Brief Assessment of Impaired Cognition Questionnaire (BASIC‐Q)—Development and validation of a new tool for identification of cognitive impairment in community settings

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.

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Cognitive Impairment in People with Diabetes-Related Foot Ulceration

Journal of Clinical Medicine ◽

10.3390/jcm10132808 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2808

Author(s):

Ranita Siru ◽

Melanie S. Burkhardt ◽

Wendy A. Davis ◽

Jonathan Hiew ◽

Laurens Manning ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cognitive Impairment ◽

Sex Education ◽

Foot Ulcer ◽

Screening Tests ◽

Community Settings ◽

Foot Ulceration ◽

Complex Diabetes ◽

State Examination

Aims: To determine whether there is an excess of cognitive impairment in patients with type 2 diabetes and foot ulceration. Methods: 55 patients with type 2 diabetes and foot ulcers attending Multidisciplinary Diabetes Foot Ulcer clinics (MDFU cohort) were compared with 56 patients with type 2 diabetes attending Complex Diabetes clinics (CDC cohort) using commonly used screening tests for cognitive impairment (Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA)), as well as foot self-care, mood and health literacy. MMSE was also compared between the MDFU cohort and a historical community-based cohort of patients with type 2 diabetes (FDS2 cohort). Results: Median MMSE scores were the same in all three groups (28/30). Median MOCA scores did not differ between the MDFU and CDC cohorts (25/30). There were no significant differences in the percentages of patients with MMSE ≤ 24 or MOCA ≤ 25 between MDFU and CDC cohorts (3.6% versus 10.7%, p = 0.27 and 56.4% versus 51.8%, p = 0.71, respectively), findings that did not change after adjustment for age, sex, education, diabetes duration, and random blood glucose. Conclusions: Using conventionally applied instruments, patients with type 2 diabetes and foot ulceration have similar cognition compared with patients without, from either hospital-based clinic or community settings.

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Using the Brief Assessment of Cognition in Schizophrenia (BACS) to assess cognitive impairment in older patients with schizophrenia and bipolar disorder

Bipolar Disorders ◽

10.1111/bdi.12171 ◽

2014 ◽

Vol 16 (3) ◽

pp. 326-336 ◽

Cited By ~ 14

Author(s):

Jennyfer Cholet ◽

Anne Sauvaget ◽

Jean-Marie Vanelle ◽

Caroline Hommet ◽

Karl Mondon ◽

...

Keyword(s):

Bipolar Disorder ◽

Cognitive Impairment ◽

Older Patients ◽

Brief Assessment

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A High Neutrophil-to-Lymphocyte Ratio Predicts Higher Risk of Poststroke Cognitive Impairment: Development and Validation of a Clinical Prediction Model

Frontiers in Neurology ◽

10.3389/fneur.2021.755011 ◽

2022 ◽

Vol 12 ◽

Author(s):

Fei Zha ◽

Jingjing Zhao ◽

Cheng Chen ◽

Xiaoqi Ji ◽

Meng Li ◽

...

Keyword(s):

Cognitive Impairment ◽

Prediction Model ◽

Univariate Analysis ◽

Density Lipoprotein ◽

Neutrophil To Lymphocyte Ratio ◽

Prognostic Information ◽

Lymphocyte Ratio ◽

Neuropsychological Assessments ◽

Development And Validation ◽

State Examination

ObjectivePoststroke cognitive impairment (PSCI) is a serious complication of stroke. The neutrophil-to-lymphocyte ratio (NLR) is a marker of peripheral inflammation. The relationship between the NLR and PSCI is far from well studied, and the thesis of this study was to assess the predictive value of the NLR in patients with PSCI, and establish and verify the corresponding prediction model based on this relationship.MethodsA total of 367 stroke patients were included in this study. Neutrophils, lymphocytes, and NLRs were measured at baseline, and clinical and neuropsychological assessments were conducted 3 months after stroke. The National Institutes of Health Scale (NIHSS) was used to assess the severity of stroke. A Chinese version of the Mini Mental State Examination (MMSE) was used for the assessment of cognitive function.ResultsAfter three months of follow-up, 87 (23.7%) patients were diagnosed with PSCI. The NLR was significantly higher in PSCI patients than in non-PSCI patients (P < 0.001). Patient age, sex, body mass index, NIHSS scores, and high-density lipoprotein levels also differed in the univariate analysis. In the logistic regression analysis, the NLR was an independent risk factor associated with the patients with PSCI after adjustment for potential confounders (OR = 1.67, 95%CI: 1.21–2.29, P = 0.002). The nomogram based on patient sex, age, NIHSS score, and NLR had good predictive power with an AUC of 0.807. In the validation group, the AUC was 0.816.ConclusionAn increased NLR at admission is associated with PSCI, and the model built with NLR as one of the predictors can increase prognostic information for the early detection of PSCI.

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Transcranial Doppler for Early Prediction of Cognitive Impairment after Aneurysmal Subarachnoid Hemorrhage and the Associated Clinical Biomarkers

Stroke Research and Treatment ◽

10.1155/2020/8874605 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Ahmed Esmael ◽

Tamer Belal ◽

Khaled Eltoukhy

Keyword(s):

Blood Pressure ◽

Cognitive Impairment ◽

Subarachnoid Hemorrhage ◽

Cognitive Function ◽

Cerebral Artery ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Clinical Biomarkers ◽

Poor Cognitive Function ◽

Impaired Cognition

Background and Aim. Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) stays under investigation. This study is aimed at predicting the cognitive impairment by transcranial Doppler (TCD) and detecting the associated clinical biomarkers of impaired cognition after aSAH after 3 months from the onset. Methods. Prospective study included 40 cases with acute aSAH. Initial evaluation by Glasgow Coma Scale (GCS) and the severity of aSAH was detected by both the clinical Hunt and Hess and radiological Fisher’s grading scales. TCD was done for all patients five times within 10 days measuring the mean flow velocities (MFVs) of cerebral arteries. At the 3-month follow-up, patients were classified into two groups according to Montreal Cognitive Assessment (MoCA) scale: the first group was 31 cases (77.5%) with intact cognitive functions and the other group was 9 cases (22.5%) with impaired cognition. Results. Patients with impaired cognitive functions showed significantly lower mean GCS ( p = 0.03 ), significantly higher mean Hunt and Hess scale grades ( p = 0.04 ), significantly higher mean diabetes mellitus (DM) ( p = 0.03 ), significantly higher mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) ( p = 0.02 and p = 0.005 , respectively), and significantly higher MFVs measured within the first 10 days. The patients with cognitive impairment were accompanied by a higher incidence of hydrocephalus ( p = 0.01 ) and a higher incidence of delayed cerebral ischemia (DCI) ( p < 0.001 ). Logistic regression analysis detected that MFV ≥ 86 cm / s in the middle cerebral artery (MCA), MFV ≥ 68 cm / s in the anterior cerebral artery (ACA), and MFV ≥ 45 cm / s in the posterior cerebral artery (PCA) were significantly associated with increased risk of cognitive impairment. Conclusion. Cognitive impairment after the 3-month follow-up phase in aSAH patients was 22.5%. Acute hydrocephalus and DCI are highly associated with poor cognitive function in aSAH. Increased MFV is a strong predictor for poor cognitive function in aSAH. This trial is registered with NCT04329208.

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