scholarly journals Innovative motor and cognitive dual-task approaches combining upper and lower limbs may improve dementia early detection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gianmaria Mancioppi ◽  
Laura Fiorini ◽  
Erika Rovini ◽  
Radia Zeghari ◽  
Auriane Gros ◽  
...  
Keyword(s):  
Dual Task ◽  
Regression Models ◽  
Mini Mental State Examination ◽  
Lower Limbs ◽  
Cognitive Screening ◽  
Logistic Regression Models ◽  
Non Invasive ◽  
State Examination ◽  
Spearman’S Correlation ◽  
Gold Standards

AbstractMotor and Cognitive Dual-Task (MCDT) represents an innovative chance to assess Mild Cognitive Impairment (MCI). We compare two novel MCDTs, fore-finger tapping (FTAP), toe-tapping (TTHP), to gold standards for cognitive screening (Mini-Mental State Examination—MMSE), and to a well-established MCDT (GAIT). We administered the aforementioned MCDTs to 44 subjects (MCIs and controls). Motor parameters were extracted, and correlations with MMSE investigated. Logistic regression models were built, and AUC areas computed. Spearman’s correlation demonstrated that FTAP and TTHP significantly correlate with MMSE, at each cognitive load. AUC areas computed report similar (FTAP, 0.87), and even higher (TTHP, 0.97) capability to identify MCIs, if compared to GAIT (0.92). We investigated the use of novel MCDT approaches to assess MCI, aiming to enrich the clinical repertoire with objective and non-invasive tools. Our protocol shows good correlations with MMSE, and reaches high performances in identifying MCI, adopting simpler exercises.

scholarly journals Leisure Activities, APOE ε4, and Cognitive Decline: A Longitudinal Cohort Study

2021 ◽  
Vol 13 ◽  
Author(s):  
Yun Zhang ◽  
Shihui Fu ◽  
Ding Ding ◽  
Michael W. Lutz ◽  
Yi Zeng ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Regression Models ◽  
Mini Mental State Examination ◽  
Leisure Activities ◽  
Interactive Effects ◽  
Logistic Regression Models ◽  
Healthy Longevity ◽  
Productive Activities ◽  
Ε4 Allele ◽  
State Examination

Background: Both leisure activities and the ε4 allele of the apolipoprotein E (APOE ε4) have been shown to affect cognitive health. We aimed to determine whether engagement in leisure activities protects against APOE ε4-related cognitive decline.Methods: We used the cohort data from the Chinese Longitudinal Healthy Longevity Survey. A total of 3,017 participants (mean age of 77.0 years, SD = 9.0; 49.3% female) from 23 provinces of China were recruited in 2008 and were reinterviewed in 2014. We assessed cognitive function using the Mini-Mental State Examination (MMSE). We calculated cognitive decline using subtraction of the MMSE score of each participant in 2008 and 2014. We genotyped a number of APOE ε4 alleles for each participant at baseline and determined the Index of Leisure Activities (ILAs) by summing up the frequency of nine types of typical activities in productive, social, and physical domains. We used ordinal logistic regression models to estimate the effects of leisure activities, APOE ε4, and their interaction on cognitive decline, statistically adjusted for a range of potential confounders.Results: There were significant associations between APOE ε4 and faster cognitive decline, independent of potential confounders, and between leisure activities and mitigated cognitive decline. The odds ratios were 1.25 (95% CI: 1.03, 1.53) and 0.93 (95% CI: 0.89, 0.97), respectively. We found significant interactions of APOE ε4 with leisure activities with a P-value of 0.018. We also observed interactive effects of subtypes of leisure activities: participants who regularly engaged in productive activities were more likely to reduce the risk of APOE ε4-related cognitive decline.Conclusion: Our findings provide support for the indication that participating in leisure activities reduces the risk of APOE ε4-related cognitive decline.

scholarly journals Random Forest Model in the Diagnosis of Dementia Patients with Normal Mini-Mental State Examination Scores

2022 ◽  
Vol 12 (1) ◽  
pp. 37
Author(s):  
Jie Wang ◽  
Zhuo Wang ◽  
Ning Liu ◽  
Caiyan Liu ◽  
Chenhui Mao ◽  
...  
Keyword(s):  
Machine Learning ◽  
Cognitive Impairment ◽  
Random Forest ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Machine Learning Algorithms ◽  
Assessment Model ◽  
Test Time ◽  
Cognitive Screening ◽  
State Examination

