scholarly journals Outcomes tested in non-pharmacological interventions in mild cognitive impairment and mild dementia: a scoping review

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e035980 ◽  
Author(s):  
Elyse Couch ◽  
Vanessa Lawrence ◽  
Melissa Co ◽  
Matthew Prina
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Outcome Measures ◽  
Scoping Review ◽  
Controlled Trials ◽  
Pharmacological Treatments ◽  
Pharmacological Interventions ◽  
Pilot Studies ◽  
Mild Dementia ◽  
Wide Range

ObjectivesNon-pharmacological treatments are an important aspect of dementia care. A wide range of interventions have been trialled for mild dementia and mild cognitive impairment (MCI). However, the variety of outcome measures used in these trials makes it difficult to make meaningful comparisons. The objective of this study is to map trends in which outcome measures are used in trials of non-pharmacological treatments in MCI and mild dementia.DesignScoping review.Data sourcesEMBASE, PsychINFO, Medline and the Cochrane Register of Controlled Trials were searched from inception until February 2018. An additional search was conducted in April 2019EligibilityWe included randomised controlled trials (RCTs) testing non-pharmacological interventions for people diagnosed with MCI or mild dementia. Studies were restricted to full RCTs; observational, feasibility and pilot studies were not included.Charting methodsAll outcome measures used by included studies were extracted and grouped thematically. Trends in the types of outcome measures used were explored by type of intervention, country and year of publication.Results91 studies were included in this review. We extracted 358 individual outcome measures, of which 78 (22%) were used more than once. Cognitive measures were the most frequently used, with the Mini-Mental State Examination being the most popular.ConclusionsOur findings highlight an inconsistency in the use of outcome measures. Cognition has been prioritised over other domains, despite previous research highlighting the importance of quality of life and caregiver measures. To ensure a robust evidence base, more research is needed to highlight which outcome measures should be used over others.PROSPERO registration numberCRD42018102649.

Technology use to improve everyday occupations in older persons with mild dementia or mild cognitive impairment: A scoping review

2018 ◽  
Vol 81 (10) ◽  
pp. 555-565 ◽  
Author(s):  
Ann-Helen Patomella ◽  
Meryl Lovarini ◽  
Eva Lindqvist ◽  
Anders Kottorp ◽  
Louise Nygård
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Scoping Review ◽  
Technology Use ◽  
Older Persons ◽  
Mild Dementia

Prevalence, neurobiology, and treatments for apathy in prodromal dementia

2017 ◽  
Vol 30 (2) ◽  
pp. 177-184 ◽  
Author(s):  
Chelsea Sherman ◽  
Celina S. Liu ◽  
Nathan Herrmann ◽  
Krista L. Lanctôt
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Literature Search ◽  
Neuropsychiatric Symptom ◽  
Prevalence Rates ◽  
Pharmacological Treatments ◽  
Pharmacological Interventions ◽  
Behavioral Impairment ◽  
Prodromal Dementia ◽  
Comprehensive Literature Search

ABSTRACTBackground:Apathy, characterized by diminished motivation, is a highly prevalent neuropsychiatric symptom in dementia. However, there is a substantial knowledge gap with regard to prevalence rates, neurobiological underpinnings, and effective treatments for apathy in pre-dementia states, including mild cognitive impairment (MCI) and mild behavioral impairment (MBI).Methods:We conducted a comprehensive literature search using MEDLINE, Embase, and PsycINFO databases to identify available research on apathy in prodromal dementia.Results:Apathy has consistently been detected in individuals with MCI with varying prevalence rates, and only recently has literature discussed the prevalence of apathy in MBI. Few pharmacological treatments have been utilized for apathy, with galantamine and risperidone showing mild reductions in apathetic behaviors. Non-pharmacological interventions in prodromal dementia are beginning to be explored and show promise, but few studies have replicated those results.Discussion:More comprehensive guidelines for diagnosing apathy and further research investigating neurobiological mechanisms of apathy in MCI and MBI are required in order to effectively treat apathetic patients in prodromal dementia.

scholarly journals Donepezil for mild cognitive impairment in Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Treatment Group ◽  
Outcome Measures ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Difference

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.

scholarly journals Relationship between Cognitive Performance and Measures of Neurodegeneration among Hispanic and White Non-Hispanic Individuals with Normal Cognition, Mild Cognitive Impairment, and Dementia

2017 ◽  
Vol 24 (2) ◽  
pp. 176-187 ◽  
Author(s):  
Shanna L. Burke ◽  
Miriam J. Rodriguez ◽  
Warren Barker ◽  
Maria T Greig-Custo ◽  
Monica Rosselli ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Performance ◽  
Entorhinal Cortex ◽  
Rating Scale ◽  
Structural Mri ◽  
Diagnostic Group ◽  
Disease Stage ◽  
Clinical Dementia Rating ◽  
Mild Dementia

