Identifying the most efficient items from the Mini-Mental State Examination for cognitive function assessment in older Taiwanese patients

2007 ◽  
Vol 16 (3) ◽  
pp. 502-508 ◽  
Author(s):  
Meei-Fang Lou ◽  
Yu-Tzu Dai ◽  
Guey-Shiun Huang ◽  
Po-Jui Yu
Author(s):  
Minoru Yamakado

Objective: An important medical issue in both Japan and Ashikaga City is how to extend healthy life expectancy. To determine factors associated with healthy life expectancy, we established a joint study between Ashikaga City and the Ashikaga University Faculty of Nursing called the Ashikaga Longevity Study, using new biomarkers such as Diacron reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) tests as indicators of oxidative stress. In this study, factors related to cognitive function were clarified. Methods: Participants comprised 95 individuals (36 men; mean age, 91.0±5.1 years and 59 women; mean age, 92.2±5.9 years). Cognitive impairment was assessed using the Mini-Mental State Examination (MMSE). Results: MMSE score was ≤23 in 28 subjects (29.5%) and ≥24 in 67 subjects (70.5%). MMSE score showed significant negative correlations with age (p<0.0096), plasma alkaline phosphatase (p=0.0007), and peripheral leukocyte-to-lymphocyte ratio (p=0.0119), and positive correlations with plasma albumin (p=0.0096) and BAP-to-d-ROMs ratio (p=0.0427). Conclusions: These results suggest that cognitive decline may involve brain cell dysfunction due to inflammation based on a reduced ability to control oxidative stress. Not only anti-oxidative aerobic exercise but also anti-oxidative foods, may be necessary to maintain cognitive function.


2019 ◽  
Vol 44 (5) ◽  
pp. 1115-1127 ◽  
Author(s):  
Youlu Zhao ◽  
Yuhui Zhang ◽  
Zhikai Yang ◽  
Jinwei Wang ◽  
Zuying Xiong ◽  
...  

Background: Patients with chronic kidney disease experience a high burden of sleep disorders, and there are associations between sleep disorders and cognitive impairment. Objectives: Based on our previous cross-sectional survey on cognitive impairment in peritoneal dialysis, we further explored the relationship between sleep disorders and cognitive impairment, and predictors for declining cognitive function. Method: We conducted a multicenter prospective cohort study enrolling 458 clinically stable patients on peritoneal dialysis who were then followed up for 2 years.Demographic data, comorbidities, depression, and biochemistry data were collected at baseline. Sleep disorders including insomnia, restless legs syndrome, sleep apnea syndrome, excessive daytime sleepiness, possible narcolepsy, sleep walking and nightmares, and possible rapid eye movement behavior disorders were assessed using a panel of specific sleep questionnaires at baseline and in a second survey. Global cognitive function was measured at baseline and in a second survey, using the Modified Mini-Mental State Examination. Specific cognitive domains were evaluated using Trail-Making Test Forms A and B for executive function, and subtests of the Battery for the Assessment of Neuropsychological Status were used to asses immediate and delayed memory, visuospatial skills, and language ability. Results: Sleep disorders were common among peritoneal dialysis patients. The prevalence of cognitive impairment evaluated by the Modified Mini-Mental State Examination (3MS) increased from 19.8 to 23.9%. Possible narcolepsy was associated with decreased Modified Mini-Mental State Examination scores at baseline. During follow-up, sleepwalking and nightmares were associated with higher risks of declined delayed memory in the longitudinal study. Conclusions: Possible narcolepsy was associated with general cognitive dysfunction, and sleep walking and nightmares were risk factors for impaired delayed memory.


2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Hidetoshi Watari ◽  
Yutaka Shimada ◽  
Mie Matsui ◽  
Chihiro Tohda

Background and Aims. We previously reported that the administration of traditional Japanese medicines, kihito (Gui-Pi-Tang in Chinese) and kamikihito (Jia-Wei-Gui-Pi-Tang in Chinese), to Alzheimer’s disease (AD) model mice improved memory impairment. There are a few reports that show kihito and kamikihito have a beneficial effect on the cognitive function of AD patients in clinical studies. However, these studies are not comparative and are retrospective studies; thus, more evidence is needed. Therefore, we conducted an open-label, crossover designed clinical trial to investigate the effect of kihito on cognitive function of AD patients. Methods. The inclusion criteria for eligible patients were as follows: (1) imaging diagnosis (magnetic resonance imaging and single-photon emission computed tomography) of AD, (2) a treatment regimen including acetylcholinesterase inhibitors (ChEIs), and (3) a Mini-Mental State Examination (MMSE) score ≥15. The exclusion criteria were as follows: (1) change in ChEI dosage, (2) memantine usage, and (3) MMSE score < 15. To prevent bias in age and baseline cognitive function, patients were divided into two groups: the first group received 2.5 g of kihito extract 3 times/day during the first half of the study (weeks 0-16) and the second group received the same dose of kihito during the second half of the study (weeks 17-32). ChEI dosage did not change during the study period. Patients underwent a cognitive function test during weeks 0, 16, and 32. Cognitive function was evaluated by Japanese versions of the Mini-Mental State Examination (MMSE-J) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS-J) test. Results. Ten patients completed the clinical trial (4 males, 6 females, average age 71.7 years). MMSE-J scores significantly increased during the kihito intake period. RBANS-J test scores had a slight improvement during the kihito intake period compared with the ChEI alone treatment period, but no significant changes were observed. Conclusion. Kihito improves cognitive function in AD patients.


