scholarly journals Cognitive Impairment in Patients with Ankylosing Spondylitis

2020 ◽  
Vol 47 (2) ◽  
pp. 219-225
Author(s):  
Bruno Kusznir Vitturi ◽  
Enrico Stefano Suriano ◽  
Ana Beatriz Pereira de Sousa ◽  
Dawton Yukito Torigoe
Keyword(s):  
Cognitive Impairment ◽  
Ankylosing Spondylitis ◽  
Cognitive Decline ◽  
Cognitive Assessment ◽  
Neuropsychiatric Symptoms ◽  
Functional Limitations ◽  
Healthy Controls ◽  
Cognitive Screening ◽  
Clinical Predictors ◽  
Screening Battery

ABSTRACT:Background:Little is known about the potential systemic effects of ankylosing spondylitis (AS) on the nervous system. We designed a study aiming to assess the frequency and clinical predictors of cognitive impairment in AS patients.Methods:We carried out a cross-sectional case–control study composed of consecutive patients with AS. Trained and blinded interviewers registered clinical-epidemiological data and applied a standardized neurological assessment for each subject of the study. At baseline, functional limitations were characterized using the Health Assessment Questionnaire. Cognitive impairment was evaluated with the Brief Cognitive Screening Battery, the Montreal Cognitive Assessment, and the Clinical Dementia Rating, while neuropsychiatric symptoms were investigated with the Hospital Anxiety and Depression Scale. Healthy controls were matched for age, educational attainment, sex, and comorbidities. We compared the neurological outcomes between case and controls, and we determined the clinical predictors of cognitive decline.Results:We included 40 patients (mean: 49.3 years) with AS and 40 healthy controls (mean: 48.8 years) in our study. In Brief Cognitive Screening Battery, patients with AS presented a statistically significant poor performance in the clock drawing test and in the verbal fluency. The mean Montreal Cognitive Assessment (MoCA) scores were significantly lower in AS subjects compared to the control group. Also, the prevalence of subjects classified as cognitively impaired according to MoCA was significantly higher in the AS group (90.0% vs. 57.5%, p = 0.02). Moreover, neuropsychiatric symptoms were more prevalent in AS patients. Worse functional limitations were associated with poor cognitive performance as well.Conclusions:Patients with AS might be more vulnerable to cognitive decline.

scholarly journals Neuropsychiatric symptoms in at-risk groups for AD dementia and their association with worry and AD biomarkers—results from the DELCODE study

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Lena Sannemann ◽  
◽  
Ann-Katrin Schild ◽  
Slawek Altenstein ◽  
Claudia Bartels ◽  
...  
Keyword(s):  
At Risk ◽  
Clinical Trials ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Neuropsychiatric Symptoms ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Risk Groups ◽  
Subjective Cognitive Decline ◽  
Healthy Controls

Abstract Background Early identification of individuals at risk of dementia is mandatory to implement prevention strategies and design clinical trials that target early disease stages. Subjective cognitive decline (SCD) and neuropsychiatric symptoms (NPS) have been proposed as potential markers for early manifestation of Alzheimer’s disease (AD). We aimed to investigate the frequency of NPS in SCD, in other at-risk groups, in healthy controls (CO), and in AD patients, and to test the association of NPS with AD biomarkers, with a particular focus on cognitively unimpaired participants with or without SCD-related worries. Methods We analyzed data of n = 687 participants from the German DZNE Longitudinal Cognitive Impairment and Dementia (DELCODE) study, including the diagnostic groups SCD (n = 242), mild cognitive impairment (MCI, n = 115), AD (n = 77), CO (n = 209), and first-degree relatives of AD patients (REL, n = 44). The Neuropsychiatric Inventory Questionnaire (NPI-Q), Geriatric Depression Scale (GDS-15), and Geriatric Anxiety Inventory (GAI-SF) were used to assess NPS. We examined differences of NPS frequency between diagnostic groups. Logistic regression analyses were carried out to further investigate the relationship between NPS and cerebrospinal fluid (CSF) AD biomarkers, focusing on a subsample of cognitively unimpaired participants (SCD, REL, and CO), who were further differentiated based on reported worries. Results The numbers of reported NPS, depression scores, and anxiety scores were significantly higher in subjects with SCD compared to CO. The quantity of reported NPS in subjects with SCD was lower compared to the MCI and AD group. In cognitively unimpaired subjects with worries, low Aß42 was associated with higher rates of reporting two or more NPS (OR 0.998, 95% CI 0.996–1.000, p < .05). Conclusion These findings give insight into the prevalence of NPS in different diagnostic groups, including SCD and healthy controls. NPS based on informant report seem to be associated with underlying AD pathology in cognitively unimpaired participants who worry about cognitive decline. Trial registration German Clinical Trials Register DRKS00007966. Registered 4 May 2015.

