The impact of hearing loss on cognitive decline and risk of progression to mild cognitive impairment in healthy adults

Abstract Introduction:Ageing can cause major changes in the central nervous system of the body, resulting in cognitive decline and associated disorders. Therefore, there is a growing need for an effective cognitive screening method to enhance the diagnosis of mild cognitive impairments and to prevent occurring dementia and Alzheimer's Disease (AD). Our study aimed to compare the accuracy of MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) while evaluating the independent and interaction effects of age and educational level on these screening tools in a healthy sample.Method: The data for the current study was based on the registration phase of the study during 2016-2018 in Neyshabour Longitudinal Study on Ageing (NeLSA). Both the MoCA and MMSE tests were used to assess cognitive decline among 3326 participants aged 50-94 years of old. The ROC curve analysis and the predictive values were performed to evaluate the diagnostic accuracy of MMSE to discriminate Mild Cognitive Impairment (MCI) from the cognitively healthy adult basis of MoCA scores as a gold test. A two-way ANCOVA was run to examine the effect of Age and Education level on MoCA and MMSE score, while controlling for a gender effect. Data were analyzed using MedCalc Statistical Software version 13.0.6 (MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2014). Results: The chi-square test shows that MoCA ((72% and 90%) significantly (p-value<0.001() classified more persons as cognitively impaired than the MMSE (45.1%), respectively; using a cutoff score of 24 on the MMSE, 23 and 26 on the MoCA. The cut-off point of below 25 yielded the highest Youden J index for the MMSE in discrimination between MCI and healthy basis of MOCA<23 with an AUC of 0.9 (95% CI: 0.89-0.91) and MOCA<26 with an AUC of 0.87 (95% CI: 0.86-0.89). A two-way ANCOVA results show that the effect of education variable on the MMSE and MoCA score is more important than the age variable.Discussion: Although the cut-off scores give a clear indication of the sensitivity and specificity, they are unable to monitor the impact of confounders, which increase the risk of incorrect classification. Taken together, these findings demonstrate the use of demographically adjusted MoCA and MMSE scores that could provide clinicians with a more reliable estimation of the severity of cognitive impairment, thus increasing the instrument's clinical usefulness.

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Mild Cognitive Impairment and Alzheimer Disease

10.1093/med/9780197512166.003.0077 ◽

2021 ◽

pp. 662-671

Author(s):

Philip W. Tipton ◽

Nilüfer Ertekin-Taner

Keyword(s):

Clinical Trials ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Alzheimer Disease ◽

Activities Of Daily Living ◽

Cognitive Decline ◽

Increased Risk ◽

Intervention Point ◽

Risk Of Progression

Many patients who have Alzheimer disease (AD) present initially with mild cognitive impairment (MCI). This chapter reviews the clinical features of MCI and AD, the clinical evaluation of patients with these entities, and the approaches to management. MCI is defined by cognitive decline that is more than expected by aging alone but does not meet criteria for dementia because the person has the ability to perform activities of daily living. MCI is considered to be a prodrome to dementia, especially AD, given the increased risk of progression to dementia. MCI, which probably represents the earliest stages of dementia in many patients, requires clinical follow-up and is expected to become an important intervention point in future clinical trials of novel preventive therapies.

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Affective symptoms and risk of progression to mild cognitive impairment or dementia in subjective cognitive decline: A systematic review and meta-analysis

Ageing Research Reviews ◽

10.1016/j.arr.2021.101419 ◽

2021 ◽

pp. 101419

Author(s):

Roopal Desai ◽

Tim Whitfield ◽

Glorianne Said ◽

Amber John ◽

Rob Saunders ◽

...

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Meta Analysis ◽

Subjective Cognitive Decline ◽

Affective Symptoms ◽

Risk Of Progression

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Neurological Soft Signs in Aging, Mild Cognitive Impairment, and Alzheimerâ€™s Disease â€“ The Impact of Cognitive Decline and Cognitive Reserve

Frontiers in Psychiatry ◽

10.3389/fpsyt.2015.00012 ◽

2015 ◽

Vol 6 ◽

Cited By ~ 13

Author(s):

Nadja Urbanowitsch ◽

Christina Degen ◽

Pablo Toro ◽

Johannes SchrÃ¶der

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Cognitive Reserve ◽

Neurological Soft Signs ◽

The Impact

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Estimation of the risk of conversion of mild cognitive impairment of Alzheimer type to Alzheimer's disease in a south Brazilian population-based elderly cohort: the PALA study

International Psychogeriatrics ◽

10.1017/s1041610211002043 ◽

2011 ◽

Vol 24 (4) ◽

pp. 674-681 ◽

Cited By ~ 7

Author(s):

