MMSE Score Research Articles

The sleep condition and its association with cognitive function of the elderly in six provinces of China

Objective: To analyze the association between sleep duration and cognitive function of the elderly in six provinces of China. Methods: Based on the cross-sectional survey data of the elderly from the Healthy Ageing Assessment Cohort Study in 2019, 4 644 participants' sociodemographic and economic indicators, lifestyle, prevalence of major chronic diseases, and sleep status, including night-time sleep duration, daytime sleep duration and insomnia, were collected by questionnaires. Cognitive function was evaluated by the Mini-Mental State Examination. Multivariate logistic regression was used to analyze the association between night-time sleep duration, daytime sleep duration and cognitive function. Results: The mean age of 4 644 respondents was (72.3±5.7) years, and 2 111 of them were males (45.5%). The mean total daily sleep time of the elderly was (7.9±1.9) hours, and the proportion of those who slept less than 7.0, 7.0-8.9 and≥9.0 hours was 24.1% (1 119), 42.1% (1 954) and 33.8% (1 571), respectively. The mean sleep time at night was (6.9±1.7) hours. About 23.7% (1 102) of the elderly did not sleep during the day, and the mean duration of the elderly who slept during the day was (78±51) minutes. Among the elderly with insomnia, 47.9% were still satisfied with their sleep quality. The mean value of MMSE score of 4 644 respondents was (24.5±5.3), and the cognitive impairment rate was 28.3% (1 316). The results of multivariate logistic regression model analysis showed that the OR (95%CI) value of the risk of cognitive impairment in older people who did not sleep, slept for 31 to 60 minutes and slept more than one hour was 1.473 (1.139 to 1.904), 1.277 (1.001 to 1.629) and 1.496 (1.160 to 1.928), respectively, compared with those who slept for 1 to 30 minutes during the daytime. Compared with those who slept for 7.0‒8.9 hours at night, the OR (95%CI) value of the risk of cognitive impairment in older people who slept more than 9.0 hours was 1.239 (1.011 to 1.519). Conclusion: The cognitive function is related to sleep duration in the Chinese elderly.

Associations of blood UCH-L1 and NfL levels with cognitive dysfunction in Parkinson’s disease patients

ObjectiveUbiquitin carboxy-terminal hydrolase L1 (UCH-L1) and Neurofilament light chain (NfL) are associated with Lewy body formation, Lewy bodies are the main pathological feature of Parkinson's disease (PD). The relationship between UCH-L1 and PD cognition remains unclear, and NfL is an important marker of cognitive impairment. The aim of this study is to investigate the relationship among serum UCH-L1 levels, plasma NfL levels and cognitive dysfunction in PD patients. ResultsThere were significant differences in UCH-L1 and NfL levels among PD patients with normal cognitive function (PD-CN), PD patients with mild cognitive impairment (PD-MCI), and PD-dementia patients (PDD) (P < 0.001; P < 0.001). The PDD group had lower levels of UCH-L1 (Z = 6.721, P < 0.001; Z = 7.577, P < 0.001) and higher levels of NfL (Z = −3.626, P = 0.001; Z = −2.616P = 0.027) than the PD-NC and PD-MCI groups. Serum UCH-L1 levels were positively correlated with MMSE scores, MoCA scores, and its subitems in PD patients (P < 0.001), and plasma NfL levels were negatively correlated with MMSE scores, MoCA scores, and its items (P < 0.01) (except for “abstract”). ConclusionDecreased UCH-L1 levels and elevated NfL levels in the blood are associated with cognitive dysfunction in PD; thus, these proteins are potential biomarkers for the diagnosis of cognitive dysfunction in PD patients.

Can T1-Weighted Magnetic Resonance Imaging Significantly Improve Mini-Mental State Examination-Based Distinguishing Between Mild Cognitive Impairment and Early-Stage Alzheimer's Disease?

