Non-pharmacological interventions for adults with mild cognitive impairment and early stage dementia: An updated scoping review

ObjectivesNon-pharmacological treatments are an important aspect of dementia care. A wide range of interventions have been trialled for mild dementia and mild cognitive impairment (MCI). However, the variety of outcome measures used in these trials makes it difficult to make meaningful comparisons. The objective of this study is to map trends in which outcome measures are used in trials of non-pharmacological treatments in MCI and mild dementia.DesignScoping review.Data sourcesEMBASE, PsychINFO, Medline and the Cochrane Register of Controlled Trials were searched from inception until February 2018. An additional search was conducted in April 2019EligibilityWe included randomised controlled trials (RCTs) testing non-pharmacological interventions for people diagnosed with MCI or mild dementia. Studies were restricted to full RCTs; observational, feasibility and pilot studies were not included.Charting methodsAll outcome measures used by included studies were extracted and grouped thematically. Trends in the types of outcome measures used were explored by type of intervention, country and year of publication.Results91 studies were included in this review. We extracted 358 individual outcome measures, of which 78 (22%) were used more than once. Cognitive measures were the most frequently used, with the Mini-Mental State Examination being the most popular.ConclusionsOur findings highlight an inconsistency in the use of outcome measures. Cognition has been prioritised over other domains, despite previous research highlighting the importance of quality of life and caregiver measures. To ensure a robust evidence base, more research is needed to highlight which outcome measures should be used over others.PROSPERO registration numberCRD42018102649.

Download Full-text

Financial Capacity and Regional Cerebral Tau in Cognitively Normal Older Adults, Mild Cognitive Impairment, and Alzheimer’s Disease Dementia

Journal of Alzheimer s Disease ◽

10.3233/jad-201122 ◽

2020 ◽

pp. 1-10

Author(s):

Christopher Gonzalez ◽

Nicole S. Tommasi ◽

Danielle Briggs ◽

Michael J. Properzi ◽

Rebecca E. Amariglio ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Early Stage ◽

Cognitively Normal ◽

Financial Capacity ◽

Posterior Cingulate ◽

Dorsolateral Prefrontal

Background: Financial capacity is often one of the first instrumental activities of daily living to be affected in cognitively normal (CN) older adults who later progress to amnestic mild cognitive impairment (MCI) and Alzheimer’s disease (AD) dementia. Objective: The objective of this study was to investigate the association between financial capacity and regional cerebral tau. Methods: Cross-sectional financial capacity was assessed using the Financial Capacity Instrument –Short Form (FCI-SF) in 410 CN, 199 MCI, and 61 AD dementia participants who underwent flortaucipir tau positron emission tomography from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Linear regression models with backward elimination were used with FCI-SF total score as the dependent variable and regional tau and tau-amyloid interaction as predictors of interest in separate analyses. Education, age sex, Rey Auditory Verbal Learning Test Total Learning, and Trail Making Test B were used as covariates. Results: Significant associations were found between FCI-SF and tau regions (entorhinal: p < 0.001; inferior temporal: p < 0.001; dorsolateral prefrontal: p = 0.01; posterior cingulate: p = 0.03; precuneus: p < 0.001; and supramarginal gyrus: p = 0.005) across all participants. For the tau-amyloid interaction, significant associations were found in four regions (amyloid and dorsolateral prefrontal tau interaction: p = 0.005; amyloid and posterior cingulate tau interaction: p = 0.005; amyloid and precuneus tau interaction: p < 0.001; and amyloid and supramarginal tau interaction: p = 0.002). Conclusion: Greater regional tau burden was modestly associated with financial capacity impairment in early-stage AD. Extending this work with longitudinal analyses will further illustrate the utility of such assessments in detecting clinically meaningful decline, which may aid clinical trials of early-stage AD.

Download Full-text

Development of the Positive Photo Appreciation for Dementia program for people with mild cognitive impairment and early‐stage Alzheimer's disease: A feasibility study

Geriatrics and Gerontology International ◽

10.1111/ggi.13739 ◽

2019 ◽

Vol 19 (10) ◽

pp. 1064-1066

Author(s):

Masumi Ishihara ◽

Tami Saito ◽

Takashi Sakurai ◽

Aiko Osawa ◽

Ikue Ueda ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Feasibility Study ◽

Early Stage

Download Full-text

Using Regional Homogeneity to Reveal Altered Spontaneous Activity in Patients with Mild Cognitive Impairment

BioMed Research International ◽

10.1155/2015/807093 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Yumei Wang ◽

Xiaochuan Zhao ◽

Shunjiang Xu ◽

Lulu Yu ◽

Lan Wang ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Spontaneous Activity ◽

Healthy Aging ◽

Early Stage ◽

Brain Activity ◽

Regional Homogeneity ◽

Whole Brain ◽

Spontaneous Brain Activity ◽

Regional Brain Activity

Most patients with mild cognitive impairment (MCI) are thought to be in an early stage of Alzheimer’s disease (AD). Resting-state functional magnetic resonance imaging reflects spontaneous brain activity and/or the endogenous/background neurophysiological process of the human brain. Regional homogeneity (ReHo) rapidly maps regional brain activity across the whole brain. In the present study, we used the ReHo index to explore whole brain spontaneous activity pattern in MCI. Our results showed that MCI subjects displayed an increased ReHo index in the paracentral lobe, precuneus, and postcentral and a decreased ReHo index in the medial temporal gyrus and hippocampus. Impairments in the medial temporal gyrus and hippocampus may serve as important markers distinguishing MCI from healthy aging. Moreover, the increased ReHo index observed in the postcentral and paracentral lobes might indicate compensation for the cognitive function losses in individuals with MCI.

