Montreal Cognitive Assessment Questionnaire Research Articles

Assessing the Impact of Frailty on Cognitive Function in Older Adults Receiving Home Care.

It is commonly accepted that frailty and dementia-related cognitive decline are strongly associated. However, degree of this association is often debated, especially in homebound elders with disabilities. Therefore, this study aimed to investigate the association of frailty on cognitive function in older adults receiving homecare. A screening for frailty and cognitive function was conducted at 12 primary healthcare settings of the nationally funded program "Help at Home" in Heraklion Crete, Greece. Cognitive function and frailty were assessed using the Montreal Cognitive Assessment questionnaire and the SHARE-f index, respectively. Barthel-Activities of Daily Living and the Charlson Comorbidity Index were also used for the identification of disability and comorbidity, respectively. The mean age of the 192 participants (66% female) was 78.04 ± 8.01 years old. In depth-analysis using multiple linear regression, revealed that frailty was not significantly associated with cognitive decline (frail vs. non-frail (B'=-2.39, p=0.246) even after adjusting for depression and multi-comorbidity. Importantly, as protective factors for cognitive decline progression and thus dementia development, was scientifically correlated with annual individual income >4500 (B'=2.31, p=0.005) -poverty threshold-compared to those with <4500 and, higher education level as compared to Uneducated (B'=2.94, p=0.019). However, depression was associated with cognitive decline regardless of socioeconomic variables. In conclusion, our results suggest that health professionals caring for frail people with cognitive impairment, must focus on early recognition and management of depression.

Screening for cognitive dysfunction in systemic lupus erythematosus: the Montreal Cognitive Assessment Questionnaire and the Informant Questionnaire on Cognitive Decline in the Elderly.

Cognitive dysfunction (CD) is among the most common neuropsychiatric manifestations of systemic lupus erythematosus (SLE). Traditional neuropsychological testing and the Automated Neuropsychologic Assessment Metrics (ANAM) have been used to assess CD but neither is an ideal screening test. The Montreal Cognitive Assessment Questionnaire (MoCA) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) are brief and inexpensive tests. This study evaluated the MoCA and IQCODE as screening tools. SLE patients fulfilling American College of Rheumatology (ACR) classification criteria were evaluated using the ANAM as the reference standard. The performance characteristics of the MoCA and IQCODE were assessed in comparison with normal controls (NCs) and rheumatoid arthritis (RA) patients. Four different definitions of CD were utilized. In total, 78 patients were evaluated. MoCA and ANAM scores were significantly correlated ( r = 0.51, p < 0.001). At the optimal cutoff, the sensitivity of the MoCA was ≥ 90% (depending on definition of CD) vs RA patients and ≥83% vs NCs. ANAM and IQCODE scores did not correlate ( p = 0.8152). IQCODE sensitivities were low for both RA patients and NCs regardless of definition and cutoff used. The MoCA appears to be a promising and practical screening tool for identification of patients with SLE at risk for CD.

A9796 Effect of Long-term Lifestyle Intervention on Mild Cognitive Impairment in Hypertensive Occupational Population in China

Objectives: The aim of this study was to analyze the effect of lifestyle intervention on blood pressure and cognitive function in occupational population with hypertension in China. Methods: Cluster sampling was conducted in September, 2013, in Shaanxi Jinduicheng (intervention group) and Shaanxi Hancheng (control group). The intervention group received regular lifestyle intervention for 2 years, which included diet, smoke, drink and exercise intervention. Mild cognitive impairment (MCI)was measured by the Montreal Cognitive Assessment (MoCA).We conducted BP measurement and MoCA questionnaire at baseline,6,12 and 24 months. Results: We analyzed a total of 510 subjects, whose average age was 45.6 ± 13.4 years old.With the increase of BP level, the MoCA scores decreased significantly both in control and lifestyle intervention groups (P < 0.05).There was no obvious differences between the hypertensive patients whose age was between 45 and 59 to those under 45 (P > 0.05).After 2 years, the BP,TC and glucose of the lifestyle intervention subgroup and lifestyle intervention plus medication subgroup decreased (P < 0.05), and the MoCA scores increased (P < 0.05). Compared with the control group, the BP and MoCA scores had no obvious changes at 6 months (P > 0.05), but the BP decreased and the MoCA scores increased significantly in the intervention group after 1 year and 2 years of lifestyle intervention (P < 0.05). Conclusion: Long-term lifestyle intervention can be used as adjunctive therapy to improve the blood pressure and cognitive function of hypertensive occupational population in China.

