATED CHANGES IN EMOTIONAL MEMORY AND FORGETTING: GIST VERSUS DETAIL
Stephanie L. Leal1,2, Jessica A. Noche2, Michael A. Yassa1,2, 1Johns Hopkins University, Baltimore, MD, USA; 2University of California, Irvine, Irvine, CA, USA. Contact e-mail: [email protected] Background: Changes in memory performance are one of the hallmark cognitive dysfunctions in healthy aging. However, it is not
P711
clear whether there are mechanisms that may allow older adults to compensate for this by activating modulatory systems (i.e. remembering emotional or significant information better). The Logical Memory Subset of the Wechsler Memory Scale (WMS), in which particpants are read two stories and are tested on their memory of the stories immediately and after a delay, does not assess or control for emotional content. It has been suggested that older adults show a “positivity bias,” in which positive information is remembered better (Mather & Carstensen, Trends Cog Sci 2005). We have recently reported also that older adults tend to remember emotional information better over time compared to young adults (Leal and Yassa, Behav Neurosci 2014). Methods: A new emotional version of the logical memory subset of the WMS-IV was developed. Negative, neutral, and positive stories were created to assess and control for emotional content, while all other components were matched (e.g. number to details, sentence structure, etc.). Young (age 18-35) and older (60-85) adults were tested on their memory of the three stories after an immediate, 20 minute, and 1 week delay. Performance on gist and detail information was assessed. Results: Older adults showed increased forgetting for detail information for the negative and neutral stories over time, however, details about the positive story did not change over time. The same was found for memory of the gist, in which there was no loss of gist information for the positive story, but loss of negative and neutral gist information. Conclusions: Not all memories are created equal. Modulatory influences such as emotional content can alter how experiences are remembered, and this modulation changes in the context of healthy normal aging. It is critical to control for the emotional content of stories used in the Logical Memory Test, since older adults remember emotional information differently. These data support the previous findings of a “positivity bias” in older adults.
P3-207
APPLYING ‘GROWTH CURVES’ TO AGEASSOCIATED COGNITIVE DECLINE: AN INNOVATIVE METHOD TO HELP DETERMINE NORMAL VERSUS ABNORMAL LONGITUDINAL COGNITIVE CHANGES IN THE ELDERLY
Patrick J. Bernier1, Christian Gourdeau2, Pierre-Hugues Carmichael3, JeanPierre Beauchemin4, Rene Verreault3,5, Remi W. Bouchard6, Edeltraut Kr€oger3,5, Robert Laforce, Jr.6,7, 1H^opital Christ-Roi du CSSS Vieille-Capitale, Quebec, QC, Canada; 2College Limoilou, Quebec, QC, Canada; 3Centre d’Excellence sur le Vieillissement du CHU de Quebec, Quebec, QC, Canada; 4Institut Universitaire de Cardiologie et de Pneumologie de Quebec (IUCPQ), Quebec, QC, Canada; 5Universite Laval, Quebec City, QC, Canada; 6Clinique Interdisciplinaire de memoire du CHU de Quebec, Quebec, QC, Canada; 7Universite Laval, Quebec, QC, Canada. Contact e-mail: [email protected] Background: Worldwide, the Mini-Mental State Examination (MMSE) remains the most widely used screening tool for cognitive impairment. This test is often administered repeatedly to elderly individuals at variable intervals to quantify cognitive functioning over time. Physicians and other health professionals, however, are often at a loss when attempting to determine whether a decline on repeat MMSE is compatible with normal vs. abnormal aging. We aimed to generate simple and ready-to-use cognitive charts for follow-up of age-related cognitive decline. Methods: A total of 7,729 individuals aged 65 years or older from the Canadian Study of Health and Aging completed MMSE at baseline, at 5 and 10 years. Cognitive charts were generated based on two new concepts, the cognitive quotient and age standardized to education.