scholarly journals Assessing visuo-constructive functions in patients with subjective cognitive decline, mild cognitive impairment and Alzheimer’s disease with the Vienna Visuo-Constructional Test 3.0 (VVT 3.0)

2021 ◽  
Author(s):  
Noel Valencia ◽  
Johann Lehrner
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Multinomial Logistic Regression ◽  
Subjective Cognitive Decline ◽  
Healthy Controls ◽  
Considerable Potential ◽  
Multinomial Logistic Regression Analysis

Summary Background Visuo-Constructive functions have considerable potential for the early diagnosis and monitoring of disease progression in Alzheimer’s disease. Objectives Using the Vienna Visuo-Constructional Test 3.0 (VVT 3.0), we measured visuo-constructive functions in subjective cognitive decline (SCD), mild cognitive impairment (MCI), Alzheimer’s disease (AD), and healthy controls to determine whether VVT performance can be used to distinguish these groups. Materials and methods Data of 671 participants was analyzed comparing scores across diagnostic groups and exploring associations with relevant clinical variables. Predictive validity was assessed using Receiver Operator Characteristic curves and multinomial logistic regression analysis. Results We found significant differences between AD and the other groups. Identification of cases suffering from visuo-constructive impairment was possible using VVT scores, but these did not permit classification into diagnostic subgroups. Conclusions In summary, VVT scores are useful indicators for visuo-constructive impairment but face challenges when attempting to discriminate between several diagnostic groups.

scholarly journals Normal-tension glaucoma is associated with cognitive impairment

2021 ◽  
pp. bjophthalmol-2020-317461
Author(s):  
Sean Mullany ◽  
Lewis Xiao ◽  
Ayub Qassim ◽  
Henry Marshall ◽  
Puya Gharahkhani ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Vision Loss ◽  
Linear Trend ◽  
Normal Tension Glaucoma ◽  
Cognitive Screening ◽  
Visual Interpretation ◽  
Cross Sectional ◽  
High Tension ◽  
Advanced Glaucoma

Background/aimsRecent research suggests an association between normal-tension glaucoma (NTG) and dementia. This study investigated whether cognitive impairment is more strongly associated with NTG than high tension glaucoma (HTG) using cognitive screening within an Australiasian Glaucoma Disease Registry.MethodsThe authors completed a case–control cross-sectional cognitive screening involving 290 age-matched and sex-matched NTG participants and HTG controls aged ≥65 randomly sampled from the Australian and New Zealand Registry of Advanced Glaucoma. Cognitive screening was performed using the Telephone Version of the Montreal Cognitive Assessment (T-MoCA). The T-MoCA omits points requiring visual interpretation, accounting for confounding factors related to vision loss in visually impaired participants. Cognitive impairment was defined by a T-MoCA score of <11/22. Cognition was compared between NTG and HTG participants using predetermined thresholds and absolute screening scores.ResultsA total of 290 participants completed cognitive assessment. There were no differences in NTG (n=144) and HTG (n=146) cohort demographics or ocular parameters at baseline. Cognitive impairment was more prevalent in the NTG cohort than the HTG cohort (OR=2.2; 95% CI 1.1 to 6.7, p=0.030). Though a linear trend was also observed between lower absolute T-MoCA scores in the NTG cohort when compared with the HTG cohort, this association was not statistically significant (p=0.108).ConclusionThis study demonstrated an association between NTG status and poor cognition, supporting the hypothesis that there exists a disease association and shared pathoaetiological features between NTG and dementia.

