Serum amino acid profiles in patients with mild cognitive impairment and in patients with mild dementia or moderate dementia

Abstract Objective Traditional performance validity tests (PVTs) often yield high false positive rates in dementia evaluations. The current study examined the frequency of extremely low scores (≤ 2 percentile) on WAIS-IV Digit Span Forward (DSF) in older adults with Mild Cognitive Impairment (MCI) or dementia to evaluate its possible utility as a PVT in these populations. Method Archival data from outpatient neuropsychological evaluations were analyzed. Individuals who were not diagnosed with a neurocognitive disorder, had missing data, or were believed to be invalidly performing were excluded. Participants (n = 195; mean age = 72.8; mean education = 13.2 years) were classified according to their evaluation diagnosis of MCI (n = 72; mean RBANS Total Score = 86.8) or dementia. Dementia patients were further divided by MoCA score into groups of mild dementia (n = 90; MoCA≥15; mean RBANS Total Score = 71.0) or moderate dementia (n = 33; MoCA < 15; mean RBANS Total Score = 55.9). Frequencies of scaled scores were analyzed to calculate specificity values for each group. Results A WAIS-IV DSF scaled score of ≤4 (≤ 2 percentile) resulted in specificity values of 0.99 and 0.94 in MCI and mild dementia, respectively. Conversely, in moderate dementia, ≥0.90 specificity was achieved only when using a more conservative cutoff of ≤2. Conclusions Low DSF scaled scores occurred infrequently in MCI and mild dementia, indicating strong specificity and potential utility as a PVT in these populations. However, in moderate dementia, low DSF scores were more common, requiring use of a more stringent cutoff. Future research should examine DSF sensitivity to invalid performance, as well as DSF specificity according to specific etiologies of MCI and dementia.

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A-76 Specificity of the Repeatable Battery for the Assessment of Neuropsychological Status Digit Span as a Validity Indicator in Patients with Mild Cognitive Impairment and Dementia

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz034.76 ◽

2019 ◽

Vol 34 (6) ◽

pp. 936-936

Author(s):

J Quattlebaum ◽

P Martin ◽

A Moltisanti ◽

H Clark ◽

R Schroeder

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Digit Span ◽

Future Research ◽

Performance Validity ◽

Mild Dementia ◽

Neuropsychological Status ◽

Moderate Dementia ◽

Repeatable Battery

Abstract Objective The current study sought to examine the specificity of Digit Span (DS) scaled score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) as a performance validity test (PVT) in older adults with Mild Cognitive Impairment (MCI) or dementia. Method Archival data were utilized and included 195 patients (mean age = 72.8; mean education = 13.2) who underwent outpatient neuropsychological evaluations. Cases that had missing data, did not meet criteria for a neurocognitive disorder, or whose performance was deemed invalid were excluded. Participants were classified according to their evaluation diagnosis of MCI (n = 72; mean RBANS total score = 86.8) or dementia. Those diagnosed with dementia were divided by MoCA performance and categorized as mild dementia (n = 90; MoCA≥15; mean RBANS Total Score = 71.0) or moderate dementia (n = 33; MoCA < 15; mean RBANS Total Score = 55.9). Scaled score frequencies were analyzed to calculate specificity for each group. Results An RBANS DS scaled score of ≤4 occurred infrequently in older adults with MCI and mild dementia, resulting in specificity values of 0.93 and 0.90, respectively. In moderate dementia, specificity fell to 0.68 when using a scaled score of ≤4, with a cutoff of ≤2 required to maintain adequate specificity. Conclusions Findings suggest utility of RBANS DS scaled score as a PVT in dementia evaluations provided use of appropriate cutoffs. A more stringent cutoff was required in examinees with moderate dementia relative to patients with MCI and mild dementia. Future research should examine the RBANS DS sensitivity to invalid performance, as well as DS specificity across specific etiologies of MCI and dementia.

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Assessing Everyday Activities Across the Dementia Spectrum with the Amsterdam IADL Questionnaire

Current Alzheimer Research ◽

10.2174/1567205015666180925113411 ◽

2018 ◽

Vol 15 (13) ◽

pp. 1261-1266 ◽

Cited By ~ 3

Author(s):

David Facal ◽

Miguel Angel Ruiz Carabias ◽

Arturo X. Pereiro ◽

Cristina Lojo-Seoane ◽

María Campos-Magdaleno ◽

...

