Folstein Mini-Mental State Examination Research Articles

Depression and Cognitive Function in Accordance with the Nutritional Status of Elderly Women Residing in Rajarhat-Newtown Area of Kolkata, India

ABSTRACT Introduction: The nutritional status of elderly persons is reported to be affected by depression and cognitive function. The most prevalent psychological issue in old age is depression, and cognitive decline is also seen in this age range. Objective: The aim of the present study was to establish the relationship between nutritional status, depression scale, and cognitive function in older women. Materials and Methods: A total of 250 older women participated in a cross-sectional study (residing at Rajarhat-Newtown area). The lengthy version of the Mini-Nutritional Assessment tool (MNA®) was used to evaluate the participants’ nutritional status. The Geriatric Depression Scale (GDS 30) was used to evaluate the severity of the depression. Using the Folstein Mini-Mental State Examination, cognitive function was assessed. Using SPSS software, the Chi-square, Kruskal–Wallis test, and Spearman’s rho correlation coefficient were computed. Multinominal logistic regression model was used by taking nutritional status as dependent variable while depression and cognitive function as independent variables. Results: Participants with mild depression made up about 50.8% and those with severe depression made up 9.2%. Age-related cognitive function was found to be severely impaired in 1.6% and mild or moderate impairment was found in 70.4% of older women. A multinominal logistic regression model validated the finding that there was a significant relationship between dietary status and both depression and cognitive performance (P < 0.05). Conclusions: Both depression and impairment in cognitive function can cause malnutrition or vice versa among older women.

Comparative analysis of nutritional status among institutionalised and community-dwelling elderly women and its association with mental health status and cognitive function.

Population pyramids are significantly impacted by the global phenomena of ageing. It has been reported that depression and cognitive function have an impact on the nutritional status of older adults. Depression is the most common psychiatric problem in old age, and cognitive deterioration is frequently observed in this age group. This descriptive and comparative study set out to compare the cognitive abilities, nutritional health and depression status of older adults who lived in community settings and in assisted living facilities. A total of 250 older women (125 from institutionalised old age home and 125 from community) participated in a cross-sectional study (residing at Rajarhat, Newtown area). The lengthy version of the Mini Nutritional Assessment tool (MNA®) was used to evaluate the participants' nutritional status. The Geriatric Depression Scale (GDS 30) was used to evaluate the severity of the depression. Using the Folstein Mini-Mental State Examination (MMSE), cognitive function was assessed. Using SPSS software, the Chi-square, Kruskal-Wallis test, and Spearman's rho correlation coefficient were computed. In the present study, it was observed that only 30.4% of the respondents who are community-dwelling elderly had normal MNA score, whereas 69.6% were at risk of malnutrition or already malnourished. Considering institutionalised elderly it was observed that only 7.2% were normal and 92.8% were malnourished/at risk of malnutrition. Statistically significant association was observed between nutritional status and mental health status (P = 0.00) as well as cognitive function (P = 0.00) among old age home residing elderly. Among the community-dwelling elderly mental health status has significant association with their nutritional status (P = 0.00) and cognitive function (P = 0.00) as well. Community-dwelling elderly were relatively healthy compared to old age home residents. Maintaining the nutritional, cognitive, and mental health of institutionalised and community-dwelling elderly women requires the implementation of physical and cognitive stimulation activities as well as interventions targeted at improving a healthy diet.

Retinal photoreceptor layer thickness has disease specificity and distinguishes predicted FTLD-Tau from biomarker-determined Alzheimer's disease

While Alzheimer's disease (AD) is associated with inner retina thinning (retinal nerve fiber layer and ganglion cell layer), we have observed photoreceptor outer nuclear layer (ONL) thinning in patients with frontotemporal lobar degeneration tauopathy (FTLD-Tau) compared to normal controls. We hypothesized that ONL thinning may distinguish FTLD-Tau from patients with biomarker evidence of AD neuropathologic change (ADNC) and will correlate with FTLD-Tau disease severity.Predicted FTLD-Tau (pFTLD-Tau; n = 21; 33 eyes) and predicted ADNC (pADNC; n = 24; 46 eyes) patients were consecutively enrolled, underwent optical coherence tomography macula imaging, and disease was categorized (pFTLD-Tau vs. pADNC) with cerebrospinal fluid biomarkers, genetic testing, and autopsy data when available. Adjusting for age, sex, and race, pFTLD-Tau patients had a thinner ONL compared to pADNC, while retinal nerve fiber layer and ganglion cell layer were not significantly different. Reduced ONL thickness correlated with worse performance on Folstein Mini-Mental State Examination and clinical dementia rating plus frontotemporal dementia sum of boxes for pFTLD-Tau but not pADNC. Photoreceptor ONL thickness may serve as an important noninvasive diagnostic marker that distinguishes FTLD-Tau from AD neuropathologic change.

