The sensitive Amnesia Light and Brief Assessment (ALBA) is a valid 3-min test of 4 tasks indicative of mild cognitive deficits.

Participation in daily activities is crucial for healthy aging. There is limited research on participation of older adults with subjective cognitive decline (SCD), defined as the experience of cognitive deficits with no evidence of objective cognitive deficits. Therefore, this study examined perceived changes in participation in this population, and compared it to perceived changes reported by individuals with objective cognitive deficits. The study aimed to: (1) examine the reported changes in activity participation of older with SCD; (2) investigate differences in the reported changes in participation between individuals with SCD and those with mild or severe objective cognitive deficits; (3) examine the relationship between activity participation, subjective memory, and objective cognitive status; and (4) explore whether subjective memory explains additional variance in activity participation after accounting for age and objective cognitive deficits. Participants were 115 older adults (60+), divided into three groups based on their Montreal Cognitive Assessment (MoCA) scores: (1) SCD (MoCA≥26; n = 66); (2) mild objective cognitive deficits (MoCA = 20–25; n = 34); and (3) severe objective cognitive deficits (MoCA ≤ 19; n = 15). The Activity Card Sort was used to measure participation in instrumental activities of daily living, social, and leisure activities. The Multifactorial Memory Questionnaire—Ability subscale was used to assess subjective memory. We found that individuals with SCD, mild cognitive deficits and severe cognitive deficits reported participation withdrawal to a level of 80, 70, and 58% of their past participation, respectively. A significant between group difference was found on participation [χ2(2) = 16.44, p < 0.01], with the SCD group reporting higher participation than the other two groups. Participation significantly correlated with both cognitive status (r = 0.40, p < 0.01) and subjective memory (r = 0.45, p < 0.05). A regression analysis revealed that subjective memory contributed significantly to the explained variance in participation, beyond that accounted for by objective cognitive deficits and age. Our findings demonstrate the important role of subjective memory problems in activity participation of older adults, even in the absence of objective cognitive deficits.

O-16 Resting-state functional cortical connectivity are abnormal in HIV patients

population ageing will lead to a leap in the dementia population in Asia. However, information about potentials for low-cost and low-risk interventions is limited. to study the associations between lifestyle activities and global cognition from the Cognitive and Lifestyle Activity Study for Seniors in Asia (CLASSA). a cross-sectional study. we studied the association between global cognition and lifestyle activity participation in community living older adults (60 years or over) across nine sites in East Asia. A standardised lifestyle activity questionnaire exploring activities from four categories (intellectual, physical, social and recreational) was used to measure the pattern. Global cognition was categorised by locally validated versions of Mini-mental state examination (MMSE) or Montreal Cognitive Assessment (MoCA) (good cognition, GC-scored at the top 25% among participants with no significant cognitive deficit (SCD); normal cognition, NC-middle 50% among participants with no SCD; mild cognitive deficit, MCD-lowest 25% among participants with no SCD; SCD-below local cut-offs for dementia). two thousand four hundred and four (1,009 men; 1,395 women) participants were recruited. The mean age was 71.0 (7.2) years. A higher variety of intellectual and physical activities were associated with GC; more social activities were associated with higher risks of having impaired cognition (multinomial logistic regression). The same association was found in participants with no SCD and had regular activities for over 10 years (n = 574). intellectual activity and physical exercise were associated with better cognitive states in Asian older adults. Community-based intervention may take considerations into specific types of activities to optimise cognition.

More unaffected first-degree relatives of essential tremor cases have mild cognitive deficits than age-matched controls

