Early Detection Of Cognitive Impairment Research Articles

Ouvrier’s Modified Mini Mental State Examination as a screening test for cognitive impairment in school-aged children with epilepsy

Background Epilepsy may affect children's development, including their cognitive function. The prevalence of cognitive impairment in epilepsy patients is quite high. Weschler Intelligence Scale for Children (WISC) takes a long time to administer and is expensive, so a simpler screening tool for cognitive evaluation is needed in pediatric epilepsy patients.
 Objective To assess the diagnostic value of Ouvrier’s Modified Mini Mental State Examination (MMSE) for detecting cognitive impairment in children aged 8-11 years with epilepsy.
 Methods This diagnostic study was conducted in December 2018 to February 2019 at Cipto Mangunkusumo and Fatmawati Hospitals in Jakarta. Data were collected with purposive sampling of children with epilepsy aged 8 to 11 years. Cognitive function was assessed by Ouvrier’s Modified MMSE and WISC. Ouvrier’s Modified MMSE was compared to WISC as and the gold standard. Results were analyzed using a 2x2 table.
 Results The prevalence of cognitive impairment in 8-11-year-old epilepsy patients was 72.9%. Ouvrier’s Modified MMSE had 83% sensitivity, 85% specificity, 94% positive predictive value, 65% negative predictive value, and 83% accuracy.
 Conclusions Ouvrier’s Modified MMSE has good diagnostic value, thus it may be useful for early detection of cognitive impairment in pediatric epilepsy.

Survey on Acceptance of Passive Technology Monitoring for Early Detection of Cognitive Impairment (2747)

Survey on Acceptance of Passive Technology Monitoring for Early Detection of Cognitive Impairment (2747)

Análisis acústico de la voz para la detección del deterioro cognitivo

Background and aimRecent research has shown that acoustic voice analysis is a valuable tool for both the objective assessment of cognitive impairment and the monitoring of disease progression. The aim of this study is to determine whether automatic voice analysis is also useful for diagnosis of cognitive impairment. Materials and methodsThis is a descriptive cross-sectional correlational study in which a comparison is made between an experimental group composed of 10 participants with cognitive impairment and a control group with 10 healthy participants. Voice recordings were collected from both groups while they performed 4 tasks: counting backwards (from 305 to 285), description of an image and two tasks of verbal fluency (phonological and semantic). The voice samples were later acoustically analyzed to extract from them variables predictive of the cognitive state of the subject. ResultsThe results show that the acoustic variables are effective for early detection of cognitive impairment, achieving a classification rate of 100% when predicting the cognitive status of the subjects in our sample. From the results it is clear that verbal fluency tasks are more effective than counting backwards and describing an image. ConclusionsIn light of our results, we consider that automatic voice analysis could be an additional objective assessment tool for elderly people with cognitive impairment. The implications of the results found are discussed.

Electroencephalographic abnormalities are correlated with cognitive deficits in children with benign childhood epilepsy with centrotemporal spikes: A clinical study of 61 cases

ObjectiveThe objective of this study was to explore the effect of spikes on cognition in patients with benign childhood epilepsy with centrotemporal spikes (BECTS) and to identify electroencephalography (EEG) markers enabling early detection of cognitive impairment. MethodsSixty-one children with BECTS diagnoses and 60 age- and education-matched healthy controls were enrolled. Four-hour EEG recordings were analyzed for each patient to check for interictal spikes, high-frequency oscillations (HFOs), nondipole spikes, and other atypical EEG features and to examine the spike–wave index of nonrapid eye movement (NREM) sleep. All 121 children underwent a series of neuropsychological tests to assess cognitive function. ResultsPatients with a high NREM sleep discharge index (≥55%) in the first sleep cycle exhibited significantly lower scores for arithmetic calculation, executive function, and attention and memory tests than patients with a low discharge index (<55%). Eight patients with HFOs exhibited even poorer performance than HFO-negative patients for arithmetic calculation, executive function, vocabulary comprehension, visual perception, vocal perception, spatial memory ability, and response ability. Children with bilateral discharge exhibited poorer ability in three-dimensional spatial imaging test, poorer memory, and slower response than did those with unilateral discharge (P < .05). Nondipole spikes, multiple asynchronous discharges, and generalized spike–wave discharges respectively had an impact on calculation ability, memory, and reaction ability respectively (P < .05). ConclusionsSpike frequencies in stage 3 and 4 sleep varied from those observed in stage 1 and 2 sleep; the highest spike frequency was in stage 2 sleep. High NREM sleep discharge index (i.e., ≥55%) and HFOs were linked to the highest risk for cognitive deficit, while bilateral discharges, nondipole spikes, multiple asynchronous discharges, and generalized spike–wave discharges were less indicative of cognitive impairment.

