Difference In Montreal Cognitive Assessment Scores Research Articles

Evaluation of the montreal cognitive assessment in idiopathic tinnitus patients with mild hearing loss

Objective:To explore the effect of mild hearing loss on cognitive function by evaluating the Montreal Cognitive Assessment（MoCA） in idiopathic tinnitus patients with mild hearing loss. Methods:102 patients with idiopathic tinnitus（68 patients with normal hearing and 34 patients with mild hearing loss） whose first complaint is tinnitus and 34 healthy volunteers（control group） were included. All subjects were asked to fill the MoCA, Tinnitus Handicap Inventory（THI）, Self-rating Anxiety Scale（SAS）, Self-rating Depression Scale（SDS）, and Pittsburgh Sleep Index（PQSI） after collecting medical history, pure tone audiometry, tinnitus matching and masking test. The clinical characteristics and scores of each scale were compared among the groups. Results:The score and each dimension score of MoCA in idiopathic tinnitus patients with normal hearing were significantly lower than the normal population（P<0.05）; compared with patients with idiopathic tinnitus with normal hearing, patients with mild hearing loss were older（P<0.01） and had lower MoCA scores（P<0.05）. There was no significant difference in MoCA scores（P>0.05） between tinnitus patients with normal hearing and mild hearing loss after correcting confounding factors（age, gender, years of education, duration of tinnitus, frequency of tinnitus tones, side of tinnitus, THI score, SAS score, SDS score, and PQSI score）; idiopathic tinnitus patients with mild hearing loss scored significantly lower in attention and working memory dimensions than idiopathic tinnitus patients with normal hearing（P<0.01）. Conclusion:Patients with idiopathic tinnitus may have cognitive dysfunction, and mild hearing loss may not be a factor that promotes the further aggravation of cognitive dysfunction in patients with idiopathic tinnitus. The role of hearing loss in cognitive dysfunction in patients with idiopathic tinnitus needs further research.

Impact of Metabolic Syndrome Longitudinal Changes on Cognitive Health: A 10‐Year Follow‐up Study in Middle‐Aged Adults

AbstractBackgroundMetabolic syndrome (MS) has been linked to cognitive functions, yet limited research has explored the longitudinal effects of changes in MS on cognitive performance. This study aims to investigate the predictive impact of longitudinal MS status on cognitive performance and dissect its sex‐specific influence over a 10‐year follow‐up.MethodIn this community‐based prospective cohort study, 766 healthy subjects underwent baseline MS status assessment between 2006 and 2011. Changes in MS status and cognitive performance were evaluated from 2016 to 2021 using the Montreal Cognitive Assessment (MoCA). MS change status was categorized into four groups: never MS, ever MS with improvement, newly onset MS, and persistent MS. Linear regression analysis was used to assess the impact of longitudinal MS changes on endpoint cognition status while controlling for covariates. Categorical variables were dummy‐coded, and sex‐specific effects were examined by reanalyzing the data divided by sex.ResultSubjects had a mean age of 54.50 ± 8.03 years at baseline, with a mean follow‐up duration of 10.40 ± 0.79 years; 39.2% were men. The MoCA score in the persistent MS group was significantly lower than that in the never MS group (adjusted p = 0.020). However, no significant differences in MoCA scores were observed between the never MS group and the ever MS with improvement group (adjusted p = 0.759) or the newly onset MS group (adjusted p = 0.469). Further analysis of cognitive domains revealed that memory and language were the most significantly affected. In assessing sex‐specific effects, a significant association was found only in women, with no significant associations observed in men.ConclusionPersistent MS status contributes to cognitive decline over a 10‐year period, contrasting with the lack of impact in those with improving or newly onset MS status. This effect is particularly pronounced in middle‐aged women. The findings suggest that modifying MS status among middle‐aged individuals, especially women, may be beneficial in preventing future cognitive decline.

