Do cognitive complaints either predict future cognitive decline or reflect past cognitive decline? A longitudinal study of an elderly community sample

1997 ◽  
Vol 27 (1) ◽  
pp. 91-98 ◽  
Author(s):  
A. F. JORM ◽  
H. CHRISTENSEN ◽  
A. E. KORTEN ◽  
A. S. HENDERSON ◽  
P. A. JACOMB ◽  
...  

Data from a two-wave longitudinal study of an elderly community sample were used to assess whether cognitive complaints either predict subsequent cognitive decline or reflect past cognitive decline. Cognitive complaints and cognitive functioning were assessed on two occasions three and a half years apart. Cognitive complaints at Wave 1 were found not to predict future cognitive change on the Mini-Mental State Examination, an episodic memory test or a test of mental speed. Similarly, cognitive complaints at Wave 2 were unrelated to past cognitive changes on these tests after statistically controlling for the effects of anxiety and depression. Furthermore, cognitive complaints did not predict either mortality (after controlling for anxiety and depression) or future dementia. These results are evidence against the inclusion of cognitive complaints in diagnostic criteria for proposed disorders such as age-associated memory impairment, mild cognitive disorder and ageing-associated cognitive decline.

1995 ◽  
Vol 25 (4) ◽  
pp. 673-683 ◽  
Author(s):  
C. Brayne ◽  
C. Gill ◽  
E. S. Paykel ◽  
F. Huppert ◽  
D. W. O'Connor

SYNOPSISA sample of 1111 survivors from a population aged 75 years and over completed the Mini-Mental State Examination (MMSE) twice, separated by 28 months on average. There was a mean decline of 1·3 points in MMSE score. With increasing age, mean drop in score also increased. The proportion at each age identified as newly cognitively impaired according to any standard cut-point on MMSE rose markedly. Mean decline was greater in women than men even after adjustment for age. Cognitive change on the MMSE was approximately unimodally and normally distributed. This distribution was a marked contrast to the distribution of MMSE scores themselves, which was skewed due to truncation of scores at the maximum. The decline was not due to the inclusion of individuals with physical impairment. These findings indicate that cognitive decline, like dementia, becomes increasingly common with advancing age, and suggest that dementia may be regarded as one extreme of the continuum of cognitive decline.


2000 ◽  
Vol 12 (2) ◽  
pp. 231-247 ◽  
Author(s):  
Ling Han ◽  
Martin Cole ◽  
Francois Bellavance ◽  
Jane McCusker ◽  
Francois Primeau

Objectives: To estimate the annual rate of change scores (ARC) on the Mini-Mental State Examination (MMSE) in Alzheimer's disease (AD) and to identify study or population characteristics that may affect the ARC estimation. Methods: MEDLINE was searched for articles published from January 1981 to November 1997 using the following keywords: AD and longitudinal study or prognosis or cognitive decline. The bibliographies of review articles and relevant papers were searched for additional references. All retrieved articles were screened to meet the following inclusion criteria: (a) original study; (b) addressed cognitive decline or prognosis or course of AD; (c) published in English; (d) study population included AD patients with ascertainable sample size; (e) used either clinical or pathological diagnostic criteria; (f) longitudinal study design; and (g) used the MMSE as one of the outcome measures. Data were systematically abstracted from the included studies, and a random effects regression model was employed to synthesize relevant data across studies and to evaluate the effects of study methodology on ARC estimation and its effect size. Results: Of the 439 studies screened, 43 met all the inclusion criteria. After 6 studies with inadequate or overlapping data were excluded, 37 studies involving 3,492 AD patients followed over an average of 2 years were included in the meta-analysis. The pooled estimate of ARC was 3.3 (95% confidence interval [CI]: 2.9-3.7). The observed variability in ARC across studies could not be explained with the covariates we studied, whereas part of the variability in the effect size of ARC could be explained by the minimum MMSE score at entry and number of assessments. Conclusions: A pooled average estimate of ARC in AD patients was 3.3 points (95% CI: 2.9-3.7) on the MMSE. Significant heterogeneity of ARC estimates existed across the studies and cannot be explained by the study or population characteristics investigated. Effect size of ARC was related to the initial MMSE score of the study population and the number of assessments.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 366-366
Author(s):  
Joohong Min ◽  
Jieun Song

Abstract Prior research has found that the risk of cognitive decline increases after the death of a spouse. In general, the impact of life transitions is contingent on contextual factors such as socio-demographic characteristics or relationship quality. However, there is limited research on how marital quality before spousal loss and gender influence the association between spousal loss and cognitive change. The current study examines the effects of spousal loss on change in cognitive functioning as well as the moderating effects of pre-loss marital quality and gender. Data from two waves of the Midlife in the United States (MIDUS) study were analyzed (MIDUS2: 2004-05, MIDUS3: 2013-14). The analytic sample consists of two groups: (1) 179 bereaved adults who were age 54 or older at MIDUS2 (M = 65.2, SD = 9.5) and whose spouses died between MIDUS2 and MIDUS3, and (2) 179 non-bereaved adults, matched with the bereaved group on age and gender, who did not experience spousal loss between the two waves. Cognitive function was assessed via BTACT (Brief Telephone Adult Cognition Test) at both waves. Regression results show that both pre-loss marital quality and gender significantly moderate the association between spousal loss and change in cognitive functioning. Specifically, relative to their counterparts, men and those who reported better marital relationships prior to spousal death had a greater risk of cognitive decline after a spouse’s death. The findings suggest the significance of pre-loss marital quality and gender for cognitive changes in widowhood and have implications for the development of efficient interventions


2010 ◽  
Vol 32 (3) ◽  
pp. 223-230 ◽  
Author(s):  
Jerson Laks ◽  
Evandro Silva Freire Coutinho ◽  
Washington Junger ◽  
Heitor Silveira ◽  
Raphael Mouta ◽  
...  