Effects of social isolation on the cognitive status of people over 65 years of age during the SARS-CoV-2 pandemic: A longitudinal comparative study.

Introduction: The SARS-CoV-2 pandemic has affected the entire population, especially vulnerable people with risk factors, such as people over 65 years. Globally and nationally, health protection measures were established to reduce transmission and the impact of the disease on the healthcare system, such as using face masks, hand washing, and social distancing, among others. This led to restrictions on activities outside the home, which affected the cognitive sphere of the population, especially people over 65 years of age. Objective: To demonstrate that social isolation causes changes in the cognitive status of people over 65 years of age. Methods: A longitudinal study was conducted from 2019 to 2020, with the participation of 37 older adults in a parish club of support activities who voluntarily agreed to participate by signing the informed consent form. The Folstein Mini-Mental State Examination was administered to all of them at two points in the study: before the pandemic and after six months of strict social isolation established as a control measure for the SARS-CoV-2 pandemic. We looked for cognitive status differences during this period and studied qualitative-quantitative sociodemographic variables. Results: The club members were older people, predominantly women. Mean age of the participants was 75.4 years; 89.2% had little schooling (less than ten years of formal education). Identified prevalent diseases were arterial hypertension and type-2 diabetes mellitus. In the first evaluation, six out of thirty-seven participants had slight cognitive deficits (16.2%), all females; there were no cases of cognitive impairment; the rest had normal cognitive status (31 out of 37, or 83.8%). After the second evaluation (at the end of strict isolation due to the pandemic), we observed that 11 (29.7%) participants had slight cognitive deficits (ten female and one male), which represents an increase of 13.5%. In addition, four participants (10.8%) showed mild cognitive impairment, all females. Such changes were statistically significant (p-value < 0.05). We conclude that social isolation due to the SARS-CoV-2 pandemic was related to changes in the cognitive status of the elderly.

Clinical Trajectories at the End of Life in Autopsy-Confirmed Dementia Patients With Alzheimer Disease and Lewy Bodies Pathologies.

Evaluating and understanding the heterogeneity in dementia course has important implications for clinical practice, health care decision-making, and research. However, inconsistent findings have been reported with regard to the disease courses of the 2 most common dementias: Alzheimer disease (AD) and dementia with Lewy bodies (DLB). Using autopsy-confirmed diagnoses, we aimed to examine the disease trajectories in the years before death among patients with dementia with pure AD, pure DLB, or mixed (AD and DLB) pathologies. The current retrospective longitudinal study included 62 participants with autopsy-confirmed diagnoses of pure AD (n = 34), mixed AD and DLB (AD + DLB; n = 17), or pure DLB (n = 11) from the Predictors 2 Cohort Study, a prospective, clinic-based, cohort of patients with dementia. Generalized estimating equation models, with time zero at death, were used to examine the trajectory of cognition (Folstein Mini-Mental State Examination [MMSE]), function (activities of daily living [ADL]), and Dependence Scale among patients with different autopsy-confirmed diagnosis (pure AD, AD + DLB, and pure DLB). The models were adjusted for age, sex, education, and baseline features including extrapyramidal signs, MMSE, ADL, and Dependence Scale. The participants on average received 9.4 ± 4.6 assessments at 6-month intervals during a mean 5.4 ± 2.9 years of follow-up. The 3 groups were similar in both cognition and function status at baseline. Cognition and function were highly correlated among patients with AD + DLB but not in pure AD or pure DLB at baseline. Patients of the 3 groups all declined in both cognition and function but had different trajectories of decline. More specifically, the patients with pure DLB experienced approximately double the rate of both cognitive decline and functional decline than the patients with pure AD, and the mixed pathology group showed double the rate of functional decline as compared to pure AD. In this longitudinal study, we found that among patients with dementia, those with Lewy body pathology experienced faster cognitive and functional decline than those with pure AD pathology.