A-16 MoCA Subtest Analysis: Discriminating between Healthy Controls and MCI

2021 ◽  
Vol 36 (6) ◽  
pp. 1057-1057
Author(s):  
Lauren N Ratcliffe ◽  
Taylor F McDonald ◽  
Craig Marker
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Pacific Islander ◽  
Word Recall ◽  
Healthy Controls ◽  
Cognitive Markers ◽  
Attention Tasks ◽  
Asian Pacific Islander ◽  
Significant Difference ◽  
Asian Pacific

Abstract Objective The Montreal Cognitive Assessment (MoCA) is a suitable, sensitive, and specific cognitive screener for detecting mild cognitive impairment (MCI). Previous research has found markers to discriminate between healthy controls and MCI on MoCA subtest scores. Specifically, MCI performed worse on executive functioning and attention tasks (i.e., inverse digits, serial 7’s, repetition, fluency, abstraction, and word recall). The aim of the present study is to assess for discrimination patterns in MoCA performance between healthy controls and MCI. Method Data was collected through the National Alzheimer’s Coordinating Center (NACC). A sample of healthy controls (n = 3776, 65% female, 80% White, 17% Black, 3% Asian/Pacific Islander) and MCI (n = 1143; 51% female, 82% White, 15% Black, 3% Asian/Pacific Islander) were examined. Results An initial independent t-test revealed a statistically significant difference in MoCA scores for healthy controls (M = 26.18, SD = 2.78) and MCI (M = 22.01, SD = 3.49; t(4917) = 36.91, p = 0.000, Cohen’s d = 1.32). Additional t-tests were performed to compare MoCA subtest scores and domain scores for diagnostic groups. There was a statistically significant difference for healthy controls and MCI groups across all MoCA subtests and domains. Further examination using normal distribution revealed worse performance on cube copy and word recall in MCI groups. Conclusions Consistent with previous findings, word recall was able to discriminate between healthy controls and MCI. However, this study was able to find discrimination in cube copy performance. These findings may guide clinicians to use these interval changes as early cognitive markers for impairment, allowing for early detection and intervention.

scholarly journals Altered Prefrontal–Basal Ganglia Effective Connectivity in Patients With Poststroke Cognitive Impairment

2020 ◽  
Vol 11 ◽  
Author(s):  
Jing Zhang ◽  
Zixiao Li ◽  
Xingxing Cao ◽  
Lijun Zuo ◽  
Wei Wen ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Basal Ganglia ◽  
Cognitive Decline ◽  
Effective Connectivity ◽  
Network Connectivity ◽  
Brain Regions ◽  
Neuronal Model ◽  
Causal Modeling ◽  
Healthy Controls

