Hearing Loss and Risk of Mild Cognitive Impairment and Dementia: Findings from the Singapore Longitudinal Ageing Study

2017 ◽  
Vol 43 (5-6) ◽  
pp. 259-268 ◽  
Author(s):  
Rebecca Heywood ◽  
Qi Gao ◽  
Ma Shwe Zin Nyunt ◽  
Lei Feng ◽  
Mei Sian Chong ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Hearing Impairment ◽  
Rating Scale ◽  
Normal Subjects ◽  
Clinical Dementia Rating ◽  
Cross Sectional ◽  
Time Activity ◽  
Cognitively Normal

Aim: To investigate the associations between hearing loss and prevalent and incident mild cognitive impairment (MCI), dementia and MCI or dementia (all cases). Methods: Cross-sectional and longitudinal analyses of baseline and follow-up data were performed in a population-based cohort. The baseline sample of 2,599 adults aged ≥55 included 1,515 cognitively normal subjects who were followed up to 8 years. Hearing loss at baseline was determined by the whispered voice test, and MCI and dementia by Mini-Mental State Examination screening, Clinical Dementia Rating scale, neurocognitive tests, MRI, and panel consensus diagnosis. Results: Hearing impairment was associated with increased prevalence of dementia (odds ratio = 3.63, 95% confidence interval [CI] 1.16-11.4, p = 0.027) but not MCI alone or all cases of MCI or dementia, adjusted for sex, age, ethnicity, education, central obesity, hypertension, diabetes, dyslipidemia, smoking, alcohol, leisure time activity, cardiac diseases, and depressive symptoms. Among participants who were cognitively normal at baseline, those with hearing impairment were more likely to develop MCI or dementia (hazard ratio [HR] = 2.30, 95% CI 1.08-4.92, p = 0.032). Hearing loss was associated with elevated but statistically nonsignificant estimates of adjusted HR (1.85, 95% CI 0.78-4.40) for incident MCI alone. Conclusions: Hearing loss is independently associated with prevalent dementia and incident MCI or dementia.

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)

Can the Clinical Dementia Rating Scale Identify Mild Cognitive Impairment and Predict Cognitive and Functional Decline?

2016 ◽  
Vol 41 (5-6) ◽  
pp. 292-302 ◽  
Author(s):  
Claudia Woolf ◽  
Melissa J. Slavin ◽  
Brian Draper ◽  
Floortje Thomassen ◽  
Nicole A. Kochan ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Rating Scale ◽  
Functional Decline ◽  
High Specificity ◽  
Cognitive Change ◽  
Functional Change ◽  
Clinical Dementia Rating ◽  
Dementia Rating Scale ◽  
Low Sensitivity

Background: The Clinical Dementia Rating Scale (CDR) is used to rate dementia severity. Its utility in diagnosing mild cognitive impairment (MCI) and its predictive value remain unknown. Aims: The aim of this study was to examine the association between CDR scores and expert MCI diagnosis, and to determine whether baseline CDR scores were predictive of cognitive or functional decline and progression to dementia over 6 years. Methods: At baseline, the sample comprised 733 non-demented participants aged 70-90 years from the longitudinal Sydney Memory and Ageing Study. Global and sum of boxes CDR scores were obtained at baseline. Participants also received comprehensive neuropsychological and functional assessment as well as expert consensus diagnoses at baseline and follow-up. Results: At baseline, CDR scores had high specificity but low sensitivity for broadly defined MCI. The balance of sensitivity and specificity improved for narrowly defined MCI. Longitudinally, all baseline CDR scores predicted functional change and dementia, but CDR scores were not predictive of cognitive change. Conclusion: CDR scores do not correspond well with MCI, except when MCI is narrowly defined, suggesting that the CDR taps into the more severe end of MCI. All CDR scores usefully predict functional decline and incident dementia.

