Comparing measures of decline to dementia in amnestic MCI subjects in the National Alzheimer's Coordinating Center (NACC) Uniform Data Set

ABSTRACTBackground: Many studies have investigated factors associated with the rate of decline and evolution from mild cognitive impairment (MCI) to Alzheimer's disease (AD) dementia in elderly patients. In this analysis, we compared the rates of decline to dementia estimated from three common global measures of cognition: Mini-Mental State Examination (MMSE) score, Clinical Dementia Rating sum of boxes (CDR-SB) score, and a neuropsychological tests composite score (CS).Methods: A total of 2,899 subjects in the National Alzheimer's Coordinating Center Uniform Data Set aged 65+ years diagnosed with amnestic mild cognitive impairment (aMCI) were included in this analysis. Population-averaged decline to dementia rates was estimated and compared for standardized MMSE, CDR-SB, and CS using Generalized Estimating Equations (GEE). Associations between rate of decline and several potential correlates of decline were also calculated and compared across measures.Results: The CDR-SB had the steepest estimated slope, with a decline of 0.49 standard deviations (SD) per year, followed by the MMSE with 0.22 SD per year, and finally the CS with 0.07 SD per year. The rate of decline of the three measures differed significantly in a global test for differences (p < 0.0001). Age at visit, body mass index (BMI) at visit, Apolipoprotein E (APOE) ɛ4 allele status, and race (black vs. white) had significantly different relationships with rate of decline in a global test for difference among the three measures.Conclusions: These results suggest that both the rate of decline and the effects of AD risk factors on decline to dementia can vary depending on the evaluative measure used.

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A Case Report of a Patient with Mild Cognitive Impairment Treated with Gugijihwang-tang

The Journal of Internal Korean Medicine ◽

10.22246/jikm.2021.42.5.1082 ◽

2021 ◽

Vol 42 (5) ◽

pp. 1082-1093

Author(s):

Mi-so Park ◽

Seock-man Kang ◽

Dai-won Yoo ◽

In-cheol Chae ◽

Gyeong-soon Kim ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Mini Mental State Examination ◽

Treatment Method ◽

Clinical Dementia Rating ◽

Irreversible Brain Damage ◽

State Examination ◽

With Memory

Objective: Alzheimer's disease is characterized by progressive, irreversible brain damage and cognitive decline. Although the diagnosis and treatment of the prodromal symptoms of dementia are important, no treatment for mild cognitive impairment has been currently established. Herein, we report the case of an 80-year-old female patient with memory complaints treated with Gugijihwang-tang, a traditional Korean medicine herbal formula, as an add-on medication.Case Presentation: The patient was diagnosed with mild cognitive impairment based on clinical examinations using the Mini-Mental State Examination (MMSE), the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Activities of Daily Living (ADL) Scale, Global Deterioration (GDR) Scale, and Clinical Dementia Rating (CDR) Scale. She was treated with Gugijihwang-tang bis in die for 12 months while continuing her original medications, including 5-mg donepezil and 590-mg acetyl-l-carnitine. The MMSE score in the Korean Version of the CERAD Assessment Packet increased from 21 to 27 during the 12-month treatment period, and the CERAD 2 score increased from 33 to 62. The instrumental ADL scale score improved from 11 to 5. Other clinical examination results also showed improvement. The patient was satisfied and experienced no significant adverse events related to the Gugijihwang-tang treatment.Conclusion: This case suggests that Gugijihwang-tang could be considered as a treatment method for patients with mild cognitive impairment.

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Mini-Mental State Examination (MMSE) for the early detection of dementia in people with mild cognitive impairment (MCI)

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd010783.pub3 ◽

2021 ◽

Vol 2021 (7) ◽

Author(s):

Ingrid Arevalo-Rodriguez ◽

Nadja Smailagic ◽

Marta Roqué-Figuls ◽

Agustín Ciapponi ◽

Erick Sanchez-Perez ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Early Detection ◽

Mental State ◽

Mini Mental State Examination ◽

State Examination

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Can the MMSE help clinicians predict progression from mild cognitive impairment to dementia?

BJPsych Advances ◽

10.1192/apt.21.6.363 ◽

2015 ◽

Vol 21 (6) ◽

pp. 363-366 ◽

Cited By ~ 3

Author(s):

Alex J. Mitchell

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Risk Prediction ◽

Mental State ◽

Mini Mental State Examination ◽

Case Finding ◽

Cognitive Test ◽

Prediction Tool ◽

State Examination

SummaryThe Mini-Mental State Examination (MMSE) is the most widely used bedside cognitive test. It has previously been shown to be poor as a case-finding tool for both dementia and mild cognitive impairment (MCI). This month's Cochrane Corner review examines whether the MMSE might be used as a risk prediction tool for later dementia in those with established MCI. From 11 studies of modest quality, it appears that the MMSE alone should not be relied on to predict later deterioration in people with MCI. As this is the case, it is likely that only a combination of predictors would be able to accurately predict progression from MCI to dementia.