Association between type of menopause and mild cognitive impairment: The REDLINC XII study

ObjectiveTo evaluate the association between type of menopause (spontaneous or surgical) and mild cognitive impairment (MCI). Study designThis study was a cross-sectional, observational, and sub-analytical investigation conducted within gynecological consultations across nine Latin American countries. MethodWe assessed sociodemographic, clinical, and anthropometric data, family history of dementia, and the presence of MCI using the Montreal Cognitive Assessment (MoCA) tool. ResultsThe study involved 1185 postmenopausal women with a mean age of 55.3 years and a body mass index of 26.4 kg/m2. They had an average of 13.3 years of education, and 37 % were homemakers. Three hundred ninety-nine experienced menopause before 40, including 136 with surgical menopause (bilateral oophorectomy). Out of the 786 women who experienced menopause at 40 or more years, 110 did so due to bilateral oophorectomy. There were no differences in MoCA scores among women who experienced menopause before or after the age of 40. However, lower MoCA scores were observed in women with surgical menopause than in those with spontaneous menopause (23.8 ± 4.9 vs. 25.0 ± 4.3 points, respectively, p < 0.001). Our logistic regression model with clustering of patients within countries found a significant association between MCI and surgical menopause (OR 1.47, 95 % CI: 1.01–2.16), use (ever) of menopausal hormone therapy (OR 0.33, 95 % CI: 0.21–0.50), and having >12 years of education (OR 0.21, 95 % CI: 0.14–0.30). ConclusionWhen comparing women who experience spontaneous menopause over the age of 40 with those who undergo it before this age, there was no observed increased risk of developing MCI, while those with surgical menopause, independent of age, are more prone to cognitive decline. Women who have ever used menopausal hormone therapy have a lower MCI risk. Further research is warranted to delve deeper into this topic.

Therapeutic sleep deprivation for major depressive disorder: A randomized controlled trial

BackgroundMajor depressive disorder (MDD) is treated primarily using antidepressant drugs, but clinical effects may be delayed for weeks to months. This study investigated the efficacy of brief therapeutic sleep deprivation (TSD) for inducing rapid improvements in MDD symptoms. MethodsFrom November 2020 to February 2023, 54 inpatients with MDD were randomly allocated to TSD and Control groups. The TSD group (23 cases) remained awake for 36 h, while the Control group (31 cases) maintained regular sleep patterns. All participants continued regular drug therapy. Mood was assessed using the 24-item Hamilton Depression Scale (HAMD-24) at baseline and post-intervention in both groups. In the TSD group, the Visual Analogue Scale (VAS) was utilized to evaluate subjective mood during and after the intervention. Cognitive function was assessed at baseline and post-intervention using the Montreal Cognitive Assessment (MoCA). Objective sleep parameters were recorded in the TSD group by polysomnography. The follow-up period spanned one week. ResultsHAMD-24 scores did not differ between groups at baseline or post-intervention. However, the clinical response rate was 34.8 % higher in the TSD group on day 3 post-intervention compared to the Control group (3.2 %), but not sustained by day 7. Moreover, responders demonstrated a faster improvement in the VAS score during TSD than non-responders (p = 0.047). There were no significant differences in MoCA scores or objective sleep parameters between the groups. LimitationsSmall sample size and notable attrition rate. ConclusionsTherapeutic sleep deprivation can rapidly improve MDD symptoms without influencing sleep parameters or cognitive functions. Assessment of longer-term effects and identification of factors predictive of TSD response are warranted.

Dementia and mild cognitive impairment screening in an emergency homeless shelter.

Older adults represent the fastest growing segment of the homeless community. Little is known about the prevalence of dementia and mild cognitive impairment (MCI) in this population. Dementia and MCI screening using the Montreal Cognitive Assessment (MoCA) was incorporated into the standard senior evaluation for adult clients aged ≥ 55 in a large emergency homeless shelter. In a 6-week period, 104 of 112 (92.9%) assessments were positive for dementia or MCI using a standard cutoff of 26, and 81 (72.3%) were positive using a conservative cutoff of 23. There was no significant difference in MoCA scores based on sex or education level, and no significant correlation between age and MoCA score. Older adults experiencing homelessness may have a high likelihood of dementia or MCI. Routine MoCA screening in older adults experiencing homelessness is feasible and can help to identify services needed to successfully exit homelessness.