Effect of long-term lifestyle intervention on mild cognitive impairment in hypertensive occupational population in China.

Background:The incidence of hypertension in China is high, which seriously affects people's health, including occupational population in mining areas. Cognitive dysfunction has a serious impact on the work and life of patients. Lifestyle intervention can improve diabetes and cardiovascular diseases. However, there are few studies on the effects of lifestyle interventions on cognitive function in hypertensive patients. So the aim of this study was to analyze the effect of long-term lifestyle intervention on mild cognitive impairment in hypertensive occupational population in China.Methods:In September 2013, a cluster sampling was conducted for the workers in the Shaanxi Jinduicheng (intervention group) and Hancheng (control group) mining areas. In both groups, according to the blood pressure (BP) level, they were divided into hypertension stage 1 to 3 subgroups; according to their age, they were divided into between 45 and 59 and under 45 years subgroups; and according to whether or not taking medicine, they were divided into Lifestyle intervention, Lifestyle intervention plus medication, Medication, and No lifestyle intervention nor medication subgroups. The intervention group received regular lifestyle intervention for 2 years, which included diet, smoke, drink, and exercise intervention. Mild cognitive impairment was measured by the Montreal Cognitive Assessment (MoCA). The arterial stiffness was measured by Omron Automatic Atherosclerosis Tester. We conducted BP measurement and MoCA questionnaire at baseline, 6, 12, and 24 months.Results:We analyzed a total of 510 mine workers, whose average age was 45.6 ± 13.4 years old. With the increase of BP level, the MoCA scores decreased significantly both in control and lifestyle intervention groups (P < .05). There was no obvious difference between the hypertensive patients whose age was between 45 and 59 to those under 45 in MoCA scores (P > .05). After 2 years, the BP, total cholesterol, glucose, and brachial-ankle pulse wave velocity of the Lifestyle intervention subgroup and Lifestyle intervention plus medication subgroup decreased (P < .05), and the MoCA scores and ankle-brachial index increased (P < .05), and the latter improved more significantly. Compared with the No lifestyle intervention nor medication subgroup, the BP and MoCA scores had no obvious changes at 6 months (P > .05), but the BP decreased and the MoCA scores increased significantly in the Lifestyle intervention and Lifestyle intervention plus medication subgroups after 1 and 2 years of lifestyle intervention (P < .05).Conclusion:Long-term lifestyle intervention can be used as adjunctive therapy to improve the BP and cognitive function of hypertensive occupational population in China.

Use of the EMPOWER brochure to deprescribe sedative-hypnotic drugs in older adults with mild cognitive impairment

BackgroundEvidence-based mailed educational brochures about the harms of sedative-hypnotic use lead to discontinuation of chronic benzodiazepine use in older adults. It remains unknown whether patients with mild cognitive impairment (MCI) are able to understand the information in the EMPOWER brochures, and whether they achieve similar rates of benzodiazepine discontinuation.MethodsPost-hoc analysis of the EMPOWER randomized, double-blind, wait-list controlled trial that assessed the effect of a direct-to-consumer educational intervention on benzodiazepine discontinuation. 303 community-dwelling chronic users of benzodiazepine medication aged 65–95 years were recruited from general community pharmacies in the original trial, 261 (86%) of which completed the trial extension phase. All participants of the control arm received the EMPOWER brochure during the trial extension. Normal cognition (n = 139) or MCI (n = 122) was determined during baseline cognitive testing using the Montreal Cognitive Assessment questionnaire. Changes in knowledge pre- and post-intervention were assessed with a knowledge questionnaire and changes in beliefs were calculated using the Beliefs about Medicines Questionnaire. Logistic regression was used to compare knowledge gained, change in beliefs and benzodiazepine cessation rates between participants with and without MCI.ResultsComplete discontinuation of benzodiazepines was achieved in 39 (32.0% [24.4,40.7]) participants with MCI and in 53 (38.1% [30.5,46.4]) with normal cognition (adjusted OR 0.79, 95% CI [0.45–1.38]). Compared to individuals with normal cognition, MCI had no effect on the acquisition of new knowledge, change in beliefs about benzodiazepines or elicitation of cognitive dissonance.ConclusionsThe EMPOWER brochure is effective for reducing benzodiazepines in community-dwelling older adults with mild cognitive impairment.Trial registrationOur ClinicalTrials.gov identifier is NCT01148186, June 21st 2010.

