A-7 Discriminating between Mild Cognitive Impairment and Alzheimer’s Disease on the MoCA

Abstract Objective The Montreal Cognitive Assessment (MoCA) is a suitable, sensitive, and specific cognitive screener for detecting mild cognitive impairment (MCI). Previous research has found markers to discriminate between MCI and Alzheimer’s disease (ad) on MoCA subtest scores. Specifically, impaired performance on the clock drawing (i.e., number and hand placement), rhino naming, serial 7’s, word recall, and orientation were suggestive of ad. The aim of the present study is to assess for discrimination patterns in MoCA performance between MCI and ad.Method: Data was collected through the National Alzheimer’s Coordinating Center (NACC). A sample of MCI (n = 1143; 51% female, 82% White, 15% Black, 3% Asian/Pacific Islander) and ad groups (n = 1339; 56% female, 89% White, 9% Black, 2% Asian/Pacific Islander) were examined. Results An initial independent t-test revealed a statistically significant difference in MoCA scores for MCI (M = 22.01, SD = 3.49) and ad (M = 14.46, SD = 6.05; t(2480) = 38.72, p = 0.000, Cohen’s d = 1.53). Additional t-tests were performed to compare MoCA subtest scores and domain scores for diagnostic groups. There was a statistically significant difference for MCI and ad groups across all MoCA subtests and domains. Despite no discrimination in profiles noted on t-tests, further examination using normal distribution revealed worse performance on trails, clock hands, serial 7’s, repetition, fluency, date, and place in ad groups. Conclusions Consistent with previous findings, clock hands, serial 7’s, and orientation were able to discriminate between ad and MCI. This study found further discrimination in trails, repetition, and fluency. These findings may allow for clinicians to use these patterns of performance as early cognitive markers of impairment.

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A-16 MoCA Subtest Analysis: Discriminating between Healthy Controls and MCI

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.34 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1057-1057

Author(s):

Lauren N Ratcliffe ◽

Taylor F McDonald ◽

Craig Marker

Keyword(s):

Cognitive Impairment ◽

Cognitive Assessment ◽

Pacific Islander ◽

Word Recall ◽

Healthy Controls ◽

Cognitive Markers ◽

Attention Tasks ◽

Asian Pacific Islander ◽

Significant Difference ◽

Asian Pacific

Abstract Objective The Montreal Cognitive Assessment (MoCA) is a suitable, sensitive, and specific cognitive screener for detecting mild cognitive impairment (MCI). Previous research has found markers to discriminate between healthy controls and MCI on MoCA subtest scores. Specifically, MCI performed worse on executive functioning and attention tasks (i.e., inverse digits, serial 7’s, repetition, fluency, abstraction, and word recall). The aim of the present study is to assess for discrimination patterns in MoCA performance between healthy controls and MCI. Method Data was collected through the National Alzheimer’s Coordinating Center (NACC). A sample of healthy controls (n = 3776, 65% female, 80% White, 17% Black, 3% Asian/Pacific Islander) and MCI (n = 1143; 51% female, 82% White, 15% Black, 3% Asian/Pacific Islander) were examined. Results An initial independent t-test revealed a statistically significant difference in MoCA scores for healthy controls (M = 26.18, SD = 2.78) and MCI (M = 22.01, SD = 3.49; t(4917) = 36.91, p = 0.000, Cohen’s d = 1.32). Additional t-tests were performed to compare MoCA subtest scores and domain scores for diagnostic groups. There was a statistically significant difference for healthy controls and MCI groups across all MoCA subtests and domains. Further examination using normal distribution revealed worse performance on cube copy and word recall in MCI groups. Conclusions Consistent with previous findings, word recall was able to discriminate between healthy controls and MCI. However, this study was able to find discrimination in cube copy performance. These findings may guide clinicians to use these interval changes as early cognitive markers for impairment, allowing for early detection and intervention.