Effects of anterior approach to quadratus lumborum block on postoperative cognitive function following hip surgery in older people: a randomized controlled clinical trial

BackgroundPeripheral nerve block, including the quadratus lumborum block (QLB), has been used for postoperative analgesia in hip surgery. However, the effects of QLB on cognitive function after hip surgery remain unknown. This study aimed to assess the effects of the anterior approach to QLB on postoperative cognitive function in older people undergoing hip surgery.MethodsSixty older people who underwent hip surgery from May 2021 to May 2022 were randomly divided into the QLB (n = 30) and control groups (n = 30). The Montreal Cognitive Assessment (MoCA) score (mean ± SD) was measured one day preoperatively and seven and 30 days postoperatively. The frequency (%) of postoperative cognitive dysfunction (POCD) was examined seven and 30 days postoperatively. The visual analog scale (VAS) scores at rest and Bruggrmann comfort scale (BCS) scores [Median (IQR)] 6 h (t1), 12 h (t2), 24 h (t3), and 48 h (t4) after surgery were assessed. The plasma high mobility group box protein 1 (HMGB1) and levels of interleukin-6 (IL-6) (mean ± SD) were evaluated 1 h preoperatively (baseline) and 24 h postoperatively (day 1). The requirement for rescue analgesia [Median (IQR)], time to first off-bed activity (mean ± SD), and adverse effects after surgery were also recorded.ResultsCompared with the control group, the frequency of POCD was significantly lower in the QLB group seven days postoperatively (10.7% vs. 34.5%, P = 0.033), but no difference at 30 days postoperatively (3.6% vs. 10.3%, P = 0.319). There was no significant difference in MoCA scores between the two groups at one day preoperatively and 30 days postoperatively. However, the MoCA scores at seven days postoperatively were higher in the QLB group than in the control group (27.4 ± 1.81 vs. 26.4 ± 1.83, P = 0.043). In the QLB group, the VAS scores at t1, t2, and t3 were lower [3(2–4) vs. 4(3–4), P = 0.028; 3(2–3) vs. 4(3–5), P = 0.009; 2(1–3) vs. 2(2–3), P = 0.025], and the BCS scores at t1, t2, and t3 were higher than those in the control group [3(1–3) vs. 1(1–2), P = 0.006; 3(2–3) vs. 2(1–3), P = 0.011; 3(2–4) vs. 2(2–3), P = 0.041]. The patients in the QLB group reported significantly fewer requirements for rescue analgesia [0(0–1) vs. 1(0–2), P = 0.014]. The plasma levels of HMGB1 and IL-6 at 24 h postoperatively in the QLB group were significantly lower than in the control group (749.0 ± 185.7 vs. 842.1 ± 157.9, P = 0.046; 24.8 ± 8.1 vs. 31.9 ± 5.5, P < 0.001). The time to first off-bed activity from the end of surgery was shorter in the QLB group (25.3 ± 5.3 vs. 29.7 ± 6.9, P = 0.009). There was no significant difference in the incidence of postoperative complications between the two groups.ConclusionsAnterior QLB given to older people undergoing hip surgery could promote early postoperative cognitive function recovery, provide adequate postoperative analgesia, and inhibit the release of inflammatory factors.Trial registrationChictr.org.cn identifier ChiCTR2000040724 (Date of registry: 08/12/2020, prospectively registered).

Impact of high-power short-duration atrial fibrillation ablation technique on the incidence of silent cerebral embolism: a prospective randomized controlled study

BackgroundHigh-power short-duration (HPSD) ablation strategy has emerged as a popular approach for treating atrial fibrillation (AF), with shorter ablation time. The utilized Smart Touch Surround Flow (STSF) catheter, with 56 holes around the electrode, lowers electrode-tissue temperature and thrombus risk. Thus, we conducted this prospective, randomized study to investigate if the HPSD strategy with STSF catheter in AF ablation procedures reduces the silent cerebral embolism (SCE) risk compared to the conventional approach with the Smart Touch (ST) catheter.MethodsFrom June 2020 to September 2021, 100 AF patients were randomized 1:1 to the HPSD group using the STSF catheter (power set at 50 W) or the conventional group using the ST catheter (power set at 30 to 35 W). Pulmonary vein isolation was performed in all patients, with additional lesions at operator’s discretion. High-resolution cerebral diffusion-weighted magnetic resonance imaging (hDWI) with slice thickness of 1 mm was performed before and 24–72 h after ablation. The incidence of new periprocedural SCE was defined as the primary outcome. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) test.ResultsAll enrolled AF patients (median age 63, 60% male, 59% paroxysmal AF) underwent successful ablation. Post-procedural hDWI identified 106 lesions in 42 enrolled patients (42%), with 55 lesions in 22 patients (44%) in the HPSD group and 51 lesions in 20 patients (40%) in the conventional group (p = 0.685). No significant differences were observed between two groups regarding the average number of lesions (p = 0.751), maximum lesion diameter (p = 0.405), and total lesion volume per patient (p = 0.669). Persistent AF and CHA2DS2-VASc score were identified as SCE determinants during AF ablation procedure by multivariable regression analysis. No significant differences in MoCA scores were observed between patients with SCE and those without, both immediately post-procedure (p = 0.572) and at the 3-month follow-up (p = 0.743).ConclusionsInvolving a small sample size of 100 AF patients, this study reveals a similar incidence of SCE in AF ablation procedures, comparing the HPSD strategy using the STSF catheter to the conventional approach with the ST catheter.Trial registrationClinicaltrials.gov: NCT04408716.Graphical AF = Atrial fibrillation, DWI = Diffusion-weighted magnetic resonance imaging, HPSD = High-power short-duration, ST = Smart Touch, STSF = Smart Touch Surround Flow.