To compare the validity of the Montreal Cognitive Assessment (MoCA) with the criterion standard of standardized neuropsychological testing and to compare the convergent validity of the MoCA with that of existing screening tools and global measures of cognition. Cross-sectional observational study. Tertiary care hospital-based cognitive neurology subspecialty clinic. A convenience sample of 107 individuals with mild Alzheimer's disease (AD, n=75) or mild cognitive impairment (MCI, n=32) from the Sunnybrook Dementia Study. In addition to the MoCA, all participants completed the Mini-Mental State Examination (MMSE), the Mattis Dementia Rating Scale (DRS), and detailed neuropsychological testing. Convergent validity was supported, with MoCA scores correlating well with the MMSE (correlation coefficient (r)=0.66, P<.001) and the DRS (r=0.77, P<.001) and the MoCA better associated with the DRS than did the MMSE. Criterion validity was supported, with MoCA subscores according to cognitive domain correlating well with analogous neuropsychological tests and, in the case of memory (area under the receiver operating characteristic curve (AUC)=0.86), executive (AUC=0.79), and visuospatial function (AUC=0.79), being reasonably sensitive to impairment in those domains. The MoCA is a valid assessment of cognition that shows good agreement with existing screening tools and global measures (convergent validity) and was superior to the MMSE in this regard. The MoCA domain-specific subscores align with performance on more-detailed neuropsychological tests, suggesting not only good criterion validity for the MoCA, but also that it may be useful in guiding further neuropsychological testing.

The Mini-Mental State Examination and Montreal Cognitive Assessment in Persons With Mild Subacute Stroke: Relationship to Functional Outcome

Background: Human T cell lymphotropic virus type 1 (HTLV-I) can cause tropical spastic paraparesis/HTLV-1 associated myelopathy (TSP/HAM) and adult T cell leukaemia/lymphoma. More recently other diseases such as isolated peripheral...

Objectives: Compare the psychometric characteristics of three brief screening instruments - Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and its basic version (MoCA basic), for early detecting mild and major neurocognitive disorder (NCD), discriminating from normal elders and provide MoCA and MoCA basic norms and accuracy data for seniors with a lower education level, including illiterates.Methods: Cross-sectional study, with 60 years or older community dwelling individuals, submitted to diagnostic interviews (according to DSM-5) and screening tests. Of a total of 271 elderly interviewed, 59 had mild and 32 had major NCD. A sum of 266 MMSE; 104 MoCA and 81 MoCA basic were applied. Area under the ROC curve (AUC) was determined for all three tests, and sensitivity (S), specificity (E) and cutoff score (CS) for the last two were determined.Results: The total scores varied significantly according to age and education (p &lt; 0.01). MMSE had a high discriminative validity – AUC for normal vs major NCD = 0,915 (p &lt; 0.001; 95% CI 0,868– 0,963) and regular for normal vs mild NCD = 0,706 (p &lt; 0.001; 95% CI 0,631–0,781). MoCA demonstrated excellent discriminative validity – AUC for normal vs major NCD = 0.932 (p &lt; 0.001; 95% CI 0.842–1.000) and regular for mild NCD – AUC = 0.753 (p &lt; 0.001; 95% CI: 0.654– 0.853). CS was 9 (S = 83% E = 95%) and 16 (S = 83% E = 68%). MoCA basic showed excellent discriminative validity for major NCD vs normal AUC = 0.910 (p &lt; 0.001; 95% CI 0.818–1.002) and good for mild NCD vs normal AUC = 0.834 (p &lt; 0.001; 95% CI: 0.742 –0.927). CS was 21 for both conditions (S = 100% E = 72%; S = 89% E = 72%).Conclusions: The MoCA and MoCA basic are valid screening instruments for cognitive assessment of low-schooled elderly people from the community, but we found different cut-off from the original and other studies. The MMSE still remains a good and useful tool. These results provide information about psychometric characteristics of the instruments for elderly with low schooling in Brazil.

Cognitive screening is crucial for all stroke clients since not identifying cognitive impairments can negatively affect health outcomes. The Montreal Cognitive Assessment (MoCA) is a commonly used neuropsychological screen in the acute setting. However, the Menu Task (MT), a standardized performance-based functional cognitive screen, may be better at identifying cognitive deficits in this population. This study aimed to determine (a) the correlation between the MT and the MoCA, and (b) which screen better predicts outcomes (occupational performance, falls, and readmissions) in stroke patients with mild cognitive deficits. Using a prospective predictive design, both screens were administered to 80 hospitalized adults upon admission. Thirty days postdischarge occupational performance, as per the modified Rankin Scale and the Lawton Instrumental Activities of Daily Living (IADL) scale, falls and readmissions data were collected. The results showed a small, nonsignificant positive correlation between the screens and the MT may be a better predictor of occupational performance and readmissions 1 month postdischarge.

