Total MMSE Scores Research Articles

Efficacy and safety of ginkgo biloba extract combined with donepezil hydrochloride in the treatment of Chinese patients with vascular dementia: A systematic review meta-analysis.

Objective: To conduct a meta-analysis of the effectiveness and safety of ginkgo biloba extract combined with donepezil hydrochloride vs. donepezil for the treatment of vascular dementia (VaD). Methods: Four English databases (PubMed, EMBASE, Web of Science, Cochrane Library) and four Chinese databases [the China National Knowledge Infrastructure Wanfang DATA, the Chongqing VIP Database (VIP), China Biomedical Database (CBM)] were manually searched for literature published from dates of the inception of the databases to September 2023. The randomized controlled trials (RCTs) of ginkgo biloba extract with donepezil hydrochloride vs. donepezil for the treatment of VaD were included. Relevant literature was screened, and the data in the included studies were extracted for quality assessment according to the Risk of bias tool. Results: A total of 1,309 participants were enrolled in the 15 RCTs. Of these, 656 participants were in the experimental group (ginkgo biloba extract combined with donepezil) and 653 participants were in the control group (donepezil).The results showed that combination therapy was superior to donepezil alone, and there were statistically significant differences in several outcomes including RR in change for total effective rate (1.28, 95% confidence intervals 1.20, 1.38, p < 0.001), MD in change for Mini-Mental State Examination score (2.98, 95%CI 2.31, 3.65, p < 0.001), Barthel Index score (8.55,95%CI 1.11, 15.99, p = 0.024), Activity of Daily Living Scale (ADL)score (10.11,95% CI 7.16,13.07,p < 0.001). Conclusion: Ginkgo biloba extract combined with donepezil dramatically improved the total effective rate, MMSE, BI and ADL scores, and decreased homocysteine (HCY), plasma viscosity (PV), whole blood viscosity at high cut (BVH) and whole blood viscosity at low cut (BVL) in VaD patients, while the effect on mean flow velocity and pulse index (PI) of middle cerebral artery (MCA) is not obvious. However, more relevant high-quality RCTs are needed to validate these results. Systematic Review Registration: Identifier CRD42023474678.

Brain age as a biomarker for pathological versus healthy ageing – a REMEMBER study

ObjectivesThis study aimed to evaluate the potential clinical value of a new brain age prediction model as a single interpretable variable representing the condition of our brain. Among many clinical use cases, brain age could be a novel outcome measure to assess the preventive effect of life-style interventions.MethodsThe REMEMBER study population (N = 742) consisted of cognitively healthy (HC,N = 91), subjective cognitive decline (SCD,N = 65), mild cognitive impairment (MCI,N = 319) and AD dementia (ADD,N = 267) subjects. Automated brain volumetry of global, cortical, and subcortical brain structures computed by the CE-labeled and FDA-cleared software icobrain dm (dementia) was retrospectively extracted from T1-weighted MRI sequences that were acquired during clinical routine at participating memory clinics from the Belgian Dementia Council. The volumetric features, along with sex, were combined into a weighted sum using a linear model, and were used to predict ‘brain age’ and ‘brain predicted age difference’ (BPAD = brain age–chronological age) for every subject.ResultsMCI and ADD patients showed an increased brain age compared to their chronological age. Overall, brain age outperformed BPAD and chronological age in terms of classification accuracy across the AD spectrum. There was a weak-to-moderate correlation between total MMSE score and both brain age (r = -0.38,p < .001) and BPAD (r = -0.26,p < .001). Noticeable trends, but no significant correlations, were found between BPAD and incidence of conversion from MCI to ADD, nor between BPAD and conversion time from MCI to ADD. BPAD was increased in heavy alcohol drinkers compared to non-/sporadic (p = .014) and moderate (p = .040) drinkers.ConclusionsBrain age and associated BPAD have the potential to serve as indicators for, and to evaluate the impact of lifestyle modifications or interventions on, brain health.

