Impact Of Mild Cognitive Impairment Research Articles

Influence of mild cognitive impairment on clinical and functional prognosis in older candidates for cardiac surgery.

In this study, we analyzed the prognostic impact of mild cognitive impairment (MCI) prior to cardiac surgery on 12-month clinical outcomes in older patients. We performed a longitudinal prospective study of 48 patients undergoing cardiac surgery and 26 neurologically healthy participants aged 65 years or older. All participants underwent a neuropsychological assessment. Functional status, quality of life and frailty were assessed in candidates for surgery. One year after surgery, 24 patients remained in the study. Mild cognitive impairment (MCI) was diagnosed in 35% of the patients at baseline. Postsurgical changes in functionality consisted of a tendency toward impaired basic activities of daily living (BADL) in the MCI group and a statistically significant worsening in instrumental activities of daily living (IADL) in women with MCI. Changes in quality of life consisted of a significant improvement in anxiety-depression in the MCI group and a tendency toward greater pain-discomfort in the non-MCI group. Cognitive status significantly declined only in the non-MCI group. Neither group showed significant changes in frailty. Relative risk analysis showed that patients with a diagnosis of MCI at baseline had a higher risk of cognitive decline at follow-up, while those without a diagnosis of MCI at baseline had a lower risk of impaired IADL. No association was found between MCI and resource use. Preoperative impairment in memory, visuospatial and executive functions was significantly associated with loss of quality of life at follow-up. Impairment of memory and visuospatial function was significantly associated with cognitive decline. Preserved memory was associated with a lower risk of impaired BADL at follow-up. The present study provides clue on the impact of MCI in candidates for cardiac surgery. Preoperative detection of cognitive impairment could be highly valuable to help guide pre- and post-operative management.

Impact of mild cognitive impairment on one's fall risk and risk for more frequent and severe traumatic brain injuries

Impact of mild cognitive impairment on one's fall risk and risk for more frequent and severe traumatic brain injuries

Mild Cognitive Impairment is Associated with Poorer Everyday Decision Making.

Older adults are faced with many unique and highly consequential decisions such as those related to finances, healthcare, and everyday functioning (e.g., driving cessation). Given the significant impact of these decisions on independence, wellbeing, and safety, an understanding of how cognitive impairment may impact decision making in older age is important. To examine the impact of mild cognitive impairment (MCI) on responses to a modified version of the Short Portable Assessment of Capacity for Everyday Decision making (SPACED). Participants were community-dwelling, actively driving older adults (N = 301; M age = 77.1 years, SD = 5.1; 69.4% with a college degree or higher; 51.2% female; 95.3% White) enrolled in the Advancing Understanding of Transportation Options (AUTO) study. A generalized linear model adjusted for age, education, sex, randomization group, cognitive assessment method, and study site was used to examine the relationship between MCI status and decision making. MCI status was associated with poorer decision making; participants with MCI missed an average of 2.17 times more points on the SPACED than those without MCI (adjusted mean ratio: 2.17, 95% CI: 1.02, 4.61, p = 0.044). This finding supports the idea that older adults with MCI exhibit poorer decision-making abilities than cognitively normal older adults. It also suggests that older adults with MCI may exhibit poorer decision making across a wide range of decision contexts.

