Association Of Mild Cognitive Impairment Research Articles

Association of mild cognitive impairment, dementia and vitamin B12 levels in older adults

AbstractBackgroundVitamin B12 deficiency has been associated with the development of multiple pathologies. However, it is still controversial if the deficiency is associated with cognitive impairment. Objective: To determine the association between cognitive performance and the vitamin B12 levels.MethodCross‐sectional study including 241 adults aged 60 or older, treated as an outpatient at a tertiary care hospital, who had serum levels of vitamin B12. Participans underwent a cognitive assessment and assigned to one of three groups: normal cognition (NC), mild cognitive impairment (MCI), and dementia. Vitamin B12 levels were classified in three categories: sufficiency (>400 pg/ml), subclinical deficiency (201‐400 pg/ml), and absolute deficiency (≤200 pg/ml). Univariate and multivariate linear regression analyzes were used to assess the association between cognitive performance and vitamin B12 levelsResultMean age was 81.4 ± 8.0 years and 68% were women. The prevalence of absolute and subclinical B12 deficiency was 17.8% and 39.8%, respectively. Eigthy participants (33%) had MCI and 70 (29%) dementia. Those with MCI and dementia had lower vitamin B12 levels compaired with NC after adjusting for age, sex and education level (p = 0.019).ConclusionThis study suggests a statistically significant association between global cognitive performance and serum levels of vitamin B12 in older adults

Prevalence of mild cognitive impairment in an urban, community dwelling, elderly population and its association with Serum Vitamin B12 levels in South India.

AbstractBackgroundPrevalence of cognitive disorders is becoming higher in low and middle income societies with increasing lifespan1. Multiple factors contribute to emergence of cognitive disorders including genes, lifestyle, diet and nutrition, co‐morbid metabolic and vascular risk factors 2. There has been only a few studies from India, looking at the prevalence of cognitive impairment in the community. Ageing and dietary preferences pose a higher risk for B12 and Folic acid deficiencies, contributing to cognitive difficulties3. Our study aims to look at the prevalence of cognitive impairment in a community dwelling elderly population and the association of mild cognitive Impairment (MCI) with serum B12 levels.MethodA total of 308 individuals above the age of 60 were screened for medical issues and psychiatric illnesses. Those who fulfilled the intake criteria were evaluated using Subjective Memory Complaint Questionnaire (SMCQ), MOCA, ACE‐R or RUDAS and FAB. Serum B12 levels were evaluated for all the individuals.Result51.8 percent of individuals had normal cognitive function. The prevalence of cognitive impairment was 48.8%. Among these 42.3% of individuals had mild cognitive impairment. There was no significant correlation between MCI and Serum B12 levels in the screened population.ConclusionThere is a high prevalence of cognitive difficulties in the studied population.Dietary deficiency of Vitamin B12 does not appear to be a major factor contributing to the MCI. Alzheimer’s disease, vascular cognitive impairment and lifestyle and metabolic risk factors may need to be considered as contributory factors

Association of mild cognitive impairment and physical activity level in older persons in Chile

BackgroundUnderstanding the association between cognitive impairment and low physical activity is a useful way to proactively prevent MCI or delay the onset of dementia. This study aims to explore the association between MCI and physical activity (PA) levels in Chilean persons aged 60 and over. MethodsData came from the 2016–17 Chilean National Health Survey data. MCI was evaluated with Mini-Mental State Examination and Pfeffer Functional Activities Questionnaire, excluding individuals with suspected dementia. The Global Physical Activity Questionnaire was used to assess PA levels. The association between MCI and PA levels was examined using logistic regression analysis, including overall and sex stratified models. ResultsA total of 1981 participants were analysed. The mean age was 70.7 years (SD: 7.77), and 63% were women. The MCI prevalence was 10%, increasing with age. The overall MCI model for low PA level showed an Odds Ratio (OR): 1.95 (95% Confidence Interval (95% CI): 1.18; 3.20, p = 0.009), meaning that a low PA level has a significant association with the risk of having MCI. The MCI model for PA levels in women was not statistically significant; however, the model for men showed an OR of 2.44 (95% CI: 1.17; 5.11, p = 0.018). ConclusionsA low PA level significantly increases the likelihood of developing MCI, and the risk was significantly higher among men. Therefore, promoting PA for older persons should be considered as a valuable prevention strategy among healthy older adults or those with initial symptoms of MCI.

Neuropsychiatric symptoms in Brazilians with mild cognitive impairment and dementia.

