Addenbrooke's Cognitive Examination-Revised Research Articles

Age-related impairment in Addenbrooke’s cognitive examination revised scores in patients with amyotrophic lateral sclerosis

Objective: Older age is thought to be a risk factor for cognitive impairment in amyotrophic lateral sclerosis (ALS). However, very few clinical studies have investigated this relationship using sufficient numbers of healthy controls that correspond to each generation. The purpose of this study was to determine the age-related changes of Addenbrooke’s Cognitive Examination-Revised (ACE-R) score in ALS patients by comparing healthy controls of various ages.Methods: 131 ALS patients (86 males, 45 females; mean age: 64.8 ± 10.2; mean education: 12.5 ± 2.7) and 151 age-, gender-, and education-matched healthy controls were enrolled. We applied ACE-R, which could evaluate not only global cognition but five cognitive subdomains that included orientation/attention, memory, verbal fluency, language, and visuospatial ability.Results: ALS patients had significantly lower total and subdomain scores of ACE-R than healthy controls. Multiple regression analysis suggested that age at examination and age at onset had significant influence on ACE-R scores. When we divided ALS patients and healthy controls into 4 groups according to age at examination for ALS, total and each subdomain scores were significantly lower with age, particularly in the older-middle and the oldest group (66.31 years or more) of ALS compared with healthy controls. Locally weighted scatterplot smoothing analysis supported that these reductions of ACE-R total and subdomain scores in ALS patients were more accelerated by approximately 60 years as compared with healthy controls.Conclusion: ALS patients showed accelerated age-related ACE-R score reduction beyond normal ageing processes.

Factors associated with cognitive performance in elderly caregivers

To explore the socioeconomic, demographic and psychosocial factors associated with cognitive performance in elderly caregivers from Brazil. We evaluated 351 Brazilian elderly caregivers attending primary healthcare services regarding sociodemographic and care variables. Addenbrooke's Cognitive Examination-Revised (ACE-R) domains of orientation/attention, memory, verbal fluency, language and visuospatial were used as dependent variables in the Tobit model. Literacy and family income were positively associated with all ACE-R domains. Age, gender, time of care (days/week) were negatively associated with some cognitive domains. Moreover, receiving emotional help and the level of hope were positively associated with specific domains. The results may be useful for planning interventions aimed at elderly caregivers in order to prevent deficits in the different cognitive domains.

DUCHENNE MUSCULAR DYSTROPHY - GENETICS: P.220A neuropsychological and neuroimaging study of female carriers of DMD mutations

Dystrophinopathies are caused by DMD mutations and include Duchenne/Becker dystrophies. Men are typically affected, but subtle clinical signs have been increasingly reported in female carriers of DMD mutations (fcDMD) as well. Cognitive and cerebral abnormalities are major findings in affected men, but have not yet been assessed in fcDMD. Objectives: To investigate cognitive and neuroanatomical abnormalities in fcDMD. Fourteen fcDMD were submitted to neurological and neuropsychological examination, employing either the Addenbrooke's Cognitive Examination – Revised (ACE-R) test or the Montreal Cognitive Assessment (MoCA). For each subject, volumetric T1 cerebral sequences were obtained in a 3T MRI scanner. A control group of 14 age-matched healthy women was used for comparison. We computed cortical thickness measurements using the FreeSurfer software. Between-group comparisons were performed with GLM taking total intracranial volumes as covariates. Pearson coefficients explored associations between cognitive tests and MRI results. P values <0.05 were considered significant. Mean age and education of the fcDMD were 37.3±6.4 years and 8.5±3.6 years, respectively. None of the fcDMD presented muscular weakness or ECG abnormalities. Mean ACE-R and MOCA scores were 73.7±9.6 and 24.5±2.1. Half of patients (n=7) scored below the expected Brazilian and schooling-adjusted reference levels. Abnormal domains included attention/temporal orientation, language and visuospatial skills. MRI analyses revealed right inferior temporal cortical thinning in fcDMD, but it did not correlate with cognitive scores. fcDMD have cognitive and neuroanatomical abnormalities. Temporal regions look particularly vulnerable, but further studies are needed to fully characterize the structural pattern of damage in fcDMD.

