Mini‐Mental State Examination trajectories across dementia subtypes in the Swedish Registry for Cognitive/Dementia Disorders and U.S. National Alzheimer's Coordinating Center
7 affiliations
- 1Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm Sweden
- 2Department of Information Science and Engineering School of Electrical Engineering and Computer Science KTH Royal Institute of Technology Stockholm Sweden
- 3Department of Mathematics KTH Royal Institute of Technology Stockholm Sweden
- 4Department of Occupational Therapy and Physiotherapy Sahlgrenska University Hospital Mölndal Sweden
- 5Faculty of Public Health University of Medicine and Pharmacy Vietnam National University Hanoi Vietnam
- 6Department of Women's and Children's Health Division of Clinical Paediatrics Karolinska Institutet Stockholm Sweden
- 7Aging and Inflammation Theme Karolinska University Hospital Stockholm Sweden
Abstract
INTRODUCTION: Mini‐Mental State Examination (MMSE) trajectories are widely used to describe cognitive decline in dementia, but estimates may be sensitive to cohort structure, follow‐up density, and modeling assumptions. We compared subtype‐specific MMSE trajectories across two complementary longitudinal data resources.
METHODS: The analyzed data were from the Swedish Registry for Cognitive/Dementia Disorders (SveDem) and the U.S. National Alzheimer's Coordinating Center (NACC). Participants were included with at least two valid cognitive assessments separated by ≥ 90 days. The final cohorts included 30,115 SveDem participants and 33,429 NACC participants. Subtype‐stratified regression‐spline generalized additive mixed models and linear mixed‐effects models were fitted with adjustment for demographic and clinical covariates.
RESULTS: Compared with NACC, SveDem participants were older (median age 79 vs. 72 years), had lower baseline MMSE scores (22.3 ± 4.2 vs. 26.5 ± 4.6), and had shorter follow‐up (median 1.9 vs. 3.2 years; mean cognitive assessments 2.9 vs. 4.5). Shared dementia subtypes showed broadly similar relative decline patterns across cohorts. In regression‐spline models, Alzheimer's disease showed faster estimated annualized decline than vascular dementia in both SveDem (−0.79 vs. −0.49 MMSE points/year) and NACC (−1.22 vs. −0.24 points/year). Lewy body dementias and frontotemporal dementia showed intermediate but less consistent patterns. Absolute decline estimates varied by model specification, particularly where later follow‐up was sparse.
DISCUSSION: Relative subtype‐specific MMSE decline patterns were broadly reproducible, whereas absolute long‐horizon estimates required cautious interpretation. These cross‐cohort reference patterns may support future dementia epidemiology studies using MMSE trajectories to compare subtypes, examine clinical factors or evaluate treatment‐related associations.
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BibTeX
@article{bao2026minimental,
title = {{Mini‐Mental State Examination trajectories across dementia subtypes in the Swedish Registry for Cognitive/Dementia Disorders and U.S. National Alzheimer's Coordinating Center}},
author = {Xinqi Bao and Belén García Pascual and Eirik Blakstad and Jakob Norgren and Tamar Abzhandadze and Nanbo Zhu and Minh Tuan Hoang and Saikat Chatterjee and Martina Scolamiero and Maria Eriksdotter and Hong Xu and Sara Garcia Ptacek},
journal = {Alzheimer's \& Dementia : Diagnosis, Assessment \& Disease Monitoring},
year = {2026},
month = oct,
doi = {10.1002/dad2.70531},
url = {https://doi.org/10.1002/dad2.70531},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Mini‐Mental State Examination trajectories across dementia subtypes in the Swedish Registry for Cognitive/Dementia Disorders and U.S. National Alzheimer's Coordinating Center
AU - Xinqi Bao
AU - Belén García Pascual
AU - Eirik Blakstad
AU - Jakob Norgren
AU - Tamar Abzhandadze
AU - Nanbo Zhu
AU - Minh Tuan Hoang
AU - Saikat Chatterjee
AU - Martina Scolamiero
AU - Maria Eriksdotter
AU - Hong Xu
AU - Sara Garcia Ptacek
PY - 2026
DA - 2026/10/30
JO - Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring
DO - 10.1002/dad2.70531
UR - https://doi.org/10.1002/dad2.70531
AB - INTRODUCTION: Mini‐Mental State Examination (MMSE) trajectories are widely used to describe cognitive decline in dementia, but estimates may be sensitive to cohort structure, follow‐up density, and modeling assumptions. We compared subtype‐specific MMSE trajectories across two complementary longitudinal data resources. METHODS: The analyzed data were from the Swedish Registry for Cognitive/Dementia Disorders (SveDem) and the U.S. National Alzheimer's Coordinating Center (NACC). Participants were included with at least two valid cognitive assessments separated by ≥ 90 days. The final cohorts included 30,115 SveDem participants and 33,429 NACC participants. Subtype‐stratified regression‐spline generalized additive mixed models and linear mixed‐effects models were fitted with adjustment for demographic and clinical covariates. RESULTS: Compared with NACC, SveDem participants were older (median age 79 vs. 72 years), had lower baseline MMSE scores (22.3 ± 4.2 vs. 26.5 ± 4.6), and had shorter follow‐up (median 1.9 vs. 3.2 years; mean cognitive assessments 2.9 vs. 4.5). Shared dementia subtypes showed broadly similar relative decline patterns across cohorts. In regression‐spline models, Alzheimer's disease showed faster estimated annualized decline than vascular dementia in both SveDem (−0.79 vs. −0.49 MMSE points/year) and NACC (−1.22 vs. −0.24 points/year). Lewy body dementias and frontotemporal dementia showed intermediate but less consistent patterns. Absolute decline estimates varied by model specification, particularly where later follow‐up was sparse. DISCUSSION: Relative subtype‐specific MMSE decline patterns were broadly reproducible, whereas absolute long‐horizon estimates required cautious interpretation. These cross‐cohort reference patterns may support future dementia epidemiology studies using MMSE trajectories to compare subtypes, examine clinical factors or evaluate treatment‐related associations.
SN - 2352-8729
ER -