Detecting early-stage Alzheimer's disease (AD) is still problematic in clinical practice. This work aimed to find T1-weighted MRI-based markers for AD and mild cognitive impairment (MCI) to improve the screening process. Our assumption was to build a screening model that would be accessible and easy to use for physicians in their daily clinical routine. The multinomial logistic regression was used to detect status: AD, MCI, and normal control (NC) combined with the Bayesian information criterion for model selection. Several T1-weighted MRI-based radiomic features were considered explanatory variables in the prediction model. The best radiomic predictor was the relative brain volume. The proposed method confirmed its quality by achieving a balanced accuracy of 95.18%, AUC of 93.25%, NPV of 97.93%, and PPV of 90.48% for classifying AD versus NC for the European DTI Study on Dementia (EDSD). The comparison of the two models: with the MMSE score only as an independent variable and corrected for the relative brain value and age, shows that the addition of the T1-weighted MRI-based biomarker improves the quality of MCI detection (AUC: 67.04% versus 71.08%) while maintaining quality for AD (AUC: 93.35% versus 93.25%). Additionally, among MCI patients predicted as AD inconsistently with the original diagnosis, 60% from ADNI and 76.47% from EDSD were re-diagnosed as AD within a 48-month follow-up. It shows that our model can detect AD patients a few years earlier than a standard medical diagnosis. The created method is non-invasive, inexpensive, clinically accessible, and efficiently supports AD/MCI screening.

Validation study of “Santé-Cerveau”, a digital tool for early cognitive changes identification

BackgroundThere is a need for a reliable, easy-to-use, widely available, and validated tool for timely cognitive impairment identification. We created a computerized cognitive screening tool (Santé-Cerveau digital tool (SCD-T)) including validated questionnaires and the following neuropsychological tests: 5 Word Test (5-WT) for episodic memory, Trail Making Test (TMT) for executive functions, and a number coding test (NCT) adapted from the Digit Symbol Substitution Test for global intellectual efficiency. This study aimed to evaluate the performance of SCD-T to identify cognitive deficit and to determine its usability.MethodsThree groups were constituted including 65 elderly Controls, 64 patients with neurodegenerative diseases (NDG): 50 AD and 14 non-AD, and 20 post-COVID-19 patients. The minimum MMSE score for inclusion was 20. Association between computerized SCD-T cognitive tests and their standard equivalent was assessed using Pearson's correlation coefficients. Two algorithms (a simple clinician-guided algorithm involving the 5-WT and the NCT; and a machine learning classifier based on 8 scores from the SCD-T tests extracted from a multiple logistic regression model, and data from the SCD-T questionnaires) were evaluated. The acceptability of SCD-T was investigated through a questionnaire and scale.ResultsAD and non-AD participants were older (mean ± standard deviation (SD): 72.61 ± 6.79 vs 69.91 ± 4.86 years old, p = 0.011) and had a lower MMSE score (Mean difference estimate ± standard error: 1.74 ± 0.14, p < 0.001) than Controls; post-COVID-19 patients were younger than Controls (mean ± SD: 45.07 ± 11.36 years old, p < 0.001). All the computerized SCD-T cognitive tests were significantly associated with their reference version. In the pooled Controls and NDG group, the correlation coefficient was 0.84 for verbal memory, -0.60 for executive functions, and 0.72 for global intellectual efficiency. The clinician-guided algorithm demonstrated 94.4% ± 3.8% sensitivity and 80.5% ± 8.7% specificity, and the machine learning classifier 96.8% ± 3.9% sensitivity and 90.7% ± 5.8% specificity. The acceptability of SCD-T was good to excellent.ConclusionsWe demonstrate the high accuracy of SCD-T in screening cognitive disorders and its good acceptance even in individuals with prodromal and mild dementia stages. SCD-T would be useful in primary care to faster refer subjects with significant cognitive impairment (and limit unnecessary referrals) to specialized consultation, improve the AD care pathway and the pre-screening in clinical trials.

Frequency and Risk Factors of Subsyndromal Delirium in the Intensive Care Units: A Prospective Cohort Study.