Impact of individual and neighborhood dimensions of socioeconomic status on the prevalence of mild cognitive impairment over seven-year follow-up

Objectives: There is strong evidence about the association between low socioeconomic status (SES) and higher risk of dementia. However, it has not been conveniently addressed so far the role of SES on the incidence of mild cognitive impairment (MCI). This study examines the impact of individual and neighbourhood dimensions of SES, as well as their interaction, on the risk of developing MCI in a sample of older adults.Method: Data from the Vallecas Project cohort, an ongoing community-based longitudinal study for early detection of cognitive impairment and dementia, were used to build two indices of SES namely individual and neighbourhood, as well as a global SES as a combination of both, and to investigate their effects on MCI conversion by means of a multivariate-adjusted Cox proportional hazard model.Results: A total of 1180 participants aged 70 years and older were enrolled in this study. Of these, 199 cases of MCI (16.9%) were diagnosed at any point of the follow-up. The individual and neighbourhood dimensions of SES played different roles in the dynamics of the MCI occurrence through aging. Most importantly, the risk of developing MCI was almost double for lower SES quartiles when compared to the highest one.Conclusion: The incidence of MCI in older adults was related to both individual characteristics and socioeconomic context. Public health strategies should be holistic and focus not only on promoting the classical individual preventive measures, but also on reducing social inequalities to foster healthy aging and reduce dementia burden.

Digital biomarker-based individualized prognosis for people at risk of dementia.

BackgroundResearch investigating treatments and interventions for cognitive decline fail due to difficulties in accurately recognizing behavioral signatures in the presymptomatic stages of the disease. For this validation study, we took our previously constructed digital biomarker‐based prognostic models and focused on generalizability and robustness of the models.MethodWe validated prognostic models characterizing subjects using digital biomarkers in a longitudinal, multi‐site, 40‐month prospective study collecting data in memory clinics, general practitioner offices, and home environments.ResultsOur models were able to accurately discriminate between healthy subjects and individuals at risk to progress to dementia within 3 years. The model was also able to differentiate between people with or without amyloid neuropathology and classify fast and slow cognitive decliners with a very good diagnostic performance.ConclusionDigital biomarker prognostic models can be a useful tool to assist large‐scale population screening for the early detection of cognitive impairment and patient monitoring over time.

Brief cognitive tests validated in Peru for detection of cognitive impairment A systematic mapping of the scientific literature.

.Brief cognitive tests (BCTs) are necessary for early detection of cognitive impairment, particularly in primary care settings.Objective:This report describes a systematic review of BCTs evaluated in Peruvian populations.Methods:We used systematic mapping techniques to identify articles on screening tests for cognitive impairment involving Peruvian subjects. We included studies published in English and Spanish up to 2018. We reviewed 6 reference databases within the Virtual Health Library network, as well as the Web of Science, Scopus (MEDLINE), and EMBASE databases.Results:Ten out of 447 articles met the inclusion criteria. Studies included both outpatient (9) and community-based (2) samples. Eligibility criteria of the studies were similar. Although different protocols were applied, the diagnostic criteria were standardized. For discrimination between dementia and controls, IFS (AUC: 0.99) and ACE (AUC: 0.95 to 1.00) showed superior performance, as did the M@T (AUC: 1.00) and CDT-Mv (AUC: 0.94 to 1.00) for discriminating between Alzheimer’s disease (AD) and controls.Conclusion:The available evidence is limited. However, our analysis of national data suggests that the ACE may be a good choice whenever it can be applied to Peruvian patients. Alternatively, the M@T and IFS can be used for screening patients with suspected AD or FTD, respectively.