The relationship between four GWAS-identified loci in Alzheimer’s disease and the risk of Parkinson's disease, amyotrophic lateral sclerosis, and multiple system atrophy

BackgroundA number of genetic variants have previously been identified and associated with the risk of Alzheimer’s disease (AD), including rs10838725 in CELF1, rs28834970 in PTK2B, rs17125944 in FERMT2, and rs10410544 in SIRT2 based on genome-wide association studies. Considering the overlap between the clinical manifestation and pathological characteristics of AD and Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS) and multiple system atrophy (MSA), we conducted a large sample study to investigate the associations between these variants and these three common neurodegenerative diseases in a Chinese population. MethodsA total of 2449 patients, including 1219 PD, 870 sporadic ALS, and 360 MSA, and 821 healthy controls were examined for this study. All cases were genotyped for single-nucleotide polymorphisms using Sequenom iPLEX assay technology. ResultsNo significant differences were found in genotype distribution and minor allele frequencies between the four candidate variants and the three neurodegenerative diseases. However, a significant difference was found in the minor allele frequency of rs28834970 in PTK2B between PD patients with normal and abnormal cognitive function (p = 0.001). Moreover, the minor allele “C” was associated with an increased risk for cognitive impairment in PD (OR = 1.84). Although this observation was not significant (p = 0.064), the mean Addenbrooke's Cognitive Examination-Revised (ACER) score of PD patients with the risk allele of rs28834970 was 2.913 ± 1.569 points lower than that of PD patients without the risk allele. ConclusionThis study provides new insight into some of the phenotypes that may share the common pathogenesis of different neurodegenerative diseases.

Corpus callosal involvement is correlated with cognitive impairment in multiple system atrophy.

We examined the anatomical involvement related to cognitive impairment in patients with multiple system atrophy (MSA). We examined 30 patients with probable MSA and 15 healthy controls. All MSA patients were assessed by the Unified MSA-Rating scale and Addenbrooke's Cognitive Examination-Revised (ACE-R). We classified 15 MSA patients with ACE-R scores > 88 as having normal cognition (MSA-NC) and 15 with scores ≤ 88 as having cognitive impairment (MSA-CI). All subjects underwent 3T MRI scanning and were investigated using voxel-based morphometry and diffusion tensor imaging. Both the MSA-NC and MSA-CI patients exhibited cerebellar but not cerebral atrophy in voxel-based morphometry compared to controls. In contrast, tract-based spatial statistics revealed widespread and significantly decreased fractional anisotropy (FA) values, as well as increased mean diffusivity, radial diffusivity, and axial diffusivity in both the cerebrum and cerebellum in MSA-CI patients compared to controls. MSA-NC patients also exhibited similar involvement of the cerebellum but less extensive involvement of the cerebrum compared with the MSA-CI patients. In particular, FA values in MSA-CI patients were significantly decreased in the anterior part of the left corpus callosum compared with those in MSA-NC patients. The mean FA values in the left anterior part of the corpus callosum were significantly correlated with total ACE-R scores and subscores (memory, fluency, and language) in MSA patients. Decreased FA values in the anterior corpus callosum showed a significant correlation with cognitive impairment in MSA.

Diagnostic test accuracy of the Montreal Cognitive Assessment in the detection of post-stroke cognitive impairment under different stages and cutoffs: a systematic review and meta-analysis.

