Informant questionnaire on cognitive decline in the elderly (IQCODE) for classifying cognitive dysfunction as cognitively normal, mild cognitive impairment, and dementia

2017 ◽  
Vol 29 (9) ◽  
pp. 1461-1467 ◽  
Author(s):  
Moon Ho Park
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Dysfunction ◽  
Roc Curve ◽  
Roc Curves ◽  
The Elderly ◽  
Youden Index ◽  
Cognitively Normal ◽  
Dichotomous Classification

ABSTRACTBackground:The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) is a reliable, validated informant-based instrument in screening for cognitive dysfunction. However, previous studies have evaluated only the ability to discriminate dichotomously, such as dementia from cognitively normal (CN) individuals or mild cognitive impairment (MCI) from CN. This study investigated the ability of the IQCODE to classify not only dichotomous but also multiple stages of cognitive dysfunction.Methods:We examined 228 consecutive participants (76 CN, 76 with MCI, and 76 with dementia). Receiver operating characteristic (ROC) curves determined dichotomous classification parameters. Multi-category ROC surfaces were evaluated to classify three stages of cognitive dysfunction.Results:Dichotomous classification using the ROC curve analyses showed that the area under the ROC curve was 0.91 for dementia from participants without dementia and 0.71 for MCI from CN. Simultaneous multi-category classification analyses showed that the volume under the ROC surface was 0.61 and the derived optimal cut-off points were 3.15 and 3.73 for CN, MCI, and dementia. The Youden index for the IQCODE was estimated as 0.51 and the derived optimal cut-off points were 3.33 and 3.70. The overall classification accuracy by the VUS was 58.3% and that by the Youden index 61.8%.Conclusions:IQCODE is useful to classify the dichotomous and multi-category stages of cognitive dysfunction.

scholarly journals Lower functional hippocampal redundancy in mild cognitive impairment

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Stephanie Langella ◽  
◽  
Muhammad Usman Sadiq ◽  
Peter J. Mucha ◽  
Kelly S. Giovanello ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Resting State ◽  
Memory Performance ◽  
Potential Mechanism ◽  
Network Efficiency ◽  
Cognitively Normal ◽  
Normal Individuals ◽  
The Relationship

AbstractWith an increasing prevalence of mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in response to an aging population, it is critical to identify and understand neuroprotective mechanisms against cognitive decline. One potential mechanism is redundancy: the existence of duplicate elements within a system that provide alternative functionality in case of failure. As the hippocampus is one of the earliest sites affected by AD pathology, we hypothesized that functional hippocampal redundancy is protective against cognitive decline. We compared hippocampal functional redundancy derived from resting-state functional MRI networks in cognitively normal older adults, with individuals with early and late MCI, as well as the relationship between redundancy and cognition. Posterior hippocampal redundancy was reduced between cognitively normal and MCI groups, plateauing across early and late MCI. Higher hippocampal redundancy was related to better memory performance only for cognitively normal individuals. Critically, functional hippocampal redundancy did not come at the expense of network efficiency. Our results provide support that hippocampal redundancy protects against cognitive decline in aging.

scholarly journals Mild Cognitive Impairment in Clinical Practice: A Review Article

2018 ◽  
Vol 33 (8) ◽  
pp. 500-507 ◽  
Author(s):  
Sukanya Jongsiriyanyong ◽  
Panita Limpawattana
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Preventive Intervention ◽  
Lifestyle Modification ◽  
The Elderly ◽  
Vascular Cognitive Impairment ◽  
Review Article ◽  
Subjective Cognitive Impairment ◽  
Rate Of Progression

The spectrum of cognitive decline in the elderly ranges from what can be classified as normal cognitive decline with aging to subjective cognitive impairment to mild cognitive impairment (MCI) to dementia. This article reviewed the up-to-date evidence of MCI including the diagnostic criteria of MCI due to Alzheimer’s disease, vascular cognitive impairment and MCI due to Parkinson disease, management and preventive intervention of MCI. There are various etiologies of MCI, and a large number of studies have been conducted to ascertain the practical modalities of preserving cognition in predementia stages. Lifestyle modification, such as aerobic exercise, is an approved modality to preserve cognitive ability and decrease the rate of progression to dementia, as well as being recommended for frailty prevention.