34 Gender Difference in the Association between Handgrip Strength and Cognitive Performance of Older Adults in Rural Malaysia

Abstract Introduction Handgrip strength is an easy and safe measurement to evaluate the physical functioning of older adults. Lower hand grip strength is associated with cognitive decline, and can be used as an effective method for early detection of cognitive impairment. Objective This study aimed to evaluate the gender differences in association between hand grip strength and cognitive performance among older adults in rural Malaysia Methods This was a cross-sectional study done among 200 community dwelling older adults (100 men and 100 women) aged ≥ 50 years. The study was embedded in the ongoing longitudinal study of South East Asia Community Observatory (SEACO) in Segamat district of Johor, Malaysia. Data was collected by trained data collectors during home visits. Cognitive performance was assessed using Mini Mental State Examination (MMSE). Hand grip strength was measured using digital grip dynamometer. Results The mean age of study participants was 61.5 years (SD= 8.4). Women had lower mean hand grip strength (19.8, SD=5.6) compared to men (33.4, SD= 8.2). The mean MMSE score for women and men were 23 (SD= 4.5) and 25.1(SD=3) respectively. Cognitive impairment was detected in 26% of men and 21% of women. Hand grip strength showed positive association with MMSE score, among women (ß coefficient= 0.302, p&amp;lt;0.001), but not among men (p= 0.077). Hand grip strength was significantly association with MMSE score among women (ß coefficient=0.162, 95% CI = 0.026- 0.298; p=0.02) after controlling for age, level of education and body mass index. Conclusion The study shows that lower hand grip strength is associated with poor cognitive performance among women, while hand grip strength is not associated with cognitive performance among men.

The Frequency of Sleep Medication Use and the Risk of Subjective Cognitive Decline (SCD) or SCD With Functional Difficulties in Elderly Individuals Without Dementia.

The present study investigated whether the frequency of sleep medication use affects subjective cognitive decline (SCD) or SCD with functional difficulties in elderly individuals. The 2018 Korea Community Health Survey data, which consists of national representative and community-based data, was used in this study. A total of 57,050 individuals aged 65 years or older were included in this study. SCD was measured using the Behavioral Risk Factor Surveillance System. A logistic regression analysis was used to analyze the data. In total, 16,966 (29.7%) participants had SCD and 3,487 (6.1%) had SCD with functional difficulties. The elderly individuals who took sleep medication more than once a week had higher risks of both SCD and SCD with functional difficulties than those who did not take any sleep medication in a month (SCD: odds ratio [OR] = 1.329, 95% confidence interval [CI] = 1.194-1.480; SCD with functional difficulties: OR = 1.752, 95% CI = 1.491-2.058). Frequent sleep medication use was associated with both SCD and SCD with functional difficulties. This study suggests that early detection of cognitive impairment and efforts to reduce the frequent use of sleeping pills in patients with insomnia might be helpful to reduce the burden of SCD and SCD with functional difficulties in the elderly population.

The Relationship Between Serum Lead Level and Neurobehavioral Performance

Background: Lead is one of the metals, which has an important role in the industry. Objectives: We designed a study to assess the serum lead level in battery manufacturing workers and its association with neurobehavioral performance. Methods: In this cross-sectional, 154 individuals who worked in a battery factory participated. Venous blood samples were collected for measuring blood lead levels by atomic absorption method. Three selected tests of neuropsychological performance approved by World Health Organization were conducted, including simple reaction time (SRT), Benton Visual Retention Test (BVRT), and Santa Ana manual dexterity test. Results: The present study demonstrates a positive correlation between blood lead levels and work experience. The higher blood lead levels and longer work experience were associated with lower scores on the Benton Visual Test. Simple reaction time showed a significant relationship with the work experience. Conclusions: The results of this study suggest that occupational exposure to lead can induce a neurobehavioral dysfunction in battery manufacturing workers. Thus neurobehavioral assessment in health surveillance of exposed workers can be effective in the early detection of cognitive impairment.