Neurofilament Light Chain levels during admission after out-of-hospital cardiac arrest is associated with cognitive performance at 3-months follow-up

Abstract Background Patients who are resuscitated from out-of-hospital cardiac arrest (OHCA) and hospitalized in coma are at high risk of mortality or brain injury with consequent cognitive impairment, and new therapy are wanted. Biomarkers of brain injury, including Neuron-specific enolase (NSE) and Neurofilament light chain (NfL), predict mortality from cerebral injury. However, prognostication of cognitive dysfunction after discharge in OHCA survivors is challenging. Montreal Cognitive Assessment (MoCA) is a recommended standardized cognitive function testing which is used in the months following OHCA. Nevertheless, prognostic methods assessed in the initial phase of admittance which identify patients at risk of developing cognitive impairment are needed. Purpose To investigate the effect of tocilizumab administered at admission after OHCA on cognitive performance assessed by MoCA at 3-month follow-up, and to investigate the association to time-to-ROSC, and NSE as well as NfL levels during index admission with MoCA at follow-up. Methods The IMICA trial evaluated tocilizumab for reducing systemic inflammation after OHCA and randomized 80 comatose adult patients at admission to an infusion of either tocilizumab (8mg/kg, maximum 800mg) or placebo. NSE at 48 hours was measured as part of routine biochemistry based on serum samples, and NFL at 48 hours was measured in serum samples from the biobank. Time-to-ROSC was reported from pre-hospital data and cognitive performance at 3 months follow-up were assessed by the MoCA test. The association between MoCA and time-to-ROSC, NSE and NfL was assessed by Spearman’s correlation analyses. Results At follow-up, 35 patients had a MoCA test performed, while 28 patients were deceased, and 17 were alive without having an available MoCA score. There was no difference in MoCA scores at follow-up in the tocilizumab group compared to placebo group (p=0.72), and therefore results for both groups were pooled for analyses. NfL was found to be inversely correlated with MoCA score, r = -0.49, p = 0.003 (Figure), while there were no correlations with MoCA for time-to-ROSC or NSE (p = 0.46 and p = 0.34). Conclusions NfL measured at 48 hours after admission was inversely correlated with cognitive performance at 3 months for survivors of OHCA.

Virtual reality-based monitoring test for MCI: A multicenter feasibility study.

As the significance of the early diagnosis of mild cognitive impairment (MCI) has emerged, it is necessary to develop corresponding screening tools with high ecological validity and feasible biomarkers. Virtual reality (VR)-based cognitive assessment program, which is close to the daily life of the older adults, can be suitable screening tools for MCI with ecological validity and accessibility. Meanwhile, dehydroepiandrosterone (DHEA) has been observed at a low concentration in the older adults with dementia or cognitive decline, indicating its potential as a biomarker of MCI. This study aimed to determine the efficacy and usability of a VR cognitive assessment program and salivary DHEA for screening MCI. The VR cognitive assessment program and the traditional Montreal Cognitive Assessment (MOCA) test were performed on 12 patients with MCI and 108 healthy older adults. The VR program operates in a situation of caring for a grandchild, and evaluates the memory, attention, visuospatial, and executive functions. An analysis of covariance (ANCOVA), a partial correlation analysis, and receiving operating characteristic (ROC) curve analysis were conducted for statistical analysis. According to the ANCOVA, no significant difference in MOCA scores was found between the normal and MCI groups (F = 2.36, p = 0.127). However, the VR total score of the MCI group was significantly lower than that of the normal group (F = 8.674, p = 0.004). There was a significant correlation between the MOCA and VR scores in the total and matched subdomain scores. The ROC curve analysis also showed a larger area under the curve (AUC) for the VR test (0.765) than for the MOCA test (0.598), and the sensitivity and specificity of the VR program were 0.833 and 0.722, respectively. Salivary DHEA was correlated with VR total (R 2 = 0.082, p = 0.01) and attention scores (R 2 = 0.086, p = 0.009). The VR cognitive test was as effective as the traditional MOCA test in the MCI classification and safe enough for older adults to perform, indicating its potential as a diagnostic tool. It has also been shown that salivary DHEA can be used as a biomarker for MCI.

