Swallowing Dynamics and Breathing-Swallowing Coordination Are Altered in Patients with Mild Cognitive Impairment

Introduction: Postinspiratory activity, which is essential for laryngeal closure during swallowing to prevent aspiration of food into the airways, is reduced in a mouse model of tauopathy. Therefore, we hypothesized that patients at the stage of mild cognitive impairment (MCI) exhibit alterations in swallowing dynamics and coordination between swallowing and breathing. Methods: We examined breathing-swallowing coordination in patients with MCI. Patients who scored ≥24 on the Mini-Mental State Examination and <26 on the Japanese version of the Montreal Cognitive Assessment were recruited at Sumoto Itsuki Hospital. Parameters associated with breathing-swallowing coordination were assessed using a combination of two sensors: a respiratory flow sensor and a piezoelectric sensor attached to the skin surface of the anterior neck. Results: Nineteen patients met the criteria for MCI; 16 of these patients (79.5 ± 9.1 years old) scored <3 on the 10-item Eating Assessment Tool and were enrolled in the study. Their data were compared with those of an age-matched elderly cohort (79.9 ± 2.9 years old). The frequencies of swallowing during inspiration and swallowing immediately followed by inspiration in patients with MCI were 6.9% and 9.6%, respectively; these frequencies were not significantly different from those of the age-matched elderly cohort. However, the timing of swallowing in the respiratory cycle was significantly delayed in the MCI patients, and both time from the onset to the peak of laryngeal elevation and the duration between the onset of rapid laryngeal elevation and the time when the larynx returned to the resting position were significantly lengthened in this group. Conclusion: At the stage of MCI, breathing-swallowing coordination has already started to decline.

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Validity of the Japanese Version of the Quick Mild Cognitive Impairment Screen

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16060917 ◽

2019 ◽

Vol 16 (6) ◽

pp. 917 ◽

Cited By ~ 4

Author(s):

Ayako Morita ◽

Rónán O’Caoimh ◽

Hiroshi Murayama ◽

D. Molloy ◽

Shigeru Inoue ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Predictive Value ◽

Mini Mental State Examination ◽

Japanese Version ◽

Community Dwelling ◽

Cognitive Screening ◽

State Examination ◽

Normal Cognition ◽

Moderate Positive Correlation

Early detection of dementia provides opportunities for interventions that could delay or prevent its progression. We developed the Japanese version of the Quick Mild Cognitive Impairment (Qmci-J) screen, which is a performance-based, easy-to-use, valid and reliable short cognitive screening instrument, and then we examined its validity. Community-dwelling adults aged 65–84 in Niigata prefecture, Japan, were concurrently administered the Qmci-J and the Japanese version of the standardized Mini-Mental State Examination (sMMSE-J). Mild cognitive impairment (MCI) and dementia were categorized using established and age-adjusted sMMSE-J cut-offs. The sample (n = 526) included 52 (9.9%) participants with suspected dementia, 123 (23.4%) with suspected MCI and 351 with likely normal cognition. The Qmci-J showed moderate positive correlation with the sMMSE-J (r = 0.49, p < 0.001) and moderate discrimination for predicting suspected cognitive impairment (MCI/dementia) based on sMMSE-J cut-offs, area under curve: 0.74, (95%CI: 0.70–0.79), improving to 0.76 (95%CI: 0.72 to 0.81) after adjusting for age. At a cut-off of 60/61/100, the Qmci-J had a 73% sensitivity, 68% specificity, 53% positive predictive value, and 83% negative predictive value for cognitive impairment. Normative data are presented, excluding those with any sMMSE-J < 27. Though further research is required, the Qmci-J screen may be a useful screening tool to identify older adults at risk of cognitive impairment.

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Mini-Mental State Examination (MMSE) for the early detection of dementia in people with mild cognitive impairment (MCI)

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd010783.pub3 ◽

2021 ◽

Vol 2021 (7) ◽

Author(s):

Ingrid Arevalo-Rodriguez ◽

Nadja Smailagic ◽

Marta Roqué-Figuls ◽

Agustín Ciapponi ◽

Erick Sanchez-Perez ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Early Detection ◽

Mental State ◽

Mini Mental State Examination ◽

State Examination

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Simple Clinical Information Feeds a Powerful Risk Assessment Tool for Mild Cognitive Impairment, Study Suggests

Neurology Today ◽

10.1097/01.nt.0000463174.34913.6b ◽

2015 ◽

Vol 15 (6) ◽

pp. 11-12

Author(s):

Richard Robinson

Keyword(s):

Risk Assessment ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Assessment Tool ◽

Clinical Information ◽

Risk Assessment Tool

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Can the MMSE help clinicians predict progression from mild cognitive impairment to dementia?