OBJECTIVE: Mini-Mental State Examination cutoffs have been presented for schooling levels to screen cognitive impairment. However, items may behave differently with regards to education. The objective of this study was to examine the impact of education on MMSE subscales and items. METHOD: Community-dwelling participants aged 65 years or more (n = 990, females = 637, age = 74.1 years, range 65-108) were stratified as illiterate (n = 373), 1-8 (n = 540), 9-12 (n = 63), and more than 12 years of schooling (n = 14) and were screened with MMSE and Pfeffer Functional Activities Questionnaire. To make the Mini-Mental State Examination items comparable, each item was transformed into z scores. Multiple linear regression was used to estimate the effect of schooling on MMSE subs and items controlling for age, sex, and activities of daily life. RESULTS: Temporal and space orientation, attention/calculation, repetition, reading, writing, and drawing scores improved as education increased, but not memory registration, three step command, and naming. Reading and writing displayed the largest coefficients, whereas education exerted no influence on naming and three step command tasks. CONCLUSION: Education does not exert an important effect on naming, three step command, memory registration, and delayed recall. As memory is a key factor for diagnosing dementia, these items could be considered despite education.


2021 ◽  
Vol 26 (4) ◽  
pp. 46-49
Author(s):  
O. V. Kim ◽  
Yo. N. Madzhidova ◽  
F. R. Sharipov

Introduction. In chronic cerebrovascular diseases (CVD), neuroprotective medications, the effectiveness of which requires further study, are widely used. The effectiveness of Cytoflavinum in patients with chronic CVD was evaluated.Material and methods. The data of 60 patients (35 women and 25 men) with chronic CVD were analyzed. 30 patients, included in the main group (mean age 61 ± 5.87 years old), in addition to basic therapy (antihypertensive, antithrombotic drugs, statins), received Cytoflavinum according to the following scheme: 1 time a day in the morning intravenously 10.0 ml for 10 days, then 2 tablets 2 times a day for 30 days. 30 patients in the comparison group (mean age 59.8 ± 8.7 years old) received only basic therapy. An analysis of patient complaints, neurological status was carried out. Mini Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS) were used.Results. In the group of patients taking Cytoflavinum, there was a decrease in the frequency and intensity of headache, dizziness, an increase in MMSE score from 26.32 ± 0.86 to 28.05 ± 1.36 (p ≤ 0.05), in MoCA score from 25.35 ± 0.96 to 27.88 ± 1.13 (p ≤ 0.05), decrease in anxiety score from 8.82 ± 1.31 to 5.2 ± 2.82 (p ≤ 0.05) and decrease in HADS depression score from 8.31 ± 1.85 to 4.6 ± 3.15 (p ≤ 0.05).Conclusion. The inclusion of Cytoflavinum in the treatment regimen for patients with chronic CVD helps to reduce the frequency and intensity of headaches and dizziness, improve cognitive functions, and reduce the level of anxiety and depression.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S94-S94 ◽  
Author(s):  
Erik L Knight ◽  
Ryan Giuliano ◽  
Sean Shank ◽  
Megan Clarke ◽  
David M Almeida

Abstract The two branches of the autonomic nervous system (ANS) have been individually linked to age-related changes in cognitive functioning: The parasympathetic nervous system (PNS) is thought to support healthy cognitive aging, whereas the sympathetic nervous system (SNS) has been linked to heightened cognitive decline. Despite these separate findings and despite the integrative nature of the ANS, little work has examined the two branches simultaneously to better understand their interactive effects on age-related cognitive changes. We examined cognitive change in two waves of the MIDUS cognitive project and indexed PNS and SNS activity from heart rate variability and epinephrine levels (respectively) from the MIDUS biomarker project (n = 764, 56% female, mean age = 54.1 years). Our findings indicate that higher PNS levels attenuate cognitive decline, but only among individuals with low SNS levels; at higher SNS levels, the beneficial effects of the PNS are blocked. Further, lower PNS levels can be somewhat compensated for by increased SNS levels. This pattern was most robust among individuals transitioning to mid-life (i.e., 35-40 years old at the initial cognitive test). These results suggest that interventions targeting the ANS as a modifiable factor in cognitive aging should consider both ANS branch’s effects simultaneously, particularly in the early stages of midlife.


2014 ◽  
Vol 43 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Viviane Philipps ◽  
Hélène Amieva ◽  
Sandrine Andrieu ◽  
Carole Dufouil ◽  
Claudine Berr ◽  
...  

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.


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