scholarly journals A-02 Comparing Rate of Change in MoCA and MMSE Scores Over Time in an MCI and AD sample

2020 ◽  
Vol 35 (6) ◽  
pp. 792-792
Author(s):  
Carlew A ◽  
Goette W ◽  
Womack K ◽  
Hynan L ◽  
Lacritz L
Keyword(s):  
Empirical Support ◽  
Cognitive Change ◽  
Consensus Conference ◽  
Rate Of Change ◽  
Longitudinal Change ◽  
Reliable Change Index ◽  
Multilevel Regression ◽  
Change Over Time ◽  
Significant Change ◽  
Over Time

Abstract Objective The Montreal Cognitive Assessment (MoCA) and Mini-Mental Status Exam (MMSE) are used for tracking cognitive change in mild cognitive impairment (MCI) and Alzheimer’s disease (AD), despite limited empirical support for this purpose. This study compared longitudinal change in MMSE and MoCA scores to investigate their applicability for tracking cognitive change. Method Inclusion criteria were: diagnosis of MCI or AD (CDR global = .5) by consensus conference, administration of the MoCA and MMSE across ≥3 visits, and no reversion to normal (n = 59; Mage = 70.81; Meducation = 14.97; 56% male; 76.3% Caucasian; 80% MCI at baseline). Testing sessions occurred ~ 12 months apart (M = 12.59, SD = 3.43, range 5–28 months). Change in MMSE and MoCA scores was modeled using multilevel regression. A 95% bootstrap confidence interval (BCI) for the slopes of both tests was computed and used to evaluate whether the tests measured significantly different change. Results Controlling for age and education, the MoCA demonstrated significantly more change over time (95% BCI [−0.06, −0.02]; MoCA Visit 1 M = 24.00, Visit 4 M = 21.88) than the MMSE (95% BCI [−0.03, 0.01]; MMSE Visit 1 M = 27.83, Visit 4 M = 27.50). MoCA scores significantly declined over the study period (but did not exceed the reliable change index), while MMSE scores did not. Conclusions The MMSE did not show significant change over time, while the MoCA did in this heavily MCI sample. Although statistically significant, clinical significance of change in the MoCA is unclear. Increasing MoCA use calls for additional research to understand what constitutes a clinically significant change and whether it is appropriate for tracking cognitive trajectories.

scholarly journals A morphometric double dissociation: cortical thickness is more related to aging; surface area is more related to cognition

2021 ◽  
Author(s):  
Sophia Borgeest ◽  
Richard N Henson ◽  
Tim C. Kietzmann ◽  
Christopher R. Madan ◽  
Theresa Fox ◽  
...  
Keyword(s):  
Surface Area ◽  
Cortical Thickness ◽  
Cognitive Abilities ◽  
Fluid Intelligence ◽  
Cognitive Change ◽  
Longitudinal Change ◽  
Change Over Time ◽  
Shape Metrics ◽  
Brain Age ◽  
Over Time

The thickness and surface area of cortex are genetically distinct aspects of brain structure, and may be affected differently by age. However, their potential to differentially predict age and cognitive abilities has been largely overlooked, likely because they are typically aggregated into the commonly used measure of volume. In a large sample of healthy adults (N=647, aged 18-88), we investigated the brain-age and brain-cognition relationships of thickness, surface area, and volume, plus five additional morphological shape metrics. Cortical thickness was the metric most strongly associated with age cross-sectionally, as well as exhibiting the steepest longitudinal change over time (subsample N=261, aged 25-84). In contrast, surface area was the best single predictor of age-residualized cognitive abilities (fluid intelligence), and changes in surface area were most strongly associated with cognitive change over time. These findings were replicated in an independent dataset (N=1345, aged 18-93). Our results suggest that cortical thickness and surface area make complementary contributions the age-brain-cognition triangle, and highlight the importance of considering these volumetric components separately.