BJPsych Advances ◽

10.1192/apt.21.6.363 ◽

2015 ◽

Vol 21 (6) ◽

pp. 363-366 ◽

Cited By ~ 3

Author(s):

Alex J. Mitchell

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Risk Prediction ◽

Mental State ◽

Mini Mental State Examination ◽

Case Finding ◽

Cognitive Test ◽

Prediction Tool ◽

State Examination

SummaryThe Mini-Mental State Examination (MMSE) is the most widely used bedside cognitive test. It has previously been shown to be poor as a case-finding tool for both dementia and mild cognitive impairment (MCI). This month's Cochrane Corner review examines whether the MMSE might be used as a risk prediction tool for later dementia in those with established MCI. From 11 studies of modest quality, it appears that the MMSE alone should not be relied on to predict later deterioration in people with MCI. As this is the case, it is likely that only a combination of predictors would be able to accurately predict progression from MCI to dementia.

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Kanji and Kana agraphia in mild cognitive impairment and dementia: A trans-cultural comparison of elderly Japanese subjects living in Japan and Brazil

Dementia & Neuropsychologia ◽

10.1590/s1980-57642010dn40400008 ◽

2010 ◽

Vol 4 (4) ◽

pp. 300-305 ◽

Cited By ~ 1

Author(s):

Kyoko Akanuma ◽

Kenichi Meguro ◽

Mitsue Meguro ◽

Rosa Yuka Sato Chubaci ◽

Paulo Caramelli ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Abilities ◽

Prevalence Study ◽

Clinical Dementia Rating ◽

Spontaneous Writing ◽

Elderly Japanese ◽

Questionable Dementia ◽

State Examination ◽

Japanese Subjects

Abstract This study verifies the environmental effects on agraphia in mild cognitive impairment and dementia. We compared elderly Japanese subjects living in Japan and Brazil. Methods: We retrospectively analyzed the database of the Prevalence Study 1998 in Tajiri (n=497, Miyagi, Japan) and the Prevalence Study 1997 of elderly Japanese immigrants living in Brazil (n=166, migrated from Japan and living in the São Paulo Metropolitan Area). In three Clinical Dementia Rating (CDR) groups, i.e., CDR 0 (healthy), CDR 0.5 (questionable dementia), and CDR 1+ (dementia) , the Mini-Mental State Examination (MMSE) item of spontaneous writing and the Cognitive Abilities Screening Instrument (CASI) domain of dictation were analyzed with regard to the number of Kanji and Kana characters. Formal errors in characters and pragmatic errors were also analyzed. Results: The immigrants in Brazil wrote similar numbers of Kanji or Kana characters compared to the residents of Japan. In spontaneous writing, the formal Kanji errors were greater in the CDR 1+ group of immigrants. In writing from dictation, all the immigrant CDR groups made more formal errors in Kana than the Japan residents. No significant differences in pragmatic errors were detected between the two groups. Conclusions: Subjects living in Japan use Kanji frequently, and thus the form of written characters was simplified, which might be assessed as mild formal errors. In immigrants, the deterioration in Kanji and Kana writing was partly due to decreased daily usage of the characters. Lower levels of education of immigrants might also be related to the number of Kanji errors.

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A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2008.04.014 ◽

2009 ◽

Vol 43 (4) ◽

pp. 411-431 ◽

Cited By ~ 457

Author(s):

Alex J. Mitchell

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Mental State ◽

Mini Mental State Examination ◽

Meta Analysis ◽

State Examination

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Detection of mild cognitive impairment in middle-aged and older adults with obstructive sleep apnoea

European Respiratory Journal ◽

10.1183/13993003.01137-2018 ◽

2018 ◽

Vol 52 (5) ◽

pp. 1801137 ◽

Cited By ~ 7

Author(s):

Katia Gagnon ◽

Andrée-Ann Baril ◽

Jacques Montplaisir ◽

Julie Carrier ◽

Sirin Chami ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Obstructive Sleep Apnoea ◽

Mental State ◽

Cognitive Assessment ◽

Mini Mental State Examination ◽

Sleep Apnoea ◽

Screening Tests ◽

Obstructive Sleep ◽

State Examination

Obstructive sleep apnoea increases the risk for mild cognitive impairment and dementia. The present study aimed to characterise the ability of two cognitive screening tests, the Mini-Mental State Examination and the Montreal Cognitive Assessment, to detect mild cognitive impairment in adults aged 55–85 years with and without obstructive sleep apnoea.We included 42 subjects with mild and 67 subjects with moderate-to-severe obstructive sleep apnoea. We compared them to 22 control subjects. Mild cognitive impairment was diagnosed by a comprehensive neuropsychological assessment. We used receiver operating characteristic curves to assess the ability of the two screening tests to detect mild cognitive impairment.The two screening tests showed similar discriminative ability in control subjects. However, among the mild and the moderate-to-severe obstructive sleep apnoea groups, the Mini-Mental State Examination was not able to correctly identify subjects with mild cognitive impairment. The Montreal Cognitive Assessment's discriminant ability was acceptable in both sleep apnoea groups and was comparable to what was observed in controls.The Mini-Mental State Examination should not be used to screen for cognitive impairment in patients with obstructive sleep apnoea. The Montreal Cognitive Assessment could be used in clinical settings. However, clinicians should refer patients for neuropsychological assessment when neurodegenerative processes are suspected.