2005 ◽  
Vol 152 (4) ◽  
pp. 605-610 ◽  
Author(s):  
Peter Wiesli ◽  
Beat Schwegler ◽  
Beat Schmid ◽  
Giatgen A Spinas ◽  
Christoph Schmid

Objective: To determine whether systematic evaluation of cognitive function by the Mini-Mental State Examination (MMSE) allows the objective detection and documentation of cognitive deterioration in patients referred for evaluation of suspected hypoglycaemic disorders by the 72-h fast. Design: Prospective case series. Methods: In 50 patients referred for evaluation of suspected hypoglycaemic disorders, the MMSE score (maximum 30 points) was assessed at the start and at the end of the fast. Results: The fast was terminated before 72 h in 14 patients because they developed neuroglycopenic symptoms due to hypoglycaemic disorders. Their MMSE score fell from a median of 29 points (range 20–30) at the beginning to 17 points (range 0–24) at the termination of the fast. The score dropped by ≥6 points in all patients with hypoglycaemic disorders. Median (range) plasma glucose concentration at the end of the fast was 2.1 (1.1–2.5) mmol/l. Thirty-six individuals developed no neuroglycopenic symptoms throughout the 72-h fast, their MMSE score remained between 27 and 30 throughout the fast and their median plasma glucose concentration dropped to 2.9 (2–3.6) mmol/l. Conclusions: Systematic evaluation of cognitive function by the MMSE at the beginning and at the termination of the fast allows objective determination and documentation of the deterioration of the cognitive state in patients with hypoglycaemic disorders. A decline in the cognitive performance by ≥6 points in the MMSE score rather than a distinct plasma glucose concentration should be used as the criterion to terminate the prolonged fast before 72 h.


2020 ◽  
Vol 7 (2) ◽  
pp. 60
Author(s):  
Murdiyanti Prihatin Putri Dewi MPP

<p><em>The aging process continues as time goes by and there will be an impairment of the organ. Decreased body functions that often appear one of them is a decrease in cognitive function. Most of the elderly experienced dementia by showing changes in behavior. This study was to identify the effect of  art therapy on cognitive function of the elderly with dementia with the design of this study was Quasy Experimental Pre-Post Control Goup Design. There were 82 respondents divided into control groups and intervention groups. Measurement of cognitive function of the elderly with dementia using the Mini-Mental State Examination (MMSE). The result of the research showed that </em><em>there </em><em>wa</em><em>s a significant improvement of </em><em>the </em><em>cognitive function in </em><em>elderly</em><em> with dementi</em><em>a after a</em><em>rt therapy for 4 (four) weeks.</em><em> It can be concluded thatbrain exercise and art therapy exercise can be applied to increase cognitive function towards the elderly.</em></p>


Author(s):  
Stefanus Erdana Putra ◽  
Muhammad Hafizhan ◽  
Raden Ajeng Hanindia Riani Prabaningtyas