Sleep Quality and Cognitive Impairment in Patients with Parkinson’s Disease in Iran

Ad dress for Cor res pon den ce/Ya z›fl ma Ad re si: Seyed Mehran Homam MD, Islamic Azad University Faculty of Medicine, Mashhad branch, Department of Neurology, Mashhad, Iran Phone: +989153137889 E-mail: mmazloomfarsibaf@yahoo.com Re cei ved/Ge lifl Ta ri hi: 04.02.2016 Ac cep ted/Ka bul Ta ri hi: 04.07.2016 ©Turkish Journal of Neurology, Published by Galenos Publishing House. This article is distributed under the terms of the “Creative Commons Attribution NonCommercial 4.0 International Licence (CC BY-NC 4.0)”. Objective: To evaluate the cognitive status and sleep quality and their association in patients with Parkinson’s disease (PD). Materials and Methods: In this analytical cross-sectional study, 120 patients with PD were selected from 22-Bahman and 17-Shahrivar hospitals. Demographic information was recorded on a form and Parkinson’s severity was determined using the Hoehn and Yahr scale (HY). Pittsburgh Sleep Quality Index (PSQI) and Epworth sleepiness scale (ESS) were used for the assessment of sleep quality and excessive daytime sleepiness, respectively. Cognitive status was assessed using the Montreal Cognitive Assessment questionnaire. Results: The mean age of patients with PD was 65.9±11.7 years, and 67.5% were men. Cognitive impairment was found in 113 (94.2%) patients, poor sleep quality in 87 (72.5%), and excessive daytime sleepiness in 27 (22.5%) patients. The mean PSQI and ESS scores were 9.03±4.70 and 7.38±3.73, respectively. There was a significant association between cognitive status and sleep quality, as well as daytime sleepiness (independent sample t-test, p<0.0001 for both). Conclusion: There is a significant association between cognitive impairment and poor sleep quality as well as excessive daytime sleepiness.

Lower cognitive performance in healthy G2019S LRRK2 mutation carriers

To assess cognitive abilities of healthy first-degree relatives of Ashkenazi patients with Parkinson disease (PD), carriers of the G2019S mutation in the LRRK2 gene. In this observational study, 60 consecutive healthy first-degree relatives (aged 50.9 ± 6.2 years; 48% male; 30 G2019S carriers) were assessed using a computerized cognitive program, the Montreal Cognitive Assessment questionnaire, the Unified Parkinson's Disease Rating Scale Part III, and the Geriatric Depression Scale. G2019S carriers scored significantly lower on the computerized executive function index (p = 0.04) and on specific executive function tasks (Stroop test, p = 0.007). Carrying the LRRK2 G2019S mutation was associated with lower executive performance in a population at risk for PD.

The Effect of Cognitive Behavioral Therapy and Changes of Depressive Symptoms Among Thai Adult HIV-Infected Patients

Background: In Thailand, the therapeutic effect of cognitive behavioral therapy (CBT) for depression among adult HIV-infected patients has been limitedly studied. Objectives: To determine the association of CBT and changes of de-pression both immediately post treatment and at 3-month post-treatment.Materials and Methods: A prospective cohort study was conducted at the University Hospital in Thailand. Forty and eighty HIV-infected adults who voluntarily received and did not receive CBT were recruited from the immunology clinic and sexually transmitted diseases clinic between September 2010 and February 2011. Sociodemographic characteristics and medical histories of the participants were collected. A standard Thai Depression Inventory (TDI) was used for evaluation of depressive symptoms. TDI score of 21 or above was interpreted as depression. Other questionnaires included a Montreal Cognitive Assessment questionnaire, standard questionnaire for evaluating life stress event and questionnaire for HIV social support. Results: The mean ages of participants were 44.8 and 43.4 years in the CBT and non-CBT groups respectively. In both group, about half of the subjects were females. Life stress event score in CBT group was significantly higher than the non-CBT group (p <0.01). At baseline, the mean TDI scores of the CBT group and non-CBT group were 26.7 and 25.3 respectively. After adjustment for age, gender, social support, life stress event and current opportunistic infection; the mean changes of TDI scores in the CBT group were significantly higher than the non-CBT group both immediately [12.13 (95%CI ,10.00 -14.26)] (p <0.001) and at 3-month post-treatment [15.94 (95%CI, 13.69-18.18)] (p < 0.001). Conclusion: CBT is beneficial for treatment of depression among adult HIV-infected patients in Thailand. The beneficial effect of CBT was not only immediate but also sustained at 3-month post-treatment.