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Saffron for mild cognitive impairment and dementia: a systematic review and meta-analysis of randomised clinical trials

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-020-03102-3 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Zahra Ayati ◽

Guoyan Yang ◽

Mohammad Hossein Ayati ◽

Seyed Ahmad Emami ◽

Dennis Chang

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Clinical Trials ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Function ◽

Daily Living ◽

Randomised Clinical Trials ◽

Disease Assessment ◽

Significant Difference

Abstract Background Saffron (stigma of Crocus sativus L.) from Iridaceae family is a well-known traditional herbal medicine that has been used for hundreds of years to treat several diseases such as depressive mood, cancer and cardiovascular disorders. Recently, anti-dementia property of saffron has been indicated. However, the effects of saffron for the management of dementia remain controversial. The aim of the present study is to explore the effectiveness and safety of saffron in treating mild cognitive impairment and dementia. Methods An electronic database search of some major English and Chinese databases was conducted until 31st May 2019 to identify relevant randomised clinical trials (RCT). The primary outcome was cognitive function and the secondary outcomes included daily living function, global clinical assessment, quality of life (QoL), psychiatric assessment and safety. Rev-Man 5.3 software was applied to perform the meta-analyses. Results A total of four RCTs were included in this review. The analysis revealed that saffron significantly improves cognitive function measured by the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) and Clinical Dementia Rating Scale-Sums of Boxes (CDR-SB), compared to placebo groups. In addition, there was no significant difference between saffron and conventional medicine, as measured by cognitive scales such as ADAS-cog and CDR-SB. Saffron improved daily living function, but the changes were not statistically significant. No serious adverse events were reported in the included studies. Conclusions Saffron may have the potential to improve cognitive function and activities of daily living in patients with Alzheimer’s disease and mild cognitive impairment (MCI). However, due to limited high-quality studies there is insufficient evidence to make any recommendations for clinical use. Further clinical trials on larger sample sizes are warranted to shed more light on its efficacy and safety.

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Retinal Microvascular Alterations in Alzheimer’s Disease and Mild Cognitive Impairment

10.21203/rs.3.rs-37801/v1 ◽

2020 ◽

Author(s):

Jacqueline Chua ◽

Qinglan Hu ◽

Mengyuan Ke ◽

Bingyao Tan ◽

Jimmy Hong ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Foveal Avascular Zone ◽

Retinal Microvasculature ◽

Diabetes Status ◽

Significant Difference ◽

Perfusion Density ◽

Large Vessels

Abstract Background: The retina and brain share many neuronal and vasculature characteristics developmentally and potential biomarkers may be present in the retina. We investigated the retinal microvasculature in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) using optical coherence tomography angiography (OCTA).Methods: In this cross-sectional study, 24 AD participants, 37 MCI participants, and 29 controls were diagnosed according to internationally accepted criteria. OCTA images of the superficial and deep capillary plexus (SCP, DCP) of the retinal microvasculature were obtained using a commercial OCTA system (Zeiss Cirrus HD-5000 with AngioPlex, Carl Zeiss Meditec, Dublin, CA). The main outcome measures were vessel density (VD) and fractal dimension (FD) in the SCP and DCP within a 2.5-mm ring around the fovea were compared between groups. Perfusion density of large vessels and foveal avascular zone (FAZ) area were additional outcome parameters.Results: Age, gender and race did not differ among groups. However, there was a significant difference in diabetes status (P=0.039), and systolic blood pressure (P=0.008) among the groups. After adjusting for confounders, AD participants showed significantly decreased VD in SCP and DCP (P = 0.005 and P = 0.016, respectively) and decreased FD in SCP (P = 0.008), compared to controls. MCI participants showed significantly decreased VD and FD only in SCP (P = 0.005 and P < 0.001, respectively) and not the DCP (P > 0.05) compared with controls. There was no difference in the OCTA variables between AD and MCI (P > 0.05). Perfusion density of large vessels and FAZ area did not differ significantly between groups (P > 0.05).Conclusions and relevance: Eyes of patients with AD have significantly reduced macular VD in both plexuses whereas MCI participants only showed reduction in the superficial plexus. Changes in the retinal microvasculature and capillary network may mirror small vessel cerebrovascular changes in AD.

