Predicting Who Will Develop Dementia in a Cohort of Canadian Seniors

ABSTRACT:Objectives:We examined whether easily attainable variables were useful in predicting who became demented over a five year period and determined the rates of incident dementia for different categories of mild cognitive impairment.Methods:This was a cohort study of subjects recruited nationally in a population-based survey of Canadians 65 years and older (the Canadian Study of Health and Aging). After standardized clinical assessments, a subset of subjects (n=1782) was categorized as not demented at time one. Identical study methods allowed a reassessment of the cognitive status of surviving subjects (n=892) five years later.Results:Three baseline variables (Modified Mini Mental State (3MS) score, subject's age, and an informant's report of the presence of memory problems) were statistically significant predictors of the development of a dementia. An equation incorporating these three variables had a sensitivity of 79% and a specificity of 56% for predicting dementia among survivors at time two. An equation substituting the MMSE for the 3MS showed similar results. The various categories of mild cognitive impairment examined showed significantly different likelihoods for the subsequent development of a dementia. Some categories with a higher dementia risk were characterized by inclusion criteria requiring neuropsychological test scores that were greater than one standard deviation (SD) below the mean of age based normative data.Conclusion:In the absence of extensive laboratory, radiologic or neuropsychological tests, simple variables that can be easily determined in the course of a single clinical encounter were useful in predicting subjects with a higher risk of developing dementia. Attempts to use neuropsychological results to predict the development of dementia should look for significant impairments on age-standardized tests.

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Influence of Pre-Existing Mild Cognitive Impairment and Dementia on Post-Stroke Mortality. The Dijon Stroke Registry

Neuroepidemiology ◽

10.1159/000497614 ◽

2019 ◽

Vol 54 (6) ◽

pp. 490-497 ◽

Cited By ~ 4

Author(s):

Mathilde Graber ◽

Lucie Garnier ◽

Sophie Mohr ◽

Benoit Delpont ◽

Christelle Blanc-Labarre ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cox Regression ◽

Case Fatality ◽

Population Based ◽

Cognitive Status ◽

Stroke Severity ◽

Day Case ◽

Stroke Registry ◽

Dementia Patients

Objective: We assessed the association between pre-stroke cognitive status and 90-day case-fatality. Methods: Patients with ischemic stroke (IS) or spontaneous intracerebral hemorrhage (ICH) were prospectively identified among residents of Dijon, France, between 2013 and 2015, using a population-based registry. Association between pre-stroke cognitive status and case-fatality at 90 days was evaluated using Cox regression. Results: Seven hundred sixty-two patients were identified, and information about pre-stroke cognitive status was obtained for 716 (92.6%) of them, including 603 IS (84.2%) and 113 ICH (15.8%). Before stroke, 99 (13.8%) patients had mild cognitive impairment (MCI) and 98 (13.7%) had dementia. Patients with cognitive impairment were older, had a higher prevalence of several risk factors, more severe stroke, more frequent ICH, and less admission to stroke unit. Case-fatality rate at 90 days was 11.7% in patients without cognitive impairment, 32.3% in MCI patients, and 55.1% in patients with dementia. In multivariable analyses, pre-existing MCI (hazard ratio [HR] 2.22, 95% CI 1.21–4.05, p = 0.009) and dementia (HR 4.35, 95% CI 2.49–7.61, p < 0.001) were both associated with 90-day case-fatality. Conclusion: Pre-stroke MCI and dementia were both associated with increased mortality. These associations were not fully explained by baseline characteristics, pre-stroke dependency, stroke severity or patient management, and underlying reasons need to be investigated.

