Cantonese Version Of Mini-Mental State Examination Research Articles

Association of circadian rhythm with mild cognitive impairment among male pneumoconiosis workers in Hong Kong: a cross-sectional study

Weakened circadian activity rhythms (CARs) were associated with mild cognitive impairment (MCI) in the general population. However, it remains unclear among pneumoconiosis patients. We aimed to address this knowledge gap. This cross-sectional study comprised 186 male pneumoconiosis patients (71.3 ± 7.8 years) and 208 healthy community men. Actigraphy was used to determine CARs parameters (percent rhythm, amplitude, MESOR, and acrophase). Values below the corresponding medians of the CARs parameters represented weakened CARs. The Cantonese version of Mini-Mental State Examination (CMMSE) was used to assess cognitive function, MCI, and the composite outcome of MCI plus cognitive impairment. Compared with the community referents, pneumoconiosis patients had worse cognition and dampened CARs. Compared with the community referents or pneumoconiosis patients with robust circadian rhythm, pneumoconiosis patients with weakened circadian rhythm were consistently associated with increased risk of MCI and the composite outcome. However, significant association was only observed between MESOR and the composite outcome (adjusted OR = 1.99, 95%: 1.04–3.81). A delayed phase of CARs was insignificantly associated with MCI and the composite outcome. Our findings showed that weakened CARs were associated with worse cognitive function among male pneumoconiosis workers. Intervention in improving CARs may mitigate cognitive deterioration in male pneumoconiosis workers.

Loneliness interacts with family relationship in relation to cognitive function in Chinese older adults.

a cross-sectional study. face-to-face interview. 497 older adults with normal global cognition were interviewed. Loneliness was assessed with Chinese 6-item De Jong Gierverg's Loneliness Scale. Confiding network was defined as people who could share inner feelings with, whereas non-confiding network was computed by subtracting the confiding network from the total network size. Cognitive performance was expressed as a global composite z-score of Cantonese version of mini mental state examination (CMMSE), Categorical verbal fluency test (CVFT) and delayed recall. Linear regression was used to test the main effects of loneliness and the size of various networks, and their interaction on cognitive performance with the adjustment of sociodemographic, physical and psychological confounders. Significant interaction was found between loneliness and non-confiding network on cognitive performance (B = .002, β = .092, t = 2.099, p = .036). Further analysis showed a significant interaction between loneliness and the number of family members in non-confiding network on cognition (B = .021, β = .119, t = 2.775, p = .006). Results suggested that a non-confiding relationship with family members might put lonely older adults at risk of cognitive impairment. Our study might have implications on designing psychosocial intervention for those who are vulnerable to loneliness as an early prevention of neurocognitive impairments.

The computerized version of the Hong Kong Oxford Cognitive Screen for dementia (HK-OCSd): Estimates of concurrent validity and reliability

The computerized version of the Hong Kong Oxford Cognitive Screen for dementia (HK-OCSd): Estimates of concurrent validity and reliability

Prevalence of CMMSE defined cognitive impairment among peritoneal dialysis patients and its impact on peritonitis.

Peritoneal dialysis (PD) exchange procedure is complex. Patients with cognitive impairment (CI) may require assistance. We studied the prevalence of CI among PD patients, its impact on PD-related peritonitis and the outcome of assisted PD. Cantonese version of Mini-Mental State examination (CMMSE) was performed in 151 patients newly started on PD. Data on patient characteristics including demographics, co-morbidities, blood parameters, medications, and number of PD-related peritonitis in the first 6 months were collected. 151 subjects were recruited. The age of studied patients was 60 ± 15.0 years, and 45% were female. The prevalence of CI was 13.9% using education-adjusted cut-off of CMMSE. Patients older than 65-year-old, female, and lower education level were independent risk factors for CI (OR 9.27 p = 0.001, OR 14.84 p = 0.005, and OR 6.10 p = 0.009, respectively). Age greater than 65-year old is an independent risk factor for PD-related peritonitis but CI was not. Patients requiring assisted PD were of older age (p < 0.001), lower CMMSE (p < 0.001), and scored higher for age-adjusted Charlson Co-morbidity index (p < 0.001). Compared with self-care PD patients, assisted PD patients did not have higher rates exit site infection (p = 0.30) but had a trend of higher PD peritonitis (p = 0.07). CI is common among local PD patients. Overall, CI could not be identified as an independent risk factor for PD peritonitis. There is a higher prevalence of CI among assisted PD patients but helpers may not completely eliminate the risk of PD-related peritonitis.