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Retinal microvasculature dysfunction is associated with Alzheimer’s disease and mild cognitive impairment

Alzheimer s Research & Therapy ◽

10.1186/s13195-020-00724-0 ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Jacqueline Chua ◽

Qinglan Hu ◽

Mengyuan Ke ◽

Bingyao Tan ◽

Jimmy Hong ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Valuable Insight ◽

Retinal Microvasculature ◽

Diabetes Status ◽

Significant Difference ◽

Perfusion Density ◽

Large Vessels

Abstracts Background The retina and brain share many neuronal and vasculature characteristics. We investigated the retinal microvasculature in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) using optical coherence tomography angiography (OCTA). Methods In this cross-sectional study, 24 AD participants, 37 MCI participants, and 29 controls were diagnosed according to internationally accepted criteria. OCTA images of the superficial and deep capillary plexus (SCP, DCP) of the retinal microvasculature were obtained using a commercial OCTA system (Zeiss Cirrus HD-5000 with AngioPlex, Carl Zeiss Meditec, Dublin, CA). The main outcome measures were vessel density (VD) and fractal dimension (FD) in the SCP and DCP within a 2.5-mm ring around the fovea which were compared between groups. Perfusion density of large vessels and foveal avascular zone (FAZ) area were additional outcome parameters. Results Age, gender, and race did not differ among groups. However, there was a significant difference in diabetes status (P = 0.039) and systolic blood pressure (P = 0.008) among the groups. After adjusting for confounders, AD participants showed significantly decreased VD in SCP and DCP (P = 0.006 and P = 0.015, respectively) and decreased FD in SCP (P = 0.006), compared to controls. MCI participants showed significantly decreased VD and FD only in SCP (P = 0.006 and P < 0.001, respectively) and not the DCP (P > 0.05) compared with controls. There was no difference in the OCTA variables between AD and MCI (P > 0.05). Perfusion density of large vessels and FAZ area did not differ significantly between groups (P > 0.05). Conclusions and relevance Eyes of patients with AD have significantly reduced macular VD in both plexuses whereas MCI participants only showed reduction in the superficial plexus. Changes in the retinal microvasculature and capillary network may offer a valuable insight on the brain in AD.

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Egocentric and Allocentric Spatial Cognition in Amnestic Mild Cognitive Impairment and Early Alzheimer’s Disease

European Neurology ◽

10.1159/000509495 ◽

2020 ◽

Vol 83 (4) ◽

pp. 395-403

Author(s):

Ritsuo Hashimoto ◽

Momoko Uechi ◽

Noriyo Komori

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Spatial Cognition ◽

Spatial Information ◽

Amnestic Mild Cognitive Impairment ◽

Significant Difference ◽

Topographical Disorientation ◽

The Individual

Background: Topographical disorientation is one of the early symptoms of Alzheimer’s disease (AD). The nature of this symptom, however, remains unclear. Objective: The aim of the study was to investigate egocentric and allocentric spatial cognition in patients with amnestic mild cognitive impairment (aMCI) and early AD. Participants and Methods: The participants consisted of normal healthy volunteers (n = 23), patients with aMCI (n = 26), and patients with early AD (n = 22). We administered the card placing test (CPT), in which a subject was required to recreate an array of 3 cards, each of which was randomly placed on 8 grids around the individual, before (part A) and after (part B) the individual’s rotation. With this design, the CPT can reveal an individual’s ability to represent spatial information either egocentrically (CPT-A) or allocentrically (CPT-B). A qualitative analysis of errors in performing the CPT was also conducted. Results: Compared with the controls, the aMCI patients showed significantly poorer CPT-B performance, while there was no significant difference in CPT-A performance between these 2 groups. In contrast, the AD patients demonstrated significantly poorer performance on both the CPT-A and CPT-B than the controls and aMCI patients. There was no significant difference in the profile of errors on the CPT-B between the controls and aMCI patients, whereas there was a notable difference in those on the CPT-A between the controls and AD patients and the aMCI and AD patients. Conclusion: Allocentric spatial cognition is selectively impaired in aMCI patients, while an egocentric spatial cognition is additionally impaired in AD patients.