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Impact of impairment in instrumental activities of daily living and mild cognitive impairment on time to incident dementia - results of the Leipzig Longitudinal Study Of The Aged (LEILA75+)

Psychiatrische Praxis ◽

10.1055/s-0031-1277901 ◽

2011 ◽

Vol 38 (S 01) ◽

Author(s):

T Luck ◽

M Luppa ◽

M Angermeyer ◽

A Villringer ◽

HH König ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Longitudinal Study ◽

Activities Of Daily Living ◽

Daily Living ◽

Instrumental Activities ◽

Incident Dementia

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Paraoxonase 1, B Vitamins Supplementation, and Mild Cognitive Impairment

Journal of Alzheimer s Disease ◽

10.3233/jad-210137 ◽

2021 ◽

pp. 1-19

Author(s):

Joanna Perła-Kaján ◽

Olga Włoczkowska ◽

Anetta Zioła-Frankowska ◽

Marcin Frankowski ◽

A. David Smith ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Controlled Trial ◽

Verbal Learning ◽

Cognitive Status ◽

B Vitamins ◽

Paraoxonase 1 ◽

Phenyl Acetate ◽

Double Blind ◽

Trail Making

Background: Identification of modifiable risk factors that affect cognitive decline is important for the development of preventive and treatment strategies. Status of paraoxonase 1 (PON1), a high-density lipoprotein-associated enzyme, may play a role in the development of neurological diseases, including Alzheimer’s disease. Objective: We tested a hypothesis that PON1 status predicts cognition in individuals with mild cognitive impairment (MCI). Methods: Individuals with MCI (n = 196, 76.8-years-old, 60% women) participating in a randomized, double-blind placebo-controlled trial (VITACOG) were assigned to receive a daily dose of folic acid (0.8 mg), vitamin B12 (0.5 mg) and B6 (20 mg) (n = 95) or placebo (n = 101) for 2 years. Cognition was analyzed by neuropsychological tests. Brain atrophy was quantified in a subset of participants (n = 168) by MRI. PON1 status, including PON1 Q192R genotype, was determined by quantifying enzymatic activity of PON1 using paraoxon and phenyl acetate as substrates. Results: In the placebo group, baseline phenylacetate hydrolase (PhAcase) activity of PON1 (but not paraoxonase activity or PON1 Q192R genotype) was significantly associated with global cognition (Mini-Mental State Examination, MMSE; Telephone Inventory for Cognitive Status-modified, TICS-m), verbal episodic memory (Hopkins Verbal Learning Test-revised: Total Recall, HVLT-TR; Delayed Recall, HVLT-DR), and attention/processing speed (Trail Making A and Symbol Digits Modalities Test, SDMT) at the end of study. In addition to PhAcase, baseline iron and triglycerides predicted MMSE, baseline fatty acids predicted SDMT, baseline anti-N-Hcy-protein autoantibodies predicted TICS-m, SDMT, Trail Making A, while BDNF V66M genotype predicted HVLT-TR and HVLT-DR scores at the end of study. B-vitamins abrogated associations of PON1 and other variables with cognition. Conclusion: PON1 is a new factor associated with impaired cognition that can be ameliorated by B-vitamins in individuals with MCI.

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Psychometric Properties of the Persian Montreal Cognitive Assessment in Mild Cognitive Impairment and Alzheimer Disease

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000514673 ◽

2021 ◽

pp. 51-57

Author(s):