Subsyndromal delirium (SSD) is a common neuropsychiatric disorder among the intensive care units (ICU) patients. SSD is characterized by the presence of delirium symptoms but it does not meet the diagnostic criteria of delirium, resulting in poor patient prognosis. The aim of this study was to explore the prevalence and risk factors for SSD among adult patients admitted to the ICU of XXX hospital in Southwest China. The study participants comprised 309 patients referred to the ICU in XXX hospital between 10th August 2021 and 5th June 2022. Demographic information, medical history, and other patient information were recorded. ICDSC assessment, physical examination and laboratory tests were performed on enrolled patients. Cognitive evaluation was conducted using the MMSE method. The results showed that out the 309 patients, 99 had possible SSD (prevalence of 32.0%), with 55 SSD1 cases (ICDSC score of 1, 17.8% prevalence), 29 SSD2 cases (ICDSC score of 2, 9.4% prevalence) and 15 SSD3 cases (ICDSC score of 3, 4.9% prevalence). Previous history of mental illness (OR, 3.741; 95% CI, 1.136-12.324; P <0.05), auxiliary ventilation (OR, 3.364; 95% CI, 1.448-7.813; P <0.01), hemodialysis (OR, 11.369; 95% CI, 1.245-103.840; P <0.05), MMSE score (OR, 0.845; 95% CI, 0.789-0.904; P <0.001) and a temperature ≥ 37.5 °C (OR, 3.686; 95% CI, 1.404-9.732; P <0.01) were independent risk factors for occurrence of SSD among ICU patients. Approximately one-third of the patients in the intensive care unit had high risk of SSD. Nursing staff should pay attention to management of the high-risk patients to prevent SSD from progressing delirium to improve patient prognosis.

A Graph Theory Study of Resting-State Functional MRI Connectivity in Children With Carbon Monoxide Poisoning.

The effect of carbon monoxide (CO) poisoning on the topology of brain functional networks is unclear, especially in children whose brains are still developing. To investigate the topological alterations of the whole-brain functional connectome in children with CO poisoning and characterize its relationship with disease severity. Cross-sectional and prospective study. A total of 26 patients with CO poisoning and 26 healthy controls. A 3.0 T MRI system/echo planar imaging (EPI) and 3D brain volume imaging (BRAVO) sequences. We used the network-based statistics (NBS) method to explore between-group differences in functional connectivity strength and a graph-theoretical-based analytic method to explore the topology of brain networks. Student's t-test, chi-square test, NBS, Pearson correlation coefficient, and false discovery rate correction. The statistical significance threshold was set at P < 0.05. The case group's brain functional network topology was impaired in comparison to the control group (reduced global efficiency and small-worldness, increased characteristic path length). According to node and edge analyses, the case group showed topologically damaged regions in the frontal lobe and basal ganglia, as well as neuronal circuits with weaker connections. Also, there was a significant correlation between the patients' coma time and the degree (r = -0.4564), efficiency (r = -0.4625), and characteristic path length (r = 0.4383) of the nodes in the left orbital inferior frontal gyrus. Carbon monoxide hemoglobin content (COHb) concentration and right rolandic operculum node characteristic path length (r = -0.3894) were significantly correlated. The node efficiency and node degree of the right middle frontal gyrus (r = 0.4447 and 0.4539) and right pallidum (r = 0.4136 and 0.4501) significantly correlated with the MMSE score. The brain network topology of CO poisoned children is damaged, which is manifested by reduced network integration and may lead to a series of clinical symptoms in patients. 2. Stage 2.

Characteristics of Mild Cognitive Impairment and Associated Factors in MSA Patients

Mild cognitive impairment (MCI) in multiple-system atrophy (MSA) patients is common but remains poorly characterized, and the related factors are unclear. This retrospective study included 200 consecutive patients with a clinical diagnosis of possible or probable MSA, 102 MSA patients with MCI (MSA-MCI), and 98 MSA patients with normal cognition (MSA-NC). Cognitive profiles were compared between MSA-MCI and MSA-NC patients using the MoCA. In addition, demographic as well as major motor and nonmotor symptom differences were compared between MSA-MCI and MSA-NC patients. The median MMSE score was 26 points. Overall, MSA-MCI was observed in 51% of patients, with predominant impairment in visuospatial, executive, and attention functions compared with MSA-NC patients. MSA-MCI patients were older (p = 0.015) and had a later onset age (p = 0.024) and a higher frequency of hypertension, motor onset, and MSA with the predominant parkinsonism (MSA-P) phenotype than MSA-NC patients. The positive rate of orthostatic hypotension (OH) in MSA-MCI patients was significantly decreased and depression/anxiety was significantly increased compared with MSA-NC patients (p = 0.004). Multivariate logistic analysis showed that motor onset was independently associated with MCI in MSA patients. MSA-MCI patients had impairment in visuospatial, executive, and attention functions. More prominent memory impairment was observed in MSA-P than in MSA-C patients. Motor onset was independently associated with MCI in MSA patients. MCI was commonly presented in MSA with more prominent memory impairment in MSA-P. Future follow-up studies are warranted to identify more factors that influence cognitive impairment in MSA.