Antihypertensive therapy is associated with improved visuospatial, executive, attention, abstraction, memory, and recall scores on the montreal cognitive assessment in geriatric hypertensive patients.

The prevalence of Mild Cognitive Impairment (MCI) has increased over the past few decades. However, it can potentially be reversed if detected early. Early detection of MCI using the sensitive Montreal Cognitive Assessment (MoCA) might prove to be an important cog in the wheel in identifying and slowing down this morbid pandemic in hypertensive persons. To study the association of antihypertensive agents on cognitive scores and prevalence of MCI using the MoCA. This is a single-center, controlled, observational, cross-sectional study in a tertiary care teaching hospital in India. Cognitive assessment was done using the Montreal Cognitive Assessment. Data on MoCA scores were comprehensively analyzed. A total of N=210 patients (n=105 the in study and control groups) were included in the study. The median (IQR) MoCA score (out of 30 points) in patients taking antihypertensives was 26 (25 - 27), while it was 24 (22 - 25) in the control group. There was no difference in MoCA scores between patients taking lipophilic or hydrophilic antihypertensives. Similarly, there was no difference in MoCA scores between patients taking different drug regimens. Anti-hypertensive therapy and lower blood pressure had a statistically significant positive association with visuospatial, executive, attention, abstraction, memory, and recall MoCA scores. Patients on antihypertensive therapy also had a lower prevalence of MCI. MoCA scores were similar in patients on either lipophilic or hydrophilic drugs and were similar between patients on different antihypertensive drug classes.

Study on the Correlation between Chinese Medicine Syndrome and Cognitive Dysfunction in Mild Cognitive Impairment.

Objective To investigate the correlation between Chinese medicine syndrome and cognitive dysfunction in patients with mild cognitive impairment (MCI). Methods 121 MCI patients were included for syndrome differentiation and syndrome scoring according to the Chinese medicine syndrome classification standard of senile dementia. The cognitive function and cognitive subitems (including visual space and executive function, naming, attention, language, abstraction, delayed recall, and orientation) of patients with different Chinese medicine syndromes were scored with the Montreal Cognitive Assessment (MoCA). Correlation analysis was made on Chinese medicine syndromes and cognitive domain damage. Results Chinese medicine syndromes from most to least were kidney deficiency and marrow reduction syndrome, turbid phlegm obstructing orifices syndrome, deficiency of heart and spleen syndrome, qi stagnation and blood stasis syndrome, and yin deficiency of heart and liver syndrome. There were no significant differences in MoCA scores among different Chinese medicine syndromes (P > 0.05).In the kidney deficiency and marrow reduction syndrome, the delayed recall score was 1.74 ± 1.23 and the difference was statistically significant when compared with deficiency of heart and spleen syndrome or the yin deficiency of heart and liver syndrome (P < 0.05). In the turbid phlegm obstructing orifices syndrome, the delayed recall score was 1.81 ± 1.33 and the difference was statistically significant when compared with the yin deficiency of heart and liver syndrome (P < 0.05). There was a significant negative correlation between the kidney deficiency and marrow reduction syndrome's Chinese medicine syndrome scores and MoCA scores (P < 0.01), and there was a negative correlation between the turbid phlegm obstructing orifices syndrome's Chinese medicine syndrome scores and MoCA scores (P < 0.05). Correlation analysis showed that the kidney deficiency and marrow reduction syndrome was significantly negatively correlated with delayed recall scores (P < 0.01), and it was also negatively correlated with visual space and executive function scores (P < 0.05). The turbid phlegm obstructing orifices syndrome was significantly negatively correlated with delayed recall scores (P < 0.01). Conclusion The kidney deficiency and marrow reduction syndrome and the turbid phlegm obstructing orifices syndrome were the most common syndromes in MCI. Patients with kidney deficiency and marrow reduction syndrome might have obvious damage in delayed recall function and have damage in visual space and executive function. Patients with turbid phlegm obstructing orifices syndrome might have obvious damage in delayed recall function.