Vahid Rashedi ◽

Mahshid Foroughan ◽

Negin Chehrehnegar

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Alzheimer Disease ◽

Psychometric Properties ◽

Cognitive Assessment ◽

Screening Test ◽

Cognitive Status ◽

Montreal Cognitive Assessment ◽

Cutoff Score ◽

Persian Version

Introduction: The Montreal Cognitive Assessment (MoCA) is a cognitive screening test widely used in clinical practice and suited for the detection of Mild Cognitive Impairment (MCI). The aims were to evaluate the psychometric properties of the Persian MoCA as a screening test for mild cognitive dysfunction in Iranian older adults and to assess its accuracy as a screening test for MCI and mild Alzheimer disease (AD). Method: One hundred twenty elderly with a mean age of 73.52 ± 7.46 years participated in this study. Twenty-one subjects had mild AD (MMSE score ≤21), 40 had MCI, and 59 were cognitively healthy controls. All the participants were administered the Mini-Mental State Examination (MMSE) to evaluate their general cognitive status. Also, a battery of comprehensive neuropsychological assessments was administered. Results: The mean score on the Persian version of the MoCA and the MMSE were 19.32 and 25.62 for MCI and 13.71 and 22.14 for AD patients, respectively. Using an optimal cutoff score of 22 the MoCA test detected 86% of MCI subjects, whereas the MMSE with a cutoff score of 26 detected 72% of MCI subjects. In AD patients with a cutoff score of 20, the MoCA had a sensitivity of 94% whereas the MMSE detected 61%. The specificity of the MoCA was 70% and 90% for MCI and AD, respectively. Discussion: The results of this study show that the Persian version of the MoCA is a reliable screening tool for detection of MCI and early stage AD. The MoCA is more sensitive than the MMSE in screening for cognitive impairment, proving it to be superior to MMSE in detecting MCI and mild AD.

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The Effect of CAG Repeats within the Non-Pathological Range in the HTT Gene on Cognitive Functions in Patients with Subjective Cognitive Decline and Mild Cognitive Impairment

Diagnostics ◽

10.3390/diagnostics11061051 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1051

Author(s):

Valentina Bessi ◽

Salvatore Mazzeo ◽

Silvia Bagnoli ◽

Giulia Giacomucci ◽

Assunta Ingannato ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Spatial Ability ◽

Cognitive Status ◽

Cag Repeat ◽

Cag Repeats ◽

Subjective Cognitive Decline ◽

Visual Spatial ◽

Premorbid Intelligence

The Huntingtin gene (HTT) is within a class of genes containing a key region of CAG repeats. When expanded beyond 39 repeats, Huntington disease (HD) develops. Individuals with less than 35 repeats are not associated with HD. Increasing evidence has suggested that CAG repeats play a role in modulating brain development and brain function. However, very few studies have investigated the effect of CAG repeats in the non-pathological range on cognitive performances in non-demented individuals. In this study, we aimed to test how CAG repeats’ length influences neuropsychological scores in patients with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). We included 75 patients (46 SCD and 29 MCI). All patients underwent an extensive neuropsychological battery and analysis of HTT alleles to quantify the number of CAG repeats. Results: CAG repeat number was positively correlated with scores of tests assessing for executive function, visual–spatial ability, and memory in SCD patients, while in MCI patients, it was inversely correlated with scores of visual–spatial ability and premorbid intelligence. When we performed a multiple regression analysis, we found that these relationships still remained, also when adjusting for possible confounding factors. Interestingly, logarithmic models better described the associations between CAG repeats and neuropsychological scores. CAG repeats in the HTT gene within the non-pathological range influenced neuropsychological performances depending on global cognitive status. The logarithmic model suggested that the positive effect of CAG repeats in SCD patients decreases as the number of repeats grows.

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Same-Sex Couples and Cognitive Impairment: Evidence From the Health and Retirement Study

The Journals of Gerontology Series B ◽

10.1093/geronb/gbaa202 ◽

2020 ◽

Author(s):

Hui Liu ◽

Ning Hsieh ◽

Zhenmei Zhang ◽

Yan Zhang ◽

Kenneth M Langa

Keyword(s):