Effect of Elderly Exercises on Increasing Memory (Mini-Mental State Examination =MMSE)

The purpose of this study was to examine the effect of elderly exercise intervention on Memory (MMSE) in the elderly in Bogor Regency, West Java. Method by conducting interviews and observations with MMSE before intervention. The next step is to provide elderly exercise care to improve MMSE. The results of the difference in average MMSE scores were compared to see how far the effect of elderly exercise interventions on memory function. The minimum number of samples was determined by the test formula of the mean difference before and after the intervention with a total of 11 and to maintain the drop out the number of samples was 20 subjects. with dropout criteria, if they did not participate in the exercise 3 times during the intervention. Results: The overall mean ± the SD age range was 95% CI 64.4 ± 3.77 with a minimum age of 60 years and a maximum of 66 years with a CI of 95% (62.4 – 66.3). Where the average age of primary ± for men was 76.0 ± 2.82, the median age for women was 63.6 ± 3.75. The overall mean value of several cognitive components increased after the administration of elderly exercise so that there was a cognitive influence of the elderly where the cognitive value before the elderly exercise intervention was 22.00 ± 6.010 with a confidence level of 95% (95% CI) between 18.91 – 25.09 and the average cognitive value after the elderly exercise intervention was 26.53 ± 68.3 with a confidence level of 95% (95% CI) between 24.53 – 28.53. Conclusion: The conclusion of the intervention before and after elderly exercise on the effect of MMSE scores showed significant results before and after the elderly exercise intervention.

Abnormal intra- and inter-network functional connectivity of brain networks in early-onset Parkinson's disease and late-onset Parkinson's disease.

The purpose of this study is to look into the altered functional connectivity of brain networks in Early-Onset Parkinson's Disease (EOPD) and Late-Onset Parkinson's Disease (LOPD), as well as their relationship to clinical symptoms. A total of 50 patients with Parkinson' disease (28 EOPD and 22 LOPD) and 49 healthy controls (25 Young Controls and 24 Old Controls) were admitted to our study. Employing independent component analysis, we constructed the brain networks of EOPD and Young Controls, LOPD and Old Controls, respectively, and obtained the functional connectivity alterations in brain networks. Cerebellar network (CN), Sensorimotor Network (SMN), Executive Control Network (ECN), and Default Mode Network (DMN) were selected as networks of interest. Compared with their corresponding health controls, EOPD showed increased functional connectivity within the SMN and ECN and no abnormalities of inter-network functional connectivity were found, LOPD demonstrated increased functional connectivity within the ECN while decreased functional connectivity within the CN. Furthermore, in LOPD, functional connectivity between the SMN and DMN was increased. The functional connectivity of the post-central gyrus within the SMN in EOPD was inversely correlated with the Unified Parkinson's Disease Rating Scale Part III scores. Age, age of onset, and MMSE scores are significantly different between EOPD and LOPD (p < 0.05). There is abnormal functional connectivity of networks in EOPD and LOPD, which could be the manifestation of the associated pathological damage or compensation.