Previous validation studies demonstrated that BrainCheck Assess (BC-Assess), a computerized cognitive test battery, can reliably and sensitively distinguish individuals with different levels of cognitive impairment (i.e., normal cognition (NC), mild cognitive impairment (MCI), and dementia). Compared with other traditional paper-based cognitive screening instruments commonly used in clinical practice, the Montreal Cognitive Assessment (MoCA) is generally accepted to be among the most comprehensive and robust screening tools, with high sensitivity/specificity in distinguishing MCI from NC and dementia. In this study, we examined: (1) the linear relationship between BC-Assess and MoCA and their equivalent cut-off scores, and (2) the extent to which they agree on their impressions of an individual's cognitive status. A subset of participants (N = 55; age range 54-94, mean/SD = 80/9.5) from two previous studies who took both the MoCA and BC-Assess were included in this analysis. Linear regression was used to calculate equivalent cut-off scores for BC-Assess based on those originally recommended for the MoCA to differentiate MCI from NC (cut-off = 26), and dementia from MCI (cut-off = 19). Impression agreement between the two instruments were measured through overall agreement (OA), positive percent agreement (PPA), and negative percent agreement (NPA). A high Pearson correlation coefficient of 0.77 (CI = 0.63-0.86) was observed between the two scores. According to this relationship, MoCA cutoffs of 26 and 19 correspond to BC-Assess scores of 89.6 and 68.5, respectively. These scores are highly consistent with the currently recommended BC-Assess cutoffs (i.e., 85 and 70). The two instruments also show a high degree of agreement in their impressions based on their recommended cut-offs: (i) OA = 70.9%, PPA = 70.4%, NPA = 71.4% for differentiating dementia from MCI/NC; (ii) OA = 83.6%, PPA = 84.1%, NPA = 81.8% for differentiating dementia/MCI from NC. This study provides further validation of BC-Assess in a sample of older adults by showing its high correlation and agreement in impression with the widely used MoCA.

BackgroundPrevious validation studies demonstrated that BrainCheck Assess (BC‐Assess), a computerized cognitive test battery, can reliably and sensitively distinguish individuals with different levels of cognitive impairment (i.e., normal cognition (NC), mild cognitive impairment (MCI), and dementia). Compared with other traditional paper‐based cognitive screening instruments commonly used in clinical practice, the MoCA is generally accepted to be among the most comprehensive and robust screening tools, with high sensitivity/specificity in distinguishing MCI from NC and dementia. In this study, we examined: (1) the linear relationship between BC‐Assess and MoCA and their equivalent cut‐off scores, and (2) the extent to which they agree on their impressions of an individual’s cognitive status.MethodA subset of participants (N = 55; age range 54‐94, mean/SD = 80/9.5) from two previous studies who took both the MoCA and BC‐Assess were included in this analysis. Linear regression was used to calculate equivalent cut‐off scores for BC‐Assess based on those originally recommended for the MoCA to differentiate MCI from NC (cut‐off = 26), and dementia from MCI (cut‐off = 19). Impression agreement between the two instruments were measured through overall agreement (OA), positive percent agreement (PPA), and negative percent agreement (NPA).ResultA high Pearson correlation coefficient of 0.77 (CI = 0.63 ‐ 0.86) was observed between the two scores. According to this relationship, MoCA cutoffs of 26 and 19 correspond to BC‐Assess scores of 89.6 and 68.5, respectively. These scores are highly consistent with the currently recommended BC‐Assess cutoffs (i.e. 85 and 70). The two instruments also show a high degree of agreement in their impressions based on their recommended cut‐offs: (i) OA = 70.9%, PPA = 70.4%, NPA = 71.4% for differentiating dementia from MCI/NC; (ii) OA = 83.6%, PPA = 84.1%, NPA = 81.8% for differentiating dementia/MCI from NC.ConclusionThis study provides further validation of BC‐Assess in a sample of older adults by showing its high correlation and agreement in impression with the widely used MoCA.