239 The Influence of Apolipoproteins E Gene Polymorphism on Cognitive Outcome in Patients with Moderate Degree Diffuse Brain Injuries

INTRODUCTION: APO-lipoproteins have a primary role in solubilizing and transporting lipids across cell membranes. APO-lipoprotein E isoform 4 (among APOE ε 1,2,3,4) is least efficient in clearing Aβ protein from the brain and is considered as a risk factor for Alzheimer disease. METHODS: After institutional ethics committee clearance, a prospective cohort study was done from 2017 to 2021 on adult patients who sustained moderate degree diffuse brain injury. APOE gene analysis were carried out on them. Patients who went on to subsequently develop focal lesions, those who died or were lost to follow up were excluded. Fifty consecutive patients who fulfilled the criteria, subsequently participate in a Mini Mental State Examination at the end of 1 month and 3 months were analysed. RESULTS: In our study, the allele frequencies for APOE gene ɛ2, ɛ3, ɛ4 were 36%, 53%, 11%, respectively. Patients were categorized into group A (who had at least one APOE ɛ4 allele) and group B (who did not have any APOE ɛ4 allele). In our study patients in group A had a prolonged hospitalisation and increased risk of convulsion than group B. The lack of improvement in MMSE scores (language and praxis subdomains) in group A as compared to group B after 3 months was statistically significant. The difference between the two groups in the rest of subdomains (attention, calculation, memory, orientation) and total MMSE scores at 3 months compared to that at discharge were insignificant. CONCLUSIONS: The presence of the APOE ɛ4 allele affects language and praxis during recovery. It increases the risk of post-traumatic seizures and increases the length of hospital stay but does not have a significant outcome on overall cognition after a course of 3 months.

Comparative characteristics of neuropsychological and neurometabolic changes in patients with Alzheimer's disease and vascular cognitive impairment

To investigate the pattern and connections of neuropsychological and metabolic indices in patients with cognitive disorders of Alzheimer's and vascular (subcortical-cortical) types of different severity. A total of 177 patients were examined, including 85 patients with Alzheimer's disease (AD) and 92 patients with vascular cognitive impairment (VCI). All patients underwent complex neuropsychological examination; 18F-FDG PET was performed in 17 patients with AD and 15 patients with VCI. The greatest changes in patients with AD were noted in the mnestic sphere, and the indicators significantly differed from the results of the study of patients with VCI already at the pre-dementia stage. Neurodynamic and dysregulatory disorders prevailed in patients with VCI. Patients with AD showed bilateral symmetrical reduction of metabolic activity in the cortex of parietal and temporal lobes, often in combination with marked hypometabolism in the hippocampal region. In patients with VCI, there were areas of decreased brain tissue metabolism of different localization and size, mainly in the projection of the basal ganglia and in the prefrontal and parietal cortex, as well as in the cingulate gyrus, which indirectly confirms the mechanism of disconnection of subcortical and cortical structures. In AD, impaired metabolic activity in the hippocampal region correlated with impaired temporal and spatial orientation (ρ=-0.54, p<0.05), memory impairment (ρ=-0.71, p<0.005). Hypometabolism of the parietal lobe cortex was associated with total MMSE score (ρ=-0.8, p<0.001), 10-word test (ρ=-0.89, p<0.001 and ρ=-0.82, p<0.001), visual-spatial impairment (ρ=-0.64, p<0.01), categorical association test (ρ=-0.73, p<0.005). In patients with VCI, dysregulatory disorders correlated with hypometabolism in the thalamic projection (ρ=-0.56, p<0.05), prefrontal cortex (ρ=-0.64, p<0.05) and in the cingulate gyrus (anterior regions) (ρ=-0.53, p<0.05). The results indicate the presence of differences in cognitive impairment and cerebral metabolism in patients with AD and VCI.

STUDY OF INTER-RELATIONSHIP BETWEEN QUALITY OF LIFE AND COGNITION IN PEOPLE WITH EPILEPSY CROSS SECTIONAL STUDY FROM NORTH COASTAL ANDHRA PRADESH