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Study on the Behavioural Assessment of the Dysexecutive Syndrome (BADS) performance in healthy individuals, Mild Cognitive Impairment and Alzheimer's disease: A preliminary study

Dementia & Neuropsychologia ◽

10.1590/s1980-57642009dn30200006 ◽

2009 ◽

Vol 3 (2) ◽

pp. 101-107 ◽

Cited By ~ 6

Author(s):

Cristiane Garcia da Costa Armentano ◽

Cláudia Sellitto Porto ◽

Sonia Maria Dozzi Brucki ◽

Ricardo Nitrini

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Rating Scale ◽

Neuropsychiatric Symptoms ◽

Inhibitory Response ◽

Healthy Controls ◽

Healthy Individuals ◽

Significant Difference

Abstract Executive deficits as well as deficits in episodic memory characterize the initial phases of Alzheimer Disease (AD) and are clinically correlated to neuropsychiatric symptoms and functional loss. Patients with Mild Cognitive Impairment present more problems as to inhibitory response control, switching and cognitive flexibility. Objective: To compare performance on the BADS with performance on other executive functional tests among patients with mild Alzheimer's disease, Amnestic Mild Cognitive Impairment (aMCI) to performance of control individuals and to examine discriminative capacity of BADS among these groups. Methods: The BADS was performed by 35 healthy controls, 13 patients with aMCI, and 16 mild probable AD patients. Besides performing the BADS, subjects underwent neuropsychological evaluation which comprised: the Dementia Rating Scale (DRS), verbal fluency by phonemic categories (F.A.S) and Concentrated Attention Test (CA). Results: There were no differences among groups by educational level, but performance differed for age (p<0.01). No difference between healthy controls and aMCI patients was found on total scores or subitems of the BADS. A significant difference was observed between aMCI and AD patients (p<0.05) and between controls and AD patients (p<0.05) on total and standard scores. Conclusions: Performance on the BADS differed between healthy individuals and mild AD patients. The BADS proved to be a sensitive method for discriminating AD from aMCI.

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Does plasma phoenixin level associate with cognition? Comparison between subjective memory complaint, mild cognitive impairment, and mild Alzheimer's disease

International Psychogeriatrics ◽

10.1017/s1041610217000825 ◽

2017 ◽

Vol 29 (9) ◽

pp. 1543-1550 ◽

Cited By ~ 7

Author(s):

Mehmet Yuruyen ◽

Gozde Gultekin ◽

Gizem Cetiner Batun ◽

Hakan Yavuzer ◽

Fundan Engin Akcan ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Systolic Pressure ◽

Screening Tests ◽

Subjective Memory ◽

Memory Complaint ◽

Subjective Memory Complaint ◽

Significant Difference

ABSTRACTBackground:Alteration in energy expenditure or metabolism is the most accused risk issue for the onset and for the course of neurodegenerative cognitive disorders. Neuropeptides are suggested to be related with learning and memory. Phoenixin (PNX) is the most recently reported neuropeptide and we aimed to compare the plasma level in people with subjective memory complaints, patients with mild cognitive impairment, and mild Alzheimer's disease (AD).Methods:Ninety two participants enrolled in the study. After screening tests, all participants were assessed with a neuropsychological battery for further cognitive evaluations. We used ELISA kit to assay the level of Human PNX.Results:Patients with AD were significantly older than people in subjective memory complaint group (p = 0.02). There was no significant difference between groups according to gender (p = 0.435). Mean plasma PNX level was not significantly different between groups (p = 0.279). Mean plasma PNX level in MCI group was positively correlated with BMI (r = 0.402 and p = 0.028), serum HDL level (r = 0.454 and p = 0.012), blood systolic pressure (r = 0.428 and p = 0.018) and negatively correlated with logical memory (r=−0.335 and p=0.031). The mean plasma PNX level was positively correlated with immediate recall in subjective memory complaint group (r = 0.417 and p = 0.034).Conclusion:This study is the first studying the association of plasma PNX level and cognitive complaints or decline. The knowledge about the role, interaction, and physiological functions of PNX is lacking. Lower plasma PNX level might be important in prodromal stages as MCI and the predictive role of PNX should be investigated in further studies.