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Kanji and Kana agraphia in mild cognitive impairment and dementia: A trans-cultural comparison of elderly Japanese subjects living in Japan and Brazil

Dementia & Neuropsychologia ◽

10.1590/s1980-57642010dn40400008 ◽

2010 ◽

Vol 4 (4) ◽

pp. 300-305 ◽

Cited By ~ 1

Author(s):

Kyoko Akanuma ◽

Kenichi Meguro ◽

Mitsue Meguro ◽

Rosa Yuka Sato Chubaci ◽

Paulo Caramelli ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Abilities ◽

Prevalence Study ◽

Clinical Dementia Rating ◽

Spontaneous Writing ◽

Elderly Japanese ◽

Questionable Dementia ◽

State Examination ◽

Japanese Subjects

Abstract This study verifies the environmental effects on agraphia in mild cognitive impairment and dementia. We compared elderly Japanese subjects living in Japan and Brazil. Methods: We retrospectively analyzed the database of the Prevalence Study 1998 in Tajiri (n=497, Miyagi, Japan) and the Prevalence Study 1997 of elderly Japanese immigrants living in Brazil (n=166, migrated from Japan and living in the São Paulo Metropolitan Area). In three Clinical Dementia Rating (CDR) groups, i.e., CDR 0 (healthy), CDR 0.5 (questionable dementia), and CDR 1+ (dementia) , the Mini-Mental State Examination (MMSE) item of spontaneous writing and the Cognitive Abilities Screening Instrument (CASI) domain of dictation were analyzed with regard to the number of Kanji and Kana characters. Formal errors in characters and pragmatic errors were also analyzed. Results: The immigrants in Brazil wrote similar numbers of Kanji or Kana characters compared to the residents of Japan. In spontaneous writing, the formal Kanji errors were greater in the CDR 1+ group of immigrants. In writing from dictation, all the immigrant CDR groups made more formal errors in Kana than the Japan residents. No significant differences in pragmatic errors were detected between the two groups. Conclusions: Subjects living in Japan use Kanji frequently, and thus the form of written characters was simplified, which might be assessed as mild formal errors. In immigrants, the deterioration in Kanji and Kana writing was partly due to decreased daily usage of the characters. Lower levels of education of immigrants might also be related to the number of Kanji errors.

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A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2008.04.014 ◽

2009 ◽

Vol 43 (4) ◽

pp. 411-431 ◽

Cited By ~ 457

Author(s):

Alex J. Mitchell

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Mental State ◽

Mini Mental State Examination ◽

Meta Analysis ◽

State Examination

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Detection of mild cognitive impairment in middle-aged and older adults with obstructive sleep apnoea

European Respiratory Journal ◽

10.1183/13993003.01137-2018 ◽

2018 ◽

Vol 52 (5) ◽

pp. 1801137 ◽

Cited By ~ 7

Author(s):

Katia Gagnon ◽

Andrée-Ann Baril ◽

Jacques Montplaisir ◽

Julie Carrier ◽

Sirin Chami ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Obstructive Sleep Apnoea ◽

Mental State ◽

Cognitive Assessment ◽

Mini Mental State Examination ◽

Sleep Apnoea ◽

Screening Tests ◽

Obstructive Sleep ◽

State Examination

Obstructive sleep apnoea increases the risk for mild cognitive impairment and dementia. The present study aimed to characterise the ability of two cognitive screening tests, the Mini-Mental State Examination and the Montreal Cognitive Assessment, to detect mild cognitive impairment in adults aged 55–85 years with and without obstructive sleep apnoea.We included 42 subjects with mild and 67 subjects with moderate-to-severe obstructive sleep apnoea. We compared them to 22 control subjects. Mild cognitive impairment was diagnosed by a comprehensive neuropsychological assessment. We used receiver operating characteristic curves to assess the ability of the two screening tests to detect mild cognitive impairment.The two screening tests showed similar discriminative ability in control subjects. However, among the mild and the moderate-to-severe obstructive sleep apnoea groups, the Mini-Mental State Examination was not able to correctly identify subjects with mild cognitive impairment. The Montreal Cognitive Assessment's discriminant ability was acceptable in both sleep apnoea groups and was comparable to what was observed in controls.The Mini-Mental State Examination should not be used to screen for cognitive impairment in patients with obstructive sleep apnoea. The Montreal Cognitive Assessment could be used in clinical settings. However, clinicians should refer patients for neuropsychological assessment when neurodegenerative processes are suspected.

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Comparison of the Mini-Mental State Examination and Computerized Brief Cognitive Screening Test as Cognitive Screening Tools in Patients with Mild Cognitive Impairment

Current Alzheimer Research ◽

10.2174/1567205018666211215151418 ◽

2021 ◽

Vol 18 ◽

Author(s):

Che-Sheng Chu ◽

I-Chen Lee ◽

Chuan-Cheng Hung ◽

I-Ching Lee ◽

Chi-Fa Hung ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Normal Control ◽

Internal Consistency ◽

Mental State ◽

Screening Test ◽

Mini Mental State Examination ◽

Cognitive Screening ◽

Validity And Reliability ◽

State Examination

Background: The aim of this study was to establish the validity and reliability of the Computerized Brief Cognitive Screening Test (CBCog) for early detection of cognitive impairment. Method: One hundred and sixty participants, including community-dwelling and out-patient volunteers (both men and women) aged ≥ 65 years, were enrolled in the study. All participants were screened using the CBCog and Mini-Mental State Examination (MMSE). The internal consistency of the CBCog was analyzed using Cronbach’s α test. Areas under the curves (AUCs) of receiver operating characteristic analyses were used to test the predictive accuracy of the CBCog in detecting mild cognitive impairment (MCI) in order to set an appropriate cutoff point. Results: The CBCog scores were positively correlated with the MMSE scores of patients with MCI-related dementia (r = 0.678, P < .001). The internal consistency of the CBCog (Cronbach’s α) was 0.706. It was found that the CBCog with a cutoff point of 19/20 had a sensitivity of 97.5% and a specificity of 53.7% for the diagnosis of MCI with education level ≥ 6 years. The AUC of the CBCog for discriminating the normal control elderly from patients with MCI (AUC = 0.827, P < 0.001) was larger than that of the MMSE for discriminating the normal control elderly from patients with MCI (AUC= 0.819, P < .001). Conclusion: The CBCog demonstrated to have sufficient validity and reliability to evaluate mild cognitive impairment, especially in highly educated elderly people.

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