The Association between Tau Protein Level in Cerebrospinal Fluid and Cognitive Status: A Large-Scale Analysis of GAAIN Database.

Alzheimer’s disease (AD) and the associated neurodegenerative dementia have become of increasing concern in healthcare. The tau protein has been considered a key hallmark of progressive neurodegeneration. In this paper, a large-scale analysis of five datasets (more than 2500 people) from the Global Alzheimer’s Association Interactive Network (GAAIN) databases was performed to investigate the association between the level of tau protein, including total tau and phosphorylated tau (p-tau), in cerebrospinal fluid (CSF) and cognitive status. Statistically significant (or marginally significant) high total tau or p-tau concentrations in CSF were observed in dementia patients compared with healthy people in all datasets. There is also a statistically significant (or marginally significant) negative correlation between p-tau concentrations in CSF and Folstein Mini-Mental State Examination (MMSE) scores. In addition, transcriptomic data derived from mouse microglial cells showed multiple genes upregulated in Toll-like receptor signaling and Alzheimer’s disease pathways, including TNF, TLR2, IL-1β, and COX subunits, suggesting that the mechanism of action that relates p-tau and MMSE scores may be through overactivation of pro-inflammatory microglial activity by Aβ peptides, TNF-mediated hyperphosphorylation of tau, and the infectious spread of pathological tau across healthy neurons. Our results not only confirmed the association between tau protein level and cognitive status in a large population but also provided useful information for the understanding of the role of tau in neurodegeneration and the development of dementia.

Association of Leisure Activities With Cognitive Impairment and Dementia in Older Adults in Colombia: A SABE-Based Study.

Observational and interventional studies suggest that participation in leisure activities may help protect against cognitive decline in older people. This study aimed to examine the association between participation in leisure activities and cognitive impairment in older adults in Colombia. Data for this study were derived from the Colombian National Survey of Aging (SABE 2015), a cross-sectional survey with a sample size of 23,694 older adults representing the total population (mean age, 70.8 years; 57.3% females). Cognitive impairment was classified as cognitive impairment without dementia (CIWD) and dementia, according to the revised version of the Folstein Mini-Mental State Examination and the Lawton and Brody functional scale. Leisure activities were evaluated using six items of a questionnaire. Sex-stratified multinomial regression models were used to analyze the association of leisure activities with CIWD and dementia after adjusting for educational attainment, literacy, and other potential confounders. In adjusted models for men, leisure activities in later life were associated with a decreased risk of CIWD (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.68–0.78) and dementia (OR, 0,52; 95% CI, 0.48–0.58). For women, leisure activities in later life were associated with a decreased risk of CIWD (OR, 0.72; 95% CI, 0.66–0.78) and dementia (OR, 0.48; 95% CI, 0.43–0.53). The findings suggest that greater participation in leisure activities in later life may act as a protective factor against CIWD and dementia among older adults in Colombia, independent of educational attainment and literacy.

Role for Physical Fitness in the Association between Age and Cognitive Function in Older Adults: A Mediation Analysis of the SABE Colombia Study.

Objectives. We investigated the association between physical fitness and cognitive status. Further, we examined whether physical fitness mediates the association between cognitive functioning and aging. Design. Cross-sectional study. Setting. Urban and rural Colombian older adults. Methods. 4416 participants from the SABE study were included in the current analysis. Physical fitness was assessed with the handgrip test and the usual gait speed test. Cognitive status was evaluated through the Folstein Mini-Mental State Examination. A parallel mediation path was used to test the possible mediator role of physical fitness between aging and cognitive functioning. Results. Older adults with lower handgrip strength (HGS) were more likely to have mild-cognitive status than older adults with healthy HGS (OR = 1.53, 95% CI = 1.15; 2.02). In addition, older adults with a slower gait speed were more likely to have mild cognitive impairment (OR = 2.05, 95% CI = 1.54; 2.78). Age had an inverse relationship with cognitive function (β = −0.110, 95% CI = −0.130; −0.100) and it was also inversely associated with HGS (β = −0.003, 95% CI = −0.005; −0.002) and gait speed (β = −0.010, 95% CI = −0.011; −0.009). The indirect effects, which indicate that the effect of age on cognitive function is transmitted through mediators, showed that both gait speed (β = −0.028, 95% CI = −0.036; −0.020) and HGS (β = −0.014, 95% CI = −0.024; −0.005) were independent mediators of the detrimental effect of aging on cognitive function. Conclusions. Physical fitness mediates the effects of aging on cognitive functioning. Our findings suggest that physical activity can be a key factor to prevent cognitive deterioration during aging process.

