The Mini-Mental State Examination and Other Neuropsychological Assessment Tools for Detecting Cognitive Decline

Author(s):  
R. Mahendran ◽  
J. Chua ◽  
L. Feng ◽  
E.H. Kua ◽  
V.R. Preedy
2018 ◽  
Vol 31 (2) ◽  
pp. 84-89 ◽  
Author(s):  
Juliana Hack ◽  
Daphne Eschbach ◽  
Rene Aigner ◽  
Ludwig Oberkircher ◽  
Steffen Ruchholtz ◽  
...  

Objective: The aim of this study was to identify factors that are associated with cognitive decline in the long-term follow-up after hip fractures in previously nondemented patients. Methods: A consecutive series of 402 patients with hip fractures admitted to our university hospital were analyzed. After exclusion of all patients with preexisting dementia, 266 patients were included, of which 188 could be examined 6 months after surgery. Additional to several demographic data, cognitive ability was assessed using the Mini-Mental State Examination (MMSE). Patients with 19 or less points on the MMSE were considered demented. Furthermore, geriatric scores were recorded, as well as perioperative medical complications. Mini-Mental State Examination was performed again 6 months after surgery. Results: Of 188 previously nondemented patients, 12 (6.4%) patients showed a cognitive decline during the 6 months of follow-up. Multivariate regression analysis showed that age ( P = .040) and medical complications ( P = .048) were the only significant independent influencing factors for cognitive decline. Conclusions: In our patient population, the incidence of dementia exceeded the average age-appropriate cognitive decline. Significant independent influencing factors for cognitive decline were age and medical complications.


Author(s):  
Stefanus Erdana Putra ◽  
Muhammad Hafizhan ◽  
Raden Ajeng Hanindia Riani Prabaningtyas

THE RELATIONSHIP BETWEEN ELEVATED C-REACTIVE PROTEIN AND COGNITIVE FUNCTION DETERIORATION OF GERIATRIC OUTPATIENTSABSTRACTIntroduction: Geriatric patients have different characteristics compared to other patients in general, in which they potentially experiencing cognitive impairment, decreasing of physiological and functional status, also the immunological system. This situation causes various inflammatory reactions that play a role in the development of neurodegenerative diseases, including the increase production of acute phase protein called C-reactive protein (CRP).Aims: To determine the association  between the CRP serum concentration  elevation and the deterioration  of geriatric outpatients’s cognitive function at Neurology Clinic Sebelas Maret University Hospital.Methods: A cross-sectional study of geriatric patients at the Neurology Clinic of Sebelas Maret University Hospital, Surakarta.   The cognitive state was evaluated using Mini-Mental State Examination (MMSE) and those with MMSE score<24 were considered cognitively declined. Concentrations of serum CRP were measured. Multiple logistic regression analysis was used to calculate Odds ratios (ORs) for cognitive decline, adjusted for the covariates of age, sex, body mass index, and disease history.Results: There were 73 participants with mean age was 65.6 years old. There were 56,2% who were experiencing a cognitive decline. Relative to the lowest (first) quartile of CRP concentration, adjusted ORs were 1,44 for the second, 1,97 for the third, and 2,33 for the highest quartiles (p=0,035). The association between CRP levels and decreased cognitive function was found to be significant after adjusting for covariates. When data were stratified by sex, the association between CRP concentration and cognitive decline was observed in women.Discussions: This research  suggested an association  between higher CRP concentration  and lower cognitive function. Chronic inflammation might affect cognitive function in geriatric, particularly in women.Keywords: C-reactive protein, cognitive function, geriatric outpatientsABSTRAKPendahuluan: Pasien geriatri memiliki karakteristik yang berbeda dengan pasien pada umumnya, yaitu selain berpotensi mengalami gangguan fungsi kognitif juga menurunnya daya cadangan fisiologis serta status fungsional dan sistem imunologi. Keadaan ini menimbulkan berbagai reaksi inflamasi yang berperan dalam perkembangan penyakit neurodegeneratif, antara lain peningkatan produksi protein fase akut bernama C-reactive protein (CRP) oleh hepar.Tujuan: Mengetahui hubungan antara peningkatan kadar CRP dengan penurunan fungsi kognitif pasien geriatri rawat jalan di Poliklinik Saraf RS Universitas Sebelas Maret.Metode: Penelitian potong lintang terhadap pasien geriatri di Poli Saraf RS Universitas Sebelas Maret, Surakarta. Evaluasi fungsi kognitif menggunakan Mini-Mental State Examination (MMSE); dengan skor <24 dikategorikan mengalami penurunan fungsi kognitif. Kadar serum CRP masing-masing subjek juga diukur. Analisis regresi logistik berganda digunakan dalam menghitung rasio Odds (RO) untuk penurunan fungsi kognitif, dengan pengaturan kovariat usia, jenis kelamin, indeks massa tubuh, dan riwayat penyakit sebelumnya.Hasil: Didapatkan 73 subjek dengan rerata usia 65,6 tahun. Sebanyak 56,2% subjek mengalami penurunan fungsi kognitif. Dengan perbandingan relatif terhadap kuartil konsentrasi CRP terendah (pertama), RO yang telah diatur adalah 1,44 untuk kuartil kedua; 1,97 untuk kuartil ketiga; serta 2,33 untuk kuartil keempat (p=0,035). Hubungan kadar CRP dan penurunan fungsi kognitif ditemukan signifikan setelah disesuaikan dengan kovariat. Setelah dilakukan sub-analisis berdasarkan jenis kelamin, peningkatan kadar CRP terhadap penurunan kognitif secara signifikan terjadi pada subjek perempuan.Diskusi: Penelitian ini menunjukkan adanya hubungan antara peningkatan kadar CRP dengan penurunan fungsi kognitif. Inflamasi kronis memengaruhi fungsi kognitif geriatri khususnya perempuan.Kata kunci: C-reactive protein, fungsi kognitif pasien rawat jalan, geriatri