Development of standardized regression-based formulas to assess meaningful cognitive change in early Parkinson’s disease

2020 ◽  
Author(s):  
Hannah L Combs ◽  
Kate A Wyman-Chick ◽  
Lauren O Erickson ◽  
Michele K York
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Test Scores ◽  
Prediction Models ◽  
Early Stage ◽  
Cognitive Change ◽  
Cognitive Test ◽  
Healthy Controls ◽  
Change Over Time ◽  
Over Time

Abstract Objective Longitudinal assessment of cognitive and emotional functioning in patients with Parkinson’s disease (PD) is helpful in tracking progression of the disease, developing treatment plans, evaluating outcomes, and educating patients and families. Determining whether change over time is meaningful in neurodegenerative conditions, such as PD, can be difficult as repeat assessment of neuropsychological functioning is impacted by factors outside of cognitive change. Regression-based prediction formulas are one method by which clinicians and researchers can determine whether an observed change is meaningful. The purpose of the current study was to develop and validate regression-based prediction models of cognitive and emotional test scores for participants with early-stage idiopathic PD and healthy controls (HC) enrolled in the Parkinson’s Progression Markers Initiative (PPMI). Methods Participants with de novo PD and HC were identified retrospectively from the PPMI archival database. Data from baseline testing and 12-month follow-up were utilized in this study. In total, 688 total participants were included in the present study (NPD = 508; NHC = 185). Subjects from both groups were randomly divided into development (70%) and validation (30%) subsets. Results Early-stage idiopathic PD patients and healthy controls were similar at baseline. Regression-based models were developed for all cognitive and self-report mood measures within both populations. Within the validation subset, the predicted and observed cognitive test scores did not significantly differ, except for semantic fluency. Conclusions The prediction models can serve as useful tools for researchers and clinicians to study clinically meaningful cognitive and mood change over time in PD.

scholarly journals Neglecting Decline: Remembered and Predicted Personal Development Diverge from Actual Longitudinal Change.

2019 ◽  
Author(s):  
Sarah Molouki ◽  
Daniel Bartels ◽  
Oleg Urminsky
Keyword(s):  
Longitudinal Study ◽  
Personal Development ◽  
Absolute Magnitude ◽  
Longitudinal Change ◽  
Personal Change ◽  
Future Change ◽  
Change Over Time ◽  
Time Period ◽  
One Year ◽  
Over Time

A one-year longitudinal study was conducted to investigate the accuracy of people’s assessmentsof their own personal change over time. We compared people’s predicted, actual, and recalledchange in their personality, values, and preferences over this time period. On average,participants underestimated the absolute magnitude of their personal change, yet simultaneouslyoverestimated their net improvement, in both prediction and recall. This effect was due to anasymmetry whereby people selectively neglected negative changes, especially prospectively.Although participants in our sample both improved and declined over the year, they were morelikely to remember past improvements than declines, and made nearly uniformly positivepredictions of future change. We discuss how the current findings reconcile researchdemonstrating expectations of personal improvement (e.g., Wilson & Ross, 2001; Kanten &Teigen, 2008) with other research that suggests people overpredict their personal stability(Quoidbach, Gilbert, & Wilson, 2013).

Prognostication of Asymptomatic Penetrating Aortic Ulcers: A Modern Approach

Circulation ◽  
2021 ◽  
Author(s):  
Charles DeCarlo ◽  
Christopher A. Latz ◽  
Laura T. Boitano ◽  
Young Kim ◽  
Adam Tanious ◽  
...  
Keyword(s):  
Cumulative Incidence ◽  
Radiographic Progression ◽  
Intramural Hematoma ◽  
Rate Of Change ◽  
Change Over Time ◽  
Modern Approach ◽  
Ulcer Size ◽  
Risk Of Death ◽  
Over Time

Background: Literature detailing the natural history of asymptomatic penetrating aortic ulcers (PAU) is sparse and lacks long-term follow-up. This study sought to determine the rate of asymptomatic PAU growth over time and adverse events from asymptomatic PAU. Methods: A cohort of patients with asymptomatic PAU from 2005-2020 was followed. One ulcer was followed per patient. Primary endpoints were change in size over time and the composite of symptoms, radiographic progression, rupture, and intervention; cumulative incidence function estimated the incidence of the composite outcome. Ulcer size and rate of change were modeled using a linear mixed effects model. Patient and anatomic factors were evaluated as potential predictors of the outcomes. Results: There were 273 patients identified. Mean age was 75.5±9.6 years; 66.4% were male. The majority of ulcers were in the descending thoracic aorta (53.9%), followed by abdominal aorta (41.4%), and aortic arch (4.8%). Fusiform aneurysmal disease was present in 21.6% of patients at a separate location; 2.6% had an associated intramural hematoma; 23.6% had at least one other PAU. Symptoms developed in one patient who ruptured; 8 patients (2.9%) underwent an intervention for PAU (one for rupture, 2 for radiographic progression, 5 for size/growth) at a median of 3.1 years (IQR:1.0-6.5) after diagnosis. Five and 10-year cumulative incidence of the primary outcome, adjusted for competing risk of death, was 3.6% (95% CI: 1.6-6.9%) and 6.5% (95% CI: 3.1-11.4%), respectively. For 191 patients with multiple CT scans (760 total CT's) with median radiographic follow-up of 3.50 years (IQR:1.20-6.63 years), mean initial ulcer width, ulcer depth, and total diameter in millimeters (mm) was 13.6, 8.5, and 31.4, respectively. Small, but statistically significant change over time was observed for ulcer width (0.23 mm/year) and total diameter (0.24 mm/year); ulcer depth did not significantly change over time. Hypertension, hyperlipidemia, diabetes, initial ulcer width>20 mm, thrombosed PAU, and associated saccular aneurysm were associated with larger changes in ulcer size over time, however the magnitude of difference was small, ranging from 0.4-1.9 mm/year. Conclusions: Asymptomatic PAU displayed minimal growth and infrequent complications including rupture. Asymptomatic PAU may be conservatively managed with serial imaging and risk-factor modification.