Objective: To study the Inter – relationship between Quality of life and Cognitive dysfunction in People with Epilepsy and to identify the factors that influence Cognition and QOL in PWE. Methods: We analyzed the factors that were independently associated with QOLIE-31, MMSE and MOCA scores which included demographic and clinical variables using Chi square, ANOVA and Multivariate regression analysis. Pearson coefficient calculator to know the interrelationship between QOLIE-3 scores, MMSE and MOCA. Results: We found a significant association between polytherapy, TLE and LRE with QOLIE-31 scores (p value being 0.0007 and &lt;0.00001 respectively). We found a significant association between low MMSE scores and long duration of epilepsy more than 6 years( p: 0.001 and 0.002), statistically highly significant association when compared with TLE and LRE (p: 0.000). However MOCA showed strong positive correlation with QOLIE-31 scores when compared with MMSE. We found a moderate positive correlation with r value being 0.6 and a significant p value being &lt;0.0001. Correlation between MOCA and QOLIE 31 score showed a significant positive correlation with an r value of 0.7 and a P value of &lt;0.0000. Correlation between total MMSE and MOCA scores showed a significant positive correlation of r value being 0.8, p value being 0.000. Conclusion: Polytherapy, Long duration of Epilepsy, Temporal Lobe and other Focal Epilepsies, Poor Quality of Life standards are all independent factors determining the Cognitive dysfunction. There seems to be bidirectional relationship between Quality of Life and Cognitive dysfunction. MOCA seems to be superior to MMSE for Neurocognitive screening in PWE.

Association of Hand Grip Strength with Mild Cognitive Impairment in Middle-Aged and Older People in Guangzhou Biobank Cohort Study.

Background: Lower hand grip strength has been linked to cognitive impairment, but studies in older Chinese are limited. We examined the association of hand grip strength with cognitive function in a large sample of older Chinese. Methods: 6806 participants aged 50+ years from the Guangzhou Biobank Cohort Study (GBCS) were included. Relative grip strength was calculated by absolute handgrip strength divided by the body mass index (BMI). Cognitive function was assessed using the Delayed Word Recall Test (DWRT, from 0 to 10) and the Mini Mental State Examination (MMSE, from 0 to 30), with higher scores indicating better cognition. Results: After adjusting for multiple potential confounders, lower absolute grip strength and relative grip strength were significantly associated with lower DWRT (all p < 0.05) in all participants. No significant interaction effects between sex and handgrip strength on cognitive impairment were found (p from 0.27 to 0.87). No significant association between handgrip strength and total MMSE scores was found in the total sample or by sex (p from 0.06 to 0.50). Regarding the individual components of MMSE, lower absolute and relative grip strength were significantly associated with lower scores of the recall memory performance in all participants (p from 0.003 to 0.04). Conclusion: We have shown for the first time a positive association of grip strength with recall memory performance, but not general cognitive function in older people, which warrants further investigation.

541 - MRI-BASED MEASUREMENT OF HIPPOCAMPAL VOLUME IN PATIENTS WITH DEMENTIA

Background:Dementia due to probable Alzheimer’s disease (AD) represents between 60 and 80% of all dementias. The total number of estimated AD cases worldwide by 2030 is 65.7 million and 115.4 million by 2050; this represents a twofold population increase in the next 20 years.Magnetic resonance imaging (MRI) has been the primary tool of interest to link hippocampal volume loss with dementia firmly.MRI-based volumetry has been proposed as a promising biomarker.Hippocampal volumetry is useful in discriminating not only cognitively normal individuals from those with dementia but can also differentiate Mild Cognitive Impairment (MCI) from various types of dementia.Research objective:To measure hippocampal volume in various types of dementia. (MMSE) and Activities of daily living (ADL) in patients with dementia.Method:A cross-sectional study conducted for period of one year among 21 patients with Alzheimer’s, vascular dementia, amnestic mild cognitive impairment and 20 healthy age matched controls. MMSE scale was used to stratify patients on cognitive function impairments. ADL scale to assess functional status of the patient ability to perform activities of daily living independently in diverse settings. Hippocampal volume measured using MRI 1.5 T Philips Ingenia, a coronal T1-weighted FFE (Fast Field Echo) 3D sequence.Results:Total Hippocampal volume was reduced by 35% in Alzheimer’s disease, 27% in vascular dementia and 10% in amnestic mild cognitive impairment, compared with control groupConclusions:Moderate positive correlation between mean total hippocampal volume and MMSE scores in patients with dementia which was statistically significant. (P value= 0.001).

Comparison of Behavior-Related Features in the MMSE Sentence in Behavioral Variant Frontotemporal Dementia and Alzheimer's Disease.