A rare case presentation of top of basilar artery syndrome

Top of basilar syndrome occurs due to the thrombotic occlusion of basilar artery. It is very rare in occurrence and constitutes about 1% of all strokes. Clinical manifestations commonly may have the hallmarks of basilar artery occlusion that include dysarthria, visual, oculomotor and behavioural abnormalities with or without significant motor dysfunction and non-specific symptoms like vertigo and headache. Here we report a case of 60year old male who presented with decreased responsiveness and slurring of speech since 2 days and history of vomiting since one day. Neurological examination revealed normal higher mental functions with MMSE score of 28/30, horizontal nystagmus was present, other cranial nerve examination was normal, tone was increased in all the four limbs, Power was 4/5 in all the 4 limbs and Plantar was mute bilaterally. Patient condition deteriorated later and on further evaluation patient was found to have Basilar Artery Occlusion.

Early detection of cognitive decline in Alzheimer's disease using eye tracking.

Patients with Alzheimer's disease (AD) are known to exhibit visuospatial processing impairment, as reflected in eye movements from the early stages of the disease. We investigated whether the pattern of gaze exploration during visual tasks could be useful for detecting cognitive decline at the earliest stage. Sixteen AD patients (age: 79.1 ± 7.9 years, Mini Mental State Examination [MMSE] score: 17.7 ± 5.3, mean ± standard deviation) and 16 control subjects (age: 79.4 ± 4.6, MMSE score: 26.9 ± 2.4) participated. In the visual memory task, subjects memorized presented line drawings for later recall. In the visual search tasks, they searched for a target Landolt ring of specific orientation (serial search task) or color (pop-out task) embedded among arrays of distractors. Using video-oculography, saccade parameters, patterns of gaze exploration, and pupil size change during task performance were recorded and compared between AD and control subjects. In the visual memory task, the number of informative regions of interest (ROIs) fixated was significantly reduced in AD patients compared to control subjects. In the visual search task, AD patients took a significantly longer time and more saccades to detect the target in the serial but not in pop-out search. In both tasks, there was no significant difference in the saccade frequency and amplitude between groups. On-task pupil modulation during the serial search task was decreased in AD. The number of ROIs fixated in the visual memory task and search time and saccade numbers in the serial search task differentiated both groups of subjects with high sensitivity, whereas saccade parameters of pupil size modulation were effective in confirming normal cognition from cognitive decline with high specificity. Reduced fixation on informative ROIs reflected impaired attentional allocation. Increased search time and saccade numbers in the visual search task indicated inefficient visual processing. Decreased on-task pupil size during visual search suggested decreased pupil modulation with cognitive load in AD patients, reflecting impaired function of the locus coeruleus. When patients perform the combination of these tasks to visualize multiple aspects of visuospatial processing, cognitive decline can be detected at an early stage with high sensitivity and specificity and its progression be evaluated.

Does the Loss of Teeth Have an Impact on Geriatric Patients' Cognitive Status?

Our aim was to evaluate dentures' impact on the cognitive state of geriatric patients. A total of 108 individuals seeking treatment at the Faculty of Dental Medicine in Iasi, Romania, participated in the study, which ran from May 2022 to October 2022. Cognitive dysfunction was assessed using the Mini-Mental State Examination. The acquired data were analyzed with IBM SPSS 26.0, and the p-value was set at 0.05. The average value of the MMSE score was 21.81 ± 3.872. Differences between groups of wearer/non-wearer subjects were statistically significant for most of the questions in the questionnaire. Linear regression analysis showed that individuals with a high MMSE score have prosthodontic treatment. A decrease in the MMSE score is associated with a decrease in masticatory efficiency (B = 1.513, p = 0.268). This study provides further evidence that tooth loss is associated with worse cognitive performance. It is thus conceivable that the necessary effects can be achieved by increasing the efforts dedicated to preventing tooth loss in the adult population.

Changes in CSF sPDGFRβ level and their association with blood–brain barrier breakdown in Alzheimer’s disease with or without small cerebrovascular lesions