We investigated the association between poststroke cognitive impairment and a specific effective network connectivity in the prefrontal–basal ganglia circuit. The resting-state effective connectivity of this circuit was modeled by employing spectral dynamic causal modeling in 11 poststroke patients with cognitive impairment (PSCI), 8 poststroke patients without cognitive impairment (non-PSCI) at baseline and 3-month follow-up, and 28 healthy controls. Our results showed that different neuronal models of effective connectivity in the prefrontal–basal ganglia circuit were observed among healthy controls, non-PSCI, and PSCI patients. Additional connected paths (extra paths) appeared in the neuronal models of stroke patients compared with healthy controls. Moreover, changes were detected in the extra paths of non-PSCI between baseline and 3-month follow-up poststroke, indicating reorganization in the ipsilesional hemisphere and suggesting potential compensatory changes in the contralesional hemisphere. Furthermore, the connectivity strengths of the extra paths from the contralesional ventral anterior nucleus of thalamus to caudate correlated significantly with cognitive scores in non-PSCI and PSCI patients. These suggest that the neuronal model of effective connectivity of the prefrontal–basal ganglia circuit may be sensitive to stroke-induced cognitive decline, and it could be a biomarker for poststroke cognitive impairment 3 months poststroke. Importantly, contralesional brain regions may play an important role in functional compensation of cognitive decline.

scholarly journals Prevalence of cognitive impairment among hill-tribe older people in the Northern part of Thailand

2018 ◽  
Vol 32 (6) ◽  
pp. 478-484
Author(s):  
Supaporn Trongsakul ◽  
Thapakorn Ruanjai ◽  
Wilawan Chaiut ◽  
Ratipark Tamornpark ◽  
Tawatchai Apidechkul
Keyword(s):  
Cognitive Impairment ◽  
Older People ◽  
Cognitive Decline ◽  
Health Care Professionals ◽  
Cultural Bias ◽  
Cognitive Screening ◽  
Content Type ◽  
Hill Tribe ◽  
History Of ◽  
Amphetamine Use

Purpose The purpose of this paper is to investigate the prevalence and factors related to cognitive impairment among hill-tribe older people in Chiang Rai province, Thailand. Design/methodology/approach A cross-sectional study was carried out amongst 459 hill-tribe older people aged 60 years and above. A Mini Mental State Examination (MMSE) Thai 2002 version was used for cognitive screening. A questionnaire and medical records were used for demographic and clinical data collection while descriptive statistics were used to analyze characteristic data. Potential factors related to cognitive impairment were analyzed by using univariate logistic regression analysis. Findings The prevalence of cognitive impairment amongst the participants was 49.89 percent (95% CI 45.32%, 53.47 percent). Factors related to cognitive decline included no occupation (OR=1.49, 95% CI 1.10–2.03, p<0.04) and a history of amphetamine use (OR=1.57, 95% CI 1.09–2.33, p<0.04). Originality/value Cognitive decline should be a cause for concern amongst Thai hill-tribe older people, especially amongst those in the group with a history of amphetamine use. However, Thai health care professionals need to be aware of the potential cultural bias in the MMSE Thai 2002 version as a cognition test targeted at the hill-tribe population as the questionnaire may not provide a true reflection of their cultural experience and background.

scholarly journals The influence of schooling on cognitive screening test in the elderly

2007 ◽  
Vol 1 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Gustavo Christofoletti ◽  
Merlyn Mércia Oliani ◽  
Florindo Stella ◽  
Sebastião Gobbi ◽  
Lílian Teresa Bucken Gobbi
Keyword(s):  
Cognitive Decline ◽  
Educational Level ◽  
Screening Test ◽  
Neuropsychological Tests ◽  
Formal Education ◽  
The Elderly ◽  
Cognitive Status ◽  
Cognitive Screening ◽  
Screening Battery ◽  
Cognitive Screening Test

Abstract Introduction: Tests for screening cognitive functions are gaining importance with the increasing incidence and prevalence of demential syndromes. For our elderly population, the challenge is to develop neuropsychological tests independent from the influence of educational level. Objective: To compare the influence of education on the elderly with or without cognitive decline, on the Brief Cognitive Screening Battery (BCSB). Methods: We studied 176 elderly people: 60 with cognitive decline (aged 73.6±9.3 years and with 5.7±0.7 years of education) and 116 without cognitive impairments (aged 73.4±0.6 years and with 5.6±0.5 years of education). The BCSB was applied in all subjects. The data were submitted to descriptive statistics and analyzed by Independent Student test with 95% confidence intervals. Results: The data showed that the BCSB is an appropriate battery for identifying cognitive status in normal elderly individuals, as well as cognitive decline in our elderly sample. The BCSB items were not significantly influenced by schooling years, making this test favorable for different groups characterized by illiterate individuals, as well as by those with low or high levels of formal education. Conclusion: The BCSB proved to be a useful cognitive screening test for old people with or without cognitive decline independent of their educational level.