Depression and mild cognitive impairment – Comorbidity and/or continuum?

2016 ◽  
Vol 33 (S1) ◽  
pp. S190-S191
Author(s):  
G. Sobreira ◽  
M.A. Aleixo ◽  
C. Moreia ◽  
J. Oliveira
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Late Life ◽  
The Elderly ◽  
Late Life Depression ◽  
Pubmed Database ◽  
Competing Interest ◽  
The Relationship

IntroductionDepression and mild cognitive impairment are common among the elderly. Half the patients with late-life depression also present some degree of cognitive decline, making the distinction between these conditions difficult.ObjectivesTo conduct a database review in order to understand the relationship between these entities, and treatment approaches.AimsTo create and implement clinical guidelines at our institution, to evaluate and treat elderly patients presenting with depression and mild cognitive impairment.MethodsA PubMed database search using as keywords “late life depression”, “depression”; “cognitive impairment”; “mild cognitive impairment” and “dementia” between the year 2008 and 2015.ResultsLate-life depression and cognitive impairment are frequent among the elderly (10–20%). Depression is also common in the early stages of dementia decreasing as the cognitive decline progresses. The causal relationship between these entities is not well understood and some authors advocate a multifactorial model (genetic risk factors; neuroendocrine changes; vascular risk factors) and the cognitive impairment of said changes is dependent on the individual's cognitive reserve. Regarding treatment of depression in patients with cognitive impairment, most authors advocate a stepped approach with watchful waiting and then, if symptoms persist, the introduction of pharmacotherapy and psychosocial intervention.ConclusionsThe relationship between cognitive impairment and depression is still not clear and probably multifactorial. The diagnosis of depressive symptoms in patients with severe cognitive impairment can be difficult and most forms of pharmacological treatment in this population are not beneficial, making it important to carefully evaluate the benefits of introducing new medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Use of Magnetic Resonance Imaging to Identify Mild Cognitive Impairment: Who Should Be Imaged?

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S16) ◽  
pp. 18-20 ◽  
Author(s):  
Liana G. Apostolova
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Clinical Care ◽  
Neuropsychological Testing ◽  
The Elderly ◽  
Cognitive Change ◽  
Normal Aging ◽  
Cognitive Changes ◽  
New Information

Problems with memory are a very common complaint in the elderly and are not synonymous with dementia. Some degree of cognitive decline, manifested as greater difficulty in learning and retrieving new information for instance, develops with normal aging. Thus many older patients do not perform at the same level they did when they were younger but they do perform well when compared to their peers. For many, cognitive change ends at this stage and they proceed to lead normal, healthy, dementia-free lives.The cohort that has cognitive changes beyond what is expected in normal aging but does not yet meet criteria for dementia concerns clinicians greatly as many of these patients eventually become demented. These patients usually go through a latent stage in which neurodegenerative pathology silently spreads in the brain. Once there is enough pathological burden, cognitive decline beyond what is expected for normal aging can be detected by formal neuropsychological testing. Frequently such patients go through a state called mild cognitive impairment (MCI). In this state patients are still functionally intact and live independently, but show cognitive impairment relative to the age- and education-adjusted norms.The MCI state in itself is a prominent risk factor for developing dementia. Most patients with amnestic MCI develop Alzheimer’s disease (AD) dementia over time. At six years, as many as 80% progress to AD. Thus, MCI is a very important topic of research and an increasingly important topic of clinical care.

scholarly journals CSF sTREM2 correlates with CSF tau in advancing Parkinson’s disease

2019 ◽  
Author(s):  
Edward N. Wilson ◽  
Michelle S. Swarovski ◽  
Patricia Linortner ◽  
Marian Shahid ◽  
Abigail J. Zuckerman ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Microglial Activation ◽  
Soluble Form ◽  
Motor Symptoms ◽  
Cognitively Normal ◽  
Csf Concentration