Background: Despite the ubiquity of cognitive assessments using the MMSE, there has been little investigation of currently unscored features of the MMSE sentence item relevant to behavior and language in patients with behavioral variant Frontotemporal Dementia (bvFTD) and Alzheimer’s disease (AD).Objective: To describe and compare the unscored content and grammar elements of the MMSE sentence item in patients with bvFTD and AD.Methods: Categorization of predefined content and grammar elements of the MMSE sentence was performed by two blinded raters in patients with bvFTD (n = 74) and AD (n = 84). Chi-square and ANCOVAs were conducted to identify differences between the diagnostic groups. A multinomial logistic regression analysis was conducted to determine whether these features aid in the prediction of diagnosis of bvFTD or AD.Results: A higher proportion of patients with bvFTD wrote sentences addressed to the examiner (22.7% vs. 4.7%, X2 = 11.272, p = 0.001) and about interpersonal relationships (35.3% vs. 16.0%, X2 = 10.139, p = 0.017) in comparison to those with AD. The number of words written was lower in patients with AD and was positively correlated with lower total MMSE scores in AD but not in bvFTD (AD: r = 0.370, p < 0.001; FTD: r = 0.209, p = 0.07). Assessment of the MMSE sentence content and grammar variables did not add to the prediction bvFTD or AD diagnosis beyond the variance explained by age and total MoCA score.Conclusions: Patients with bvFTD and AD showed differences in aspects of the content of the written MMSE sentence item, though these differences did not aid in the diagnosis prediction.

Influence of education level on MMSE and MoCA scores of elderly inpatients

Objective The purpose of this study was to investigate the influence of education level on MMSE and MoCA scores of elderly inpatients. Method This is a cross-sectional study. A total of 260 elderly inpatients were evaluated by the MMSE and MoCA sequentially. Results The total MMSE scores were highly correlated with the total MoCA scores (r = 0.7629, p < 0.0001), and were correlated with the length of education (r = 0.2723, p < 0.0001). The total MoCA scores were also correlated with the length of education (r = 0.3323, p < 0.0001). Meanwhile, MoCA was also used to reevaluate the elderly inpatients with normal MMSE scores at different education levels. There were no significant differences at different education levels (χ 2=1.351, p = 0.5090). Finally, we analyzed the diagnostic consistency of MMSE and MoCA at different education levels, and the results showed that education level was closely related to the consistency of the diagnoses based on the MMSE and MoCA (χ 2=10.23, p = 0.0368). Conclusions In general, the results of both the MMSE and MoCA were influenced by education level, and this effect was more obvious for the MoCA. However, in the cognitive assessment of elderly patients, the ability to identify impairment with the MoCA is obviously superior to that with the MMSE.

Impact of depression on mental fatigue and attention in patients with multiple sclerosis

• Depression and fatigue had a great impact on cognition in patients with MS. • Patients with MS had severe fatigue and depression irrespective of disease duration. • Mental fatigue was strongly correlated with depression. • As depression became more severe, mental and physical fatigue increased. Abstract 1 1 Abbreviations BDI, Beck Depression Inventory; CFS, Chalder Fatigue Scale; EDSS, Expanded Disability Status Scale; HC, Health control subjects; MMSE, Mini-Mental State Examination MS, Multiple sclerosis; PASAT, Paced Auditory Serial Addition Test; QoL, Quality-of-life SD, Standard deviation; SDMT, Symbol Digit Modalities Test; VC, Visual cancellation; Depression and fatigue are debilitating symptoms in multiple sclerosis (MS), which affect cognitive function. This study investigated the association between depression and fatigue, and whether depression or fatigue influences cognition in MS patients. Twenty MS patients were included. The severity of fatigue was assessed using the Chalder Fatigue Scale (CFS), which classified CFS_Physical and CFS_Mental fatigue and MMSE. Depression was assessed using the Beck Depression Inventory (BDI). Attention deficit was evaluated using several tasks. The CFS scores, the BDI scores and performance during the attention tasks were compared between MS patients and healthy control subjects (HCs). Correlations between CFS sub-scores, BDI values, and participants’ attention performance were also investigated. The total CFS, BDI, and MMSE scores were significantly worse in MS patients compared to HCs ( p < 0.05). The CFS_Mental sub-score was significantly correlated with performance on attention tasks ( p < 0.05). MS patients with severe depression exhibited the worst scores on attention tests and significantly higher CFS_Mental sub-scores than the remaining MS patients and HCs. The BDI scores of MS patients with severe depression correlated with disease duration. In the remaining MS patients, attention tests and BDI scores did not differ significantly from those in HCs. This study had a small sample size, which limits generalization. Premobid cognitive functions were not matched. Mental fatigue is closely associated with attention deficit. Depression affects mental fatigue and attention in MS patients.