Cognitive predictors for five-year conversion to dementia in community-dwelling Chinese older adults

This study evaluates which cognitive measure is best for predicting incident dementia in a population-based random sample of Chinese older adults without dementia over a five-year period. A total of 787 community-dwelling Chinese older adults without dementia in Hong Kong were assessed at baseline (T0), at two years (T1), and at five years (T2). The annual conversion rate to dementia was 1.6% and 6.3% for baseline normal participants and baseline mild cognitive impairment (MCI) participants, respectively. The Cantonese version of Mini-mental State Examination (CMMSE) scores declined significantly over time. In participants who progressed to dementia, Category Verbal Fluency Test (CVFT) scores dropped significantly from T0 to T1. A 1-SD drop of either CMMSE or CVFT in two years predicted dementia at five years with 91.5% sensitivity and 62.0% specificity. A stable CMMSE and CVFT at two years predicted a 91% chance of not progressing to clinical dementia at five years. In this community sample of Chinese older adults, a decline in cognitive screening tests in short term (two years) offered useful information in predicting dementia conversion over a longer period.

Rehabilitation outcomes of older Chinese patients with different cognitive function in a geriatric day hospital

The relationship between cognitive function and geriatric day hospital (GDH) rehabilitation has not been explored. This study investigated this association in 547 older Chinese patients attended GDH. Cognitive status was assessed by Cantonese version of mini-mental state examination (C-MMSE). Functional independence measure (FIM) upon GDH admission and discharge were measured, with FIM gain = FIM discharge − FIM admission while FIM efficiency = FIM gain/by number of GDH visits. FIM discharge ≥90 was defined as satisfactory outcome of rehabilitation. Positive correlation was observed between C-MMSE admission and FIM discharge ( p < 0.001). There were significant differences in the FIM admission and FIM discharge among the three C-MMSE groups, with lower discharge scores in low C-MMSE groups ( p < 0.001). The FIM gain and FIM efficiency during GDH rehabilitation were not different among different C-MMSE groups. C-MMSE admission ( p = 0.03) and FIM admission ( p < 0.001) were both positive independent predictors for a satisfactory rehabilitation outcomes (FIM discharge ≥90). Cognitive function was not associated with FIM gain and efficiency. This suggested that selected patients with impaired cognition could still benefit from GDH rehabilitation.

Rehabilitation outcomes of older patients at 6 months follow-up after discharged from a geriatric day hospital (GDH)

Whether rehabilitation outcome can be maintained after discharged from GDH has not been thoroughly investigated. This study was conducted to examine the rehabilitation outcome and its predictors 6 months after discharged from GDH. We studied 418 patients attended a GDH in Hong Kong. All of them had post-6-month assessment. Cognitive status was assessed with Cantonese version of mini-mental state examination (C-MMSE). Functional independence measure (FIM) upon GDH admission (FIM-adm), discharge (FIM-dis) and 6 months after discharge (FIM-p6m) were measured. FIM gain was FIM-dis − FIM-adm while FIM efficiency was FIM gain divided by number of GDH visits. Of the study pool, 164 (39.2%) showed a drop of FIM-p6m. There was a significant drop of FIM-p6m as compared with FIM-dis ( p < 0.001). However, the FIM-p6m remained significantly higher than FIM-adm ( p < 0.001). Multivariate analysis revealed that FIM-dis was a negative predictor ( p < 0.001) while Parkinsonism was a positive predictor for drop of FIM-p6m ( p = 0.008). A proportion of functional gain can still be maintained 6 months after discharged from GDH. More studies are needed to look for strategies in maintaining functional gain in GDH discharged patients, especially those with Parkinsonism.

Prevalence of clinically significant depressive symptoms in an epidemiologic sample of community‐dwelling elders with milder forms of cognitive impairment in Hong Kong SAR

Depression and cognitive impairment in later-life have great bearings on public health. The two conditions often co-occur and have mutual implications on short-term risk and long-term prognosis. A two-phase epidemiologic survey on the prevalence of dementia in elders aged 60 and over was conducted in Hong Kong in 2005-2006. In the first phase, 6,100 randomly selected community dwelling elders were assessed with Cantonese version of Mini-Mental State Examination (C-MMSE) and Abbreviated Memory Inventory for Chinese (AMIC). Two thousand and seventy-three subjects were screened positive and invited for second phase cognitive and psychiatric assessment. 35.5% of screen-positive subjects participated in Phase 2 assessment conducted by psychiatrists for diagnosis of dementia. Severity of dementia was determined using Clinical Dementia Rating Scale (CDR). Cornell Scale for Depression in Dementia (CSDD) and a structured bedside cognitive battery were also administered to each subject. 1.7% of subjects with CDR 0.5 and 5.9% of subjects with CDR 1 had clinically significant depressive symptoms (>or= 8 on CSDD). Score on CSDD correlated positively with duration of cognitive symptoms, scores on CIRS and CMMSE in linear regression model. In a logistic regression model, male gender, duration of cognitive symptoms, CIRS and CMMSE was associated with increased risk for clinically significant depressive symptoms. In our sample, milder forms of cognitive impairment were associated with increased risk for depression in the presence of other risk factors such as male gender, higher physical illness burden and longer duration of cognitive symptoms.