Impact of handedness on mental and neuropsychological performance in young adults

Background: Handedness is predominance of one hand over the other. Factors such as prenatal environment, genetic factors, cultural influences, and person’s environment contribute to handedness. Each cerebral hemisphere is responsible for different tasks that are not usually carried out by opposite hemisphere. Hence, handedness may have notable impact on neuropsychological capacities. Aims and Objectives: The main purpose of this study is to find out there any differences in mental and neuropsychological performance in left-handed and right-handed individuals using standard tests of cognitive function. Materials and Methods: This cross-sectional study was conducted on thirty right-handed and thirty left-handed males under the age range of 18–25 years. Subjects were chosen by simple sampling, by applying criteria for inclusion and exclusion. Standardized tests have been used to assess the various aspects of mental and neuropsychological performance. We compared the findings using student’s Unpaired “t-test.” Results: The left-handed subjects took less time than the right-handed to finish the trail making test. No difference was found in the Digit Span test score between the groups. In Folstein mini-mental status examination, no significant differences were found in memory score but the memory score duration was less in left-handed subjects. Most of the right-handed have auditory as style of learning while majority of the left-handed have visual as style of learning. Conclusion: Our study showed that left-handed individuals showed high mental and neuropsychological performance than right-handed individuals.

Cognitive and Psychopathological Profile on Catholic Nuns in Puerto Rico: An exploratory study

Introduction: The vocation of Catholic nun has spread virtually throughout the world for hundreds of years. The purpose of this pioneer nun study in Puerto Rico is to generate a comprehensive cognitive and psychopathological profile in a particular sample that usually shares a similar environment and lifestyle. Even though, nuns have been studied in the United States and other parts of the world, no known study conducted with Puerto Rican nuns has been found in local academic databases explored in the last ten years using the subject keywords (i.e., Puerto Rican Nuns) in data search. Method: The sample consists of 25 female catholic nuns, residents in Puerto Rico, with a median age of 60.96 years old (SD= 17.594; RANGE= 61). A Non-probability sampling method was utilized to retrieve the participants. Instruments: Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Beck Hopelessness Inventory (BHS), Symptom Checklist 90-R and Folstein Mini-Mental State Examination (MMSE). Findings: Significant findings among BDI-II results (t=2.377, p&lt;.05), BHS results (t=34.671, p&lt;.05) and Mini-mental examination (t=16.613, p&lt;.05). An ANOVA was conducted evaluate significant differences among the subscales of the 90-Symptom Checklist Significant differences were found. Conclusion: Results suggest that symptoms of psychopathology are present predominantly at a minimal level. However, mild to moderate results were also found. Nuns in the sample showed high cognitive functioning and were capable of performing the tasks assigned. Future research may include a bigger sample and comparisons among cloistered and apostolic nuns. A mixed methodology is suggested.

Uticaj sociodemografskih faktora na pojavu demencije i depresije kod starih osoba

Introduction: The most common mental disorders in the elderly are depression and dementia. Objective: Examine the impact of sociodemographic characteristics on the appearance of depression and dementia in elder patients treated in Primary Health Center (PHC), Banja Luka. Method: The study included 208 patients over 65 years of age, selected by random selection method, registered in 6 family medicine teams at the PHC Banja Luka in the period from March to May 2016. Respondents completed the Sociodemographic Questionnaire, Beck's Depression Inventory, and Folstein Mini-Mental State Examination (MMSE) for dementia assessment. Different statistical procedures were used in the data processing: descriptive analysis in the form of frequencies and percentages, Chi-square test, T-test. The results of the research were statistically analyzed by SPSS 11.5 program. Results: The study included 208 patients older than 65, of whom 38.9% were male. Impaired cognition was found in 7.2% and moderate depression in 24.5% of patients. Dementia was statistically significantly (p = 0.000) more present in the eldest respondents ≥ 81 years, while depression was mostly present in patients aged 76-80. Physically active individuals were significantly less affected by depression (p = 0.001) and dementia (p = 0.000). Dementia and depression occurred more frequently in people living alone and people with a low level of education. Conclusion: A family physician plays an important role in the early detection of depression and dementia in the elderly, the identification of risk factors, prevention, and treatment of these patients.