Rates of Cognitive Decline in 100 Patients With Alzheimer Disease.

Background: In the state of Louisiana, the prevalence of Alzheimer disease (AD) is projected to increase 26.4% by 2025 because of the rapidly increasing geriatric population. While significant research is available on risk factors for developing AD, less data are available regarding AD progression and the rate of change among patients with the disease. To date, no research has established the baseline cognitive decline of patients with AD residing in New Orleans, Louisiana.Methods: We evaluated 100 patients in the Ochsner Health system from September 2013 to December 2019 who had a diagnosis of AD and repeated Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA) scores to determine annual rates of decline. Associated variables that were analyzed included race, age at diagnosis, social factors, and comorbidities.Results: The average annual rates of decline for MMSE and MoCA scores were 2.43 (SD 2.82) points and 2.39 (SD 1.88) points, respectively. Our results were significant for a faster rate of decline in MMSE scores among smokers (3.50 points, SD 3.20) vs nonsmokers (1.54 points, SD 2.07). We found no significant difference in MoCA scores for smokers vs nonsmokers, in addition to other demographic and lifestyle variables.Conclusion: The rate of decline seen in an urban population of patients with AD is lower than the average rate of decline reported in the literature, a finding that can help inform future interventional studies that use rate of decline as a primary outcome.

A-7 Discriminating between Mild Cognitive Impairment and Alzheimer’s Disease on the MoCA

Abstract Objective The Montreal Cognitive Assessment (MoCA) is a suitable, sensitive, and specific cognitive screener for detecting mild cognitive impairment (MCI). Previous research has found markers to discriminate between MCI and Alzheimer’s disease (ad) on MoCA subtest scores. Specifically, impaired performance on the clock drawing (i.e., number and hand placement), rhino naming, serial 7’s, word recall, and orientation were suggestive of ad. The aim of the present study is to assess for discrimination patterns in MoCA performance between MCI and ad.Method: Data was collected through the National Alzheimer’s Coordinating Center (NACC). A sample of MCI (n = 1143; 51% female, 82% White, 15% Black, 3% Asian/Pacific Islander) and ad groups (n = 1339; 56% female, 89% White, 9% Black, 2% Asian/Pacific Islander) were examined. Results An initial independent t-test revealed a statistically significant difference in MoCA scores for MCI (M = 22.01, SD = 3.49) and ad (M = 14.46, SD = 6.05; t(2480) = 38.72, p = 0.000, Cohen’s d = 1.53). Additional t-tests were performed to compare MoCA subtest scores and domain scores for diagnostic groups. There was a statistically significant difference for MCI and ad groups across all MoCA subtests and domains. Despite no discrimination in profiles noted on t-tests, further examination using normal distribution revealed worse performance on trails, clock hands, serial 7’s, repetition, fluency, date, and place in ad groups. Conclusions Consistent with previous findings, clock hands, serial 7’s, and orientation were able to discriminate between ad and MCI. This study found further discrimination in trails, repetition, and fluency. These findings may allow for clinicians to use these patterns of performance as early cognitive markers of impairment.

A-16 MoCA Subtest Analysis: Discriminating between Healthy Controls and MCI

Abstract Objective The Montreal Cognitive Assessment (MoCA) is a suitable, sensitive, and specific cognitive screener for detecting mild cognitive impairment (MCI). Previous research has found markers to discriminate between healthy controls and MCI on MoCA subtest scores. Specifically, MCI performed worse on executive functioning and attention tasks (i.e., inverse digits, serial 7’s, repetition, fluency, abstraction, and word recall). The aim of the present study is to assess for discrimination patterns in MoCA performance between healthy controls and MCI. Method Data was collected through the National Alzheimer’s Coordinating Center (NACC). A sample of healthy controls (n = 3776, 65% female, 80% White, 17% Black, 3% Asian/Pacific Islander) and MCI (n = 1143; 51% female, 82% White, 15% Black, 3% Asian/Pacific Islander) were examined. Results An initial independent t-test revealed a statistically significant difference in MoCA scores for healthy controls (M = 26.18, SD = 2.78) and MCI (M = 22.01, SD = 3.49; t(4917) = 36.91, p = 0.000, Cohen’s d = 1.32). Additional t-tests were performed to compare MoCA subtest scores and domain scores for diagnostic groups. There was a statistically significant difference for healthy controls and MCI groups across all MoCA subtests and domains. Further examination using normal distribution revealed worse performance on cube copy and word recall in MCI groups. Conclusions Consistent with previous findings, word recall was able to discriminate between healthy controls and MCI. However, this study was able to find discrimination in cube copy performance. These findings may guide clinicians to use these interval changes as early cognitive markers for impairment, allowing for early detection and intervention.