AbstractParkinson’s disease (PD) is the second most common neurodegenerative disease after Alzheimer’s disease (AD) and affects 1% of the population above 60 years old. Although PD commonly manifests with motor symptoms, a majority of patients with PD subsequently develop cognitive impairment which often progresses to dementia, a major cause of morbidity and disability. PD is characterized by α-synuclein accumulation that frequently associates with amyloid beta (Aβ) and tau fibrils, the hallmarks of AD neuropathologic changes; this co-occurrence suggests that onset of cognitive decline in PD may be associated with appearance of pathologic Aβ and/or tau. Recent studies have highlighted the appearance of the soluble form of the Triggering Receptor Expressed on Myeloid cells 2 (sTREM2) receptor in CSF during development of AD. Given the known association of microglial activation with advancing PD, we investigated whether CSF and/or plasma sTREM2 increased with progression to PD dementia. We examined 165 participants consisting of 17 cognitively normal elderly, 45 PD patients with no cognitive impairment, 86 with mild cognitive impairment, and 17 with dementia. Stratification of subjects by CSF Aβ and tau levels revealed that CSF sTREM2 concentrations were elevated in PD subgroups with abnormal tau, but not Aβ, CSF concentration. These findings indicate that CSF sTREM2 could serve as a surrogate immune biomarker of neuronal injury in PD that is associated with cognitive decline.One sentence summaryCSF sTREM2 correlates with CSF tau in PD

An abbreviated version of Silhouettes test: a brief validated mild cognitive impairment screening tool

2018 ◽  
Vol 31 (06) ◽  
pp. 849-856
Author(s):  
Lin Huang ◽  
Ke-Liang Chen ◽  
Bi-Ying Lin ◽  
Le Tang ◽  
Qian-Hua Zhao ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Space Perception ◽  
The Elderly ◽  
Cognitive Test ◽  
Visual Object ◽  
Neuropsychological Battery ◽  
Cross Sectional ◽  
Chinese Elderly ◽  
Cognitively Normal

ABSTRACTObjectives:To revise an abbreviated version of the Silhouettes subtest of the Visual Object and Space Perception (VOSP) battery in order to recognize mild cognitive impairment (MCI) and determine the optimal cutoffs to differentiate among cognitively normal controls (NC), MCI, and Alzheimer’s Disease (AD) in the Chinese elderly.Design:A cross-sectional validation study.Setting:Huashan Hospital, Shanghai, China.Subjects:A total of 591 participants: Individuals with MCI (n = 211), AD (n = 139) and NC (n = 241) were recruited from the Memory Clinic, Huashan Hospital, Shanghai, China.Methods:Baseline neuropsychological battery (including VOSP) scores were collected from firsthand data. An abbreviated version of silhouettes test (Silhouettes-A) was revised from the original English version more suitable for the elderly, including eight silhouettes of animals and seven silhouettes of inanimate objects, with a score ranging from 0 to 15.Results:Silhouettes-A was an effective test to screen MCI in the Chinese elderly with good sensitivity and specificity, similar to the Montreal cognitive assessment and superior to other single tests reflecting language, spatial, or executive function. However, it had no advantage in distinguishing MCI from AD. The corresponding optimal cutoff scores of Silhouettes-A were 10 for screening MCI and 8 for AD.Conclusion:Silhouettes-A is a quick, simple, sensitive, and dependable cognitive test to distinguish among NC, MCI, and AD patients.

scholarly journals Combining functional scales and cognitive tests in screening for mild cognitive impairment at a university-based memory clinic in Brazil

2008 ◽  
Vol 30 (4) ◽  
pp. 346-349 ◽  
Author(s):  
Izabella Dutra de Abreu ◽  
Paula Villela Nunes ◽  
Breno Satler Diniz ◽  
Orestes Vicente Forlenza
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Cognitive Decline ◽  
Mental State ◽  
Mini Mental State Examination ◽  
The Elderly ◽  
Elderly Subjects ◽  
Cognitive State ◽  
State Examination

OBJECTIVE: To determine the diagnostic accuracy of the Mini-Mental State Examination combined to the Informant Questionnaire on Cognitive Decline in the Elderly for the identification of mild cognitive impairment. METHOD: 191 elderly subjects were assessed with the Mini-Mental State Examination, and their informants were assessed with the Informant Questionnaire on Cognitive Decline in the Elderly. Subjects were divided into three groups according to their cognitive state (controls: n = 67, mild cognitive impairment: n = 65 and dementia: n = 59), which was ascertained by clinical and neuropsychological evaluation. The diagnostic accuracy of each test in the discrimination of diagnostic groups (mild cognitive impairment vs. controls, mild cognitive impairment vs. dementia and dementia vs. controls) was examined with the aid of ROC curves. We additionally verified if the combination of both tests would increase diagnostic accuracy for mild cognitive impairment and control identification. RESULTS: The combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly scores did not increase the Mini-Mental State Examination diagnostic accuracy in the identification of patients with mild cognitive impairment. CONCLUSIONS: The present data do not warrant the combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly as a sufficient diagnostic tool in the diagnostic screening for mild cognitive impairment.