Background: Mini-Mental State Examination (MMSE) is the most widely used tool in cognitive screening. Some individuals with normal MMSE scores have extensive cognitive impairment. Systematic neuropsychological assessment should be performed in these patients. This study aimed to optimize the systematic neuropsychological test battery (NTB) by machine learning and develop new classification models for distinguishing mild cognitive impairment (MCI) and dementia among individuals with MMSE ≥ 26. Methods: 375 participants with MMSE ≥ 26 were assigned a diagnosis of cognitively unimpaired (CU) (n = 67), MCI (n = 174), or dementia (n = 134). We compared the performance of five machine learning algorithms, including logistic regression, decision tree, SVM, XGBoost, and random forest (RF), in identifying MCI and dementia. Results: RF performed best in identifying MCI and dementia. Six neuropsychological subtests with high-importance features were selected to form a simplified NTB, and the test time was cut in half. The AUC of the RF model was 0.89 for distinguishing MCI from CU, and 0.84 for distinguishing dementia from nondementia. Conclusions: This simplified cognitive assessment model can be useful for the diagnosis of MCI and dementia in patients with normal MMSE. It not only optimizes the content of cognitive evaluation, but also improves diagnosis and reduces missed diagnosis.

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

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.

scholarly journals Trends in the prevalence of cognitive impairment in Chinese older adults: based on the Chinese Longitudinal Healthy Longevity Survey cohorts from 1998 to 2014

2020 ◽  
Vol 12 (5) ◽  
pp. 378-387
Author(s):  
Weihong Kuang ◽  
Mingyue Gao ◽  
Liantian Tian ◽  
Yang Wan ◽  
Peiyuan Qiu
Keyword(s):  
Cognitive Impairment ◽  
Daily Living ◽  
Regression Models ◽  
Mini Mental State Examination ◽  
Female Gender ◽  
Multilevel Regression ◽  
Chinese Older Adults ◽  
Healthy Longevity ◽  
Cognitive Activities ◽  
State Examination

Abstract In the context of a rapidly ageing Chinese population, this study aims to examine trends in the prevalence of cognitive impairment among people ≥65 y of age in China. Our sample is 72 821 adults aged 65–105 y from the seven waves of the Chinese Longitudinal Healthy Longevity Survey, a national mixed longitudinal cohort. The Chinese version of the Mini-Mental State Examination was used to measure CI. Risk factor-adjusted prevalence trend was examined using multilevel regression models. Age-standardized prevalence of cognitive impairment increased from 11.00% in 1998 to 11.84% in 2008 and decreased to 8.88% in 2014. Older age, female gender, less education, rural residence, not married, lack of physical and cognitive activities, suffering from stroke, vision and hearing impairment, and activities of daily living disability were negatively associated with cognitive impairment. Our study suggests a decreasing trend of cognitive impairment prevalence in China. However, whether decreasing prevalence will contribute to a reduced burden of cognitive impairment given the ageing of the population is unknown.

scholarly journals Is the Mini-Mental State Examination the best cognitive screening test for less educated people?

2019 ◽  
Vol 77 (5) ◽  
pp. 330-334 ◽  
Author(s):  
Luis Felipe Scarabelot ◽  
Mariane de Moraes Monteiro ◽  
Mauren Carneiro da Silva Rubert ◽  
Viviane de Hiroki Flumignan Zetola
Keyword(s):  
Verbal Fluency ◽  
Mini Mental State Examination ◽  
Recall Test ◽  
Cognitive Screening ◽  
Delayed Recall ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test ◽  
State Examination ◽  
Fluency Test

ABSTRACT Mini-Mental State Examination (MMSE) results are strongly influenced by educational level. The Brief Cognitive Screening Battery (BCSB) is an alternative assessment tool that provides more accurate results in individuals with less education. Objective: Our aim was to compare the MMSE and BCSB as screening tests. Methods: The MMSE and BCSB were assessed in 112 participants by two evaluators blind to the other test's result. Participants were classified according to their level of education. The influence of education level was analyzed using the Kruskal-Wallis and multiple comparison tests. Results: Scores of the MMSE (p < 0.0001) and the clock-drawing test (p < 0.0001) were influenced by education level but the delayed recall test score was not (p = 0.0804). The verbal fluency test (p = 0.00035) was influenced only by higher educational levels. It took three minutes less to apply the MMSE than to apply the BCSB (p < 0.0001). Conclusions: These findings suggest that the delayed recall test and the verbal fluency test of the BCSB are better than the MMSE and clock-drawing test as tools for evaluating cognition in people with limited education.