ACTR-07. LONG-TERM OUTCOMES FROM INTERGROUP NCCTG 86-72-51 (ALLIANCE): FINAL REPORT OF A PHASE III PROSPECTIVE RANDOMIZED TRIAL OF HIGH DOSE VERSUS LOW DOSE RADIATION IN ADULT SUPRATENTORIAL LOW-GRADE GLIOMA

Abstract PURPOSE To provide a final update on oncologic and cognitive outcomes of high dose versus low dose radiation for low-grade glioma. METHODS Between 1986 and 1994, 203 patients with supratentorial low grade glioma were randomized to 50.4 Gy in 28 fractions versus 64.8 Gy in 36 fractions after any degree of resection. Histologic subtype was oligodendroglioma (71%) or astrocytoma (29%). Primary outcome was overall survival (OS). Cognitive status was followed using Folstein Mini-Mental State Examination (MMSE). RESULTS For the entire cohort of 203 patients, median OS was 8.4 years (95% CI: 7.2 – 10.8). Median progression-free survival (PFS) was 5.2 years (95% CI: 4.3 – 6.6). Median follow-up is 17.2 years for the 33 patients still alive. High-dose radiation did not improve OS (15-yr OS: 22.4% vs. 24.9%, log rank p=0.978) or PFS (15-yr PFS: 15.2% vs. 9.5%, p=0.7142). OS was significantly better for patients with pre-operative tumor diameter &lt; 5 cm (15-yr OS: 39.4% vs. 15.2%, p&lt; 0.001), baseline MMSE &gt; 27 (15-yr OS: 27.3% vs. 9.8%, p=0.001), and for patients who underwent gross total resection (GTR) (15-yr OS: 39.3% GTR vs. 16.4% subtotal resection vs. 24.5% biopsy only, p=0.0119). PFS was improved for patients with oligodendroglioma versus astrocytoma (15-yr PFS: 13.8% vs. 8.6%, p=0.0221). PFS was also improved for patients with pre-operative tumor diameter &lt; 5 cm, patients who had GTR, and patients with baseline MMSE &gt; 27. For patients who had normal MMSE at baseline, at 7 years only 1 patient (5%) had a clinically significant decrease in MMSE from the previous time point, with the remainder (95%) stable. None had decrease in MMSE at 10, 12, or 15 years. CONCLUSIONS Long-term follow-up indicates no benefit to high-dose over low-dose radiation for low-grade gliomas. Minimal late decline in cognitive function after radiation was seen by MMSE. SUPPORT: U10CA180821,U10CA180882. https://acknowledgments.alliancefound.org

Cognitive training and neuroplasticity in mild cognitive impairment (COG-IT): protocol for a two-site, blinded, randomised, controlled treatment trial

IntroductionMild cognitive impairment (MCI) is common in older adults and represents a high-risk group for progression to Alzheimer’s disease (AD). Medication trials in MCI have generally failed, but new discoveries...

Frontal assessment battery in Parkinson's disease: A study on 170 patients.

Frontal assessment battery (FAB) was devised as a specific study design to assess frontal lobe dysfunction. Since Parkinson's disease (PD) is often associated with cognitive and other higher mental function complications, FAB test has been carried out by a number of workers to assess the integrity of the frontal lobe. On the other hand, the other frequently conducted test, performed in order to evaluate the mental status, is the Mini Mental State examination of Folstein (MMSE), but its reliability has been questioned in PD, since it does not assess the functions of the frontal lobe alone. The present study was undertaken in order to assess the suitability of application of the FAB test in Indian patients and to perform its comparative analysis with the MMSE scale. It was observed that the FAB test correlated with the age and the level of education of the patient. The results also correlated with that of the MMSE study, in spite of the fact that the latter is not considered to be a test which can assess exclusively the status of the frontal lobe. To the best of our knowledge, this is first study undertaken in India in this regard.

Association of Nutritional Status with Depression and Cognitive Function of Older Women Residing in Old-age Homes of Kolkata, India.