2021 ◽  
Author(s):  
Nayyereh Aminisani ◽  
Rasoul alimi ◽  
Ali Javadpour ◽  
Mohhamad Asghari-Jafarabadi ◽  
Mozhgan Jourian ◽  
...  

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.


2009 ◽  
Vol 21 (6) ◽  
pp. 1037-1040
Author(s):  
Ling Han

It was well beyond my expectations when I heard from Professor Ames that our meta-analysis paper (Han et al., 2000) was among the top-cited papers in International Psychogeriatrics. As an expression of my gratitude to the editor for the invitation and to the audience of this paper, I would like to offer this informal discussion on the background of the paper and extend a few ideas that were not conveyed fully at the time, due either to insufficient knowledge or unavailability of relevant data or methodologies.


Proceedings ◽  
2018 ◽  
Vol 2 (19) ◽  
pp. 1247 ◽  
Author(s):  
Iván González ◽  
Rocío Garrido ◽  
Fco Navarro ◽  
Jesús Fontecha ◽  
Ramón Hervás ◽  
...  

This paper presents a cross-sectional study to analyze the impact on cognitive decline of a set of characteristics used for frailty assessment in elderly people. Considered characteristics come from several dimensions, including anthropometric, biological, nutritional, functional and mobility. Cognitive functioning is estimated by the Mini-Mental State Examination test. Additionally, mobility dimension is assessed from two perspectives: one based on direct observation of ambulation through subjective gait analyses; and the other performing explicit gait trials by using the instrumentation provided. In order to accomplish the purpose of this research, a multiple logistic regression analysis is carried out. Variables are grouped according to popular and/or standardized categories adopted in other clinical studies. Mini-Mental State Examination represents the dependent variable, while the characteristics for frailty assessment make up the set of explanatory variables. The multiple logistic regression is performed using a sample of 81 frail elders from two nursing homes in Spain. The results obtained indicate that frail elders aged 90 years of older, with moderate dependence in daily functioning, moderate risk of falls and with a stride interval gait variability greater than 6% were most likely to suffer cognitive decline, representing what is called cognitive frails.


2008 ◽  
Vol 30 (4) ◽  
pp. 346-349 ◽  
Author(s):  
Izabella Dutra de Abreu ◽  
Paula Villela Nunes ◽  
Breno Satler Diniz ◽  
Orestes Vicente Forlenza

OBJECTIVE: To determine the diagnostic accuracy of the Mini-Mental State Examination combined to the Informant Questionnaire on Cognitive Decline in the Elderly for the identification of mild cognitive impairment. METHOD: 191 elderly subjects were assessed with the Mini-Mental State Examination, and their informants were assessed with the Informant Questionnaire on Cognitive Decline in the Elderly. Subjects were divided into three groups according to their cognitive state (controls: n = 67, mild cognitive impairment: n = 65 and dementia: n = 59), which was ascertained by clinical and neuropsychological evaluation. The diagnostic accuracy of each test in the discrimination of diagnostic groups (mild cognitive impairment vs. controls, mild cognitive impairment vs. dementia and dementia vs. controls) was examined with the aid of ROC curves. We additionally verified if the combination of both tests would increase diagnostic accuracy for mild cognitive impairment and control identification. RESULTS: The combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly scores did not increase the Mini-Mental State Examination diagnostic accuracy in the identification of patients with mild cognitive impairment. CONCLUSIONS: The present data do not warrant the combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly as a sufficient diagnostic tool in the diagnostic screening for mild cognitive impairment.


2021 ◽  
Vol 8 (2) ◽  
pp. 56-59
Author(s):  
V K Deshpande ◽  
Vishwin Doda

The role of cholesterol in Cognitive Decline is less known as compared to other pathologies linked with dyslipidaemia. However, Cholesterol is well-known to have multiple functions in normal functioning of the brain and the aging process. This study therefore aimed at finding a co-relation, if any, between Cholesterol and age-related cognitive decline.To assess Cognitive Function of subjects and compare it with respective blood cholesterol levels. The study included 50 elderly subjects from Maharashtra (females: 12%) assessed using Marathi version of Mini Mental State Examination (MMSE) and their cholesterol blood concentrations obtained using a Lipid Profile investigation. Cholesterol levels and cognitive function was then co-related using statistical analysis.The subjects with a higher Total Cholesterol & LDL Cholesterol had slightly less scores on the Mini Mental State Examination (MMSE) Test. However, the difference was found to be significant.Based on the results obtained, no relevant co-relation could be found between Blood Cholesterol Levels and Cognitive Function


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