BackgroundCSF-soluble platelet-derived growth factor receptor beta (sPDGFRβ) is closely associated with pericyte damage. However, the changes in CSF sPDGFRβ levels and their role in blood–brain barrier (BBB) leakage at different stages of Alzheimer’s disease (AD), with or without cerebral small vessel disease (CSVD) burden, remain unclear.MethodsA total of 158 individuals from the China Aging and Neurodegenerative Disorder Initiative cohort were selected, including 27, 48, and 83 individuals with a clinical dementia rating (CDR) score of 0, 0.5, and 1–2, respectively. CSF total tau, phosphorylated tau181 (p-tau181), Aβ40, and Aβ42 were measured using the Simoa assay. Albumin and CSF sPDGFRβ were measured by commercial assay kits. CSVD burden was assessed by magnetic resonance imaging.ResultsCSF sPDGFRβ was the highest level in the CDR 0.5 group. CSF sPDGFRβ was significantly correlated with the CSF/serum albumin ratio (Q-alb) in the CDR 0–0.5 group (β = 0.314, p = 0.008) but not in the CDR 1–2 group (β = − 0.117, p = 0.317). In the CDR 0–0.5 group, CSF sPDGFRβ exhibited a significant mediating effect between Aβ42/Aβ40 levels and Q-alb (p = 0.038). Q-alb, rather than CSF sPDGFRβ, showed a significant difference between individuals with or without CSVD burden. Furthermore, in the CDR 0.5 group, CSF sPDGFRβ was higher in subjects with progressive mild cognitive impairment than in those with stable mild cognitive impairment subjects (p < 0.001). Meanwhile, CSF sPDGFRβ was significantly associated with yearly changes in MMSE scores in the CDR 0.5 group (β = − 0.400, p = 0.020) and CDR 0.5 (A+) subgroup (β = − 0.542, p = 0.019).ConclusionsWe provide evidence that increased CSF sPDGFRβ is associated with BBB leakage in the early cognitive impairment stage of AD, which may contribute to cognitive impairment in AD progression.

Factors of Anxiety-Affective Symptoms Persistence in Depressions of Various Origins

The aim of study: the current study has been caried out in order to find the anxiety-affective symptomatology persistence duration (AASPD) under standard antidepressants therapy and its neurobiological and premorbid personality predictors in different diagnostic groups.Patients and methods: 191 patients were included into study. Among them 57 patients with organic anxiety affective disorder (OAAD), 41 with endogenous depression (ED), 14 with anxiety neurotic disorder (AND) and 93 with schizophrenia. The Munich personality test and Toronto alexithymia scale were used for assessment of premorbid personality, while SCL-90 and MMSE — for the assessment of psychopathology structure. For the assessment of handedness Annett scale has been used. The product moment correlation analysis was performed for the assessment of relationships between premorbid personality, MMSE and Annett scale score and psychopathology persistence.Results: the symptomatology persistence was maximal in OAAD (21.37 ± 8.33) and smallest in ED (16.27 ± 4.38). Neuroticism correlated positively with AASPD in ED (r = 0.481; р = 0.001). Duration of disorder correlated positively with AASPD (r = 0,286; p = 0.031), while MMSE correlated negatively (r = –0.267; p = 0.045) in OAAD. In AND the negative correlation between MMSE and AASPD (r = –0.585; p = 0.028) and between Annett score and AASPD (r = –0.617; p = 0.032). No stochastically significant correlations were revealed in schizophrenia.Conclusion: the data obtained are important both for further study of the pathogenesis of these disorders and for the prediction and prevention of affective disorders in clinical practice.