Use of benzodiazepines and cognitive performance in primary care patients with first cognitive complaints

2017 ◽  
Vol 30 (4) ◽  
pp. 597-601 ◽  
Author(s):  
G. Grande ◽  
I. Tramacere ◽  
D. L. Vetrano ◽  
S. Pomati ◽  
C. Mariani ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Performance ◽  
Mini Mental State Examination ◽  
Cognitive Complaints ◽  
Logistic Regression Models ◽  
Benzodiazepine Use ◽  
Primary Care Patients ◽  
Long Acting ◽  
The Impact ◽  
State Examination

ABSTRACTThe aim of the present study is to investigate the impact of benzodiazepine use on cognitive performance in primary care patients with first cognitive complaints. The association between the exposition to benzodiazepines (short and long half-life) and cognitive performance, evaluated through the Mini Mental State Examination (MMSE), was tested through analysis of the covariance and logistic regression models. Within the 4,249 participants (mean age 77.0 ± 8.2, 66.4% women), 732 (17%) were on benzodiazepines. When compared with non-users, short- and long-acting benzodiazepine users presented overlapping adjusted MMSE mean scores (respectively, mean MMSE score: 25.3, 95%CI 25.2–25.5; 25.4, 95%CI 25.1–25.7, and 25.9, 95%CI 25.3–26.4; p = 0.156). When tested according to the logistical regression model, after adjusting for potential confounders, no association was found between short and long acting benzodiazepine use and a MMSE < 24 (respectively, OR 0.9, 95%CI 0.7–1.2; OR 0.8, 95%CI 0.7–1.3) as compared with non-users. In conclusion, according to the results of our study, benzodiazepine use seems not to impact on cognitive performance- as assessed with the MMSE- of primary care patients referring to GPs for first cognitive complaints.

scholarly journals Converting from the Montreal Cognitive Assessment to the Mini-Mental State Examination-2

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254055
Author(s):  
Hwabeen Yang ◽  
Daehyuk Yim ◽  
Moon Ho Park
Keyword(s):  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Intraclass Correlation ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Conversion Table ◽  
Linear Smoothing ◽  
Log Linear ◽  
State Examination

Objective The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination-2 (MMSE-2) are useful psychometric tests for cognitive screening. Many clinicians want to predict the MMSE-2 score based on the MoCA score. To facilitate the transition from the MoCA to the MMSE-2, this study developed a conversion method. Methods This study retrospectively examined the relationship between the MoCA and MMSE-2. Overall, 303 participants were evaluated. We produced a conversion table using the equipercentile equating method with log-linear smoothing. Then, we evaluated the reliability and accuracy of this algorithm to convert the MoCA to the MMSE-2. Results MoCA scores were converted to MMSE-2 scores according to a conversion table that achieved a reliability of 0.961 (intraclass correlation). The accuracy of this algorithm was 84.5% within 3 points difference from the raw score. Conclusions This study reports a reliable and easy conversion algorithm for transforming MoCA scores into converted MMSE-2 scores. This method will greatly enhance the utility of existing cognitive data in clinical and research settings.

scholarly journals Deglutition Impairment during Dual Task in Parkinson Disease Is Associated with Cognitive Status

2020 ◽  
Author(s):  
Luciana Grolli Ardenghi ◽  
Alana Verza Signorini ◽  
Gerson Schulz Maahs ◽  
Fabio Selaimen ◽  
Konrado Massing Deutsch ◽  
...  
Keyword(s):  
Parkinson Disease ◽  
Dual Task ◽  
Mini Mental State Examination ◽  
Cognitive Status ◽  
Motor Tasks ◽  
Concurrent Tasks ◽  
Task Assessment ◽  
Group A ◽  
Motor Movements ◽  
State Examination

Abstract Introduction Dysphagia is a relevant symptom in Parkinson disease (PD), and its pathophysiology is poorly understood. To date, researchers have not investigated the effects of combined motor tasks on swallowing. Such an assessment is of particular interest in PD, in which patients have specific difficulties while performing two movements simultaneously. Objective The present study tested the hypothesis that performing concurrent tasks could decrease the safety of swallowing in PD patients as visualized using fiberoptic endoscopic evaluation of swallowing (FEES). Methods A total of 19 patients and 19 controls matched by age, gender, and level of schooling were compared by FEES under two conditions: isolated swallowing and dual task (swallowing during non-sequential opposition of the thumb against the other fingers). The two tasks involved volumes of food of 3 mL and 5 mL. The PD subjects were classified according to the Hoehn & Yahr (H&Y) Scale, the Mini Mental State Examination (MMSE), and the Montreal Cognitive Assessment (MoCA). The FEES assessment was performed according to the Boston Residue and Clearance Scale (BRACS). Results The data showed a significant worsening of swallowing in the dual task assessment for both volumes (3 mL: p ≤ 0.001; 5 mL: p ≤ 0.001) in the PD group. A correlation between the MoCA and dual-task swallowing of 3 mL was also found. Conclusion These findings suggest that additional tasks involving manual motor movements result in swallowing impairment in patients with PD. Moreover, these data highlight the need to further evaluate such conditions during treatment and assessment of PD patients.

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