The purposes of this review were to give the optimal cutoffs of the Montreal Cognitive Assessment (MoCA) by comparing sensitivity and specificity under different cutoffs and compare the MoCA with other screening tools in post-stroke cognitive impairment (PSCI) determined by a neuropsychological evaluation. Articles were derived from a systematic search in PubMed, Web of science, Embase, and CINAHL and were assessed for internal validity by the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). The figure of risk of bias was made by Review Manager 5.3, and data of selected studies were synthesized by MetaDisc 1.4. Twelve diagnostic studies, involving 2130 patients, were included. The area under the curve (AUC) under cutoffs of 20v19, 21v20, and 26v25 are 0.90, 0.90, and 0.95, showing high predictive validity for PSCI screening within 1month. When the sensitivity and specificity are equal important, the optimal cutoff is 20v19 (Youden Index = 0.58). Compared to the Mini-Mental State Examination (MMSE), the MoCA has higher sensitivity but lower specificity. The optimal cutoff differs in different stages of stroke. Both the MMSE and MoCA are appropriate screening tools for PSCI, and the use of these two tools should be in accordance with the aim of screening. The Addenbrooke's Cognitive Examination-Revised (ACE-R) can act as a supplement for the MoCA.

Distinct manifestation of cognitive deficits associate with different resting-state network disruptions in non-demented patients with Parkinson's disease.

Cognitive deficits in Parkinson's disease (PD) are heterogeneous entities, but a relationship between the heterogeneity of cognitive deficits and resting-state network (RSN) changes remains elusive. In this study, we examined five sub-domain scores according to Addenbrooke's Cognitive Examination-Revised (ACE-R) for the cognitive evaluation and classification of 72 non-demented patients with PD. Twenty-eight patients were classified as PD with normal cognition (PD-NC). The remaining 44 were subdivided into the following 2 groups using a hierarchical cluster analysis: 20 with a predominant decrease in memory (PD with amnestic cognitive deficits: PD-A) and 24 with good memory who exhibited a decrease in other sub-domains (PD with non-amnestic cognitive deficits: PD-NA). We used an independent component analysis of RS-fMRI data to investigate the inter-group differences of RSN. Compared to the controls, the PD-A showed lower FC within the ventral default mode network (vDMN) and the visuospatial network. On the other hand, the PD-NA showed lower FC within the visual networks and the cerebellum-brainstem network. Significant differences in the FC within the vDMN and cerebellum-brainstem network were observed between the PD-A and PD-NA, which provided a good discrimination between PD-A and PD-NA using a support vector machine. Distinct patterns of cognitive deficits correspond to different RSN changes.

Bilingualism and the severity of poststroke aphasia

ABSTRACTBackground: Bilingualism has been associated with cognitive benefits in healthy people as well as in patients with cognitive impairment due to stroke and dementia. However, the relationship between bilingualism and aphasia is more complex. While bilinguals are as likely as monolinguals to develop aphasia after stroke, studies of relationship between bilingualism and severity of poststroke language recovery are few and have produced conflicting results, with much evidence derived from immigrant populations or small case series.Aims: Against this background of limited number of studies, we set out to explore the relationship between bilingualism and severity of language impairment in stroke aphasia. We explored the hypothesis that enhanced cognitive abilities related to bilingualism may have a positive impact on recovery from aphasia.Methods & Procedures: We investigated 38 bilingual and 27 monolingual patients who participated in a longitudinal hospital-based stroke registry and were evaluated at least 3 months after stroke (mean 11.5 months). Patient performance on language and other cognitive functions was evaluated with Addenbrooke’s Cognitive Examination – Revised (ACE-R) validated for use in aphasia in local languages and for varying educational levels. The results of monolinguals and bilinguals were compared after accounting for confounding variables, including age, gender, education, occupation, medical, and stroke characteristics.Outcomes & Results: Aphasia severity as measured by the language domain sub-scores (total of language and fluency scores) of ACE-R was significantly higher in monolinguals compared with bilinguals (7.0 vs. 14.4, maximum score 40; p = 0.008, effect size = −0.691). Bilinguals performed significantly better than their monolingual counterparts in attention, memory, and visuospatial domains of ACE-R. A univariate general linear model analysis showed that bilingualism was significantly associated with higher language domain scores of ACE-R after adjusting for other confounding variables.Conclusions: The results suggest that although bilingual speakers are at equal risk of developing aphasia after stroke as monolingual ones, their aphasia is likely to be less severe.