Cognitive disorders in the elderly persons and their psychometric markers

IntroductionPopulation aging is accompanied by an increase in mental disorders of late age, cognitive impairment and dementia, which makes research on their diagnosis, prevention and therapy particularly relevant.ObjectivesIn order to improve the diagnosis of cognitive disorders in elderly patients, a comparative characteristic of the MMSE and MoCA psychometric scales is presented. Due to the lack of differentiation of results in the MoCA - test according to the severity of cognitive disorders, ranking was carried out to determine the scoring levels of cognitive decline.MethodsOn the clinical basis of the scientific department of gerontopsychiatry of the Moscow Research Institute of Psychiatry - branch of the V. Serbsky National Medical Research Center for Psychiatry and Narcology, 46 people over 60 years old were examined. The identified mental disorders were coded under the ICD-10 F00-F09 rubric “Organic, including symptomatic mental disorders”. Cognitive status assessment was carried out by psychometric scales MMSE and MoCA. Psychometric and statistical research methods were used. To compare MoCA and MMSE scores, an equal-percentage alignment method was usedResultsIn patients examined by MMSE and MoCA, different point values were determined in assessing cognitive functions. In most observations, the MoCA- test indicators were lower than the MMSE values. The following correspondences of the score values of the scales were revealed: MOCA 23-30 - MMSE 28-30 points; MOCA 22-18 - MMSE 27-25; MOCA 17-12 – MMSE 23-20; MOCA 12-0 – MMSE 19-0.ConclusionsSuch features of the MMSE scale as insufficient sensitivity in assessing memory impairment and differentiation of non-dementia levels of cognitive impairment, regulatory functions of programming and goal-setting, lexical fluency were revealed. The advantages of the MoCA - test were the ability to assess visual-constructive and executive skills, praxis, a more accurate assessment of memory impairments, mobility of mental processes and the ability to switch, logical thinking, the possibility of topical diagnosis of brain damage. The disadvantages of the MoCA - test were the duration of its implementation, the fatigue of patients, the lack of tasks for assessing written speech and motor praxis.The MoCA - test is a more sensitive method for detecting and differentiating cognitive impairment compared to the MMSE scale, which makes it possible to recommend it for widespread introduction into psychiatric practice. Relevant in further studies are the determination of indicators of moderate cognitive impairment as a threshold value between mild cognitive impairment (MCI) and incipient dementia, clarification of the point values of different levels of dementia.Disclosure of InterestNone Declared

Suicide risk in epilepsy: Clinical variables, psychiatric disorders, and social support.

To explore the relationship between suicide risk, the perception of social support and quality of life (QoL), and with the clinical variables of adult people with epilepsy (PWEs). A total of 98 consecutive PWEs cared for in the outpatient setting, with a mean age of 48.1±15.9 years, having had epilepsy for 26.4±16.4 years and 48 (48.9%) female cases participated in this study. The MINI suicide module, the Social support satisfaction scale (SSSS), the Quality of life in epilepsy inventory (QOLIE-31), and the Hospital anxiety and depression scale (HADS) were used. A logistic regression was conducted to assess the factors associated with the suicide risk. Suicide risk was present in 33 cases. Younger age, earlier age at epilepsy onset, depression and anxiety in the HADS scale, and lower MMSE, QOLIE-31, and SSSS scores were significantly associated with suicide risk in the univariate analysis. The logistic regression analysis identified that lower scores in the MMSE (OR 0.826, 95%CI 0.705-0.969), presence of anxiety (OR 0.197, CI 0.073-0.530), and a low perception regarding satisfaction with family (OR 0.953, CI 0.920-0.988) are the factors associated with the highest risk of suicide. Suicide risk and recurrence of a suicide attempt was high in the PWEs. Suicide risk was associated with clinical variables, the presence of anxiety and the perception of less social support from the family.

Combined clinical and laboratory diagnostics of neurodegenerative disorders

IntroductionAlzheimer’s disease (AD) is a neurodegenerative pathology that develops mainly in elderly and senile people.ObjectivesThe aim of the study was a comparative analysis of the results of neuropsychological tests with the indicators of the study of oral fluid and buccal epithelium cytograms in patients with Alzheimer’s disease.MethodsIn the main group of 12 patients with Alzheimer’s disease, m=76.25±4.89. There were 12 cognitively healthy people in the control group. The average MMSE score among the observations of the main group was 13.42±3.63. The ADAS-COG scale was used to detail the impaired cognitive functions. The concomitant pathology is compensated. The content of BDNF, TNF-α, IL1RA, IL-6, and IL-8 was determined in the oral fluid and in the blood serum. The concentration of salivary and serum biomarkers was determined by multiparametric fluorescence analysis with magnetic microspheres. Micronuclei, karyopycnosis, karyorexis, and karyolysis were determined in the cellular structures of the buccal epithelium. The material for cytological examination was collected from the inner surface of the cheek.ResultsWhen analyzing buccal cytograms, attention was drawn to a pronounced increase in the number of cells with micronuclei in patients with AD to 1.8%; in the control group, the median was 0.1% (p&lt;0.05). A direct correlation was established between the number of binuclear cells and the level of BDNF in the blood serum (r=0.646; p=0.03) in patients with AD. It is also important to note that the level of serum BDNF had a significant direct correlation with immediate memory, and the concentration of salivary BDNF correlates with the parameter of naming objects.ConclusionsCorrelations between amnesia, speech disorders, praxis, gnosis and pathology of the oral fluid and buccal epithelium, especially with the severity of karyopycnosis and karyorexis, have been established, indicating a direct correlation between the neurodegenerative process pathogenetically associated with Alzheimer’s disease and the processes of systemic inflammation and degeneration of the buccal epithelium.Disclosure of InterestNone Declared