THE RELATIONSHIP BETWEEN ELEVATED C-REACTIVE PROTEIN AND COGNITIVE FUNCTION DETERIORATION OF GERIATRIC OUTPATIENTSABSTRACTIntroduction: Geriatric patients have different characteristics compared to other patients in general, in which they potentially experiencing cognitive impairment, decreasing of physiological and functional status, also the immunological system. This situation causes various inflammatory reactions that play a role in the development of neurodegenerative diseases, including the increase production of acute phase protein called C-reactive protein (CRP).Aims: To determine the association  between the CRP serum concentration  elevation and the deterioration  of geriatric outpatients’s cognitive function at Neurology Clinic Sebelas Maret University Hospital.Methods: A cross-sectional study of geriatric patients at the Neurology Clinic of Sebelas Maret University Hospital, Surakarta.   The cognitive state was evaluated using Mini-Mental State Examination (MMSE) and those with MMSE score<24 were considered cognitively declined. Concentrations of serum CRP were measured. Multiple logistic regression analysis was used to calculate Odds ratios (ORs) for cognitive decline, adjusted for the covariates of age, sex, body mass index, and disease history.Results: There were 73 participants with mean age was 65.6 years old. There were 56,2% who were experiencing a cognitive decline. Relative to the lowest (first) quartile of CRP concentration, adjusted ORs were 1,44 for the second, 1,97 for the third, and 2,33 for the highest quartiles (p=0,035). The association between CRP levels and decreased cognitive function was found to be significant after adjusting for covariates. When data were stratified by sex, the association between CRP concentration and cognitive decline was observed in women.Discussions: This research  suggested an association  between higher CRP concentration  and lower cognitive function. Chronic inflammation might affect cognitive function in geriatric, particularly in women.Keywords: C-reactive protein, cognitive function, geriatric outpatientsABSTRAKPendahuluan: Pasien geriatri memiliki karakteristik yang berbeda dengan pasien pada umumnya, yaitu selain berpotensi mengalami gangguan fungsi kognitif juga menurunnya daya cadangan fisiologis serta status fungsional dan sistem imunologi. Keadaan ini menimbulkan berbagai reaksi inflamasi yang berperan dalam perkembangan penyakit neurodegeneratif, antara lain peningkatan produksi protein fase akut bernama C-reactive protein (CRP) oleh hepar.Tujuan: Mengetahui hubungan antara peningkatan kadar CRP dengan penurunan fungsi kognitif pasien geriatri rawat jalan di Poliklinik Saraf RS Universitas Sebelas Maret.Metode: Penelitian potong lintang terhadap pasien geriatri di Poli Saraf RS Universitas Sebelas Maret, Surakarta. Evaluasi fungsi kognitif menggunakan Mini-Mental State Examination (MMSE); dengan skor <24 dikategorikan mengalami penurunan fungsi kognitif. Kadar serum CRP masing-masing subjek juga diukur. Analisis regresi logistik berganda digunakan dalam menghitung rasio Odds (RO) untuk penurunan fungsi kognitif, dengan pengaturan kovariat usia, jenis kelamin, indeks massa tubuh, dan riwayat penyakit sebelumnya.Hasil: Didapatkan 73 subjek dengan rerata usia 65,6 tahun. Sebanyak 56,2% subjek mengalami penurunan fungsi kognitif. Dengan perbandingan relatif terhadap kuartil konsentrasi CRP terendah (pertama), RO yang telah diatur adalah 1,44 untuk kuartil kedua; 1,97 untuk kuartil ketiga; serta 2,33 untuk kuartil keempat (p=0,035). Hubungan kadar CRP dan penurunan fungsi kognitif ditemukan signifikan setelah disesuaikan dengan kovariat. Setelah dilakukan sub-analisis berdasarkan jenis kelamin, peningkatan kadar CRP terhadap penurunan kognitif secara signifikan terjadi pada subjek perempuan.Diskusi: Penelitian ini menunjukkan adanya hubungan antara peningkatan kadar CRP dengan penurunan fungsi kognitif. Inflamasi kronis memengaruhi fungsi kognitif geriatri khususnya perempuan.Kata kunci: C-reactive protein, fungsi kognitif pasien rawat jalan, geriatri


2020 ◽  
Vol 60 (3) ◽  
pp. 136-40
Author(s):  
Hariadi Edi Saputra ◽  
Setyo Handryastuti ◽  
Irawan Mangunatmadja ◽  
Dwi Putro Widodo ◽  
Sudung O. Pardede

Background Epilepsy may affect children's development, including their cognitive function. The prevalence of cognitive impairment in epilepsy patients is quite high. Weschler Intelligence Scale for Children (WISC) takes a long time to administer and is expensive, so a simpler screening tool for cognitive evaluation is needed in pediatric epilepsy patients. Objective To assess the diagnostic value of Ouvrier’s Modified Mini Mental State Examination (MMSE) for detecting cognitive impairment in children aged 8-11 years with epilepsy. Methods This diagnostic study was conducted in December 2018 to February 2019 at Cipto Mangunkusumo and Fatmawati Hospitals in Jakarta. Data were collected with purposive sampling of children with epilepsy aged 8 to 11 years. Cognitive function was assessed by Ouvrier’s Modified MMSE and WISC. Ouvrier’s Modified MMSE was compared to WISC as and the gold standard. Results were analyzed using a 2x2 table. Results The prevalence of cognitive impairment in 8-11-year-old epilepsy patients was 72.9%. Ouvrier’s Modified MMSE had 83% sensitivity, 85% specificity, 94% positive predictive value, 65% negative predictive value, and 83% accuracy. Conclusions Ouvrier’s Modified MMSE has good diagnostic value, thus it may be useful for early detection of cognitive impairment in pediatric epilepsy.


Background: The oral administration of Astaxanthin may decrease depression symptoms and improved cognitive function through its beneficial effects on inflammation, and oxidative stress. Objective: This study was designed to assess whether Astaxanthin supplementation can reduce symptoms of depression and increase MMSE score in patients with Type 2 Diabetes Mellitus. Methods: This randomized, double-blind, placebo-controlled clinical trial was performed in 44 patients between 30 and 60 y of age with a diagnosis of type 2 diabetes. Patients were randomly assigned to receive either a single capsule of 8 mg of Astaxanthin /day (n = 22) or placebo (n = 22) for 8 wk. The primary [Beck Depression Inventory (BDI), which examines depressive symptoms] and secondary (Mini-Mental State Examination (MSSE) score, which evaluates cognitive function) outcomes were assessed. Results: After 8 week of intervention, Mini-Mental State Examination baseline score was significantly improved only in the group treated with Astaxanthin, during study (p < 0.01). But no significant reduction in the Beck Depression Inventory (BDI) was observed in both group. Conclusion: Overall, Astaxanthin supplementation of patients with diabetes for 8 weeks had beneficial effects on the MMSE score. Key words: Astaxanthin, Cognitive function Depression


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