MO140INDOXYL SULFATE INDUCES THE APOPTOSIS OF THE DIFFERENTIATING NEURONS BY ENHANCING OXIDATIVE STRESS AND CLINICAL COGNITIVE IMPAIRMENT

Abstract Background and Aims Indoxyl sulfate (IS) is a protein-bounded uremic toxin involving the multi-organ dysfunction, including neurologic system. It has been noticed that IS could induce the oxidative stress within brain by activating the inflammation mediated by astrocyte, and its concentration was associated with cognitive impairment. It has been noticed that the neuronal progenitor cells with differentiating abilities could replace the damaged neuron. The damage of IS on the progenitor cells with differentiating ability is still lacking. The aim of the study is to investigate the IS mediated cell damage on differentiating neuronal progenitor cells Method The study was divided into 2 parts: clinical investigation and in vitro study. The clinical investigation collected 36 participants (12 health controls and 24 ESRD patients with cognitive impairment by MMSE&amp;lt;=24). The in vitro study used the human neuroblastoma cell line SH-SY5Y cells with differentiating protocol by retinoic acid (RA, with concentration 10%). Indoxyl sulfate was given at concentration at 0, 25, 50 and 100μM at initiation of retinoic acid given and the 7 days after retinoic acid was given. Microscopic morphology, MTT assay, annexin V-PI dual stain, and western blotting for cleaved-caspase 3, Bax, Bcl-2 and oxidative stress (DCFCA) were measured. Results Among the 36 participants, the concentration of IS was higher in the ESRD patients with cognitive impairment (43365.26±24291.55 vs 5212.00±14621.82 mg/dL, p=0.00). The serum concentration of IS was negatively correlated with the total MMSE score (r=-0.446, p=0.006) and the categories of MMSE (orientation to time: r=-0.537, p=0.001, calculation: r=-0.541, p=0.001; recall: r=-0.402,p=0.014). In in vitro study, the cell viability was not influenced in undifferentiated and differentiated (retinoic acid treated for 7 days) SH-SY5Y cells. When IS during the initiation of RA treatment, the cell viability decreased 3 hours after IS was given. The annexin-V-PI dual stain demonstrated that the early apoptotic cells with annexin-V stained increased in IS treated cell with dose-dependent manner. The caspase 8 and cleaved caspase 3 increased at 6 hours after IS treated when RA given. The Bax increased after IS treated at 6 hours. The Bax/Bcl2 ratio increased at the IS concentration 50μM. The DCFCA increased after IS treated at 1 hour with dose-dependent manner, and the cell viability was rescued by N-acetylcystein. Conclusion The serum IS was negatively correlated the MMSE and predictive to cognitive impairment in our cohort with 36 participants (12 health control and 24 ESRD patients with MMSE &amp;lt;=24). The in vitro study demonstrated that IS induced differentiating SH-SY5Y cells apoptosis by activating caspase-dependent cell death after generating oxidative stress.

Increased Plasma Heme Oxygenase-1 Levels in Patients With Early-Stage Parkinson's Disease.

Introduction: Heme oxygenase-1 (HO-1) is a 32 kDa stress-response protein implicated in the pathogenesis of Parkinson’s disease (PD). Biliverdin is derived from heme through a reaction mediated by HO-1 and protects cells from oxidative stress. However, iron and carbon monoxide produced by the catabolism of HO-1 exert detrimental effects on patients with PD. The purpose of this study was to determine whether plasma HO-1 levels represent a biomarker of PD and to further explore the underlying mechanism of increased HO-1 levels by applying voxel-based morphometry (VBM).Methods: We measured plasma HO-1 levels using an enzyme-linked immunosorbent assay (ELISA) in 156 subjects, including 81 patients with early- and advanced-stage PD and 75 subjects without PD. The analyses were adjusted to control for confounders such as age, sex, and medication. We analyzed T1-weighted magnetic resonance imaging (MRI) data from 74 patients with PD using VBM to elucidate the association between altered brain volumes and HO-1 levels. Then, we compared performance on MMSE sub-items between PD patients with low and high levels of HO-1 using Mann-Whitney U tests.Results: Plasma HO-1 levels were significantly elevated in PD patients, predominantly those with early-stage PD, compared with controls (p < 0.05). The optimal cutoff value for patients with early PD was 2.245 ng/ml HO-1 [area under the curve (AUC) = 0.654]. Plasma HO-1 levels were unaffected by sex, age, and medications (p > 0.05). The right hippocampal volume was decreased in the subset of PD patients with high HO-1 levels (p < 0.05). A weak correlation was observed between right hippocampal volume and plasma HO-1 levels (r = −0.273, p = 0.018). There was no difference in total MMSE scores between the low- and high-HO-1 groups (p > 0.05), but the high-HO-1 group had higher language scores than the low-HO-1 group (p < 0.05).Conclusions: Plasma HO-1 levels may be a promising biomarker of early PD. Moreover, a high plasma concentration of the HO-1 protein is associated with a reduction in right hippocampal volume.