Early detection of cognitive dysfunction in patients with multiple sclerosis: Implications on outcome

AbstractObjective:Cognitive impairment in multiple sclerosis (MS) has a complex relationship with disease progression and neurodegeneration. The aim of this study was to shed light on the importance of early detection of cognitive impairment in MS patients.Methods:The study comprised two groups of definite MS patients, relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS), each with 25 patients. Physical disability was assessed using the Expanded Disability Status Scale (EDSS), while the risk of secondary progression was assessed using the Bayesian Risk Estimate for Multiple Sclerosis (BREMS). Cognitive functions were assessed using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and Controlled Oral Word Association Test (COWAT). Assessment of neurodegeneration was done using optical coherence tomography (OCT) via quantification of retinal nerve fiber layer (RNFL).Results:MS patients with higher RNFL thickness demonstrated a larger learning effect size than patients who had lower values in RNFL thickness regardless of MS type. RRMS patients showed significant improvement in delayed recall after giving cues than SPMS. The symbol digit modalities test was the only neuropsychological test that showed a significant negative correlation with EDSS (P = 0.009). There was a statistically significant negative correlation between BREMS scores and performance in all neuropsychological tests.Conclusion:Inclusion of neurocognitive evaluation in the periodic assessment of MS patients is mandatory to detect patients at increased risk of secondary progression. The thickness of RNFL is suggested as a method to estimate the expected benefit of cognitive rehabilitation, regardless of MS type.

Early detection of cognitive impairment in Parkinson's disease with the use of the Wisconsin Card Sorting Test: correlations with Montreal Cognitive Assessment and smell identification test.

Cognitive function is often impaired in early Parkinson's disease (PD). The Wisconsin Card Sorting Test (WCST) is a neuropsychological test of "set-shifting" ability. To see whether WCST is useful for detecting early changes of cognitive function in PD, we examined the correlations of WCST with the Montreal Cognitive Assessment (MoCA) and the Odor Stick Identification Test (OSIT). Subjects were 48 PD patients (age 66 ± 10years; Hoehn & Yahr stage 2.3 ± 0.8; mean duration 3.1 ± 2.5years). WCST sub-scores for categories achieved (CA), perseverative errors of Nelson type (PEN), and difficulties of maintaining set (DMS) were evaluated. MoCA-J (Japanese version) and OSIT-J (Japanese version) were done in that order, followed by the WCST. In PD patients, CA was 2.2 ± 2.0, PEN was 7.0 ± 6.4, and DMS was 2.3 ± 2.0, and all were worse than those of age-matched normal subjects. MoCA-J scores significantly correlated with PEN. OSIT-J scores were also significantly correlated with CA and DMS. As MoCA-J and OSIT-J show high sensitivity and specificity for detecting mild cognitive impairment in PD, WCST may also be a useful supplementary diagnostic tool for early and mild cognitive impairment in PD patients.

SAGE for the Early Detection of Cognitive Impairment at Primary Care Provider Visits

SAGE for the Early Detection of Cognitive Impairment at Primary Care Provider Visits

Inner retinal thinning as a biomarker for cognitive impairment in de novo Parkinson\u2019s disease

We investigated the association between retinal changes measured using optical coherence tomography (OCT) and diverse clinical grading scales in patients with Parkinson’s disease (PD). Seventy-four eyes of 74 patients with de novo PD and 53 eyes of age-matched control subjects were included. The thickness of the peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) were measured. We analyzed the correlations between the clinical PD grading scales and OCT parameters, and between the OCT parameters and volumetric data in the cerebral cortical and subcortical structures. The area under the receiver operating characteristic curve (AUC) was calculated for diagnosing cognitive impairment in patients with PD. Statistically significant reductions in the thickness of average, temporal, and inferior pRNFL and overall mGCIPL were observed in patients with PD. The Montreal Cognitive Assessment score was significantly associated with mGCIPL thinning. The AUC of the mGCIPL parameters for diagnosing cognitive impairment in patients with PD ranged from 0.651 to 0.760. Moreover, thinning of the mGCIPL was significantly associated with the volumetric parameters of associated brain structures. Our findings highlight the clinical implications of OCT measurements as a potential biomarker for early detection of cognitive impairment in patients with PD.