IntroductionKnowledge is limited about behavioral and psychological symptoms of mild cognitive impairment (MCI) and dementia in racial and ethnic minorities.MethodsAs part of the Pathology, Alzheimer's and Related Dementias Study (PARDoS), we interviewed knowledgeable informants of 2319 older Brazilian decedents (67% white, 11% black, 22% mixed) using the informant portion of the Clinical Dementia Rating Scale to classify MCI and dementia and the Neuropsychiatric Inventory to assess behavioral and psychological symptoms.ResultsWe identified four clusters of neuropsychiatric symptoms: agitation, affect/apathy, psychosis, and behavioral problems. On the Clinical Dementia Rating Scale, 1407 had no cognitive impairment, 180 had MCI, and 732 had dementia. Both MCI and dementia were associated with symptoms in each behavioral/psychological cluster (all P’s < .001). There was little evidence of racial differences in the association of MCI and dementia with these neuropsychiatric symptoms.ConclusionMCI and dementia are associated with elevated behavioral and psychological symptoms in older black and white Brazilians.

Association of mild cognitive impairment and characteristic of COPD and overall health status in a cohort study

ABSTRACT Introduction: We evaluated risk factors and demographic characteristics of associated with mild cognitive impairment (MCI) in patients with COPD. Methods: 220 individuals with COPD enrolled in a cohort study designed to evaluate anxiety conducted at 16 clinical centers. Cognitive impairment was assessed with the Montreal Cognitive Assessment (MoCA), a cutoff score of <26 defined as MCI. Data were collected including spirometry, 6-minute walk test, symptom burden by COPD Assessment Test and dyspnea by Modified Medical Research Council, anxiety measured by Anxiety Inventory of Respiratory Disease, Generalized Anxiety Disorder-7 and Hospital Anxiety Depression Scale, depression by Patient Health Questionnaire-9 and health status by Patient Reported Outcomes Measurement Information System and sleep quality by the Pittsburg Sleep Quality Index. Results: The median age was 65 years and 54% of participants were male. 119(54%) of participants had MCI as classified by MoCA. In multivariable logistic regression, higher odds ratios (OR) (95% confidence interval) for MCI (MoCA) <26 were associated with increased years of age, 1.06 (1.02 -1-09, p<0.003); African-American race, 3.68(1.67-8.11, p<0.001); persistent phlegm, 2 (1.12-3.57, p<0.01) and sleep disturbance, 1.04(1.01-1.08, p<0.01). Conclusions: COPD patients commonly screen positive for MCI. Characteristics associated with MCI included age, African-American race, sleep disturbance and persistent phlegm.

Association of mild cognitive impairment and metabolic syndrome in patients with hypertension.

The aim of this study was to evaluate the prevalence of mild cognitive impairment (MCI) in patients with hypertension and to evaluate the association of MCI with metabolic syndrome (MetS). 186 subjects with hypertension were evaluated on Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire (PHQ-9) for cognitive decline and depression, respectively and MetS was diagnosed as per the Consensus definition. The prevalence of MCI was 65.6 % and that of MetS was 45.7 %. Compared to those without MetS, those with MetS had significantly poorer cognitive functioning on the all cognitive domain of the MoCA, even after controlling for age, education, severity of the depression and duration of illness. Low High-Density Lipoprotein (HDL) was found to have a positive correlation with MoCA. Higher age, lower education, higher duration of illness and use of higher numbers of medications were associated with significantly lower score on MoCA. Presence of MetS among persons with hypertension is associated with cognitive decline. Hence, there is a need to monitor and manage other parameters of MetS among patients with hypertension, to reduce the risk of cognitive decline and future dementia.

PMD2 - STUDY OF STATINS EFFECTS ON COGNITIVE IMPAIRMENT AMONG OUTPATIENTS WITH TYPE 2 DIABETES MELLITUS

The study was intended to evaluate the association of mild cognitive impairment (MCI) with statins therapy among type 2 diabetic outpatients. Does statins therapy increase or decrease the MCI in diabetic outpatients? A cross-sectional study was conducted at Hospital Pulau Pinang, Malaysia, in May–October 2017. Mini-Addenbrooke's Cognitive Examination (M-ACE) developed by Hsieh et al. (2015) was used to assess MCI (With permission). M-ACE measures the person’ ability to attention, memory, language fluency and visuospatial. M-ACE score is 30, and the cut-off score for MCI is ≤21. Patients with Alzheimer's disease, stroke, blindness, paralysis, parkinsonism, <40 years old, prescribed statins < 6 months, disability reading and writing were excluded. IBM SPSS 23.0 was used for data management. M-ACE was conducted for 280 cases with a mean age (59.6 ± 11.1) years. The prescribed statins were 14.7% atorvastatin (20-80mg/daily), 4% lovastatin (20-60mg/daily), 2.3% rosuvastatin 20mg/daily and 79.1% simvastatin (10-40mg/daily). From 177 patients using statins, about 80 (45.2%) cases had MCI; with M-ACE score mean 21.4 (95% CI: 20.7 – 22.2). While from 103 statins non-users, only 27 (26.2%) had MCI, with M-ACE score mean 23 (95% CI: 21.8 – 24.1). The relative risk of MCI associated with statins use in diabetic patients is (RR: 1.72, 95% CI: 1.2 – 2.48) and the excess relative risk is 72.4%. The absolute risk is 19%, and the number needed to harm is 6. Chi-square indicated a statistically significant difference between statins users and non-users in the incidence of MCI (P-value: 0.001). Spearman’s test indicated a positive association between statins usage and MCI incidence (r: 0.188, p-value: 0.002). Binary logistic regression explored that statins usage is predictor of MCI incidence (r2: 0.036, p-value: 0.002). Statins therapy has a higher association with MCI risk than statins-free treatment among type 2 diabetic outpatients.