Download Full-text

Olfactory Function and Diffusion Tensor Imaging as Markers of Mild Cognitive Impairment in Early Stages of Parkinson's Disease

Clinical EEG and Neuroscience ◽

10.1177/15500594211058263 ◽

2021 ◽

pp. 155005942110582

Author(s):

Sophie A. Stewart ◽

Laura Pimer ◽

John D. Fisk ◽

Benjamin Rusak ◽

Ron A. Leslie ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Diffusion Tensor Imaging ◽

Mild Cognitive Impairment ◽

White Matter ◽

Neurodegenerative Disorder ◽

Diffusion Tensor ◽

Early Stage ◽

White Matter Integrity

Parkinson's disease (PD) is a neurodegenerative disorder that is typified by motor signs and symptoms but can also lead to significant cognitive impairment and dementia Parkinson's Disease Dementia (PDD). While dementia is considered a nonmotor feature of PD that typically occurs later, individuals with PD may experience mild cognitive impairment (PD-MCI) earlier in the disease course. Olfactory deficit (OD) is considered another nonmotor symptom of PD and often presents even before the motor signs and diagnosis of PD. We examined potential links among cognitive impairment, olfactory functioning, and white matter integrity of olfactory brain regions in persons with early-stage PD. Cognitive tests were used to established groups with PD-MCI and with normal cognition (PD-NC). Olfactory functioning was examined using the University of Pennsylvania Smell Identification Test (UPSIT) while the white matter integrity of the anterior olfactory structures (AOS) was examined using magnetic resonance imaging (MRI) diffusion tensor imaging (DTI) analysis. Those with PD-MCI demonstrated poorer olfactory functioning and abnormalities based on all DTI parameters in the AOS, relative to PD-NC individuals. OD and microstructural changes in the AOS of individuals with PD may serve as additional biological markers of PD-MCI.

Download Full-text

P2-009: The chemokines IL8 and MIP-1b distinguish mild cognitive impairment from early stage Alzheimer's disease

Alzheimer s & Dementia ◽

10.1016/j.jalz.2012.05.712 ◽

2012 ◽

Vol 8 (4S_Part_7) ◽

pp. P266-P267

Author(s):

Milene Gonçalves ◽

Isabel Santana ◽

Natália Francisco ◽

Catarina Cunha ◽

Sonia Batista ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Early Stage

Download Full-text

Nonwearable Sensor-Based In-Home Assessment of Subtle Daily Behavioral Changes as a Candidate Biomarker for Mild Cognitive Impairment

Journal of Personalized Medicine ◽

10.3390/jpm12010011 ◽

2021 ◽

Vol 12 (1) ◽

pp. 11

Author(s):

Takao Yamasaki ◽

Shuzo Kumagai

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Early Stage ◽

Digital Technologies ◽

Assessment Methods ◽

Behavioral Changes ◽

Behavioral Patterns ◽

Traditional Assessment ◽

Traditional Performance ◽

Traditional Assessments

Patients show subtle changes in daily behavioral patterns, revealed by traditional assessments (e.g., performance- or questionnaire-based assessments) even in the early stage of Alzheimer’s disease (AD; i.e., the mild cognitive impairment (MCI) stage). An increase in studies on the assessment of daily behavioral changes in patients with MCI and AD using digital technologies (e.g., wearable and nonwearable sensor-based assessment) has been noted in recent years. In addition, more objective, quantitative, and realistic evidence of altered daily behavioral patterns in patients with MCI and AD has been provided by digital technologies rather than traditional assessments. Therefore, this study hypothesized that the assessment of daily behavioral changes with digital technologies can replace or assist traditional assessment methods for early MCI and AD detection. In this review, we focused on research using nonwearable sensor-based in-home assessment. Previous studies on the assessment of behavioral changes in MCI and AD using traditional performance- or questionnaire-based assessments are first described. Next, an overview of previous studies on the assessment of behavioral changes in MCI and AD using nonwearable sensor-based in-home assessment is provided. Finally, the usefulness and problems of nonwearable sensor-based in-home assessment for early MCI and AD detection are discussed. In conclusion, this review stresses that subtle changes in daily behavioral patterns detected by nonwearable sensor-based in-home assessment can be early MCI and AD biomarkers.

Download Full-text