Is Qi Fu Yin effective in clinical treatment of dementia?: A meta-analysis of 697 patients.

Background:Dementia, a kind of acquired and progressive intelligence-damaging syndrome, is induced by cerebral dysfunction. Ancient records show that Qi Fu Yin (QFY) has the advantages in age-related dementia treatment. This study aims to evaluate therapeutic efficacy of QFY on dementia through meta-analysis.Methods:We comprehensively reviewed articles from various databases, including China National Knowledge Infrastructure (CNKI), Wanfang, VIP, Chinese Biomedical Literature (CBM), PubMed, and Web of Science published before June 2020, for all randomized controlled trials (RCTs) on dementia treatment with QFY. Then, we selected eligible literatures, extracted related data, and assessed risk of bias. Forest plots of total clinical effective rate, MMSE score, HDS score and ADL score illustrated the difference between the experimental group (treatment with QFY alone or combined with routine western medicine) and the control group (treatment with routine western medicine only). Random effects model and fixed effects model were adopted. Finally, publication bias was further analyzed using funnel plot, sensitivity analysis, Begg and Egger test.Results:Finally, 9 RCTs, involving 697 patients, were included in this study. The results revealed that the total clinical effective rate of the experimental group was obviously higher than that of the control group (OR = 0.33, 95% CI [0.22, 0.50], P < .001). In comparison with the control group, the experimental group showed higher MMSE score (WMD = 2.60, 95% CI [2.16, 3.03], P < .001) and HDS score (WMD = 1.51, 95%CI [1.10, 1.92], P < .001). Due to few included studies, there were no statistically significance between experimental and control groups (WMD = -9.90, 95%CI [−26.09, 6.30], P = .231) regarding ADL score. In addition, there is no publication bias towards clinical effective rate and MMDE score.Conclusions:QFY only or combined with western medicine therapy can significantly improve cognitive ability compared with only western medicine therapy in dementia. However, multiple samples, RCTs of high quality are still needed to verify our conclusions.

Clinical Correlation of Cerebrospinal Fluid Total tau Levels and MMSE Score in a memory clinic

Tau protein levels in cerebrospinal fluid are a biomarker of Alzheimer’s disease. We correlated MMSE severity to CSF tau levels in a large memory clinic sample. We retrospectively analyzed data from patients attending a memory clinic in the south shore of Boston from 2010 to 2020, and had a lumbar puncture to obtain CSF Tau levels. We compiled cognitive screen data from MMSE scores. Univariate analyses used Spearman correlation as data were non-normal. A multivariate model was created including covariates of age, sex, and race. 965 patients attended the memory clinic from 2010 to 2020. 711 had available MMSE scores. 129 subjects had lumbar punctures and available CSF tau levels. Univariate analyses showed that cognition as measured by MMSE total was not correlated to total tau levels in the CSF (rho=-0.07, p>0.05), but caucasian race was inversely associated with CSF tau levels (rho= -0.217, p<0.05). In a multivariate model, tau levels in the CSF were not associated with MMSE, race, gender, or age. In a large memory clinic sample, CSF tau levels did not correlate to MMSE scores, age, race or gender.