AbstractObjectives:The aim of this study was to determine the presence and severity of potential cultural and language bias in widely used cognitive and other assessment instruments, using structural MRI measures of neurodegeneration as biomarkers of disease stage and severity.Methods:Hispanic (n=75) and White non-Hispanic (WNH) (n=90) subjects were classified as cognitively normal (CN), amnestic mild cognitive impairment (aMCI) and mild dementia. Performance on the culture-fair and educationally fair Fuld Object Memory Evaluation (FOME) and Clinical Dementia Rating Scale (CDR) between Hispanics and WNHs was equivalent, in each diagnostic group. Volumetric and visually rated measures of the hippocampus entorhinal cortex, and inferior lateral ventricles (ILV) were measured on structural MRI scans for all subjects. A series of analyses of covariance, controlling for age, depression, and education, were conducted to compare the level of neurodegeneration on these MRI measures between Hispanics and WNHs in each diagnostic group.Results:Among both Hispanics and WNH groups there was a progressive decrease in volume of the hippocampus and entorhinal cortex, and an increase in volume of the ILV (indicating increasing atrophy in the regions surrounding the ILV) from CN to aMCI to mild dementia. For equivalent levels of performance on the FOME and CDR, WNHs had greater levels of neurodegeneration than did Hispanic subjects.Conclusions:Atrophy in medial temporal regions was found to be greater among WNH than Hispanic diagnostic groups, despite the lack of statistical differences in cognitive performance between these two ethnic groups. Presumably, unmeasured factors result in better cognitive performance among WNH than Hispanics for a given level of neurodegeneration. (JINS, 2018,24, 176–187)

THE CHANGING FACE OF MILD COGNITIVE IMPAIRMENT (MCI) AND MILD DEMENTIA

2017 ◽  
Vol 13 (7) ◽  
pp. P544-P545
Author(s):  
Connor Richardson ◽  
Fiona Matthews ◽  
Louise Robinson ◽  
Blossom C.M. Stephan
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Mild Dementia

Development of a decision-making tool for reporting drivers with mild dementia and mild cognitive impairment to transportation administrators

2017 ◽  
Vol 29 (9) ◽  
pp. 1551-1563 ◽  
Author(s):  
Duncan H. Cameron ◽  
Carla Zucchero Sarracini ◽  
Linda Rozmovits ◽  
Gary Naglie ◽  
Nathan Herrmann ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Delphi Study ◽  
Qualitative Interviews ◽  
Decision Support Tool ◽  
Driving Safety ◽  
Decision Tool ◽  
Computerized Decision Support ◽  
Support Tool ◽  
Mild Dementia

ABSTRACTBackground:Driving in persons with dementia poses risks that must be counterbalanced with the importance of the care for autonomy and mobility. Physicians often find substantial challenges in the assessment and reporting of driving safety for persons with dementia. This paper describes a driving in dementia decision tool (DD-DT) developed to aid physicians in deciding when to report older drivers with either mild dementia or mild cognitive impairment to local transportation administrators.Methods:A multi-faceted, computerized decision support tool was developed, using a systematic literature and guideline review, expert opinion from an earlier Delphi study, as well as qualitative interviews and focus groups with physicians, caregivers of former drivers with dementia, and transportation administrators. The tool integrates inputs from the physician-user about the patient's clinical and driving history as well as cognitive findings, and it produces a recommendation for reporting to transportation administrators. This recommendation is translated into a customized reporting form for the transportation authority, if applicable, and additional resources are provided for the patient and caregiver.Conclusions:An innovative approach was needed to develop the DD-DT. The literature and guideline review confirmed the algorithm derived from the earlier Delphi study, and barriers identified in the qualitative research were incorporated into the design of the tool.

Latent Factor Structure of Outcome Measures Used in the HABIT® Mild Cognitive Impairment Intervention Programs

2021 ◽  
pp. 1-13
Author(s):  
Brittany DeFeis ◽  
Gelan Ying ◽  
Andrea M. Kurasz ◽  
Liselotte De Wit ◽  
Priscilla Amofa ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Outcome Measures ◽  
Factor Structure ◽  
Goodness Of Fit ◽  
Factor Model ◽  
Post Intervention ◽  
Latent Factor ◽  
Confirmatory Factor Analyses ◽  
Stable Factor

Background: In Alzheimer’s disease and related disorders (ADRD) research, common outcome measures include cognitive and functional impairment, as well as persons with mild cognitive impairment (pwMCI) and care partner self-reported mood and quality of life. Studies commonly analyze these measures separately, which potentially leads to issues of multiple comparisons and/or multicollinearity among measures while ignoring the latent constructs they may be measuring. Objective: This study sought to examine the latent factor structure of a battery of 12-13 measures of domains mentioned above, used in a multicomponent behavioral intervention (The HABIT® program) for pwMCI and their partners. Methods: Exploratory factor analysis (EFA) involved 214 pwMCI-partner pairs. Subsequent Confirmatory factor analyses (CFA) used 730 pairs in both pre- and post-intervention conditions. Results: EFA generated a three-factor model. Factors could be characterized as partner adjustment (29.9%), pwMCI adjustment (18.1%), and pwMCI impairment (12.8%). The subsequent CFA confirmed our findings, and the goodness-of-fit for this model was adequate in both the pre- (CFI = 0.937; RMSEA = 0.057, p = 0.089) and post-intervention (CFI = 0.942; RMSEA = 0.051, p = 0.430) groups. Conclusion: Results demonstrated a stable factor structure across cohorts and intervention conditions suggesting that three broad factors may provide a straightforward and meaningful model to assess intervention outcome, at least during the MCI phase of ADRD.

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