Impact of MCI on testing performance in different cognitive domains

AbstractBackgroundImpaired memory affects cognitive testing performance. This study examined in elderly adults the impact of mild cognitive impairment (MCI) on testing performance in different cognitive domains.MethodAfter giving their IRB‐approved written consent, 10 cognitively normal subjects (65±2 years old) and 10 patients with amnestic MCI (68±2 years old) completed the Mini‐Mental State Examination (MMSE), Digit‐Span test, California Verbal Leaning Test –2nd edition (CVLT‐II), and Trail Making Test – B version (TMT‐B). Cognitive performances of the MCI and normal groups were compared by standard t tests. ANOVA was applied to evaluate the impacts of the group and trial‐number factors on immediate Free‐Recall (FR) performance in CVLT‐II.ResultThe group MMSE scores were 24.8±0.4 in the MCI group vs 29.2±0.3 in the normal subjects (P<0.0001). The time to complete TMT‐B was prolonged markedly in the MCI (154±28 s) vs. normal (56±6 s) subjects (P = 0.007). Forward performance score in the Digit‐Span test did not differ between the groups (MCI 9.0±0.6 vs normal 8.5±0.9), although backward Digit‐Span performance was superior (P = 0.021) in the normal (7.0±0.6) vs. MCI (5.1±0.4) groups. CVLT‐II immediate FR scores improved with successive trials in both MCI and normal subjects (trial‐number factor P<0.0001). Although the FR scores from the first 2 trials did not differ between the groups, there was a significant difference appeared in the FR scores of the 3rd and the overall FR scores were appreciably lower in the MCI subjects (group factor P = 0.006). Moreover, 30‐sec Short‐Delay (S‐D) and 10‐min Long‐Delay (L‐D) FR scores were significantly lower in the MCI subjects (Table).ConclusionBoth short‐term memory and visuospatial‐executive function were significantly impaired in the MCI patients as compared with the age‐matched cognitively normal cohort. Repeated trials improve the immediate Free‐Recall in both groups. The backward Digit‐Span test was more sensitive than the forward test to detect the impairment of short‐term memory and attention in the elderly adults with MCI.

The concurrent impact of mild cognitive impairment and frailty syndrome in heart failure.

Pathological processes associated with ageing increase the risk of cognitive deficits and dementia. Frailty syndrome, also known as weakness or reserve depletion syndrome, may significantly accelerate these pathological processes in the elderly population. Frailty syndrome is characterized by decreased physiological function and neuropsychiatric symptoms, including cognitive decline and depressive states. In people with cardiovascular disease, the risk of frailty is 3 times higher. Frailty syndrome is particularly prevalent in severe heart failure, which increases the risk of mortality, increases hospital readmission, and reduces patients' quality of life. In addition, co-occurrence of cognitive impairment and frailty syndrome significantly increases the risk of dementia and other adverse outcomes, including mortality, in the heart failure population.

The Economic Impact of Mild Cognitive Impairment: A Comprehensive Review

The Economic Impact of Mild Cognitive Impairment: A Comprehensive Review

UNPACKING MILD COGNITIVE IMPAIRMENT/YOUNG ONSET DEMENTIA IN THE WORKPLACE: EMPLOYER VERSUS EMPLOYEE

Abstract The symposium includes four studies exploring the impact of mild cognitive impairment and/or young onset dementia on the workplace, and area of increasing interest due to the aging workforce and government interest in prolonging work life. The papers adopt a rare, multi-level approach by examining both employee and employer perspectives, and how the interaction of both individual and organizational factors impact their self-reported outcomes. Following the paper presentations, Dr. Allison Gibson will lead a paper discussion. The goal of the symposium is to foster a research conversation amongst the presenters and symposium participants interested in exploring overlaps, potential for multi-disciplinary collaboration and future research into resolution of workplace and workforce optimization with worker satisfaction that are identified with progressive cognitive impairment.

The impact of mild cognitive impairment on decision-making under explicit risk conditions: Evidence from the Personality and Total Health (PATH) Through Life longitudinal study.

Previous research has indicated that cognition and executive function are associated with decision-making, however the impact of mild cognitive impairment (MCI) on decision-making under explicit risk conditions is unclear. This cross-sectional study examined the impact of MCI, and MCI subtypes, on decision-making on the Game of Dice Task (GDT), among a cohort of older adults. Data from 245 older adult participants (aged 72-78 years) from the fourth assessment of the Personality and Total Health Through Life study were analyzed. A diagnostic algorithm identified 103 participants with MCI, with subtypes of single-domain amnestic MCI (aMCI-single; n = 38), multi-domain amnestic MCI (aMCI-multi; n = 31), and non-amnestic MCI (n = 33), who were compared with an age-, sex-, education-, and income-matched sample of 142 cognitively unimpaired older adults. Decision-making scores on the GDT (net score, single number choices, and strategy changes) were compared between groups using nonparametric tests. Participants with MCI showed impaired performance on the GDT, with higher frequencies of single number choices and strategy changes. Analyses comparing MCI subtypes indicated that the aMCI-multi subtype showed increased frequency of single number choices compared to cognitively unimpaired participants. Across the sample of participants, decision-making scores were associated with measures of executive function (cognitive flexibility and set shifting). MCI is associated with impaired decision-making performance under explicit risk conditions. Participants with impairments in multiple domains of cognition showed the clearest impairments. The GDT may have utility in discriminating between MCI subtypes.