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The Role of Apolipoprotein E ε4 in Early and Late Mild Cognitive Impairment

European Neurology ◽

10.1159/000516774 ◽

2021 ◽

Vol 84 (6) ◽

pp. 472-480

Author(s):

Yulin Luo ◽

Li Tan ◽

Joseph Therriault ◽

Hua Zhang ◽

Ying Gao ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Apolipoprotein E ◽

Amyloid Β ◽

Disease Assessment ◽

Tau Pathology ◽

Ε4 Allele ◽

State Examination

Background: Apolipoprotein E (APOE) ε4 is highly associated with mild cognitive impairment (MCI). However, the specific influence of APOE ε4 status on tau pathology and cognitive decline in early MCI (EMCI) and late MCI (LMCI) is poorly understood. Our goal was to evaluate the association of APOE ε4 with cerebrospinal fluid (CSF) tau levels and cognition in EMCI and LMCI patients in the Alzheimer’s Disease Neuroimaging Initiative database, and whether this association was mediated by amyloid-β (Aβ). Methods: Participants were 269 cognitively normal (CN), 262 EMCI, and 344 LMCI patients. They underwent CSF Aβ42 and tau detection, APOE ε4 genotyping, Mini-Mental State Examination, (MMSE), and Alzheimer’s disease assessment scale (ADAS)-cog assessments. Linear regressions were used to examine the relation of APOE ε4 and CSF tau levels and cognitive scores in persons with and without Aβ deposition (Aβ+ and Aβ−). Results: The prevalence of APOE ε4 is higher in EMCI and LMCI than in CN (p < 0.001 for both), and in LMCI than in EMCI (p = 0.001). APOE ε4 allele was significantly higher in Aβ+ subjects than in Aβ− subjects (p < 0.001). Subjects who had a lower CSF Aβ42 level and were APOE ε4-positive experienced higher levels of CSF tau and cognitive scores in EMCI and/or LMCI. Conclusions: An APOE ε4 allele is associated with increased CSF tau and worse cognition in both EMCI and LMCI, and this association may be mediated by Aβ. We conclude that APOE ε4 may be an important mediator of tau pathology and cognition in the early stages of AD.

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Comparison of the Mini-Mental State Examination and Computerized Brief Cognitive Screening Test as Cognitive Screening Tools in Patients with Mild Cognitive Impairment

Current Alzheimer Research ◽

10.2174/1567205018666211215151418 ◽

2021 ◽

Vol 18 ◽

Author(s):

Che-Sheng Chu ◽

I-Chen Lee ◽

Chuan-Cheng Hung ◽

I-Ching Lee ◽

Chi-Fa Hung ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Normal Control ◽

Internal Consistency ◽

Mental State ◽

Screening Test ◽

Mini Mental State Examination ◽

Cognitive Screening ◽

Validity And Reliability ◽

State Examination

Background: The aim of this study was to establish the validity and reliability of the Computerized Brief Cognitive Screening Test (CBCog) for early detection of cognitive impairment. Method: One hundred and sixty participants, including community-dwelling and out-patient volunteers (both men and women) aged ≥ 65 years, were enrolled in the study. All participants were screened using the CBCog and Mini-Mental State Examination (MMSE). The internal consistency of the CBCog was analyzed using Cronbach’s α test. Areas under the curves (AUCs) of receiver operating characteristic analyses were used to test the predictive accuracy of the CBCog in detecting mild cognitive impairment (MCI) in order to set an appropriate cutoff point. Results: The CBCog scores were positively correlated with the MMSE scores of patients with MCI-related dementia (r = 0.678, P < .001). The internal consistency of the CBCog (Cronbach’s α) was 0.706. It was found that the CBCog with a cutoff point of 19/20 had a sensitivity of 97.5% and a specificity of 53.7% for the diagnosis of MCI with education level ≥ 6 years. The AUC of the CBCog for discriminating the normal control elderly from patients with MCI (AUC = 0.827, P < 0.001) was larger than that of the MMSE for discriminating the normal control elderly from patients with MCI (AUC= 0.819, P < .001). Conclusion: The CBCog demonstrated to have sufficient validity and reliability to evaluate mild cognitive impairment, especially in highly educated elderly people.

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