Relationships Between Chronic Pain Stage, Cognition, Temporal Lobe Cortex, and Sociodemographic Variables.

Non-Hispanic black (NHB) individuals have increased risk of Alzheimer's disease (AD) relative to non-Hispanic whites (NHW). Ethnicity/race can serve as a proxy sociodemographic variable for a complex representation of sociocultural and environmental factors. Chronic pain is a form of stress with high prevalence and sociodemographic disparities. Chronic pain is linked to lower cognition and accelerated biological aging. The purpose of this study is to seek understanding of potential cognitive and temporal lobe structural brain AD vulnerabilities based on chronic pain stage and ethnicity/race. Participants included 147 community dwelling NHB and NHW adults without dementia between 45-85 years old who had or were at risk of knee osteoarthritis. All participants received an MRI (3T Philips), the Montreal Cognitive Assessment (MoCA), and assessment of clinical knee pain stage. There were ethnic/race group differences in MoCA scores but no relationships with chronic knee pain stage. Ethnicity/race moderated the relationship between AD-related temporal lobe thickness and chronic pain stage with quadratic patterns suggesting thinner cortex in high chronic pain stage NHB adults. There appear to be complex relationships between chronic knee pain stage, temporal lobe cortex, and sociodemographic variables. Specifically, NHB participants without dementia but with high chronic knee pain stage appeared to have thinner temporal cortex in areas associated with AD. Understanding the effects of sociocultural and socioeconomic factors on health outcomes is the first step to challenging the disparities in healthcare that now appear to link disease conditions to neurodegenerative processes.

Altered Dynamic Neural Activity in the Default Mode Network in Lung Cancer Patients After Chemotherapy

BackgroundFew studies have examined functional brain changes specifically associated with chemotherapy (CTx) in patients with lung cancer. This prospective longitudinal research aimed to explore the change in intrinsic brain activity by investigating patients with lung cancer after CTx.Material/MethodsSixteen patients and 20 healthy individuals were enrolled in this study. The amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), dynamic amplitude of low-frequency fluctuation (dALFF), and dynamic regional homogeneity (dReHo) were computed. The group differences in resting state functional magnetic resonance imaging (rs-fMRI) parameters were compared. Alterations in the rs-fMRI parameters from before CTx to after CTx were assessed using the paired t-test. We performed correlation analyses between rs-fMRI parameters and Montreal Cognitive Assessment (MoCA) scores.ResultsWe found statistically significant differences in MoCA scores before CTx and after CTx. Compared to the healthy group, rs-fMRI values decreased in the frontal regions as well as parietal regions compared to values before CTx. In addition, we found significantly decreased rs-fMRI values in the default-mode network (DMN) region of the brain before CTx compared to after CTx. We found no significant correlations between altered intrinsic activity values and MoCA scores.ConclusionsThe current study indicated that patients with lung cancer after CTx had decreased dynamic brain activity in the DMN region, and the DMN is vulnerable when patients undergoing CTx.

Pathological Between-Network Positive Connectivity in Early Type 2 Diabetes Patients Without Cerebral Small Vessel Diseases.