P4-203: The effect of cognitive function and depressive mood on the activity of daily living and quality of life in Chinese elderly patients with Alzheimer’s disease

Patients with Alzheimer's disease (AD) are characterized by cognitive decline and depressive mood, resulting in deterioration of their activity of daily living (ADL) and quality of life (QoL). However, how their ADL and QoL are affected have been greatly ignored and not been emphasized in Hong Kong. To validate the assessment “Chinese Version of Quality of Life in Alzheimer's Disease” (CQoL–AD) and to evaluate the effect of cognitive function and depressive mood on ADL and QoL in Chinese patients with AD. This is a cross–sectional study. 121 Chinese AD patients and their caregivers were recruited from three clinical settings by purposeful sampling. The cognitive function was measured by the Cantonese version of Mini Mental State Examination (CMMSE); the depressive mood was measured by the Chinese version of Geriatric Depressive Scale (CGDS); the ADL was measured by the Chinese version of Disability Assessment for Dementia (DAD) and the QoL was measured by the Chinese version of Quality of Life in Alzheimer's Disease (CQoL–AD). Internal consistency, test–retest reliability and inter–rater reliability of CQoL–AD measure from patient report were 0.917, 0.964 and 0.993 respectively, while those from caregiver report were 0.746, 0.966 and 0.996 respectively. Both CQoL–AD scores from patient and caregiver report were not correlated with CMMSE score but had a moderate negative correlation with the CGDS score (r=–0.668 and r=–0.313 respectively). The mean CQoL–AD scores from both patient and caregiver reports were significantly higher in the non–depressed group (34.2 and 31.0 respectively) than in the depressed group (23.8 and 28.9 respectively). The CDAD score was positively correlated with CMMSE score (r=0.652) and negatively correlated with CGDS score (r=– 0.191). The mean CDAD score was significantly higher for those with mild AD (37.8) than those with severe AD (20.6). The mean CDAD score was significantly higher for those non–depressed AD patients (30.2) than those depressed AD patients (26.9). The CQoL–AD is a promising instrument in Chinese AD patients. AD patients with higher cognitive function and lesser depressive symptoms had better performance of ADL than those with lower cognitive function and greater depressive symptoms.

Correlational study of the Chinese version of the executive interview (C‐EXIT25) to other cognitive measures in a psychogeriatric population in Hong Kong Chinese

This study is designed to pilot test the feasibility and correlational properties of the adapted Chinese version of Executive Interview (C-EXIT25) to other cognitive measures in a psychogeriatric population in Hong Kong Chinese. Eighty-five community dwelling elders from different levels of residential care facilities were assessed with C-EXIT25, Cantonese version of Mini-Mental State Examination (C-MMSE), Chinese version of Mattis Dementia Rating Scale (CDRS) and Nelson's Modified Card Sorting Test (MCST). The C-EXIT25 has high internal consistency (Cronbach's alpha = 0.7995) and inter-rater reliability (r = 0.91). The C-EXIT25 has superior correlational property to performance indices of MCST than the C-MMSE and CDRS, after adjusting for age, gender and educational level. It also discriminates among subjects at different stages on Clinical Dementia Rating. The C-EXIT25 is a potentially feasible and valid bedside tool for assessment of executive cognitive functions in the psychogeriatric population in Hong Kong Chinese.

Cognitive intervention for community‐dwelling older persons with memory problems: telemedicine versus face‐to‐face treatment

Memory complaints and decline in cognitive function are common in the elderly. Cognitive intervention has been shown to be beneficial in Alzheimer's disease (AD). However, few community-based cognitive intervention programs are available in Hong Kong. The aim of this project is to examine and compare the feasibility, acceptability, and clinical outcome of a cognitive intervention program for older patients with mild cognitive impairment and mild dementia using telemedicine versus a conventional face-to-face method. Community-dwelling older subjects with mild dementia or mild cognitive impairments were recruited from a community center. A total of 12 sessions of assessment and cognitive intervention were conducted via videoconferencing or by face-to-face method. Assessment included: Cantonese version of Mini Mental State Examination (C-MMSE), Cantonese version of Rivermead Behavioural Memory test (C-RBMT) and Hierarchic Dementia Scale (HDS). Twenty-two clients were recruited. There was significant and comparable cognitive improvement in clients in both treatment arms. The videoconference arm was highly accepted by the clients and the community center. Overall compliance rate of participants was above 95%. Telemedicine was a feasible, effective and acceptable means in providing cognitive assessment and intervention to older persons with mild cognitive deficits. Promoting such a program to other community settings would further enhance the accessibility of dementia service to the community.