The impact of mild cognitive impairment on the neural dynamics serving verbal working memory

AbstractBackgroundIn healthy adults, neural oscillatory activity within a predominantly left‐lateralized network of brain regions underlies verbal working memory (VWM) performance, but how mild cognitive impairment (MCI) impacts these oscillatory dynamics is not well characterized. The present study utilized the spatiotemporal precision of magnetoencephalographic (MEG) brain imaging to investigate the effects of MCI on the neural oscillations serving specific phases (i.e., encoding, maintenance) of VWM. In congruence with the compensation‐related utilization of neural circuits hypothesis (CRUNCH), we hypothesized that MCI patients would recruit greater neural resources during VWM.MethodSixty‐one adults (13 clinically‐diagnosed MCI, 48 controls; 28 females; M age: 63.5) completed a Sternberg‐type VWM task during MEG. Only correct trials were analyzed, and the average number of trials included did not differ between groups. All MEG data underwent standard preprocessing, were transformed into the time‐frequency domain, and significant neural oscillatory responses relative to baseline were imaged using a beamformer. To determine the effect of group (MCI vs. controls), ANCOVAs were performed on the resulting encoding and maintenance whole‐brain maps with age as a covariate.ResultThroughout encoding and maintenance, decreases in alpha/beta (9‐16 Hz) oscillatory activity were seen in left fronto‐temporal regions, which were significantly larger in MCI patients during the encoding phase (p < .05, corrected). Additionally, significant group differences were detected in right inferior frontal and superior temporal cortices throughout both encoding and maintenance, such that MCI patients exhibited decreased alpha/beta activity within these regions, while these responses were largely absent in controls (p < .05, corrected). Interestingly, the strength of the alpha/beta response within the right inferior frontal cortex significantly predicted behavioral performance on the task, such that individuals who demonstrated stronger decreases in alpha/beta within this region during encoding and maintenance, tended to have faster reaction times (p < .01).ConclusionWhile both groups recruited a similar left‐hemispheric cortical network during VWM encoding and maintenance, individuals with MCI recruited some nodes more strongly and additionally recruited right fronto‐temporal regions. Additionally, stronger recruitment of the right inferior frontal cortex was beneficial for task performance. These results offer supporting evidence for CRUNCH.

Do fine motor impairments constitute a key feature of mild cognitive impairment? A systematic review and meta‐analysis

AbstractBackgroundTypical symptoms of mild cognitive impairment (MCI) include impairments in memory, executive function, and visuospatial skills. While impairments in these cognitive domains are highly apparent after MCI, impairments in motor domain are not so conspicuous. Converging evidence suggests that individuals with MCI demonstrate motor impairments in lower extremity such as reduced balance and impaired gait performance. However, the impact of MCI on upper extremity motor impairments is not well understood. In the current meta‐analysis, we examine whether fine motor impairments are a key feature of mild cognitive impairment.MethodWe performed a systematic search of electronic databases for articles published between 1990 and 2019. The meta‐analysis included studies that compared healthy older adults and adults with a clinical diagnosis of MCI on fine motor tasks such as handwriting, finger tapping, and hand dexterity.ResultTen studies with over 800 participants qualified for inclusion. Rigorous meta‐analytic techniques using random effects model, forest and funnels plots revealed a standardized mean difference effect of 0.48 (95% CI = 0.77 to 0.19, p=0.001). This moderate effect indicated deficits in fine motor control are a likely feature of MCI.ConclusionThe cumulative evidence suggests that fine motor impairments are pervasive in MCI across a range of upper extremity motor tasks. Quantitative assessment of the decline in fine motor function in MCI may be promising approach to understand the changes in motor function that occur with the onset of Alzheimer’s disease and are clearly differentiated from normal aging‐related decline.

Impact of mild cognitive impairment on unplanned readmission in patients with coronary artery disease.