Comparison Between Performance in Game and Cognitive Level: Tests with Healthy Subjects

Abstract The Cerebrovascular Accident (CVA) or Stroke presents one of main health concern mainly because its high rate of mortality and disability, having a great social and economic impact. The patient’s mental state index, or dementia level, is important for tracking the recovery of subjects affected by Stroke. There are several tests to evaluate the patient’s dementia level. For this work, Addenbrooke’s Cognitive Examination Revised (ACE-R) has been chosen because it is a comprehensive enough test and does not require great efforts from patient and professional for its execution. This work’s purpose is to compare the individuals’ group performance in a game with certain difficulty levels against their respective points obtained in the cognitive exam (ACE-R). Therefore, the tests will be performed in two steps: to play with AnkleBot and the game and perform the ACE-R test. The results present a satisfactory correlation within the established objectives, opening several study fronts in relation to game development, subjects performance in virtual games and correlation with cognitive levels.

Novel Effects of Rosa damascena Extract on Patients with Neurocognitive Disorder and Depression: A Clinical Trial Study.

Background:Dementia as a major cognitive neurological disorder is defined as impairment in one or more cognitive territories compared with the former level of performance. This disorder disrupts patient's independence, and the patient would need others aid in order of doing daily and complex activities. The aim of this study was to evaluate the efficacy of Rosa damascena extract in the improvement of cognitive function in patients with dementia.Methods:This study is a randomized double-blind, placebo-controlled clinical trial on 40 patients older than 55 years with dementia referred to Specialized Elderly Patients Clinic in 2015–2016. Patients were divided randomly into two groups (control and intervention). The intervention group used donepezil and R. damascena capsules, and in control group, placebo capsule instead of R. damascena added on donepezil. Four test was filled three times at the study initiation, after month one and also after month three: Mini–Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination Revised (ACE-R) were used for cognition evaluation, for depression assessment, Geriatric Depression Scale was administered, and checklist of memory and behavioral disorders were filled.Results:The results showed add-on donepezil and R. damascena versus placebo improved cognitive impairment based on MMSE with P = 0.002, ACE-R with total P = 0.001, depression (P = 0.012), behavioral disorders (P < 0.001), and daily activity (P < 0.001).Conclusions:The R. damascena extract affected cognitive impairment of dementia patients significantly and also have significant effects on improving depression and behavioral problems.

Effects of health education in the elderly with mild cognitive impairment.

to analyze the effects of health education on both cognition and depressive/anxiety symptoms in the elderly with Mild Cognitive Impairment (MCI). this is a randomized and controlled clinical trial. Participants (n=22) were recruited from a specialized outpatient clinic, and assigned into two groups: a Health Education Group (HEG) (n=10) and a Control Group (CG) (n=12). The participants were evaluated before and after the intervention, which was composed of classes and dynamics. The intervention consisted of 20 meetings, over a period of five months. The assessment was performed by means of the Addenbrooke's Cognitive Examination - Revised (ACER), the Mini-Mental State Examination to access participant's cognitive state, and the Beck's Scale to access depressive/anxiety symptoms. A Memory Complaints Scale (EQM) was also used. The analysis was carried out using the Student's t test for paired samples. the HEG group demonstrated an improvement in attention/orientation (p= 0,026), memory (p=0.001), language (p= 0.033), and ACE-R (p= 0.003). On the other hand, the CG did not present improvement. the results highlight the importance of non-pharmacological interventions in older adults with MCI to reduce cognitive deficits.