Cláudia Godinho ◽

Ana Luiza Camozzato ◽

Diego Onyszko ◽

Márcia Lorena Chaves

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Population Based ◽

Alzheimer Type ◽

Risk Of Progression ◽

Elderly Cohort ◽

The Impact ◽

Cognitively Intact

ABSTRACTBackground: Higher mild cognitive impairment (MCI) prognostic variability has been related to sample characteristics (community-based or specialized clinic) and to diverse operationalization criteria. The aim of the study was to evaluate the trajectory of MCI of Alzheimer type in a population-based elderly cohort in Southern Brazil. We also estimated the risk for the development of probable Alzheimer's disease (AD) in comparison with healthy subjects.Methods: Data were derived from a population-based cohort (the PALA study). MCI outcomes were sub-classified into three categories: conversion, stabilization, and reconversion. The risk of progression to dementia was compared between MCI and normal participants. The analysis was based on 21 MCI subjects and 220 cognitively intact participants (N = 241).Results: Of the 21 MCI subjects, 38% developed dementia, 24% remained stable and 38% improved. The MCI annual conversion rate to AD was 8.5%. MCI was associated with significantly higher risk of conversion to AD (HR = 49.83, p = 0.004), after adjustment for age, education, sex and Mini-Mental State Examination score.Conclusions: Independent of the heterogeneity of the outcomes, MCI of the Alzheimer type participants showed significantly higher risk of developing probable AD, demonstrating the impact of the use of these MCI criteria that emphasize long-term episodic memory impairment.

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Cognitive training in older adults with Mild Cognitive Impairment: Impact on cognitive and functional performance

Dementia & Neuropsychologia ◽

10.1590/s1980-57642009dn30200010 ◽

2009 ◽

Vol 3 (2) ◽

pp. 124-131 ◽

Cited By ~ 21

Author(s):

Paula Schimidt Brum ◽

Orestes Vicente Forlenza ◽

Mônica Sanches Yassuda

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Cognitive Training ◽

Functional Performance ◽

Depression Scale ◽

Cognitive Test ◽

Age Related ◽

The Impact

Abstract Aging is associated with cognitive decline, yet this does not prevent older adults from finding ways to compensate for age-related deficits. Earlier studies have shown that cognitively unimpaired older adults can benefit from training programs. The efficacy of cognitive interventions among older adults without dementia but with cognitive decline (mild cognitive impairment, MCI) has not yet been widely tested. Objectives: To evaluate the impact of 8-session cognitive training on the cognitive and functional performance of older adults with MCI. Methods: 16 older adults diagnosed with MCI received cognitive training (18 participated as controls). All participants were assessed pre and post intervention using the Short Cognitive Test (SKT), Direct Assessment of Functional Scale Revised (DAFS-R), Geriatric Depression Scale (GDS), and Clock Drawing Test (CDT). Results: A significant improvement was observed in the study group between pre and post-test in attention (SKT), time orientation, shopping skills and dealing with finances (DAFS-R) along with reduced depressive symptoms (GDS). Conclusion: These results indicate the importance of non-pharmacological interventions for older adults with MCI to help compensate for cognitive decline.

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The impact of hearing impairment and hearing aid use on progression to mild cognitive impairment in cognitively healthy adults: a longitudinal study of 5721 participants

10.21203/rs.3.rs-153405/v1 ◽

2021 ◽

Author(s):

Magda Bucholc ◽

Sarah Bauermeister ◽

Daman Kaur ◽

Paula McClean ◽

Stephen Todd

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Hearing Impairment ◽

Hearing Aids ◽

Hearing Aid ◽

Hearing Impaired ◽

Hearing Aid Use ◽

Increased Risk ◽

The Impact

Abstract The increasing prevalence of dementia in older adults warrants attention to the identification of practices that can delay or reduce likelihood of progression to early forms of cognitive impairment, in particular, to mild cognitive impairment (MCI) which is often considered a transitional stage between healthy aging and dementia. In this study, we investigated the effect of hearing impairment and hearing aid usage on cognitive decline and progression to MCI in cognitively healthy individuals. We used data from a large referral-based cohort obtained from the National Alzheimer’s Coordinating Center. The baseline sample included 5721 cognitively normal subjects aged ≥ 40. We found that hearing impairment was associated with increased risk of progression to MCI (hazard ratio [HR] = 1.40, 95%CI, 1.16-1.68, false discovery rate [FDR] P < 0.001) and an accelerated rate of cognitive decline (P < 0.001). Among hearing-impaired participants, hearing aid users were less likely to develop MCI (HR, 0.33; 95% CI, 0.23-0.47; FDR P < 0.001) and experienced slower cognitive decline (P = 0.004) when compared to those not using hearing aids. We found no statistically significant differences in risk of conversion to MCI between individuals with normal hearing and hearing-impaired adults using hearing aids (HR, 1.23; 95% CI, 0.99-1.50; FDR P = 0.08). Our findings highlight the need for a randomized clinical trial that will allow us to investigate whether there is a causal relationship between hearing loss, hearing aid use, and conversion to MCI. Such knowledge could provide new and novel insights into prevention of cognitive impairment and dementia.

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