Mini-Mental Examination Test Research Articles

Comparison of Frailty Criteria, Cognitive Function, Depressive and Insomnia Symptoms in Men with Localized and Advanced Prostate Cancer under Androgen Deprivation Therapy.

Prostate cancer (PCa) is considered one of the most important medical problems in the male population, with a very high incidence after the age of 65. Frailty represents one of the most critical issues facing healthcare due to its inherent relationship with poor healthcare outcomes. The physical phenotype of frailty syndrome based on Fried criteria has been associated with poor outcomes, morbidity, and premature mortality. To date, there are few studies that have analyzed frailty syndrome in patients with localized and advanced (mPCa) disease under androgen-deprivation therapy. Our goal was to assess whether there are differences in frailty criteria between mPCa and localized PCa. We also evaluated the role of other geriatric variables such as depressive and insomnia symptoms, which are frequently reported in cancer patients. In this cross-sectional study, frailty syndrome was evaluated in both groups, as well as its possible relationship with cognitive functions, depressive and insomnia symptoms, and other clinical variables related to PCa and its treatment. Frailty was defined on Fried's criteria: low lean mass, weakness, self-reported exhaustion, low activity level, and slow walking speed; prefrailty was defined as having one or two of those criteria and frailty as having three or more, depressive symptoms were defined by the Yesavage scale, cognitive functions with the Mini-Mental examination test, and insomnia symptoms by the Athens scale and self-reported health status. The prevalence of prefrailty/frailty was slightly higher in mPCa compared to localized PCa (81.5% versus 72.3%, respectively), however by analyzing each of the frailty criteria, two of them were significantly reduced in mPCa compared to localized PCa patients, e.g., gait speed (p = 0.001) and muscle strength (p = 0.04). The reduced gait speed and muscle strength in mPCa were not due to the increased age in mPCa group, or to an increase in comorbidities or shorter time under androgen-deprivation therapy. The symptoms of insomnia were significantly higher in mPCa patients compared to those with localized PCa (p < 0.05) whereas cognitive functions or depressive symptoms were not significantly different between the two groups. Patients with mPCa under androgen-deprivation therapy display higher alterations in gait speed and muscular strength and insomnia symptoms, thus interventions should be aimed to reduce these alterations in order to limit adverse outcomes related to them and to improve quality of life in these patients.

Evaluation of factors affecting the length of stay of geriatric patients in the emergency department.

The emergency department length of stay (EDLOS) is one of the essential parameters of emergency healthcare management efficacy, and prominent factors that contribute to EDLOS are critical in enhancing emergency department (ED) patient care effectiveness, particularly for older patients, which is rarely investigated. This single-center, prospective cohort study was performed in the ED of a tertiary care hospital. The patients were classified into two groups according to EDLOS (≥4 h vs. <4 h). The chief complaints, consultant branches, the patients' comorbidities, polypharmacy status, time of presentation, laboratory, imaging investigations, EDLOS, Clinical Frailty Score (CFS) score, mini mental examination test, National Early Warning Score 2 (NEWS2), consultations, and outcome of the patients were compared with Spearman and Kendall tau-b correlations. During the 30-day study period, a total of 222 geriatric patients were included in the study. The mean age of study patients was 79.13±9.43 years, and 47.05% of patients were male. The Median EDLOS was 250 (range, 60-1440) min. The patients who arrived on the night shift (p=0.047), who had chronic heart failure (p=0.025), chronic obstructive pulmonary disease (p=0.03), severe dementia according to the MMSE (p=0.008), higher CFS frailty scores (p=0.03), and higher clinical acuity according to the NEWS2 score, were found to be positively correlated to an EDLOS of >4 h. (p=0.001) Any specialty consultation and specialty consultation number, along with hospitalization, were also positively correlated to an EDLOS of >4 h. (p=0.001). High-acuity patients with frailty and dementia are at increased risk for increased EDLOS via consultations. Emergency and consultation physicians should communicate better about which patients are vulnerable to EDLOS case by case, and the patient outcome must be decided as soon as possible.

Cognitive Impairment and Mild to Moderate Dysphagia in Elderly Patients: A Retrospective Controlled Study.

Background: To investigate whether cognitive impairment in elderly patients could correlate with the severity of swallowing disorders detectable through the endoscopic fiber optic evaluation. Methods: Elderly patients (≥65years) performing a swallowing evaluation were included and divided according to the Dysphagia outcome and severity scale (DOSS). Neurological evaluation and Mini-Mental test examination (MMET) were administered to detect cognitive impairment. Results: Significantly worse swallowing function was reported in the cognitive impairment group than the control one (40% vs 19%; P = .001). A different significant distribution of swallowing performance was detected according to the patient's MMET score (P < .001; P < .001; P = .01). At the ANOVA test among dependent variables assessed, only age>65 and MMET<10 were significantly correlated with swallowing function (F = 3.862, P = .028; F = 17.49, P = .000). Conclusions: The elderly patient has an increased risk for unrecognized swallowing disorders, with a prevalence of mild to moderate forms. Assessment of cognitive performance could facilitate the identification of swallowing disorders by providing a higher level of suspicion for silent aspiration in subjects with poor MMET scores.