Association of mild cognitive impairment with coronary artery disease in elderly patients

Objective To investigate the relationship between coronary artery disease, other vascular risk factors and mild cognitive impairment in elderly patients. Methods A total of 196 inpatients were collected from the departments of cardiovascular internal medicine from April to September 2015.The unified questionnaires of cognitive status and standardized survey were developed. The patients were divided into 133 cases of mild cognitive impairment and 63 cases of cognitively normal by Montreal Cognitive Assessment Scale. The patients were divided into 79 cases of coronary heart disease and 117 cases of negative control by coronary angiography. Coronary artery disease and other vascular risk factors for mild cognitive impairment were analyzed. Results The levels of education and proportion of coronary heart disease were (9.23±4.34) years and 45.9%(61/133) in mild cognitive impairment patients, and (12.27±3.79) years and 28.6% (18/63) in cognitively normal patients. There were significant differences between the two(t = 4.77, P< 0.05, χ2=5.31, P< 0.05). Multivariate Logistic regression analysis showed that degree of education was a protective factor for mild cognitive impairment with odds ratio (OR) 0.86, 95% confidence interval (CI) 0.77 to 0.91 and P = 0.00. Coronary heart disease was an independent risk factor for mild cognitive impairment (OR=2.02, 95%CI 1.03 to 4.00; P = 0.04) . The total scores of Montreal Cognitive Assessment Scale and delayed memory were (20.9±4.8), (22.4±5.6) points and (2.1±1.6), (2.6±1.8) points in coronary heart disease and negative control patients. There were significant differences between the two (t=1.98, 4.77, all P<0.05). Conclusions The degree of education is a protective factor for mild cognitive impairment. Coronary heart disease is an independent risk factor for mild cognitive impairment, and it mainly impairs delayed memory ability. Key words: Coronary artery disease; Cognition disorders; Risk factors; Neuropsychological tests; Aged

Cognitive Impairment and Disability in Older Japanese Adults.

The prevalence of disability is increasing due to an expanding aging population and an increasing incidence of chronic health problems. Cognitive impairment may predict the development of disability in older adults. Therefore, we examined the association of mild cognitive impairment (MCI) and/or general cognitive impairment (GCI, defined as a Mini Mental State Examination [MMSE] score of 20–23) with the development of disability in a cohort of Japanese community-dwelling older adults. A total of 4290 participants (aged ≥65 years) enrolled in the Obu Study of Health Promotion for the Elderly were classified according to the presence and degree of cognitive impairment as follows: cognitively healthy, GCI, MCI single domain (MCIs), MCIs with GCI, MCI multiple domain (MCIm), and MCIm with GCI. MMSE scores, risk factors for dementia, and incidences of new disability were recorded. After an average of 29.5 months, 205 participants (4.8%) experienced a new onset of disability. All subtypes of cognitive impairment showed significant relationships with disability except for GCI alone. The following hazard ratios (HRs) were determined: MCIs (HR, 2.04; 95% CI, 1.39–3.00), MCIs with GCI (HR, 2.10; 95% CI, 1.21–3.62), MCIm (HR, 2.32; 95% CI, 1.39–3.85), and MCIm with GCI (HR, 4.23; 95% CI, 2.73–6.57). These results indicate that cognitive impairment may be related to an increased risk for the development of disability. Healthcare providers should implement global cognitive assessments to identify MCI and GCI and consider preventive interventions for disability, especially in older persons.