Keyword(s):

Regression Analysis ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Multinomial Logistic Regression ◽

Specific Pattern ◽

Subjective Cognitive Decline ◽

Mild Dementia ◽

Multinomial Logistic Regression Analysis ◽

Moderate Dementia

Background: Instrumental activities of daily living (IADL) are complex activities which involve multiple cognitive processes, and which are expected to be susceptible to the early effects of cognitive impairment. Informant-based questionnaires are the most common tools used to assess IADL performance in dementia, but must be adjusted for use in early stages of impairment. Objective: To investigate the differences in IADL on the continuum of cognitive decline (i.e. no cognitive decline - subjective cognitive decline - mild cognitive impairment- mild dementia - moderate dementia) using the Spanish version of the Amsterdam IADL Questionnaire (A-IADL-Q). Methods: A total of 500 volunteer participants were included: 88 participants with no signs of cognitive decline, 109 participants with subjective cognitive complaints, 114 participants with mild cognitive impairment (MCI), 81 participants with mild dementia and 108 participants with moderate dementia. IADL was assessed with the A-IADL-Q, a computerized and adaptive questionnaire that calculates scores according to the specific pattern of responses of each participant. The data were examined by ANOVAs and regression analysis. Multinomial logistic regression analysis was used to evaluate the capacity of the A-IADL-Q to distinguish between diagnostic groups. Results: Participants with no cognitive decline and those with subjective cognitive decline obtained higher A-IADL-Q scores than MCI participants, and participants with MCI obtained higher scores than patients with dementia. The A-IADL-Q showed excellent discrimination between non-cognitive impairment and dementia, and significant but low discrimination between non-cognitive impairment and MCI. Conclusion: A-IADL-Q can discriminate IADL functioning between groups across the dementia spectrum.

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Relationship between Cognitive Performance and Measures of Neurodegeneration among Hispanic and White Non-Hispanic Individuals with Normal Cognition, Mild Cognitive Impairment, and Dementia

Journal of the International Neuropsychological Society ◽

10.1017/s1355617717000820 ◽

2017 ◽

Vol 24 (2) ◽

pp. 176-187 ◽

Cited By ~ 5

Author(s):

Shanna L. Burke ◽

Miriam J. Rodriguez ◽

Warren Barker ◽

Maria T Greig-Custo ◽

Monica Rosselli ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Performance ◽

Entorhinal Cortex ◽

Rating Scale ◽

Structural Mri ◽

Diagnostic Group ◽

Disease Stage ◽

Clinical Dementia Rating ◽

Mild Dementia

AbstractObjectives:The aim of this study was to determine the presence and severity of potential cultural and language bias in widely used cognitive and other assessment instruments, using structural MRI measures of neurodegeneration as biomarkers of disease stage and severity.Methods:Hispanic (n=75) and White non-Hispanic (WNH) (n=90) subjects were classified as cognitively normal (CN), amnestic mild cognitive impairment (aMCI) and mild dementia. Performance on the culture-fair and educationally fair Fuld Object Memory Evaluation (FOME) and Clinical Dementia Rating Scale (CDR) between Hispanics and WNHs was equivalent, in each diagnostic group. Volumetric and visually rated measures of the hippocampus entorhinal cortex, and inferior lateral ventricles (ILV) were measured on structural MRI scans for all subjects. A series of analyses of covariance, controlling for age, depression, and education, were conducted to compare the level of neurodegeneration on these MRI measures between Hispanics and WNHs in each diagnostic group.Results:Among both Hispanics and WNH groups there was a progressive decrease in volume of the hippocampus and entorhinal cortex, and an increase in volume of the ILV (indicating increasing atrophy in the regions surrounding the ILV) from CN to aMCI to mild dementia. For equivalent levels of performance on the FOME and CDR, WNHs had greater levels of neurodegeneration than did Hispanic subjects.Conclusions:Atrophy in medial temporal regions was found to be greater among WNH than Hispanic diagnostic groups, despite the lack of statistical differences in cognitive performance between these two ethnic groups. Presumably, unmeasured factors result in better cognitive performance among WNH than Hispanics for a given level of neurodegeneration. (JINS, 2018,24, 176–187)

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THE CHANGING FACE OF MILD COGNITIVE IMPAIRMENT (MCI) AND MILD DEMENTIA

Alzheimer s & Dementia ◽

10.1016/j.jalz.2017.07.134 ◽

2017 ◽

Vol 13 (7) ◽

pp. P544-P545

Author(s):