Psychoeducational program for older adults: a proposal from the humanistic approach that promotes psychological well-being

Aging is the final result of the sum of chronological, functional, and social age. Psychological well-being is the effort to perfect one's potential. Objective: to propose a psychoeducational program with a humanistic approach that promotes psychological well-being in institutionalized older adults. Method: it is proposed to work with a non-probability sampling and an intentional selection. Participants, men and women 65 years of age and over. Approach: qualitative and the design is pre-experimental. The type of study is descriptive of transversal temporality. Instruments: Sociodemographic data sheets, Mini Mental Examination Test, Montreal Cognitive Assessment (MOCA) and Riff's Scale of Psychological Well-being, Semi-structured individual interview guide and Evolution notes. The results: It is proposed to work in 2 weekly frequencies for 10 sessions divided into 3 stages: diagnosis, intervention, evaluation and closure. Conclusions: It is necessary to offer a program that includes the psychological sphere and promotes the dimensions of autonomy, self-acceptance and relationships with others. Recommendations: Multidisciplinary care and insist on public policies aimed at older adults.

Effects of the cognitive stimulation therapy based on Roy's adaptation model on Alzheimer's patients' cognitive functions, coping-adaptation skills, and quality of life: A randomized controlled trial.

This study aims to specify the effects of Cognitive Stimulation Therapy based on Roy's adaptation model (RAM) on Alzheimer's patients' coping and adaptation skills, cognitive functions, and quality of life (QOL). This is an experimental and randomized controlled trial. Patients in the experimental group received cognitive stimulation therapy (CST) based on RAM. The cognitive function level of the experimental group was found to be higher than that of the control group at the end of the measurements (performed in the 7th week); the difference was found to be statistically significant (P < .05). In the experimental group, dimensions of troubleshooting and focusing, making physical decisions, attention processing, systematizing, learning, and establishing relationships were found to be better than those of the control group after the application, and the difference was found to be statistically significant (P < .05). However, after the application, QOL of the experimental group was found to be better than that of the control group following the measurements; the difference was found to be statistically significant (P < .05). Psychiatric nurses should evaluate the patients using Standardize Mini-Mental Test Examination before applying RAM-based CST, and they should apply CST to early- and mid-stage Alzheimer's disease (AD) patients at the end of the evaluation and work with groups consisting of six persons at most. Since the cognitive functions of individuals with AD decline from the first stage, coping-adaptation, and QOL levels will also be affected, so it is recommended to evaluate the cognitive functions, coping-adjustment and QOL levels of individuals before applying RAM-based CST. NCT02229474.

Assessment of Delirium Using the Confusion Assessment Method in Older Adult Inpatients in Malaysia.

The detection of delirium in acutely ill older patients is challenging with the lack of informants and the necessity to identify subtle and fluctuating signs. We conducted a cross-sectional study among older patients admitted to a university hospital in Malaysia to determine the presence, characteristics, and mortality outcomes of delirium. Consecutive patients aged ≥65years admitted to acute medical wards were recruited from August to September 2016. Cognitive screening was performed using the mini-mental test examination (MMSE) and the Confusion Assessment Method (CAM). The CAM-Severity (CAM-S) score was also performed in all patients. Of 161 patients recruited, 43 (26.7%) had delirium. At least one feature of delirium from the CAM-S short and long severity scores were present in 48.4% and 67.1%, respectively. Older age (OR: 1.07, 95% CI: 1.01–1.14), immobility (OR: 3.16, 95% CI: 1.18–8.50), cognitive impairment (OR: 5.04, 95% CI: 2.07–12.24), and malnutrition (OR: 3.37; 95% CI: 1.15–9.85) were significantly associated with delirium. Older patients with delirium had a higher risk of mortality (OR: 7.87, 95% CI: 2.42–25.57). Delirium is common among older patients in our setting. A large proportion of patients had altered mental status on admission to hospital although they did not fulfill the CAM criteria of delirium. This should prompt further studies on strategies to identify delirium and the use of newer, more appropriate assessment tools in this group of vulnerable individuals.

Is the Clock Drawing Test useful in the screening assessment of aged patients with chronic heart failure?