An abbreviated version of Silhouettes test: a brief validated mild cognitive impairment screening tool

2018 ◽  
Vol 31 (06) ◽  
pp. 849-856
Author(s):  
Lin Huang ◽  
Ke-Liang Chen ◽  
Bi-Ying Lin ◽  
Le Tang ◽  
Qian-Hua Zhao ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Space Perception ◽  
The Elderly ◽  
Cognitive Test ◽  
Visual Object ◽  
Neuropsychological Battery ◽  
Cross Sectional ◽  
Chinese Elderly ◽  
Cognitively Normal

ABSTRACTObjectives:To revise an abbreviated version of the Silhouettes subtest of the Visual Object and Space Perception (VOSP) battery in order to recognize mild cognitive impairment (MCI) and determine the optimal cutoffs to differentiate among cognitively normal controls (NC), MCI, and Alzheimer’s Disease (AD) in the Chinese elderly.Design:A cross-sectional validation study.Setting:Huashan Hospital, Shanghai, China.Subjects:A total of 591 participants: Individuals with MCI (n = 211), AD (n = 139) and NC (n = 241) were recruited from the Memory Clinic, Huashan Hospital, Shanghai, China.Methods:Baseline neuropsychological battery (including VOSP) scores were collected from firsthand data. An abbreviated version of silhouettes test (Silhouettes-A) was revised from the original English version more suitable for the elderly, including eight silhouettes of animals and seven silhouettes of inanimate objects, with a score ranging from 0 to 15.Results:Silhouettes-A was an effective test to screen MCI in the Chinese elderly with good sensitivity and specificity, similar to the Montreal cognitive assessment and superior to other single tests reflecting language, spatial, or executive function. However, it had no advantage in distinguishing MCI from AD. The corresponding optimal cutoff scores of Silhouettes-A were 10 for screening MCI and 8 for AD.Conclusion:Silhouettes-A is a quick, simple, sensitive, and dependable cognitive test to distinguish among NC, MCI, and AD patients.

scholarly journals Diagnosis and staging of mild cognitive impairment, using a modification of the clinical dementia rating scale: the mCDR

2010 ◽  
Vol 25 (3) ◽  
pp. 282-289 ◽  
Author(s):  
Ranjan Duara ◽  
David A. Loewenstein ◽  
Maria T. Greig-Custo ◽  
Ashok Raj ◽  
Warren Barker ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Rating Scale ◽  
Clinical Dementia Rating ◽  
Dementia Rating Scale

De novo genesis of neuropsychiatric symptoms in Mild Cognitive Impairment (MCI)

2004 ◽  
Vol 16 (1) ◽  
pp. 51-60 ◽  
Author(s):  
Yonas E. Geda ◽  
Glenn E. Smith ◽  
David S. Knopman ◽  
Bradley F. Boeve ◽  
Eric G. Tangalos ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Rating Scale ◽  
De Novo ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional ◽  
Neuropsychological Profile ◽  
Pair Wise Comparison ◽  
Normal Controls

Background: There is inadequate information regarding the neuropsychiatric aspect of Mild Cognitive Impairment (MCI).Objective: To determine the neuropsychiatric profile of MCI, and compare this with normal controls and patients with mild Alzheimer's Disease (AD).Design: Cross-sectional assessment of psychiatric symptoms in subjects that are enrolled in Mayo Clinic's longitudinal study of normal aging, MCI and dementia.Methods and Participants: The Neuropsychiatric Inventory (NPI) was administered to normal control subjects, MCI subjects and patients with early AD. Individual NPI domain scores and total NPI scores were compared among the three groups after controlling for age, educational status, Dementia Rating Scale (DRS) and Mini-Mental State Examination (MMSE) scores. Statistical analysis was performed by utilizing ANOVA, χ2 and Fisher's exact test.Results: Data were analyzed on 514 normal controls, 54 MCI subjects, and 87 subjects with mild AD (CDR of 0.5 or 1); females consisted of 60.3%, 53.7% and 57.5%; and, the average ages (SD) were 77.8 (1.95), 79 (4.6), 80.5 (14.6) respectively. ANOVA pair-wise comparison revealed that both MMSE and DRS differences among the three groups were significantly different at (p=0.05). The total NPI scores were significantly different (p=0.0001, F=107.93) among the three groups using ANOVA. Pair-wise comparison of individual behavioral domain of NPI showed statistically significant differences between MCI and normals; and MCI and AD (p=0.001). Group differences on NPI remained after controlling for age and education at p=0.0375 and p=0.0050 respectively.Conclusion: The neuropsychiatric pattern is reminiscent of the clinical, neuroimaging and neuropsychological profile of MCI. It gives further credence to the view that MCI is indeed the gray zone, with overlap on both ends of the pole.

scholarly journals Early Emergence of Neuropsychiatric Symptoms in Cognitively Normal Subjects and Mild Cognitive Impairment