Introduction:Depression and cognitive function are said to be the foes of the nutritional status of the older adults. Depression is the most common psychological problem in old age, while deterioration of cognitive function is also observed in this age group.Objectives:The main objective of the study is to find out the association of nutritional status with depression and cognitive function of older women.Materials and Methods:A cross-sectional study was done among 196 older women, residing in old-age homes of Kolkata. Nutritional status of the participants was assessed by the long version of Mini Nutritional Assessment tool (MNA®). Level of depression was assessed by Geriatric Depression Scale (GDS 30). Cognitive function was checked by using the Folstein Mini-Mental State Examination (MMSE). Chi-square, Kruskal–Wallis test, and Spearman's rho correlation coefficient was calculated using SPSS software.Results:About 38.3% and 14.8% participants were suffering from mild and severe depression. 13.2% and 9.2% older women were found with borderline impairment and impairment in cognitive function, respectively. Significant correlation of nutritional status was found with both depression and cognitive function (P < 0.05), and this was supported by multinominal logistic regression model.Conclusions:Both depression and impairment in cognitive function can cause malnutrition or vice versa among older women.

Validity and reliability of fatigue severity scale in stroke

ABSTRACTBackground: Fatigue is a frequent complaint after stroke and may be associated with dependence in activities of daily living, decreased quality of life, increased institutionalization and mortality. Although fatigue severity scale (FSS) is the most frequently used scale in stroke, validation studies are scarce.Objectives: This study aimed to examine the psychometric properties of FSS in subjects with stroke.Methods: A total of 46 subjects with stroke who were admitted for rehabilitation and 52 control subjects who were admitted for local musculoskeletal problems were included. A comprehensive assessment including functional independence measure, Folstein Mini-Mental State Examination, Hospital Anxiety and Depression Scale (HADS), visual analog scale for fatigue (VAS), FSS, and vitality subscale of 36-item Medical Outcomes Study Short-Form Health Survey (SF-36v) was conducted. FSS, VAS and SF-36v were repeated 7 days later.Results: FSS demonstrated excellent internal consistency in subjects with stroke (Cronbach’s alpha: 0.928). There was a moderate correlation between FSS and SF-36v (r = −0.498, p < 0.001). FSS was weakly correlated with HADS anxiety (r = 0.310, p = 0.041) and HADS depression (r = 0.334, p = 0.027). Test-retest reliability of SF-36v (ICC: 0. 746, CI: 0.518–0.866), VAS (ICC: 0.829, CI: 0.671–0.911) and FSS (ICC: 0.742, CI: 0.512–0.863, p < 0.001) was good. ICC values for individual items of FSS were good except for item 6.Conclusions: FSS is a valid and reliable scale to measure fatigue in stroke. FSS is not sensitive to differentiate fatigue in stroke from the control subjects with orthopedic problems with similar age and gender.

Sentence Structure Analysis in Patients with Ischemic Stroke

Introduction. The definition of brain health and the best method of promoting optimal brain health is an American Heart Association/American Stroke Association initiative. Intact cognitive function is important following an ischemic stroke for successful rehabilitation. Therefore having a simple metric of cognitive function would be optimal for all health professionals.Aim. The aim of this study was to investigate if using Developmental Sentence Scoring (DSS) on sentences written by patients on a Mini-Mental State Examination (MMSE) could provide a simple metric of cognitive function.Material and Methods. This secondary analysis reports on sentences written by patients after an ischemic stroke using quantitative and conventional content analysis methods.Results. A mean score of 24.38 (SD±13, range 9–30) was found in the 76 patients who had written something in the course of the Folstein MMSE. The number of words ranged from 1 to 16 with the greatest number (21) averaging 5 words. The DSS ranged from 0–11 with a mean of 4. The mean Folstein MMSE (N=30), was 27.53 (SD±2.74, range 18–30) in patients who consented to a home visit 3 years after their stroke. Twenty seven of the 30 patients had written something and the number of words ranged from 1 to 12 with the greatest number (10) averaging 5 words. The DSS ranged from 0–12 with a mean of 4. Conventional content analysis revealed an overarching pattern articulated in two ways: (1) Awareness of recent space and time and remote memories of people and place (2) Expression of the self as person.Conclusions. This secondary analysis provides normative data and a rich description of cognitive function in a group of individuals describing the DSS at baseline and again at 3 years after stroke but the sample was too small to be able to provide a simple metric of cognitive function. (JNNN 2018;7(4):140–144)