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Frequency of Depressive Syndromes in Elderly Individuals with No Cognitive Impairment, Mild Cognitive Impairment, and Alzheimer's Disease Dementia in a Memory Clinic Setting

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000449155 ◽

2016 ◽

Vol 42 (3-4) ◽

pp. 135-145 ◽

Cited By ~ 5

Author(s):

Jun Ho Lee ◽

Min Soo Byun ◽

Dahyun Yi ◽

Young Min Choe ◽

Hyo Jung Choi ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Memory Clinic ◽

Elderly Individuals ◽

Clinic Setting ◽

Significant Difference ◽

Depressive Syndromes ◽

Alzheimer’S Disease Dementia

Aims: The aims of this study were to investigate the frequency of various depressive syndromes in elderly individuals with no cognitive impairment (NC), mild cognitive impairment (MCI), and Alzheimer's disease dementia (AD) in a memory clinic setting, and then to test whether severe and milder forms of depressive syndromes are differentially associated with the cognitive groups. Methods: For 216 NC, 478 MCI, and 316 AD subjects, we investigated the frequency of depressive syndromes, defined by three different categories: major and minor depressive disorder (MaDD and MiDD) according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, as well as depression according to the National Institute of Mental Health provisional diagnostic criteria for depression in Alzheimer's disease (NIMH-dAD). Results: The frequency of MaDD did not show any significant difference among NC, MCI, and AD. In contrast, the frequencies of MiDD and NIMH-dAD were higher than those of MaDD and showed significant group differences with a gradual increase from NC to AD. Conclusion: The findings suggest that the degenerative process of Alzheimer's disease contributes to the occurrence of mild depressive conditions, but not to severe depression.

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Hippocampal atrophy and verbal episodic memory performance in amnestic mild cognitive impairment and mild Alzheimer's disease: A preliminary study

Dementia & Neuropsychologia ◽

10.1590/s1980-57642009dn20100008 ◽

2008 ◽

Vol 2 (1) ◽

pp. 37-41 ◽

Cited By ~ 4

Author(s):

Nathalia Carollina Peruzza Marchiani ◽

Marcio Luiz Figueredo Balthazar ◽

Fernando Cendes ◽

Benito Pereira Damasceno

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Episodic Memory ◽

Memory Performance ◽

Verbal Learning ◽

Amnestic Mild Cognitive Impairment ◽

Significant Difference ◽

Verbal Episodic Memory

Abstract To evaluate hippocampal volume in patients with AD and aMCI, and correlate its atrophy with verbal episodic memory performance. Methods: We studied 42 individuals older than 50 years, including 14 with amnestic mild cognitive impairment (aMCI), 14 with mild Alzheimer's disease (AD) and 14 normal controls. All individuals were submitted to the Rey auditory verbal learning test (RAVLT) to evaluate episodic memory. They were also submitted to the forward (FDS) and backward digit span (BDS) subtest of WAIS-R to evaluate working memory and attention, and to the Mini Mental State Examination (MMSE). Hippocampal volumetric measurements were performed according to anatomic guidelines from a standard protocol using high-resolution T1-inversion recovery 3-mm coronal MRI slices. Hippocampal volumes (HV) were corrected for the variation in total intracranial volume. There was no significant difference between the three groups concerning age and education. Results: On RAVLT, there was a continuum between the three groups, with AD recalling less words, controls more, and aMCI subjects showing an intermediate performance on all sub-items. We found an asymmetry between HVs, with smaller mean left HV for all groups. ANOVA and post hoc Tukey's test for comparisons of HV showed a significant difference among groups, with difference between controls and both AD and aMCI, although there was no significant difference between AD and aMCI groups. Conclusions: There was a significant correlation between hippocampal volumes and scores on RAVLT, confirming that medial temporal structures are closely associated with memory performance in normal ageing as well as in aMCI and AD.

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