2020 ◽  
Vol 73 (1) ◽  
pp. 209-215
Author(s):  
Keiichiro Tsunoda ◽  
Toru Yamashita ◽  
Yosuke Osakada ◽  
Ryo Sasaki ◽  
Koh Tadokoro ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Neuropsychiatric Symptoms ◽  
Normal Subjects ◽  
Cognitively Normal ◽  
Early Emergence ◽  
Cognitively Normal Subjects

scholarly journals Operational Determination of Subjective Cognitive Decline, Mild Cognitive Impairment, and Dementia Using Sum of Boxes of the Clinical Dementia Rating Scale

2021 ◽  
Vol 13 ◽  
Author(s):  
Yu-Wan Yang ◽  
Kai-Cheng Hsu ◽  
Cheng-Yu Wei ◽  
Ray-Chang Tzeng ◽  
Pai-Yi Chiu
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Abilities ◽  
Rating Scale ◽  
Area Under The Curve ◽  
Subjective Cognitive Decline ◽  
Clinical Dementia Rating ◽  
Two Phase

Objectives: The Clinical Dementia Rating (CDR) Scale is the gold standard for the staging of dementia due to Alzheimer's disease (AD). However, the application of CDR for the staging of subjective cognitive decline (SCD) and mild cognitive impairment (MCI) in AD remains controversial. This study aimed to use the sum of boxes of the CDR (CDR-SB) plus an SCD single questionnaire to operationally determine the different stages of cognitive impairment (CI) due to AD and non-AD.Methods: This was a two-phase study, and we retrospectively analyzed the Show Chwan Dementia registry database using the data selected from 2015 to 2020. Individuals with normal cognition (NC), SCD, MCI, and mild dementia (MD) due to AD or non-AD with a CDR < 2 were included in the analysis.Results: A total of 6,946 individuals were studied, including 875, 1,009, 1,585, and 3,447 with NC, SCD, MCI, and MD, respectively. The cutoff scores of CDR-SB for NC/SCD, SCD/MCI, and MCI/dementia were 0/0.5, 0.5/1.0, and 2.5/3.0, respectively. The receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) values of the test groups were 0.85, 0.90, and 0.92 for discriminating NC from SCD, SCD from MCI, and MCI from dementia, respectively. Compared with the Cognitive Abilities Screening Instrument or the Montreal Cognitive Assessment, the use of CDR-SB is less influenced by age and education.Conclusion: Our study showed that the operational determination of SCD, MCI, and dementia using the CDR-SB is practical and can be applied in clinical settings and research on CI or dementia.

Parkinson's disease mild cognitive impairment classifications and neurobehavioral symptoms

2017 ◽  
Vol 30 (2) ◽  
pp. 253-260 ◽  
Author(s):  
Kirstie L. McDermott ◽  
Nancy Fisher ◽  
Sandra Bradford ◽  
Richard Camicioli
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Rating Scale ◽  
Neuropsychiatric Symptoms ◽  
Normative Values ◽  
Clinical Dementia Rating ◽  
Dementia Rating Scale ◽  
Over Time

ABSTRACTBackground:We apply recently recommended Parkinson's disease mild cognitive impairment (PD-MCI) classification criteria from the movement disorders society (MDS) to PD patients and controls and compare diagnoses to that of short global cognitive scales at baseline and over time. We also examine baseline prevalence of neuropsychiatric symptoms across different definitions of MCI.Methods:51 PD patients and 50 controls were classified as cognitively normal, MCI, or demented using MDS criteria (1.5 or 2.0 SD below normative values), Clinical Dementia Rating Scale (CDR), and the Dementia Rating Scale (DRS). All subject had parallel assessment with the Neuropsychiatric inventory (NPI).Results:We confirmed that PD-MCI (a) is frequent, (b) increases the risk of PDD, and (c) affects multiple cognitive domains. We highlight the predictive variability of different criteria, suggesting the need for further refinement and standardization. When a common dementia outcome was used, the Level II MDS optimal testing battery with impairment defined as two SD below norms in 2+ tests performs the best. Neuropsychiatric symptoms were more common in PD across all baseline and longitudinal cognitive classifications.Conclusions:Our results advance previous findings on the utility of MDS PD-MCI criteria for PD patients and controls at baseline and over time. Additionally, we emphasize the possible utility of other cognitive scales and neuropsychiatric symptoms.

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