Cognitive Impairment ◽

The United States ◽

Population Based ◽

Cognitive Status ◽

Health And Retirement Study ◽

Sex Partners ◽

Physical And Mental Health ◽

Same Sex ◽

Same Sex Couples ◽

Retirement Study

Abstract Objectives We provide the first nationally representative population-based study of cognitive disparities among same-sex and different-sex couples in the United States. Methods We analyzed data from the Health and Retirement Study (2000–2016). The sample included 23,669 respondents (196 same-sex partners and 23,473 different-sex partners) aged 50 and older who contributed to 85,117 person-period records (496 from same-sex partners and 84,621 from different-sex partners). Cognitive impairment was assessed using the modified version of the Telephone Interview for Cognitive Status. Mixed-effects discrete-time hazard regression models were estimated to predict the odds of cognitive impairment. Results The estimated odds of cognitive impairment were 78% (p < .01) higher for same-sex partners than for different-sex partners. This disparity was mainly explained by differences in marital status and, to a much lesser extent, by differences in physical and mental health. Specifically, a significantly higher proportion of same-sex partners than different-sex partners were cohabiting rather than legally married (72.98% vs. 5.42% in the study sample), and cohabitors had a significantly higher risk of cognitive impairment than their married counterparts (odds ratio = 1.53, p < .001). Discussion The findings indicate that designing and implementing public policies and programs that work to eliminate societal homophobia, especially among older adults, is a critical step in reducing the elevated risk of cognitive impairment among older same-sex couples.

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Clinical features of incidental mild cognitive impairment and dementia in a population-based study

Geriatrics and Gerontology International ◽

10.1111/ggi.12778 ◽

2016 ◽

Vol 17 (5) ◽

pp. 722-729 ◽

Cited By ~ 3

Author(s):

Nozomi Hishikawa ◽

Yusuke Fukui ◽

Kota Sato ◽

Toru Yamashita ◽

Yasuyuki Ohta ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Clinical Features ◽

Population Based ◽

Population Based Study

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MRI and MRS predictors of mild cognitive impairment in a population-based sample

Neurology ◽

10.1212/wnl.0b013e31829a3329 ◽

2013 ◽

Vol 81 (2) ◽

pp. 126-133 ◽

Cited By ~ 51

Author(s):

K. Kantarci ◽

S. D. Weigand ◽

S. A. Przybelski ◽

G. M. Preboske ◽

V. S. Pankratz ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Population Based

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Lipidomic Network of Mild Cognitive Impairment from the Mayo Clinic Study of Aging

Journal of Alzheimer s Disease ◽

10.3233/jad-201347 ◽

2021 ◽

pp. 1-11

Author(s):

Xuewei Wang ◽

Hai Bui ◽

Prashanthi Vemuri ◽

Jonathan Graff-Radford ◽

Clifford R. Jack Jr ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Network Analysis ◽

Mayo Clinic ◽

Plasma Lipids ◽

Amyloid Β ◽

Cognitive Status ◽

Correlation Network ◽

Lipid Species ◽

Clinic Study

Background: Lipid alterations contribute to Alzheimer’s disease (AD) pathogenesis. Lipidomics studies could help systematically characterize such alterations and identify potential biomarkers. Objective: To identify lipids associated with mild cognitive impairment and amyloid-β deposition, and to examine lipid correlation patterns within phenotype groups Methods: Eighty plasma lipids were measured using mass spectrometry for 1,255 non-demented participants enrolled in the Mayo Clinic Study of Aging. Individual lipids associated with mild cognitive impairment (MCI) were first identified. Correlation network analysis was then performed to identify lipid species with stable correlations across conditions. Finally, differential correlation network analysis was used to determine lipids with altered correlations between phenotype groups, specifically cognitively unimpaired versus MCI, and with elevated brain amyloid versus without. Results: Seven lipids were associated with MCI after adjustment for age, sex, and APOE4. Lipid correlation network analysis revealed that lipids from a few species correlated well with each other, demonstrated by subnetworks of these lipids. 177 lipid pairs differently correlated between cognitively unimpaired and MCI patients, whereas 337 pairs of lipids exhibited altered correlation between patients with and without elevated brain amyloid. In particular, 51 lipid pairs showed correlation alterations by both cognitive status and brain amyloid. Interestingly, the lipids central to the network of these 51 lipid pairs were not significantly associated with either MCI or amyloid, suggesting network-based approaches could provide biological insights complementary to traditional association analyses. Conclusion: Our attempt to characterize the alterations of lipids at network-level provides additional insights beyond individual lipids, as shown by differential correlations in our study.

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