A random sample of 200 men and 200 women taken from the general population as well as subsamples of 31 male and 17 female excessive social drinkers were investigated with neuropsychological tests and computed tomography of the brain. Relatively high alcohol intake per drinking occasion did not give evidence of cognitive deficits or morphological cerebral changes. However, in males, mild cognitive deficits and morphological cerebral changes as a result of high recent alcohol intake, particularly during the 24-hr period prior to the investigation, were observed. When excluding acute effects of recent alcohol intake, mild cognitive deficits but not morphological cerebral changes that are apparently due to long-term excessive social drinking were observed in males. In females there was no association between the drinking variables and cognitive deficits or morphological cerebral changes, probably due to their less advanced drinking habits. It is suggested that future risk evaluations and estimations of safe alcohol intake should take into consideration the potential risk for brain damage due to excessive social drinking. However, it is premature to make any definite statements about safe alcohol intake and the risk for brain damage in social drinkers from the general population.

ABSTRACTMild cognitive deficits in the elderly are associated with emotional and functional difficulties, including lower participation and quality of life. The objective of this article was to operationalize a theoretically driven, participation-centered treatment protocol for this population. The underlying bio-psycho–social mechanisms that impede participation defined the major components of a Participation-Centered treatment for Elderly (PC-E) with mild cognitive deficits to enable successful adaptation. Occupational therapy cognitive and group practice models delineated the treatment methods that address the functional, cognitive, emotional, and social components. A group case study utilizing a “book club” setting was conducted to examine the preliminary effects of the PC-E. Five participants with mild cognitive deficits and significant occupational limitations were treated in a group setting. Participants regularly attended and expressed satisfaction with the treatment. They demonstrated use of external aids and reported attainment of occupational goals in daily lives. Less consistent results were found for acquisition of internal strategies and modification of negative beliefs. These preliminary findings demonstrate the potential utility of the PC-E for elderly with mild cognitive deficits in enabling them to engage in occupations and improve overall well-being. Systematic research to examine PC-E efficacy is required.

Association Between 2 Measures of Cognitive Instrumental Activities of Daily Living and Their Relation to the Montreal Cognitive Assessment in Persons With Stroke

Background and Purpose. Early detection and treatment of age-related decline, particularly balance and cognition, are increasingly being emphasized in current research. However, the majority of research on older adults focuses on participants who are 65 years and older. For individuals who are 60-64 years old, this is an age range where they may or may not be considered an older adult. This poses a problem applying the results of these studies to pre-old adults to accurately diagnose, measure and classify risk in the areas of cognition and balance. Case Description. The patient is a 61-year-old woman with a clinical diagnosis of osteoporosis. She has had 5 falls and near-falls in the past year. She also experiences memory problems, which sometimes affects her ability to plan and organize her schedule. She is otherwise well, with no limits to participation. Outcomes Assessment. Frequently used clinical tools to assess for mild balance and cognitive deficits were performed in order to detect diagnosis and/or classify risk. A total of 14 tools related to balance and falls, and 4 tools related to cognition were chosen. Results. Of the assessment tools used, only the Mini Balance Evaluation Systems Test (Mini BESTest), High Level Mobility Assessment Test (HiMAT), and the Falls Efficacy Scale- International (FES-I) were able to identify and classify risk of fall and/or balance deficits. Of the cognitive tools performed, only the Montreal Cognitive Assessment (MoCA) produced abnormal results, suggesting cognitive decline. Conclusions. Many of the frequently used clinical assessment tools were unable to identify falls history and balance deficits in this patient. In view of the lack of sensitivity in balance assessment tools in pre-old adults and the multiple factors associated with falls risk, it is difficult to conclusively determine if she does have balance deficits and to quantify her risk of future falls. Cognitive screening in this patient suggests that an algorithmic approach using the Mini Mental State Examination (MMSE) and the MoCA may be effective in screening for mild cognitive impairment (MCI). More research should be directed towards the development and validation of sensitive instruments to detect mild balance deficits and screening for MCI, especially in the pre-old adult.