Association of Mild Cognitive Impairment With Exposure to General Anesthesia for Surgical and Nonsurgical Procedures: A Population-Based Study

ObjectiveTo examine whether exposure to general anesthesia for operations and procedures after the age of 40 years is associated with incident mild cognitive impairment (MCI) in elderly patients. Patients and MethodsA population-based, prospective cohort of Olmsted County, Minnesota, residents aged 70 to 89 years at enrollment, underwent baseline and 15-month interval evaluations that included the Clinical Dementia Rating scale, a neurologic evaluation, and neuropsychological testing. Anesthesia records after the age of 40 years until last evaluation for MCI were abstracted. Proportional hazards regression, adjusting for other known MCI risk factors, was used to assess whether exposure to surgical general anesthesia after the age of 40 years is associated with the incidence of MCI. ResultsOf 1731 participants (mean age, 79 years), 536 (31.0%) developed MCI during a median follow-up of 4.8 years. Anesthesia exposure was not associated with MCI when analyzed as a dichotomous variable (any vs none; adjusted hazard ratio [HR], 1.07; 95% CI, 0.83-1.37; P=.61), the number of exposures (adjusted HR, 1.05; 95% CI, 0.78-1.42; adjusted HR, 1.12; 95% CI, 0.86-1.47; and adjusted HR, 1.02; 95% CI, 0.76-1.34, for 1, 2-3, and ≥4 exposures compared with no exposure as the reference; P=.73), or the total cumulative duration of exposure (adjusted HR, 1.00; 95% CI, 0.98-1.01, per 60-minute increase; P=.83). In secondary sensitivity analyses, anesthesia after 60 years of age was associated with incident MCI (adjusted HR, 1.25; 95% CI, 1.02-1.55; P=.04), as was exposure in the previous 20 and 10 years. ConclusionWe found no significant association between cumulative exposure to surgical anesthesia after 40 years of age and MCI. However, these data do not exclude the possibility that anesthetic exposures occurring later in life may be associated with an increase in the rate of incident MCI.

Association of mild cognitive impairment with serum Vitamin D level in type 2 diabetes mellitus

Background: Diabetes is one of the most common diseases around the world and its prevalence is continuously increasing. It is seen that many patients of diabetes with mild cognitive impairment (MCI) have low serum level of Vitamin D. The aim of the study is to identify the correlation between serum levels of 25-hydroxyvitamin D (25(OH)D) and MCI in patients with type 2 diabetes mellitus. This cross-sectional study was conducted at P.B.M. Hospital, Bikaner, Rajasthan, India. Method: In this study, 100 type 2 diabetic patients were enrolled in which 47 were male and 53 were female. For measuring the cognitive impairment in patients, we used montreal cognitive assessment (MoCA) test. After evaluating all the patients with MoCA test, 43 patients were found to have MCI with MoCA score t -test, Chi-square test, and Pearson's correlation coefficient. Results: After analyzing all the patients clinically, it was found that diabetic patients with MCI had low level of serum Vitamin D (21.97 ± 7.063 ng/ml vs. 41.17 ± 11.544 ng/ml, P value 0.0001). It was also found that diabetic patients with MCI had longer duration of diabetes (156.42 ± 58.950 months vs. 40.11 ± 36.198 months, P value 0.0001), poor blood sugar control (glycated hemoglobin [HbA1C] level 9.18 ± 1.137% vs. 7.93 ± 0.462%, P value 0.0001). Conclusion: The MoCA score was positively correlated with log 10 [25(OH) D] with correlation coefficient r = +0.512 ( P = 0.001). The association of MoCA score was found negative with duration of diabetes ( r = ­0.103), and positive with HbA1C ( r = +0.003), and P values were 0.444 and 0.984, respectively.

ApoE4 is not associated with depression when mild cognitive impairment is considered

The aim of the study was to examine the relationship between apolipoprotein E4 allele (ApoE4) and depression among an older Japanese population. Mild cognitive impairment (MCI) was taken into consideration. This is a community-based cross-sectional study. We assessed the mood and cognitive function of Japanese community-dwelling individuals aged 65 years or older. In the first phase of the study, we evaluated the mood and cognitive function. In the second phase, face-to-face structured interviews were conducted. Individuals with dementia and other mental diseases were excluded on the basis of a consensus meeting of psychiatrists and neuropsychologists; 738 subjects with full data were included in the analyses. We subdivided depression into major depressive episode (MDE) and depressive symptoms cases (DSCs). DSC was defined as a score of 6 or more on the Geriatric Depression Scale but not having a diagnosis of MDE. The relationship between depression (MDE and DSC) and ApoE4 was examined by multivariate logistic regression. The adjusted odds ratio (OR) of ApoE4 on DSC was not significant (OR = 0.82, 95%CI = 0.48-1.39, p < 0.46). Sex (OR = 2.53, 95%CI = 1.33-4.79, p < 0.01), MCI (1.95, 1.21-3.14, p < 0.01), years of education (0.87, 0.79-0.95, p < 0.01), and Nishimura's activities of daily living scores (0.75, 0.63-0.89, p < 0.01) significantly correlated with prevalence of DSC. There were no significant risk factors for MDE. Apolipoprotein E4 allele contributed to neither DSC nor MDE. The association of MCI with ApoE4 and DSC suggested that MCI is a confounder for the association between ApoE4 and DSC.