scholarly journals Exploring Changes in Activity Patterns in Individuals with Chronic Pain

2020 ◽  
Vol 17 (10) ◽  
pp. 3560
Author(s):  
Elena Rocío Serrano-Ibáñez ◽  
Rebecca Bendayan ◽  
Carmen Ramírez-Maestre ◽  
Alicia Eva López-Martínez ◽  
Gema Teresa Ruíz-Párraga ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Specific Activity ◽  
Activity Patterns ◽  
Positive Association ◽  
Random Coefficients ◽  
Rate Of Change ◽  
Linear Change ◽  
Change Over Time ◽  
Pain Duration ◽  
Over Time

This longitudinal study explored whether activity patterns change over time in a sample of 56 individuals with chronic musculoskeletal pain over a 15-day period. Once a day, the participants recorded their level of pain intensity and the degree to which they had engaged in several specific activity patterns. Linear mixed models with random coefficients were used to investigate the rate of change in the activity patterns. Age, sex, pain intensity, and pain duration were controlled. The results show that excessive persistence was the only self-reported activity pattern to show a linear change over the 15-day period. There was a decrease in excessive persistence, and this decrease was slower with higher levels of activity avoidance. However, no significant association was found between sex, age, pain intensity, and pain duration and excessive persistence at baseline or change over time. At baseline, a positive association was found between excessive persistence and pain avoidance, pain-related persistence, and pacing to reduce pain, and a negative association was found between excessive persistence and pacing to save energy for valued activities. This result suggests a profile characterized by alternate periods of high and low activity that, in this study, were unrelated to longitudinal changes in pain intensity.

Evidence Based on a dynamic source: Database support for a theory of transitive reciprocals

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Ken Safir
Keyword(s):  
Natural Language ◽  
Empirical Support ◽  
Direct Object ◽  
Evidence Based ◽  
Change Over Time ◽  
Search Results ◽  
Source Database ◽  
Linguistic Research ◽  
Dynamic Source ◽  
Over Time

AbstractThe novelty of this document is that the empirical support for the predictions it examines, predictions about the distribution and interpretation of transitive reciprocal constructions, will be different each time it is read. The evidence will change because this paper will only provide parameters for a search of the Afranaph Database (ongoing) and two other databases, and as these databases grow and change over time, the search results returned today will be different from the results returned by the same search executed months or years from now. Reversing the normal priorities of linguistic research, the proposal we present about the nature of reciprocal constructions in natural language, which contends that direct object full DPs anaphors do not directly contribute reciprocal meaning (a proposal more broadly and specifically defended by

scholarly journals Apathy as a behavioural marker of cognitive impairment in Parkinson’s disease: a longitudinal analysis

2019 ◽  
Vol 267 (1) ◽  
pp. 214-227 ◽  
Author(s):  
Glen P. Martin ◽  
Kathryn R. McDonald ◽  
David Allsop ◽  
Peter J. Diggle ◽  
Iracema Leroi
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Psychiatric Symptoms ◽  
Cognitive Change ◽  
Longitudinal Change ◽  
Random Intercept ◽  
Behavioural Factors ◽  
Over Time