Cerebrospinal fluid amyloid status and affective symptoms in mild cognitive impairment

AbstractBackgroundAffective and cognitive symptoms are common in old age, and frequently overlap in clinical practice. Mild cognitive impairment (MCI), for example, is a risk state for later dementia where neuropsychiatric symptoms such as depression and anxiety are common. The exact nature of this overlap remains unclear ‐ affective symptoms may be both causative of cognitive issues, they may be related to an underlying neurodegenerative disease, or may stem from common risk factors. Biomarkers of brain diseases such as Alzheimer’s can help determine the etiology of MCI and aid in predicting the risk of progression to dementia.AimsTo determine whether CSF‐based amyloid positive and amyloid negative individuals with MCI differ in the nature and prevalence of affective symptoms.MethodAn existing database of 476 individuals with MCI will be used. All subjects underwent extensive cognitive and behavioural assessment at baseline and follow‐up (up to 7 years). Behaviour was assessed covering a period of 2 weeks prior to inclusion and at each follow‐up visit using a battery of behavioural assessment scales: Middelheim Frontality Score (MFS), Behave‐AD, Cohen‐Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia and Geriatric Depression Scale (30 items). In a significant subgroup of these patients, the standard AD CSF biomarkers (Aβ, T‐tau, P‐tau181) have been analysed. We will evaluate whether subgroups with differing amyloid status (i.e. normal vs. abnormal CSF biomarkers) are significantly different in the nature and prevalence of affective symptoms as determined by several scales (Behave‐AD, Geriatric Depression Scale, Cornell Scale for Depression in Dementia).ResultsWe will compare prevalence, nature and severity of affective symptoms between subgroups of MCI patients (amyloid positive versus amyloid negative; AD CSF biomarker profile suggestive for AD versus not suggestive for AD). Presence and severity of affective symptoms will be related to (rate of) cognitive decline using neuropsychological data (e.g. yearly decline of total MMSE score).ConclusionWe expect to find more (severe) affective symptoms in MCI due to AD (as compared to MCI not due to AD) and to find an association between these symptoms and rate of cognitive decline. The results will be presented at AAIC 2020 in Amsterdam.

Relationship between subjective memory complaint and executive function in a community sample of South Korean elderly.

The aim of this study was to investigate the association between subjective memory complaint (SMC) and executive function in a community sample of South Korean elderly. Data for 1442 non-cognitive impaired elderly individuals aged 65 and over were selected from a nationwide dementia epidemiological study conducted in South Korea. Global cognitive function was assessed by the Korean version of the Mini-Mental State Examination (MMSE-KC). The registration and recall subscales of the MMSE were used for evaluating memory function. Executive function was measured by using the Initiation/Perseveration (IP) subscale of the Korean dementia rating scale (K-DRS). Of the 1442 participants, 1088 were in the normal control group and 354 were in the SMC group. In the SMC group, compared to the normal control group, the proportion of depression was significantly higher, total MMSE scores, delayed recall score and total IP scores were significantly lower, and the mean scores of complex/simple verbal IP, alternating movements, and graphomotor design were lower. In the unadjusted linear regression model, the SMC significantly associated with a lower score of total MMSE-KC, MMSE delayed recall, K-DRS IP, complex/simple verbal IP, alternating movements and graphomotor design. After adjusting for age, gender, education, marital status, alcohol consumption, smoking behaviour, and depression, the SMC were significantly associated with lower total MMSE score, MMSE delayed recall, K-DRS IP, and K-DRS complex/simple verbal IP. In this population-based sample, individuals with SMC had evidence of lower performance on global cognition, memory function, and executive function, especially verbal fluency, after adjusting for demographic variables and depression.

The effect of combined scalp acupuncture and cognitive training in patients with stroke on cognitive and motor functions.

To investigate the effect of combined scalp acupuncture and cognitive training on cognitive and motor functioning in patients with stroke during the recovery stage. Seventy patients with post-stroke cognitive impairment were randomly divided into an experimental group and a control group. Patients in the experimental group additionally received scalp acupuncture and cognitive training, while the control group received sham scalp acupuncture and cognitive training. The cognitive and motor functioning of all patients were assessed using MMSE, LOTCA, and FMA, before and 12 weeks after treatment. In addition, the plasma BDNF and NGF levels were measured from peripheral blood samples using ELISA kits. After 12 weeks, the MMSE, LOTCA and FMA scores were significantly higher in the experimental group than in the control group. In the experimental group, there was an improvement in the total MMSE score, orientation, spatial executive function, the total LOTCA score, and the score of command of language orientation post-treatment. Significant improvements of BDNF and NGF were found in the experimental group after treatment, while only significant improvements of NGF was found in the control group after treatment. Both BDNF and NGF in the experiment group were higher than those in the control group at the last day of treatment. Combined scalp acupuncture and cognitive training can efficiently enhance cognitive and motor functions in patients with stroke during the recovery stage, which may be a more effective rehabilitation treatment after stroke than routine therapy and rehabilitation training alone.