scholarly journals Mild Cognitive Impairment and Mild Dementia: The Role of Ginkgo biloba (EGb 761®)

2021 ◽  
Vol 14 (4) ◽  
pp. 305
Author(s):  
Carlo Tomino ◽  
Sara Ilari ◽  
Vincenzo Solfrizzi ◽  
Valentina Malafoglia ◽  
Guglielmo Zilio ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Combination Therapy ◽  
Cognitive Decline ◽  
Ginkgo Biloba ◽  
Neuropsychiatric Symptoms ◽  
The Elderly ◽  
Egb 761 ◽  
Age Related

Mild cognitive impairment (MCI) and dementia are clinically prevalent in the elderly. There is a high risk of cognitive decline in patients diagnosed with MCI or dementia. This review describes the effectiveness of Ginkgo biloba leaf special extract EGb 761® for the treatment of dementia syndromes and EGb 761® combination therapy with other medications for symptomatic dementia. This drug has shown convincing results, improving cognitive function, neuropsychiatric symptoms and consequent reduction of caregiver stress and maintenance of autonomy in patients with age-related cognitive decline, MCI and mild to moderate dementia. Currently, there is little evidence to support the combination therapy with anti-dementia drugs and, therefore, more evidence is needed to evaluate the role of EGb 761® in mixed therapy.

scholarly journals Increased Serum Neuropeptide Galanin Level Is a Predictor of Cognitive Dysfunction in Patients with Hip Fracture

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Zichao Xue ◽  
Ke Zhang ◽  
Biao Luo ◽  
Long Fan ◽  
Ruizhe Zhao ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cognitive Impairment ◽  
Hip Fracture ◽  
Cognitive Decline ◽  
Cognitive Dysfunction ◽  
Large Scale ◽  
Linear Regression Analysis ◽  
Cognitive Status ◽  
Significant Independent Predictor ◽  
Cognitively Normal

Background. Hip fracture is a common occurrence in elderly populations and is frequently followed by various levels of cognitive dysfunction, leading to adverse functional outcomes. Risk stratification of hip fracture patients to identify high-risk subsets can enable improved strategies to mitigate cognitive complications. The neuropeptide galanin has multiple neurological functions, and altered levels are documented in dementia-type and depression disorders. The present study investigated the association of serum neuropeptide galanin levels in hip fracture patients with the occurrence of cognitive dysfunction during the first week of admission. Methods. 276 hip fracture patients without preexisting delirium, cognitive impairment, or severe mental disorders were included in a cross-sectional study. Serum galanin levels were assessed by ELISA on the second day of admission. Routine clinical and laboratory variables were documented. MoCA was performed within 1 week, and those with a score < 26 were categorized with “cognitive decline.” Inferential statistics including multiple linear regression analysis were applied to determine the association of serum galanin level and cognitive status. Results. 141 patients were categorized with “cognitive decline,” and 135 patients were categorized as “cognitively normal.” Serum galanin was highly significantly increased in the “cognitive decline” group ( 34.2 ± 4.8 , pg/ml) compared to the “cognitively normal” group ( 28.9 ± 3.7 , pg/ml) and showed significant negative correlation with MoCA scores ( r = − 0.229 , p = 0.016 ). Regression analysis showed serum galanin as the sole significant independent predictor of lower MoCA scores ( β = 0.231 , p = 0.035 ) while age, gender, blood pressure, cholesterol, and blood glucose levels had no significant association. Conclusion. Higher serum galanin predicted the development of cognitive dysfunction and worse MoCA scores in a cohort of hip fracture patients without preexisting cognitive impairment or delirium at admission, thus warranting large-scale studies investigating galanin as a candidate biomarker to identify hip fracture patients at risk of cognitive decline.

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