To investigate the effect of mild cognitive impairment (MCI) on unplanned readmission in patients with coronary artery disease (CAD). From 2132 CAD patients, MCI was estimated with the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in 243 non-dementia patients who met the study criteria. The primary outcome was unplanned hospital readmission after discharge. The incidence of MCI in this cohort was 33.3%, and 51 patients (21.0%) had unplanned readmission during a mean follow-up period of 418.6 ± 203.5 days. After adjusting for the covariates, MCI (hazard ratio, 2.28; 95% confidence interval: 1.09-4.76; P = 0.03) was independently associated with unplanned readmission in the multivariable Cox proportional hazard regression analysis. In the Kaplan-Meier analysis, the cumulative incidence of unplanned readmission for the MCI group was significantly higher than that for the non-MCI group (log-rank test, P < 0.001). Even after exclusion of the patients readmitted within 30 days of discharge, the main results did not change (log-rank test, P < 0.001). Mild cognitive impairment was independently associated with unplanned readmission after adjustment for many independent variables in CAD patients. In addition to its short-term effects, the adverse effects of MCI had a persistent, long-term impact on CAD patients. Assessment of cognitive function should be conducted by health professionals prior to hospital discharge and during follow-up. To prevent readmission of CAD patients, it will be necessary to support solutions to the problems that inhibit secondary prevention behaviours based on the assessment of the patients' cognitive function.

Impact of Mild Cognitive Impairment on Quality of Life in Young and Typical Onset Parkinson's Disease.

Younger age of onset and mild cognitive impairment (MCI) are both independently associated with poorer quality of life (QOL) in Parkinson's disease (PD). The primary objective was to determine whether MCI differentially impacts QOL in young-onset PD (YOPD) and typical-onset PD (TOPD). YOPD patients (n=77) were diagnosed at age 50 or younger, TOPD (n=77) were diagnosed after age 50, and the groups were matched for cognitive status, education, and disease duration. Patients' cognitive status was classified as MCI or cognitively normal (CN) based on MDS Level II criteria. QOL was assessed using the Parkinson's Disease Questionnaire (PDQ-39). ANCOVAs were conducted for each PDQ-39 subscale, with age of onset and cognitive status as between-subjects factors and several covariates included. An interaction for the Cognition domain revealed that in TOPD, PD-MCI patients reported poorer QOL than CN patients, whereas there was no effect of MCI on cognitive satisfaction in YOPD. There was a main effect of age on Emotional Well-Being, as YOPD reported poorer QOL than TOPD in this domain. There were main effects of cognitive status, with PD-MCI patients reporting worse QOL than CN patients in the domains of Social Support, Communication, ADLs, and Mobility. The interaction revealed that PD-MCI has a greater impact on degree of cognitive concerns ("cognitive QOL") in TOPD versus YOPD. A more nuanced understanding of the effects of age of onset, MCI, and their interactions on QOL in PD will inform interventions aimed at improving quality of life in this population.

Older Adults' Daily Activity and Mood Changes Detected During the COVID-19 Pandemic Using Remote Unobtrusive Monitoring Technologies.

Background and ObjectivesThe coronavirus disease 2019 (COVID-19) pandemic has limited older adults’ access to in-person medical care, including screenings for cognitive and functional decline. Remote, technology-based tools have shown recent promise in assessing changes in older adults’ daily activities and mood, which may serve as indicators of underlying health-related changes (e.g., cognitive decline). This study examined changes in older adults’ driving, computer use, mood, and travel events prior to and following the COVID-19 emergency declaration using unobtrusive monitoring technologies and remote online surveys. As an exploratory aim, the impact of mild cognitive impairment (MCI) on these changes was assessed.Research Design and MethodsParticipants were 59 older adults (41 cognitively intact and 18 MCI) enrolled in a longitudinal aging study. Participants had their driving and computer use behaviors recorded over a 5-month period (75 days pre- and 76 days post-COVID emergency declaration) using unobtrusive technologies. Measures of mood, overnight guests, and frequency of overnight travel were also collected weekly via remote online survey.ResultsAfter adjusting for age, gender, and education, participants showed a significant decrease in daily driving distance, number of driving trips, highway driving, and nighttime driving, post-COVID-19 as compared to pre-COVID-19 (p < .001) based on generalized estimating equation models. Further, participants spent more time on the computer per day post-COVID-19 (p = .03). Participants endorsed increases in blue mood (p < .01) and loneliness (p < .001) and decreases in travel away from home and overnight visitors (p < .001) from pre- to post-COVID-19. Cognitive status did not impact these relationships.Discussion and ImplicationsFrom pre- to post-COVID-19 emergency declaration, participants drove and traveled less, used their computer more, had fewer overnight visitors, and reported greater psychological distress. These results highlight the behavioral and psychological effects of stay-at-home orders on older adults who are cognitively intact and those with MCI.