Serum levels of IL-6 are associated with cognitive impairment in the salus in apulia population-based study

Growing evidence suggests that inflammation contributes to brain aging and neurodegeneration. This study investigates the relationship between global cognitive as well executive function and the inflammatory markers IL-6, CRP, and TNF-α in a population-based study of older adults. A population-based sample, of older people in Southern Italy, was enrolled. We measured serum levels of IL-6, CRP, and TNF-α. We also administered two neuropsychological tests: Mini-Mental State Examination and Frontal Assessment Battery. Rank-based regression models were performed to investigate the relationship between inflammatory markers and cognitive functions, including major demographic and clinical confounders for adjustment. The sample consisted of 1929 subjects aged between 65 and 95 years. Multivariate linear regression analysis revealed that higher serum levels of IL-6 were associated with lower MMSE and FAB scores even after adjustment for demographic data and cardiovascular risk factors. No significant associations were found between cognitive functioning and serum levels of CRP and TNF-α. Our results suggest that higher levels of IL-6 were associated with cognitive impairment in an older adult population of Southern Italy.

Psychological Well-being Relates to Healthcare and Financial Decision Making in a Study of Predominantly White Older Adults.

The purpose of this study was to test the hypotheses that psychological well-being is associated with healthcare and financial decision making in older adults and that this association varies by the level of cognitive function. Participants were 1082 older adults (97% non-Latino White; 76% women; mean age = 81.04years; SD = 7.53) without dementia (median MMSE score = 29.00, IQR = 27.86-30.00). In a regression model adjusted for age, gender, and years of education, higher levels of psychological well-being were associated with better decision making (estimate = 0.39, standard error [SE] = 0.11, p < .001), as was better cognitive function (estimate = 2.37, SE = 0.14, p < .0001). In an additional model, an interaction of psychological well-being and cognitive function was significant (estimate = -0.68, SE = 0.20, p < .001), such that higher levels of psychological well-being were most beneficial for decision making among participants with lower levels of cognitive function. Higher levels of psychological well-being may help sustain decision making among older persons, particularly those with lower levels of cognitive function.

Associations between Autonomic Function and Cognitive Performance among Patients with Cerebral Small Vessel Disease

Data linking heart rate variability (HRV) and cognitive status remains controversial and scarce, particularly in cerebral small vessel disease (CSVD) patients. Whether the association between HRV and cognitive performance exists in CSVD patients is unclear. Hence, we aimed to investigate the association between HRV and cognitive performance in patients with CSVD. This cross-sectional study was conducted among 117 CSVD patients. All patients underwent HRV assessment and global cognitive evaluation by the Mini-Mental-State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Multivariable analyses were performed to evaluate the association between HRV and cognitive status. The mean age of study population was 59.5 ± 11.8 years and 39.3% were female. After adjusting for confounding factors, a higher high frequency (HF) norm was independently associated with better MMSE scores (β = 0.051; 95% confidence interval (CI): 0.012~0.090; p = 0.011) and MoCA scores (β = 0.061; 95% CI: 0.017~0.105; p = 0.007), while a higher low frequency (LF)/HF ratio was independently associated with worse MMSE scores (β = -0.492; 95% CI: -0.893~-0.092; p = 0.017) and MoCA scores (β = -0.691; 95% CI: -1.134~-0.248; p = 0.003). The HF norm was positively associated with global cognitive performance, whereas the LF/HF ratio was negatively associated with global cognitive performance among CSVD patients. Further study of the relationship between autonomic function and cognitive performance is warranted.