Short-term memory and verbal fluency in Type 2 diabetes

Background: Neuropathy is common in people with Type 2 (non-insulin-dependent) diabetes for a long duration. Hence, it is possible that deficits in cognitive function might also be found in those who have had diabetes for a long duration. Our objective was to assess the short-term memory and verbal fluency in subjects above 40 years with Type 2 diabetes. Aims and Objectives: The aims and objectives of this study were to determine the effect of duration of uncomplicated Type 2 diabetes on short-term memory and verbal fluency. Materials and Methods: A cross-sectional comparative study was done. One hundred male participants, between 50 and 60 years of age with uncomplicated Type 2 diabetes for at least 2 years duration, were selected. They did not have any other chronic medical disorders. An informed consent was obtained. The duration of diabetes was noted from the date of the first diagnosis. The addenbrooke’s cognitive examination-revised (ACE-R) was used to evaluate short-term memory and verbal fluency. A cross-sectional comparative study was done, and the performances were based on the scores obtained. Statistical analysis was performed using the coefficient of correlation. We considered P < 0.05 to be significant. Results: For short-term memory, the mean score obtained by the subjects was 6.35 ± 0.66, and for verbal fluency, the mean scores obtained were 7.07 ± 2.05. Duration of diabetes correlated significantly with poorer performance on short-term memory (r = −0.371) and verbal fluency (r = −0.837). Conclusion: Within the study group, an association between duration of diabetes and short-term memory and verbal fluency was found. Early diabetics performed well, whereas those who were diabetics for a longer duration performed less well. Such changes may give us insight to the process of accelerated aging in diabetes.

Descriptive data in different paper-based cognitive assessments in elderly from the community Stratification by age and education.

ABSTRACTCognitive aging is dynamic and heterogeneous in elderly, thus adequate tools such as paper-based tests are relevant to describe the cognitive profile of this population.Objective:To describe different paper-based cognitive assessments tests in elderly people stratified by age and education.Methods:A cross-sectional study of 667 elderly (≥60 years) living in the community was conducted. Sociodemographic information was collected. Global cognition was assessed by the Addenbrooke's Cognitive Examination-Revised (ACE-R), Mini Addenbrooke’s Cognitive Examination (M-ACE) and Mini-Mental State Examination (MMSE). The data were analyzed using descriptive statistics, the t-test and Pearson’s Correlation Coefficient.Results:The findings showed a predominance of women (53.8%), mean age of 71.3 (±7.7) years and 3.6 (±3.5) years of education. The best global cognitive performance and cognitive domain assessment scores were found in the group with higher formal educational level. Each year of education was associated with an increase of up to 10% in scores on the M-ACE and MMSE and up to 11% in ACE-R scores. The mean values of the scores varied according to age, where the 60-69 years group had better scores than other age groups. The correlation matrix between the cognitive tests showed that near perfect correlations (r=1) were frequent in the subgroup with higher education.Conclusion:Younger elderly and those with higher educational level had greater global and domain scores. This study describes the scores of elderly for different strata of education and age. In practice, it is important to choose the most suitable screening instrument, considering the characteristics of the elderly.

Evaluation of neurological outcome and quality of life after extended resection of gliomas

Objective To evaluate the neurological, neuropsychological and quality of life (QOL) alterations in patients who underwent extended resection of gliomas. Methods From January 2014 to November 2015, a total of 58 patients with gliomas were admitted to Department of Neurosurgery, the First Affiliated Hospital of Nanjing Medical University, and were enrolled into this study. Extended resection was performed in all patients. Patients were assessed at 3 time points, i. e. 1 day before surgery (T1), the day of discharge (T2) and 3 months post surgery (T3). National Institutes of Health Stroke Scale (NIHSS) score, Addenbrooke cognitive examination-revised (ACE-R), Hospital Anxiety and Depression (HAD) and neuropsychological test battery (NTB) were used to assess neurological and neuropsychological profiles. QOL was ascertained through the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC-QLQ C30). Results At T1 (58 cases), T2 (50 cases) and T3 (46 cases), the patient’s overall QOL score was 67.8 (48.9, 86.7), 66.7 (47.5, 85.9) and 64.8 (41.4, 88.5), respectively. There was no significant difference between different time periods (P>0.05). At T3, 24% (11/46) of the patients showed worsened neurological functions and 28% (13/46) gained neurological improvement compared with pre-operative conditions. According to the neuropsychological test, 65% (13/50) experienced deterioration of neuropsychological functions to varying degrees. However, those functions recovered at T3 for majority of patients. Conclusions Extended resection of gliomas does not seem to result in deterioration of QOL of patients. Patients undergoing extended resection might experience deterioration of neurological and neuropsychological functions in the early postoperative period, which could recover to preoperative levels after some time in most cases. Key words: Glioma; Neuropsychiatry; Quality of life; Extended resection