Importance of Increasing Modifiable Risk Factors Knowledge on Alzheimer's Disease Among Community Pharmacists and General Practitioners in Spain.

Community pharmacists and general practitioners have daily contact with patients with Alzheimer’s disease (AD) but the number of positive cases constantly increases every day. Thus, the aim of this research is to describe the level of AD knowledge among community pharmacists and general practitioners in Spain, in order to see where the biggest gaps in the knowledge are. Therefore, a cross-sectional study has been carried out, using the Alzheimer’s disease knowledge survey (ADKS), among members of the Spanish Society of Primary Care Physicians and the Spanish Society of Family and Community Pharmacy to report the differences in AD knowledge in both professional collectives. The ADKS has been responded by 578 community pharmacists and 104 general practitioners and consists of a battery of 30 questions, whose possible answers are true or false. It assesses the AD knowledge in seven areas (impact on the disease, risk factors, course of the disease, diagnosis, care, treatment and symptoms). Results indicate that Spanish pharmacists and general practitioners have a high personal knowledge of AD, nevertheless, it is not associated with greater awareness. Both scored above 80% at the categories: diagnostic, treatment and symptoms. However, lower knowledge level (60% of correct answers) was found in those related to risk factors, such as the ignorance about hypercholesterolemia or hypertension as risk factors for the disease. Community pharmacists are already acting to control cardiovascular risk factors, but a wider knowledge of the relationship of these factors to AD is needed to act against these silent risk factors. Thus, pharmacists may also be involved in the management of AD that includes recognizing early symptoms for early detection of cognitive impairment. Hence, knowledge about risk factors is very important in developing this expanding role.

Early detection of cognitive impairment in patients with insulinoma

Long-standing hypoglycemia can cause cognitive impairment, and whether recurrent severe hypoglycemia impacts cognitive function in patients with insulinoma has not been studied. This study focused on exploring the cognitive function in patients with insulinoma. A prospective study was conducted to assess cognitive function in patients with insulinoma by administering the Montreal Cognitive Assessment (MoCA) questionnaire between January 2016 and July 2017, and patients with cognitive impairment were followed up to undergo the MoCA test 1 year after surgery. The MoCA scores after surgery were compared with the scores before surgery, and the associations between cognitive impairment and relevant factors were further evaluated by multiple linear regression analysis. Eighteen out of thirty-four patients (53%) with insulinoma were screened positive for cognitive impairment as defined by a MoCA score <26. Performance in certain cognitive domains, including visuospatial and executive functions, delayed memory, attention, language, and abstraction, was significantly worse in patients with cognitive impairment. Multivariate analysis indicated that MoCA scores correlated significantly with tumor grade and years of education. Eight patients with cognitive impairment were lost to follow-up. The remaining ten patients with cognitive impairment showed improvements 1 year postoperatively, and seven patients recovered to normal cognitive function. Cognitive impairment was found in patients with insulinoma and was reversible in some patients 1 year after surgery. More studies are needed to explore the underlying mechanisms of the existence and reversibility of cognitive impairment in patients with insulinoma.

Cognitive dysfunction in major depression: From assessment to novel therapies.

Major depressive disorder (MDD) is a disabling disease associated with profound functional impairment. Cognitive deficits, increasingly recognised as a core feature of MDD, reduce educational, occupational and social outcomes, and impair quality of life and functionality. Unlike cognitive impairments associated with schizophrenia (CIAS), cognitive impairments in depression have been under diagnosed and are poorly understood. Consensus has yet to be reached regarding the nature of these deficits, their appropriate assessment and treatment options. It is unclear whether existing treatments have an impact on cognitive deficits. Here, we conduct a thorough and extensive review of recent published work on this unmet clinical need (2014-2018). We evaluate the validity of available assessment tools, and examine the evidence for efficacy of current and novel pharmacological therapies. From our analysis, we have established that cognitive deficits are indeed widespread in MDD patients. The THINC-it tool, a recently validated and sensitive cognitive assessment instrument, shows promise for earlier detection of cognitive impairment associated with MDD and could easily be applied in clinical practice. Several potential novel therapies are emerging. Methodological inconsistencies and small underpowered studies, however, have led to conflicting results and inconclusive evidence. Our recommendations include: development of a standardised neurocognitive test battery for MDD, improving clinical trial design, investigating sex differences, and patient stratification. These changes should support the development of improved therapeutic strategies for cognitive dysfunction in MDD patients, as well as facilitate their use in clinical practice.