PurposeCognitive impairment is one of the most common geriatric deficits in old patients with heart failure (HF), but there has been a lack of study on the utility of the Clock Drawing Test (CDT) when used with this group of patients. The aim of the study was to assess the usefulness of the CDT in the geriatric assessment of aged outpatients with chronic HF. Patients and methodsA cross-sectional analysis of the results of the comprehensive geriatric assessment (CGA), including the CDT, of 92 aged outpatients with heart failure was conducted. ResultsWe found a high prevalence of five examined geriatric problems. The majority of the patients presented signs of cognitive deterioration of different patterns and severity on the Clock Drawing Test. All the CDT scoring systems correlated significantly with the Mini-Mental Test Examination results. ConclusionsIt seems reasonable to perform the routine CGA with the CDT examination in all aged heart failure patients.

An Analysis of the Effects of the Physical Activities On the Cognitive Functions of the Old People with Mild Cognitive Impairment

Mild cognitive impairment is the pathological case in which the individual is between dementia and healthy. Therefore, especially in the protection, it is necessary to maintain and protect the cognitive functions. The physical activities exercised by the old people are crucial in increasing the cognitive functions or in maintenance of the present condition. The aim is to analyse the effects of the physical activities on the cognitive functions of the old people with mild cognitive impairment. The research was organized within the order of pretest-posttest design as experimental type using control groups. For the experiment,25 old people with mild cognitive impairment who were convenient for physical activities were selected with regard to the doctors’ advice. For the control group, a group of old people with mild cognitive impairment was listed. For the old people in the experimental group, a physical activity programme was applied including 30min. walk and 30min. regular exercise three days in a week which had continued for four weeks. Standardized Mini Mental Test Examination(SMMTE) was applied on the old people both before and after the activity. The average SMMTE point of the old people in the experimental group before the activity(20.6 ± 2.4) increased considerably after the activity(24.3 ± 3.6) and the difference is significant statistically(p<0.05). When the SMMTE points of the experimental and control group was compared after the activity, it was found out that the experimental group has higher points compared to the experimental group and the difference is significant(p<0.05). Regular and a three-day week physical activity program improved the cognitive functions of the old people with mild cognitive impairment.

Cognitive performance is impaired in coeliac patients on gluten free diet: A case–control study in patients older than 65 years of age

IntroductionRetrospective studies and case reports suggest an association between coeliac disease and impaired cognitive function. AimTo evaluate functional and cognitive performances in coeliac disease vs. control patients older than 65 years. MethodEighteen coeliac disease patients (75±4 years, group A) on gluten free diet since 5.5±3 years and 18 age-sex matched controls (76±4 years, group B) were studied using a battery of neuropsychological tests. Results of functional and cognitive tests are expressed as “row scores” and as “equivalent scores” by relating “raw scores” to reference rank categories. ResultsBarthel Index of functional performance was similar in the 2 groups. “Raw score” was significantly lower in coeliac disease than controls for Mini Mental Test Examination (p=0.02), Trail Making Test (p=0.001), Semantic Fluency (p=0.03), Digit Symbol Test (p=0.007), Ideo-motor apraxia (p<0.001) and Bucco-facial apraxia (p<0.002). “Equivalent score” was also lower in coeliac disease than controls for Semantic memory (p<0.01) and for Ideo-motor apraxia (p=0.007). ConclusionCognitive performance is worse in elderly coeliac disease than control patients, despite prolonged gluten avoidance in coeliacs. Awareness on the increasing phenomenon of late-onset coeliac disease is important to minimize diagnostic delay and prolonged exposure to gluten that may adversely and irreversibly affect cognitive function.

Neuropsychological pattern during gluten free diet (GFD) in elderly coeliac patients

IntroductionPrevious studies suggested a correlation between celiac disease (CD) and cognitive impairment, but only few described these characteristics in the elderly, all based on a small number of patients or...

Striatal dopamine transporter levels correlate with apathy in neurodegenerative diseases: A SPECT study with partial volume effect correction

Objectives The aim of the present study was to stress the relationship between neuropsychiatric symptoms and most particularly apathy and striatal dopamine uptake in patients with Alzheimer's disease (AD) or dementia with Lewy body (DLB). Patients and methods Twenty-two patients (AD n = 14; DLB n = 8) were included. All patients had neuropsychological and behavioral examination including Mini Mental Test Examination (MMSE), Neuropsychiatric Inventory (NPI), and UPDRS for the motor activity assessment. Apathy dimensions, emotional blunting, lack of initiative and lack of interest were assessed using the Apathy Inventory (AI). Dopamine transporter (DAT) striatal uptake was assessed using 123I-FP-CIT (DaTSCAN ®) SPECT. Quantitative measurements were obtained in 3D using a method which compensates for physical detection biases including partial volume effect. Results We observed a correlation between DAT uptake and NPI's domains only for apathy. More specifically using the AI, lack of initiative significantly correlated with bilateral putamen DAT uptake. Using partial correlation coefficients controlling for the UPDRS score, the correlation remained significant between lack of initiative and right and left putamen DAT uptake. Conclusion These results demonstrate a relationship between apathy and DAT levels independent from motor activity. They suggest that the patients with neurodegenerative diseases presenting with apathy are characterized by some degree of dopaminergic neuronal loss.