Short Montreal Cognitive Assessment

2016 ◽  
Vol 30 (2) ◽  
pp. 104-108 ◽  
Author(s):  
A. J. Larner
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Computerized Adaptive Testing ◽  
Montreal Cognitive Assessment ◽  
Test Accuracy ◽  
Cognitive Screening ◽  
Memory Clinic ◽  
Subjective Memory ◽  
Index Study ◽  
Diagnosis Of Dementia

The diagnostic accuracy of the short Montreal Cognitive Assessment (s-MoCA), a cognitive screening instrument recently derived by item response theory and computerized adaptive testing from the original MoCA, for the diagnosis of dementia and mild cognitive impairment (MCI) was assessed in 2 patient cohorts referred to a dedicated memory clinic in order to examine the validity and reproducibility of s-MoCA. Diagnosis used standard clinical diagnostic criteria for dementia and MCI as reference standard (prevalence of cognitive impairment = 0.43 and 0.46 in each cohort, respectively). There were significant differences in s-MoCA test scores for dementia, MCI, and subjective memory impairment ( P ≤ .01), and s-MoCA effect sizes (Cohen d) were medium to large (range: 0.65-1.42) for the diagnosis of dementia and MCI. Using the cut-off for s-MoCA specified in the index study, it proved highly sensitive (>0.9) for diagnosis of dementia but with poor specificity (≤0.25), with moderate sensitivity (≥0.75) and specificity (≥0.60) for diagnosis of MCI. In conclusion, in these pragmatic diagnostic test accuracy studies, s-MoCA proved acceptable and sensitive for the diagnosis of cognitive impairment in a memory clinic setting, with a performance similar to that of the original MoCA.

scholarly journals Neuropsychiatric Symptoms in Mild Cognitive Impairment

2017 ◽  
Vol 62 (3) ◽  
pp. 161-169 ◽  
Author(s):  
Damien Gallagher ◽  
Corinne E. Fischer ◽  
Andrea Iaboni
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Neuropsychiatric Symptoms ◽  
Later Life ◽  
Neurocognitive Disorders ◽  
Prognostic Indicators ◽  
Neurocognitive Disorder ◽  
Clinical Stages ◽  
Before And After

Objective: Neuropsychiatric symptoms (NPS) may be the first manifestation of an underlying neurocognitive disorder. We undertook a review to provide an update on the epidemiology and etiological mechanisms of NPS that occur in mild cognitive impairment (MCI) and just before the onset of MCI. We discuss common clinical presentations and the implications for diagnosis and care. Method: The authors conducted a selective review of the literature regarding the emergence of NPS in late life, before and after the onset of MCI. We discuss recent publications that explore the epidemiology and etiological mechanisms of NPS in the earliest clinical stages of these disorders. Results: NPS have been reported in 35% to 85% of adults with MCI and also occur in advance of cognitive decline. The occurrence of NPS for the first time in later life should increase suspicion for an underlying neurocognitive disorder. The presenting symptom may provide a clue regarding the etiology of the underlying disorder, and the co-occurrence of NPS may herald a more accelerated cognitive decline. Conclusions: NPS are prevalent in the early clinical stages of neurocognitive disorders and can serve as both useful diagnostic and prognostic indicators. Recognition of NPS as early manifestations of neurocognitive disorders will become increasingly important as we move towards preventative strategies and disease-modifying treatments that may be most effective when deployed in the earliest stages of disease.

Sign in / Sign up

Export Citation Format

Share Document