Hubungan antara Ketergantungan Nikotin berdasarkan Fagerstrom Test for Nicotine Dependence (FTND )dengan Gangguan Fungsi Kognitif yang Dinilai dengan MoCA-Ina

The aim of the study to know correlation between nicotine dependencybased on Fragerstom Test for Nicotine Dependence (FTND) and cognitive impairment that being assessed by MoCA-Ina. This is a cross sectional study was carried out in YARSI University. Consecutive sampling was used as the sampling method taken form academic community as the population. Data was analyzed using Chi-square. Forty-four subjects were enrolled in this study. All of them were being assessed using (FTND) and Montreal Cognitive Assessment Indonesian Version (MoCA-Ina). Thirty subjects were found having cognitiveimpairment with p value 0.045, there is a correlation between nicotine dependency based on FTND and cognitive impairment that being assessed by MoCA-Ina; correspond with receptor disinvitation theory. The result of study can be used by physician in counselling and early detection of cognitive impairment because the number of smokers in Indonesia is still high.

Impaired cognition in hemodialysis patients: The Montreal Cognitive Assessment (MoCA) and important clues for testing .

Cognitive impairment is common among hemodialysis (HD) patients and is associated with poor treatment compliance and mortality. The aim of this study is to evaluate relatively young HD patients with less comorbidities using the Montreal Cognitive Assessment (MoCA) and identify clues for earlier detection of cognitive impairment with the help of cognitive subscale scores. A total of 103 chronic HD patients (mean age 48.3years) and 37 stage-3 to 5 chronic kidney disease (CKD) patients with similar demographics were included. Patients with cerebrovascular disease, dementia, depression, malignancy, and infections were excluded. All participants were tested with MoCA. Patients with an MoCA global score &lt;24/30 were considered cognitively impaired. Groups were compared for MoCA subscales and clinical features. 75 patients (72.8%) in the HD group and 19 in the CKD group (51.3%) had impaired cognition. The number of patients with cognitive impairment was significantly higher in the HD group compared with the CKD group (p=0.024). The mean total MoCA score was lower in the HD group (p=0.043). MoCA subscale analysis revealed that the mean score for visuospatial/executive domain was significantly lower in the HD group (p=0.001). In this study, we showed that cognitive impairment was more common in HD patients compared with predialytic CKD patients. This difference was predominantly related to the difference in executive scores. We may think that young HD patients with less comorbidities are also at risk for cognitive impairment. Noticing progressive declines in MoCA cognitive domains, before the development of global cognitive impairment, could be beneficial for HD patients. .

Current Trends in the Epidemiology of Dementia and the Management of Patients with Cognitive Impairments

Dementia is the most important medical-social problem, whose significance increases each year because of increases in the proportion of elderly people in the population. Improvements in diagnostic methods create the conditions for earlier detection and treatment of dementing diseases. It is now 20 years since one of the main antidementia drugs – memantine – was registered in Russia. Its appearance widened the potential of treatment of patients with dementia and led to the development of the current care system for this category of patients. Moscow and most districts of the Russian Federation have opened specialist clinics and memory centers (clinical neuropsychology centers) employing state-of-the-art neuropsychological test methods. This created the conditions for multicenter studies in which 1250 patients with cognitive impairments have now taken part. Many educational measures and social projects have taken place, providing improvements in awareness of the problems of dementia in both medicine and society in general. Screening programs have been introduced for the early detection of cognitive impairments and programs for the psychological support of people caring for dementia patients have been instituted.