Connor Richardson ◽

Fiona Matthews ◽

Louise Robinson ◽

Blossom C.M. Stephan

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Mild Dementia

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Development of a decision-making tool for reporting drivers with mild dementia and mild cognitive impairment to transportation administrators

International Psychogeriatrics ◽

10.1017/s1041610217000242 ◽

2017 ◽

Vol 29 (9) ◽

pp. 1551-1563 ◽

Cited By ~ 6

Author(s):

Duncan H. Cameron ◽

Carla Zucchero Sarracini ◽

Linda Rozmovits ◽

Gary Naglie ◽

Nathan Herrmann ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Delphi Study ◽

Qualitative Interviews ◽

Decision Support Tool ◽

Driving Safety ◽

Decision Tool ◽

Computerized Decision Support ◽

Support Tool ◽

Mild Dementia

ABSTRACTBackground:Driving in persons with dementia poses risks that must be counterbalanced with the importance of the care for autonomy and mobility. Physicians often find substantial challenges in the assessment and reporting of driving safety for persons with dementia. This paper describes a driving in dementia decision tool (DD-DT) developed to aid physicians in deciding when to report older drivers with either mild dementia or mild cognitive impairment to local transportation administrators.Methods:A multi-faceted, computerized decision support tool was developed, using a systematic literature and guideline review, expert opinion from an earlier Delphi study, as well as qualitative interviews and focus groups with physicians, caregivers of former drivers with dementia, and transportation administrators. The tool integrates inputs from the physician-user about the patient's clinical and driving history as well as cognitive findings, and it produces a recommendation for reporting to transportation administrators. This recommendation is translated into a customized reporting form for the transportation authority, if applicable, and additional resources are provided for the patient and caregiver.Conclusions:An innovative approach was needed to develop the DD-DT. The literature and guideline review confirmed the algorithm derived from the earlier Delphi study, and barriers identified in the qualitative research were incorporated into the design of the tool.

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Cognitive Outcomes during COVID-19 confiNemeNt in Elderly and their Caregivers using Technologies for DEMentia (CONNECT DEM): study protocol (Preprint)

10.2196/preprints.26431 ◽

2020 ◽

Author(s):

Jessica Marian Goodman-Casanova ◽

Elena Dura-Perez ◽

Gloria Guerrero-Pertiñez ◽

Pilar Barnestein-Fonseca ◽

Jose Guzman-Parra ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Social Isolation ◽

Community Dwelling ◽

Mild Dementia ◽

Care Services ◽

Health And Social Care ◽

The Impact ◽

Community Dwelling Older Adults

BACKGROUND Coronavirus disease 2019 has forced worldwide the implementation of unprecedented restrictions to control its rapid spread and mitigate its impact. The Spanish government has enforced social distancing, quarantine and home confinement. This restriction of daily life activities and separation from loved ones may lead to social isolation and loneliness with health-related consequences in community-dwelling older adults with mild cognitive impairment or mild dementia and their caregivers. Additionally, an inadequate access to healthcare and social support services may aggravate chronic conditions. Technology home-based interventions emerge for combating social isolation and loneliness preventing the risk of viral exposure. OBJECTIVE The aim of this cohort study is to explore, analyze and determine the impact of social isolation on: 1) cognition, quality of life, mood, technophilia and perceived stress of community-dwelling older adults with mild cognitive impairment or mild dementia, and on caregiver burden; 2) health and social care services access and utilization, and 3) cognitive, social and entertainment use of ICTs. METHODS This study will be conducted in the Spanish region of Andalucía (Málaga). In total 200 dyads, consisting of a person with mild cognitive impairment or mild dementia (PMCI/MD) and their informal caregiver will be contacted by telephone. Potential respondents will be participants of the SMART 4 MD (N=100) and TV-AssistDem (N=100) clinical trials. RESULTS The change in means in the variables will be analyzed comparing baseline results in the previous studies with those during and after confinement using the ANOVA test of repeated measures or the non-parametric Friedman test if appropriate. The performance of a multivariate analysis of variance (ANCOVA) to introduce possible covariates will also be contemplated. A 95% confidence level will be used. CONCLUSIONS If the hypothesis is proven, these findings will demonstrate the negative impact of social isolation due to the COVID-19 confinement on cognition, quality of life, mood, and perceived stress of community-dwelling older adults with mild cognitive impairment and mild dementia, the impact on technophilia, caregiver burden, and health and social care services access and utilization; and the cognitive, social and entertainment use of ICTs during the COVID-19 confinement and afterwards. CLINICALTRIAL NCT: 04385797

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