VASCULAR RISK FACTORS AND COGNITIVE FUNCTIONS IN THE PATIENTS WITH CEREBROVASCULAR DISEASE

The aim: To assess the severity of cognitive impairment (CI) in patients with cerebrovascular disease (CVD) depending on the number of vascular risk factors (VRF). Materials and methods: The study consisted of five hundred and eighty patients with CVD (247 females and 333 males) aged from 45 to 89 years (mean age: 64,1±8,9 years). The patients were divided into 6 groups (I, II, III, IV, V, VI) depending on the number of VRF. The examination consisted of a standard clinical evaluation, neurological examination, the application of neuropsychological tests (the MMSE; the PALT/The Paired Associates Learning Test; clock drawing test), laboratory tests, MRI of brain. Results: According to ANOVA, the greater the number of VRF the patients had, the lower was their total MMSE score corresponding to more pronounced cognitive decline (F=2,97, p=0,012). A significant negative correlation between patients' age and their MMSE score was detected regardless of their VRF count. The patients of the V and VI groups had substantially lower parameters of immediate, delayed memory and clock drawing test score comparing to the patients of the I group. Conclusions: The presence of 4 and more VRF was related to more pronounced CI in the patients with CVD. Decline of different aspects of memory, attention, spatial orientation, abstract thinking, planning, concentration, executive and visuospatial skills in groups of patients with 4,5 and 6 vascular risk factors was established. Age was substantially associated with cognitive decline in all the group of patients.

Comparative diagnostic accuracy of ACE-III and MoCA for detecting mild cognitive impairment.

ObjectiveThe aim of this study was to validate the reliability of the Chinese version of Addenbrooke’s Cognitive Examination III (ACE-III) for detecting mild cognitive impairment. Furthermore, the present study compares the diagnostic accuracy of ACE-III with that of Montreal Cognitive Assessment (MoCA).MethodsOne hundred and twenty patients with MCI and 136 healthy controls were included in the study. All patients were evaluated by the Chinese version of ACE-III, MoCA and MMSE.ResultsSubjects in the control group showed better performance in ACE-III total score and its subdomain scores than those in the MCI group. There was a significantly positive correlation between ACE-III total score and MoCA score. Meanwhile, there was also a significantly positive correlation between ACE-III total score and MMSE score. For ACE-III total score, a cut-off point of 85 yielded a sensitivity of 97.3% and a specificity of 90.7%. The AUC for ACE-III total score was 0.978. For MoCA, a cut-off point of 23 yielded a sensitivity of 86.5% and a specificity of 97.7%. The AUC for MoCA was 0.961. There were no significant differences in diagnostic accuracy between ACE-III and MoCA.ConclusionThe present findings support that both ACE-III and MoCA are useful for detecting MCI in early stages.

Total Cerebral Small Vessel Disease Burden Is Related to Worse Performance on the Mini-Mental State Examination and Incident Dementia: A Prospective 5-Year Follow-Up.

Individual cerebral small vessel disease (CSVD) may cause cognitive decline. However, the association between total burden of CSVD and cognitive deterioration in the general population remains unclear. We aimed to determine whether total CSVD score is associated with cognitive performance change and incident dementia in the general population. In the longitudinal population-based Taizhou Imaging Study, 556 participants free of neurological disorders underwent brain MRI and neuropsychological testing at baseline. A total of 456 participants were followed up for cognitive performance for a mean (standard deviation) of 4.6 (0.6) years. Total CSVD score (range 0-4) was calculated by assigning 1 point for the presence of each of the following markers: lacune, white matter hyperintensity, cerebral microbleed, and perivascular space. Beta regression was used to evaluate the association between total CSVD burden and MMSE score change. The association of prevalent CSVD with incident dementia was studied using Fisher's exact test. CSVDs were present in 262 individuals (47.1%). The total CSVD score was significantly associated with MMSE score decline (p = 0.001). Compared to those with no CSVD, participants with 4 CSVD markers had a steeper decline in MMSE score (β: -0.53, 95% CI: -0.86 to -0.21; p = 0.001). A total of 15 participants developed dementia during follow-up. The presence of more than three CSVD markers at baseline was associated with a significantly higher risk of dementia (p = 0.020). Total CSVD burden appears to be associated with MMSE score decline and incident dementia in a general population in China.