Quantitative transcranial sonography in Wilson's disease and healthy controls: Cut-off values and functional correlates

To compare transcranial sonography (TCS) findings in patients with predominantly neurological Wilson's disease (WD) to those from controls, and to correlate TCS data with the clinical profile of WD. Patients with WD (n=40/f=18) and healthy, matched controls (n=49/f=20) were assessed in terms of TCS, serum copper and iron parameters, and clinical scales, such as the Unified Wilson's Disease Rating Scale (UWDRS), Addenbrooke's Cognitive Examination–Revised (ACE-R), Mini Mental State Examination (MMSE), and Beck Depression Inventory. Lenticular nuclei and substantia nigra echogenic area cut-off values clearly differentiated WD patients from controls (area under the curve: 95.4% and 79.4%). Substantia nigra echogenic area was significantly larger in male than in female patients (p=0.001). Compared with controls, patients showed hyperechogenicity also in thalami and midbrain tegmentum/tectum; third ventricle width was increased and midbrain axial area was reduced. In the WD group, male gender correlated with substantia nigra echogenic area (r=0.515, p=0.0007) and serum ferritin levels (r=0.479, p=0.002); lenticular nuclei hyperechogenicity correlated with dystonia (r=0.326, p=0.04) and dysarthria (r=0.334, p=0.035); third ventricle width correlated with dystonia (r=0.439 p=0.005), dysarthria (r=0.449, p=0.004), parkinsonism (r=0.527, p<0.001), UWDRS neurological and total scores (both r=0.504, p=0.0009), MMSE (r=−0.496, p=0.001), and ACE-R (r=−0.534, p=0.0004). Lenticular nuclei echogenic area allowed highly accurate discrimination between patients and controls. The gender differences in substantia nigra echogenicity and iron metabolism are of interest in further studies in WD. TCS reflects different dimensions of WD pathology clearly differentiable from healthy controls and correlating with various clinical characteristics of WD.

Possible positive effect of the APOE ε2 allele on cognition in early to mid-adult life

Backgroundε4 allele possession is associated with an increased risk of Alzheimer’s disease. Its effects earlier in life are less well understood. Previous studies have reported both detrimental effects and a lack of effect on cognition outside dementia. We used genotype based recall from the ALSPAC study to investigate whether APOE genotype influences cognition in earlier adult life. MethodsWe invited all individuals with the rarer ε22 or ε44 genotypes and equal numbers of those with ε32, ε33 or ε34 APOE genotypes (total n invited = 1936, ages 23–67). Participants were screened for dementia using the Addenbrooke’s Cognitive Examination Revised (ACE-R). Participants were asked to complete a 3 h battery of neuropsychological tests covering a range of cognitive domains. The primary outcome was performance on the Rey Auditory Verbal Learning Test (RAVLT). Transformation of variables was used where required to permit parametric testing. As genotypes are unlikely to be confounded unadjusted analyses were performed. Results114 participants were recruited to the study (39 ε33, 27 ε34, 15 ε44, 26 ε32 & 7 ε22). ε4+ participants had higher scores on the cognitive failures questionnaire (10 point increase, p = 0.006) but no deficits on objective cognitive testing. ε2 carriers had slightly better episodic memory performance (p = 0.016), slightly improved n-back accuracy and better executive functioning (trails A&B, p = 0.005). ConclusionsIt is intriguing that the ε2+ group performed better as this group have a lower risk of Alzheimer’s disease. Most previous studies have analysed as ε4/non ε4 so may have missed this effect.