A latent process model for dementia and psychometric tests

We jointly model longitudinal values of a psychometric test and diagnosis of dementia. The model is based on a continuous-time latent process representing cognitive ability. The link between the latent process and the observations is modeled in two phases. Intermediate variables are noisy observations of the latent process; scores of the psychometric test and diagnosis of dementia are obtained by categorizing these intermediate variables. We propose maximum likelihood inference for this model and we propose algorithms for performing this task. We estimated the parameters of such a model using the data of the 5 year follow-up of the PAQUID study. In particular this analysis yielded interesting results about the effect of educational level on both latent cognitive ability and specific performance in the mini mental test examination. The predictive ability of the model is illustrated by predicting diagnosis of dementia at the 8 year follow-up of the PAQUID study based on the information from the first 5 years.

Clozapine in drug induced psychosis in Parkinson’s disease: a randomised, placebo controlled study with open follow up

Objective: To compare the efficacy and safety of clozapine in drug induced psychosis in Parkinson’s disease (PD). Methods: A four week, randomised, double blind, parallel comparison of clozapine and placebo,...

Long-term cognitive and functional decline in late onset Alzheimer's disease: therapeutic implications.

National Institute of Clinical Excellence guidelines advocate the use of the Mini-Mental Test Examination and a functional assessment as a means of measuring treatment response. However, there is little knowledge of the change expected in those with Alzheimer's disease in clinical practice. to describe the long-term variability of the Mini-Mental Test Examination and Blessed Dementia Rating Scale. 374 Alzheimer's disease patients referred to psychiatric services in southeast London were followed annually over a 3-year period. the mean Mini-Mental Test Examination score for the total group at baseline was 9.9 points. Individual variability in the rate of cognitive and functional decline is large and around 40% of patients after 1 year, and up to one-quarter of patients after 3 years who survived, show no change or an improvement in scores compared with baseline measures. in the evaluation of individual treatment response the rate of change, as measured by the Mini-Mental Test Examination and Blessed Dementia Rating Scale, is of limited value.

Quantitative electroencephalography in mild cognitive impairment: longitudinal changes and possible prediction of Alzheimer’s disease

The present study evaluated the clinical course of patients with mild cognitive impairment (MCI), the pattern of electroencephalography (EEG) changes following cognitive deterioration, as well as the potential of neurophysiological measures in predicting dementia. Twenty-seven subjects with MCI were followed for a mean follow up period of 21 months. Fourteen subjects (52%) progressed (P MCI) to clinically manifest Alzheimer’s disease (AD), and 13 (48%) remained stable (S MCI). The two MCI subgroups did not differ in baseline EEG measures between each other and the healthy controls ( n = 16), but had significantly lower theta relative power at left temporal, temporo-occipital, centro-parietal, and right temporo-occipital derivation when compared to the reference AD group ( n = 15). The P MCI baseline alpha band temporo-parietal coherence, alpha relative power values at left temporal and temporo-occipital derivations, theta relative power values at frontal derivations, and the mean frequency at centro-parietal and temporo-occipital derivations overlapped with those for AD and control groups. After the follow-up, the P MCI patients had significantly higher theta relative power and lower beta relative power and mean frequency at the temporal and temporo-occipital derivations. A logistic regression model of baseline EEG values adjusted for baseline Mini-Mental Test Examination showed that the important predictors were alpha and theta relative power and mean frequency from left temporo-occipital derivation (T5-O1), which classified 85% of MCI subjects correctly.

Correlations between memory, language, gnosia, and praxia in 80 patients with senile dementia of the alzheimer type

AbstractA global neuropsychological study has been carried out with 80 in‐patients presenting a syndrome of senile dementia of the Alzheimer type (SDAT):60 scored less than 20 (mild dementia) on the Mini‐Mental Test Examination (MMSE); 20 scored less than 10 (severe dementia). The test battery included a set of tasks exploring memory, language, abstract nonverbal thought, gnosias, and praxias. In patients with mild dementia, the overall MMSE score was statistically correlated with the scores for memory, nonverbal thought, language, and gnosias, but not with the score for praxia. Language score was correlated with the scores for the other higher functions. It is suggested that the SDAT syndrome has to be considered as a unique syndrome affecting every higher function quite similarly, with no evidence of clinical subgroups. With this in mind, new studies should be designed to delineate further the role of the mnesic, linguistic, and/or perceptual factors involved in the dementia process.