Errors versus speed on the trail making test: Relevance to driving performance

Background/ObjectivesMany studies have demonstrated that speed to complete items on the Trail Making Tests (TMT A and TMT B) is useful in the prediction of driving safety. However, there is no consensus regarding optimal “cut scores” to discriminate between safe and unsafe drivers. In this study, we examine TMT speed and errors in drivers referred for a road test. DesignRetrospective analysis. SettingPatients referred for a DriveWise® evaluation at Beth Israel Deaconess Medical Center in Boston, Massachusetts. ParticipantsDrivers age 65 or older were included (total n = 373). Forty-five percent of the sample had been diagnosed with Cognitive Impairment (CI) whereas the remaining participants were in the No Cognitive Impairment (NCI) group. MeasurementsTMT Parts A & B, Folstein Mini Mental Status Examination, Washington University Road Test. ResultsCI drivers with TMT A speed exceeding 46 s were more likely to fail the road test whereas TMT B speed was not a sensitive metric in this group. In the No Cognitive Impairment (NCI) group, TMT B speed exceeding 131 s predicted driving impairment whereas TMT A speed was not sensitive. Error scores were not useful in the determination of driving fitness for either group. ConclusionsThis study provides useful criteria for health providers working with older people in the determination of driving fitness. Results suggest that TMT speed, but not error rate, is associated with road test performance. Based on our work, we advocate that pre-existing dementia should be taken into consideration when using TMT performance as a screen for driving.

Prevalence of mental illness and their association with sociodemographic factors in the rural geriatric population in Chittoor, Andhra Pradesh, India: A community-based study.

BACKGROUND:Mental health problems such as cognitive impairment, depression, anxiety, and sleep disorders arising out of senility, neurosis, and living conditions are common in the geriatric population.OBJECTIVE:The objective of this study was to estimate the prevalence of mental illness and to describe their sociodemographic factors in the rural geriatric population and see their association with other factors.METHODOLOGY:A community-based cross-sectional study was done on individuals aged more than 60 years. The study instruments were predesigned semi-structured questionnaire, Folstein's Mini–Mental Status Examination Scale for assessing dementia in cognitive functioning and Yesavages Geriatric Depression Scale to estimate the prevalence of depression and to assess the activities of the daily living by Barthel index and the anxiety were assessed based on the perception of the participants while conducting the interview.RESULTS:A total of 415 individuals participated, out of them 199 (47.9%) were males and 216 (52.1%) were females. Prevalence of mental illness was 217 (52.2%) with one or the other type of mental illness. The prevalence of cognitive impairment was 47.7% and depression according to Geriatric Depression Scale >5 was 27.7%. The remaining 62 (14.9%) had dementia and 30 (7.2%) had anxiety disorder as the mental illness. The socio-demographic factors such as age more than 70 years, female gender, illiterates, living in joint family, middle and lower socio-economic class, financially totally dependent and had poor and unfair relationship with the family members were strongly associated with the mental illness and it was statistically significant with P < 0.05.CONCLUSION:Measures should be taken to support the elders, establish community elderly societies, advisory offices, and services to help the elderly. The sequence of social interventions required for the management of the elderly psychological problems.

Depression in Elderly Patients Attending the Psychiatry OPD: A Prospective Hospital Based Study

Background: Cognitive impairment is a common clinical issue among elderly patients suffering with depression and has a more obscure etiology. The present study aimed to determine the prevalence of cognitive impairment and depression in geriatric patients attending Psychiatric OPD. Methods: This Prospective cross-sectional study was carried out on elderly people (n=110) attending the Psychiatry OPD of Govt Doon Medical college Dehradun (UK). The cognitive function and depression were assessed by applying standardized Mini-Mental State Examination of Folstein (MMSE) and the Geriatric Depression Scale (GDS), respectively. Results: Prevalence of cognitive impairment was 35.71% (36.41% women, 24.5% men), whereas the prevalence of depression was 45.45% (51.02% women, 39.89% men) significant differences were observed. Conclusions: Cognitive impairment and depression were found to be more prevalent in the females than in the males. Hence, psychiatrist should pay special attention for early detection and treatment of depressive symptoms in elderly people with cognitive impairment.