Characteristics of cognitive features in ALS using the addenbrooke’s cognitive examination revised (ACE-R)

Characteristics of cognitive features in ALS using the addenbrooke’s cognitive examination revised (ACE-R)

Cognitive impairment in two patients with strategic single infarct dementia

Background: Vascular dementia is occasionally caused by strategic single infarct (SSI), reported cognitive deficits like as inattention, verbal memory and visuospatial memory disturbance. Many neuropsychological tests used for detecting SSI dementia, now we administered Montreal Cognitive Assessment (MoCA) and Addenbrooke's Cognitive Examination-Revised (ACE-R) to two cases of SSI dementia.

Cognitive impairment of patients with chronic renal disease on hemodialysis and its relationship with sociodemographic and clinical characteristics.

ABSTRACTCognitive impairment and dementia commonly occur in individuals with chronic kidney disease, especially in advanced stages, but are still poorly diagnosed.OBJECTIVE:To evaluate the cognitive ability of patients with chronic kidney disease on hemodialysis and its relationship with sociodemographic and clinical characteristics.METHODS:A cross-sectional study was carried out in a Renal Replacement Therapy Unit in the interior of the State of São Paulo involving 99 patients. The data were collected through an individual interview, using the Sociodemographic and Clinical Characterization questionnaires and the Addenbrooke's Cognitive Examination – Revised (ACE-R) questionnaire.RESULTS:Participants were predominantly male, with a mean age of 54.68 years. The mean ACE-R score was 64.26 points, and 76.76% of patients had lower-than-expected scores, suggesting the presence of cognitive impairment. A moderate, negative correlation was found between total score on the ACE-R and age (r= –0.38, p≤0.001), a moderate positive correlation with years of education (r=0.52, p≤0.001), and a weak positive correlation of total score with hemodialysis time (r=0.26, p≤0.001).CONCLUSION:A relationship was found between cognitive ability and age, years of education and hemodialysis time, suggesting that individuals who were older, had less education and longer hemodialysis time presented greater cognitive impairment.

RELATIONSHIP BETWEEN COGNITIVE DISORDER AND METABOLIC SYNDROME IN ELDERS IN A BRAZILIAN COMMUNITY

A metabolic syndrome (MS) is associated with factors of cardiovascular risk possibly related to increased risks of Cognitive Disorders (CD)1,4,5. Genetic, environmental and lifestyle factors are some of the responsible for the line of predisposition and development of metabolic diseases as well as neurodegenerative disorders 2,7,8. cross-sectional, quantitative and correlational study. Were evaluated 110 participants (>65 years), users of public health system in a country town of the state of São Paulo. The following tests were applied: Addenbrooke's Cognitive Examination - Revised (ACE-R)6, Mini-Mental State Examination (MMSE)6, the MS was defined accordingly to the criteria established by the IDF (International Diabetes Federation)2. The sample is composed by majority of female (71.8%), mean 4.5 (±4.1) years of schooling, mean age of 72.3 (±6.4) years, use of medications (76.1%), 40, 9% with high BMI (overweight3), with MS and CD, 6.9% were found. No associations were found in the Chi-Square test between MS and ACE-R (p=.560) and MS with MMSE (p=.138). There was found important correlations using the Spearman's test between Weight X ACE-R(p=0.025/ρ=.213), Weight X ACE-R Attention-Guidance domain (p=.003/ρ=.283), Weight X ACE-R Language (p=0.028/ρ=.290), Weight X MEEM(ACE-R) (p=.007/ρ=.256), also presents correlations between Abdominal Circumference and ACE-R Attention-Guidance domain (p=.032/ρ=.205). CD did not show difference using the Mann-Whitney test when compared to groups with MS and without MS. There was also no difference in the MS to CD group and no CD and the domains that defined by ACE-R. there is no association between a MS and cognition, however, there was with one of its components and weight. As MS can compromise the quality of life in elderly, including testing that assess it can be of great value for a cognitive diagnosis with greater reliability. The adjustments of the components of MS at their ideal levels may be important for the prevention of CD.