Background and PurposePrevious neuroimaging studies have demonstrated type 2 diabetes (T2D)-related brain structural and functional changes are partly associated with cognitive decline. However, less is known about the underlying mechanisms. Chronic hyperglycemia and microvascular complications are the two of most important risk factors related to cognitive decline in diabetes. Cerebral small vessel diseases (CSVDs), such as those defined by lacunar infarcts, white matter hyperintensities (WMHs) and microhemorrhages, are also associated with an increased risk of cognitive decline and dementia. In this study, we examined brain magnetic resonance imaging (MRI) changes in patients in the early stages of T2D without CSVDs to focus on glucose metabolism factors and to avoid the interference of vascular risk factors on T2D-related brain damage.MethodsT2D patients with disease durations of less than 5 years and without any signs of CSVDs (n = 34) were compared with healthy control subjects (n = 24). Whole-brain region-based functional connectivity was analyzed with network-based statistics (NBS), and brain surface morphology was examined. In addition, the Montreal Cognitive Assessment (MoCA) was conducted for all subjects.ResultsAt the whole-brain region-based functional connectivity level, thirty-three functional connectivities were changed in T2D patients relative to those in controls, mostly manifested as pathological between-network positive connectivity and located mainly between the sensory-motor network and auditory network. Some of the connectivities were positively correlated with blood glucose level, insulin resistance, and MoCA scores in the T2D group. The network-level analysis showed between-network hyperconnectivity in T2D patients, but no significant changes in within-network connectivity. In addition, there were no significant differences in MoCA scores or brain morphology measures, including cortical thickness, surface area, mean curvature, and gray/white matter volume, between the two groups.ConclusionThe findings indicate that pathological between-network positive connectivity occurs in the early stages of T2D without CSVDs. The abnormal connectivity may indicate that the original balance of mutual antagonistic/cooperative relationships between the networks is broken, which may be a neuroimaging basis for predicting cognitive decline in early T2D patients.

Assessing performance on the Montreal Cognitive Assessment (MoCA) in experienced cochlear implant users: use of alternative scoring guidelines

ABSTRACT Although research suggests a relationship between hearing impairment and cognitive decline in older adults, nuances of this relationship remain unclear. This uncertainty could be attributed to verbal administration of standardized cognitive measures to hearing-impaired (HI) individuals. Various strategies for testing HI populations have been suggested. We tested the efficacy of applying alternative scoring methods that systematically removed auditory-based items on the Montreal Cognitive Assessment (MoCA) in 27 cochlear implant patients. We calculated the original MoCA score and three alternative scores. The first alternative removed items from the Attention and Language sections; the second alternative removed the Delayed Recall task, and the third alternative removed the Attention, Language, and Delayed Recall items. QoL was assessed using the Glasgow Benefit Inventory and Nijmegen Cochlear Implant Questionnaire. Results indicate a significant difference in MoCA scores with two alternative scoring methods. The second alternative MoCA score related to self-reported performance on the GBI.

Prevalence of Mild Cognitive Impairment Among Older People in Kazakhstan and Potential Risk Factors: A Cross-sectional Study.

There have been no epidemiological studies of mild cognitive impairment (MCI) in Central Asia. The objective of this study was to describe the prevalence of, and risk factors for, MCI in an urban population in Kazakhstan. Adults aged 60 years and over were randomly selected from registers of 15 polyclinics in Almaty. Of 790 eligible people, 668 agreed to participate (response rate 85%). Subjects were screened using the Montreal Cognitive Assessment (MoCA). Those who scored 26 or lower on the MoCA were assessed by a multidisciplinary team and a diagnosis of normal cognition, MCI or dementia was made. The median MoCA score was 22 and the prevalence of MCI was 30%. MoCA scores were lower, and MCI prevalence was higher, among those with less education and those with older age. There was no difference in MoCA scores or MCI prevalence by sex or ethnic group (Kazakh or Russian). High blood pressure, older age, and lower education were associated with increased odds of MCI in crude analyses but only age and education remained statistically significant in an adjusted logistic regression model. The prevalence of MCI in Kazakhstan is high. Higher levels of education may lead to lower prevalence of MCI in the future.

The Association between Calcified Neurocysticercosis and Cognitive Performance: A Case-Control Study Nested to a Population-Based Cohort.

Mechanisms implicated in the association between neurocysticercosis (NCC) and cognitive impairment remain unknown. Atahualpa residents aged ≥ 40 years with calcified NCC were identified as case patients and paired 1:1 to age- and gender-matched controls. The selection process generated 79 pairs. Cognitive performance was measured by the Montreal Cognitive Assessment (MoCA). A conditional logistic regression model revealed no differences in MoCA scores across case patients and controls, after adjusting for education, epilepsy, depression, and hippocampal atrophy. The single covariate remaining significant was hippocampal atrophy. When participants were stratified according to this covariate, linear models showed lower MoCA scores among case patients (but not controls) with hippocampal atrophy. In a fully adjusted linear regression model, age remained as the single covariate explaining cognitive impairment among NCC patients. This study demonstrates an association between hippocampal atrophy and poor cognitive performance among patients with calcified NCC, most likely attributable to the effect of age.