Initial Development and Evaluation of the Executive Function Performance Test-Enhanced (EFPT-E) in Women With Cancer-Related Cognitive Impairment.

Psychometrically sound instruments are needed to evaluate executive functioning in the population of people with cancer. To develop and evaluate the reliability and validity of the Executive Function Performance Test-Enhanced (EFPT-E) in women after being treated for breast cancer. Cross-sectional. University research laboratory. Women treated for breast cancer who had cognitive impairment (n = 12) and community control participants (n = 13). Evaluators (n = 8) independently scored a recorded administration of the EFPT-E to evaluate interrater reliability. An assessment battery, including the EFPT-E, was administered to evaluate the EFPT-E's known-groups validity and concurrent validity. Excellent interrater reliability was observed for the EFPT-E total score and each subtask score (intraclass correlation coefficient = .90-.98). Moderate effect sizes were noted for the EFPT-E total score (Cohen's d = 0.5) and the total number of cues (d = 0.4) between the breast cancer group and the control group, with the breast cancer group demonstrating poorer performance. A limited correlation was found between the EFPT-E and the other cognitive measures. The results support the EFPT-E's interrater reliability and warrant continued investigation to further establish its reliability and validity. Assessments are needed to quantify the impact of cognitive processes within functional tasks. The EFPT-E has been developed to assess the functional impact of mild cognitive impairment; initial testing with women with cancer showed excellent agreement between raters and promising results for validity.

Effects of Chronic Tinnitus on Metabolic and Structural Changes in Subjects With Mild Cognitive Impairment.

Tinnitus is a conscious auditory perception in the absence of an external stimulus. Despite previous reports of a recognized association between tinnitus and cognitive deficits, the effects of tinnitus on functional and structural brain changes associated with cognitive deficits remain unknown. We aimed to investigate the changes in glucose metabolism and gray matter (GM) volume in subjects diagnosed with mild cognitive impairment (MCI) depending on tinnitus. Twenty-three subjects were subclassified into MCI with the chronic tinnitus (MCI_T) and MCI without tinnitus (MCI_NT) groups. Encouraged by the identification of neural substrates associated with tinnitus and cognitive deficits, we correlated the extent of tinnitus severity with the changes in glucose metabolism and GM volume and conducted a glucose metabolic connectivity study. Compared to the MCI_NT group, the MCI_T group showed significantly lower metabolism in the right superior temporal pole and left fusiform gyrus. Additionally, the GM volume in the right insula was markedly lower in the MCI_T group compared to the MCI_NT group. Moreover, correlation analyses in metabolism or GM volumes revealed specific brain regions associated with the cognitive decline with increasing tinnitus severity. Metabolic connectivity analysis revealed that MCI_NT had markedly strengthened intra-hemispheric connectivity in the frontal, parietal, and occipital regions than did MCI_T. Furthermore, MCI_NT showed a strong negative association between the parietal and temporal and parietal and limbic regions, but the association was not observed in MCI_T. These findings indicate that tinnitus may cause metabolic and structural changes in the brain and alters complex inter- or intra-hemispheric networks in MCI. Considering the impact of MCI on accelerating dementia, these results provide a valuable basis on which yet-to-be-identified neurodegenerative markers of tinnitus can be refined.

Using Eye-Tracking Technology with Older People in Memory Clinics to Investigate the Impact of Mild Cognitive Impairment on Choices for EQ-5D-5L Health States Preferences.