Abstract Background Understanding the longitudinal course of non-motor symptoms, and finding markers to predict cognitive decline in Parkinson’s disease (PD), are priorities. Previous work has demonstrated that apathy is one of the only behavioural symptoms that differentiates people with PD and intact cognition from those with mild cognitive impairment (MCI-PD). Other psychiatric symptoms emerge as dementia in PD develops. Objective We explored statistical models of longitudinal change to detect apathy as a behavioural predictor of cognitive decline in PD. Methods We followed 104 people with PD intermittently over 2 years, undertaking a variety of motor, behavioural and cognitive measures. We applied a linear mixed effects model to explore behavioural factors associated with cognitive change over time. Our approach goes beyond conventional modelling based on a random-intercept and slope approach, and can be used to examine the variability in measures within individuals over time. Results Global cognitive scores worsened during the two-year follow-up, whereas the longitudinal evolution of self-rated apathy scores and other behavioural measures was negligible. Level of apathy was negatively (− 0.598) correlated with level of cognitive impairment and participants with higher than average apathy scores at baseline also had poorer cognition. The model indicated that departure from the mean apathy score at any point in time was mirrored by a corresponding departure from average global cognitive score. Conclusion High levels of apathy are predictive of negative cognitive and behavioural outcomes over time, suggesting that apathy may be a behavioural indicator of early cognitive decline. This has clinical and prognostic implications.

scholarly journals Assessing Recovery and Establishing Prognosis Following Total Knee Arthroplasty

2008 ◽  
Vol 88 (1) ◽  
pp. 22-32 ◽  
Author(s):  
Deborah M Kennedy ◽  
Paul W Stratford ◽  
Daniel L Riddle ◽  
Steven E Hanna ◽  
Jeffrey D Gollish
Keyword(s):  
Total Knee Arthroplasty ◽  
Lower Extremity ◽  
Functional Status ◽  
Knee Arthroplasty ◽  
Rate Of Change ◽  
Change Over Time ◽  
Total Knee ◽  
Preoperative Status ◽  
And Gender ◽  
Over Time

Background and PurposeInformation about expected rate of change after arthroplasty is critical for making prognostic decisions related to rehabilitation. The goals of this study were: (1) to describe the pattern of change in lower-extremity functional status of patients over a 1-year period after total knee arthroplasty (TKA) and (2) to describe the effect of preoperative functional status on change over time.SubjectsEighty-four patients (44 female, 40 male) with osteoarthritis, mean age of 66 years (SD=9), participated.MethodsRepeated measurements for the Lower Extremity Functional Scale (LEFS) and the Six-Minute Walk Test (6MWT) were taken over a 1-year period. Data were plotted to examine the pattern of change over time. Different models of recovery were explored using nonlinear mixed-effects modeling that accounted for preoperative status and gender.ResultsGrowth curves were generated that depict the rate and amount of change in LEFS scores and 6MWT distances up to 1 year following TKA. The curves account for preoperative status and gender differences across participants.Discussion and ConclusionThe greatest improvement occurred in the first 12 weeks after TKA. Slower improvement continued to occur from 12 weeks to 26 weeks after TKA, and little improvement occurred beyond 26 weeks after TKA. The findings can be used by physical therapists to make prognostic judgments related to the expected rate of improvement following TKA and the total amount of improvement that may be expected.

The Alzheimer's Disease Assessment Scale

1996 ◽  
Vol 8 (2) ◽  
pp. 195-203 ◽  
Author(s):  
Richard C. Mohs
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Longitudinal Data ◽  
Memory Loss ◽  
Cognitive Change ◽  
Rate Of Change ◽  
Assessment Scale ◽  
Disease Assessment ◽  
Treatment Trials ◽  
Over Time

This article reviews longitudinal data collected from patients with Alzheimer's disease (AD) that are relevant to the design and interpretation of clinical treatment trials. Longitudinal data from patients tested with the Alzheimer's Disease Assessment Scale demonstrate that cognitive symptoms, including memory loss, dysphasia, and dyspraxia, worsen relentlessly over time with the rate of change depending upon baseline dementia severity. Noncognitive symptoms, such as agitation, depressed mood, and psychosis, are episodic, do not necessarily worsen over time, and tend not to be highly correlated with one another. The reliability of cognitive change measures increases with follow-up duration so that the likelihood of detecting drug effects on the rate of cognitive deterioration is greater with longer treatment trials. Functional measures of activities of daily living are difficult to standardize for AD patients but are important for determining the overall clinical and economic impact of AD treatments.

Sign in / Sign up

Export Citation Format

Share Document