Population ageing is a phenomenon taking place in almost every global region. Current estimates indicate that 10-20% of older people in developed countries have mild cognitive impairment (MCI), with these percentages predicted to rise markedly by 2050. Our objective was to apply eye-tracking technology to investigate the information processes adopted by older people with and without MCI in determining preferences for health states in the five-level EuroQol-5 Dimensions (EQ-5D-5L) instrument. Older people (aged ≥ 65years; including both patients and family carers) attending outpatient memory clinics in Southern Adelaide between July 2017 and June 2018, competent to read and converse in English and with a Mini-Mental State Examination (MMSE) cognition score of ≥ 19 were invited to participate. In total, 52 people met the inclusion criteria, of whom 20 (38%) provided informed consent and fully participated. Participants were categorised into two subgroups (each n = 10) for comparison based upon established MMSE cognition thresholds (19-23, lower MMSE indicative of MCI; ≥ 24, higher MMSE indicative of good cognition). A discrete-choice experiment (DCE) comprising a series of pairwise choices between alternative EQ-5D-5L health states of varying survival duration with differential levels of task complexity (approximated by the degree of attribute level overlap in each choice), was administered as a face-to-face interview with the participant wearing an eye-tracking device. Attribute non-attendance (ANA) was higher for the lower MMSE subgroup than for the higher MMSE subgroup, although these differences were generally not statistically significant. ANA remained relatively low and consistent for participants with good cognition regardless of task complexity. In contrast, ANA increased notably in participants exhibiting MCI, increasing from 10% on average per participant in the lower MMSE subgroup with five attribute level overlap to 23% on average per participant in the lower MMSE subgroup with zero attribute level overlap. This exploratory study provided important insights into the information processes adopted by older people with varying levels of cognitive functioning when choosing between alternative EQ-5D-5L health states of varying survival duration and specifically the relationships between cognitive capacity, task complexity and the extent of ANA. Recent advances in econometric modelling of health state valuation data have demonstrated the added value of capturing ANA information as this can be accounted for in the DCE data analysis, thereby improving the precision of model estimates. Eye-tracking technology can usefully inform the design, conduct and econometric modelling of DCEs, driving the inclusion of this rapidly growing population traditionally excluded from preference-elicitation studies of this nature.

Driver Self-Regulation Practices in Older Drivers with and Without Mild Cognitive Impairment.

ObjectiveTo assess the impact of cognitive, socio-demographic and driving-related characteristics on self-regulation practices in older drivers with mild cognitive impairment (MCI) (determined by the Telephone Cognitive Screen (T-CogS) score), compared with drivers with no cognitive impairment.Design, Setting, ParticipantsA cross-sectional study collected information from 362 drivers with MCI and 611 drivers with no cognitive impairment, who were aged 65+ years, and were living in Western Australia between November 2018 and February 2019.MeasurementsSelf-reported self-regulation driving practices.ResultsThe majority of drivers with MCI (62.4%) and those with no cognitive impairment (57.1%) reported self-regulating their driving in at least one situation, in the past three months. The most common situations that both groups of drivers self-regulated in were “driving at night in the rain”, “parallel parking”, and “driving when raining”. Drivers with MCI were only significantly more likely to self-regulate when “making turns across oncoming traffic” and “driving at night”. They also had 39% greater odds of self-regulating in at least one driving situation, compared with drivers with no cognitive impairment (OR: 1.39, 95% CI=1.04–1.85, p=0.02). Females also had 2.3 times greater odds of self-regulating (OR=2.34, 95% CI=1.76–3.12, p<0.001). Drivers aged 75+ years had 1.6 times greater odds of self-regulating, compared with drivers aged 65–69 years (OR=1.58, 95% CI=1.12–2.23, p=0.01).ConclusionOlder drivers with MCI were more likely to self-regulate their driving, compared to drivers with no cognitive impairment, particularly in complex driving situations. This suggests that some drivers with MCI may be able to recognize their cognitive limitations and adjust their driving accordingly. However, several drivers with MCI, particularly males, did not self-regulate their driving. This highlights the importance of advising patients about the impact of MCI on driving ability, suitable self-regulation strategies, as well as monitoring their driving ability.

The impact of mild cognitive impairment on musical ability

ZUSAMMENFASSUNG Hintergrund: Patienten mit einer Alzheimer-Erkrankung zeigen Beeinträchtigungen kognitiver Prozesse einschließlich der Verarbeitung musikalischer Reize. Wir haben untersucht, ob der Rückgang der musikalischen Verarbeitung schon im Stadium der mild cognitive impairment (MCI) beginnt. Methodik: Wir haben 18 Patienten mit MCI und ohne eine andere neurologische oder psychiatrische Erkrankung eingeschlossen. Es wurde ein selbst entwickelter Musikalitätstest angewendet, der folgende Fähigkeiten misst: Identifikation von Melodien; Tonhöhenerkennung; Rhythmuserkennung; emotionaler Ausdruck der Musik. Zusätzlich haben wir Marker einer dementiellen Entwicklung im Liquor bestimmt. Wir haben die Ergebnisse der Patienten verglichen mit den Ergebnissen einer nach Alter und Geschlecht parallelisierten gesunden Vergleichsgruppe. Alle Patienten und Kontrollen hatten keine spezifische musikalische Ausbildung. Ergebnisse: Patienten mit MCI zeigten signifikant niedrigere Ergebnisse beim Rhythmus, Metrum und emotionalen Subtests und im gesamten Test-Score. Der Gesamt-Score war invers korreliert mit dem Level von Gesamt-Tau im Liquor. Diskussion: Unsere Daten deuten darauf hin, dass einige Domänen der Musikalität bei Patienten mit MCI signifikant beeinträchtigt sind. Dies bedeutet jedoch nicht notwendigerweise, dass die Produktion von und die Freude an Musik beeinträchtigt sind. Dennoch sollte die Beeinträchtigung von Teilen der Musikalität beim Einsatz von Musiktherapie bei diesen Patienten berücksichtigt werden.

Neurocognition of Aged Patients With Chronic Tinnitus: Focus on Mild Cognitive Impairment.

Objectives.To investigate the neurocognition of aged patients with chronic tinnitus and reveal the possible association between tinnitus severity and cognitive function, with attention to mild cognitive impairment (MCI).Methods.Fifty-eight elderly patients (≥65 years old) with chronic tinnitus (≥6 months) were prospectively enrolled in this study. All patients assessed the neurocognitive batteries including the Korean version of the patient health questionnaire-9 (K-PHQ-9), the Lawton instrumental activities of daily living scale (K-IADL), and the Montreal cognitive assessment (MoCA-K). After initial evaluation to exclude moderate or severe cognitive impairment by a psychiatrist, the patients were classified into two groups: MCI and non-MCI, according to the MoCA-K scores (cutoff value, 22/23). All patients underwent audiological examinations including psychoacoustic tests of tinnitus.Results.Of 58 patients, 10 (17.2%) met the MCI criteria. The tinnitus handicap inventory (THI) score in the MCI group was significantly higher than that in the non-MCI group. Based on multivariate regression analysis, a significant association between tinnitus severity and MoCA-K score was also detected. Specifically, bothersome tinnitus (THI score ≥30) was closely linked to the presence of MCI. Meanwhile, the impact of MCI on both K-PHQ-9 and K-IADL scores was not evident in patients with chronic tinnitus.Conclusion.Tinnitus severity appears to be a potential independent determinant for predicting the MCI, suggesting the underlying mechanism between chronic tinnitus and cognitive deficit. Given that MCI highly links to dementia, the evaluation of cognitive functions in aged patients with chronic tinnitus need to be considered at the initial assessment of tinnitus.

Impact of Mild Cognitive Impairment on Mortality and Cause of Death in the Elderly.

Mild cognitive impairment (MCI) is a cognitive state that lies on the continuum between normal aging and dementia, and the prevalence of MCI is higher than dementia. However, the risk for mortality of people with MCI has been far less studied than that of people with dementia, and the population attributable risk percent (PAR%) of death attributable to MCI has not been estimated yet. To investigate the impact of MCI on mortality and the cause of death in the elderly, and to estimate the PAR% of deaths attributable to MCI. Data came from 7,315 elderly subjects aged ≥60 years without dementia from two cohort studies with diagnostic assessments of MCI at baseline. Deaths among participants were confirmed through the nationwide mortality database of Statistics Korea. MCI increased the risk of mortality in a multivariate Cox proportional model adjusting for age, sex, education, smoking, alcohol drinking, chronic illness, depression, vascular components, and cohort (hazard ratio = 1.59, 95% confidence interval 1.30, 1.94). PAR% of death attributable to MCI was 10.7% for age 65-74 years, 16.0% for age 75-84 years, and 24.2% for age ≥85 years. In the elderly with MCI, mortality risks from cerebrovascular disease, respiratory disease, and external causes were higher than in the cognitively normal elderly. Our results suggest that the mortality risk of MCI in Asian countries may be comparable to that in Western countries, and MCI can contribute to the death of the elderly as much as dementia.