Abstract 19350: The Decline of the Montreal Cognitive Test Can Detect Post-stroke Cognitive Decline Determined by a Formal Neuropsychological Evaluation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kenny Xu ◽  
Catherine Dong ◽  
Christopher Chen
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Screening Tests ◽  
Cognitive Test ◽  
Cognitive Screening ◽  
Post Stroke ◽  
Diagnostic Status ◽  
Cerebrovascular Events ◽  
Moderate Cognitive Impairment ◽  
Ischemic Attack

Objective: We aimed to establish the association of decline in cognitive screening tests scores, the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE), with the decline in neuropsychological diagnostic status from 3-6 months to a year later. Method: Patients with ischemic stroke/ Transient Ischemic Attack (TIA) received the MoCA and MMSE within 14 days after stroke, then 3-6 months and 1 year later. The decline in MoCA and MMSE scores were defined by reduction of 2 points or more in total scores, while stable/improved MoCA scores referred to reduction of MoCA scores less than 2 or improved scores. The decline in neuropsychological diagnostic status was defined by category transition from no cognitive impairment to any cognitive impairment (≥1 domain), from mild cognitive impairment (impairment in 1-2 domains) to moderate cognitive impairment (impairment >2 domains) and dementia (i.e., functional loss associated with cognitive impairment, DSM-IV criteria), as well as from moderate cognitive impairment to dementia. Results: At baseline, most patients were Chinese (70.3%) and males (69.8%) with age of 59.8 ± 11.6 years and education of 7.7 ± 4.3 years. 327 out of 400 stroke/TIA patients completed neuropsychological assessments at 3-6 months and 275 completed at 1 year after their index cerebrovascular events. Of these, 31 (11.3%) had decline in neuropsychological diagnostic status. Logistic regression was used to model the association between probability of decline in neuropsychological diagnostic status and the decline in MMSE or MoCA scores. There were not significant associations between the decline of neuropsychological diagnostic status and the decline in MMSE scores. Controlling baseline MoCA scores and the change scores of MoCA from baseline to 3-6 months, patients with decline in MoCA scores (reduction of 2 points or more) were associated with higher risks of decline in neuropsychological diagnostic status, relative to those with stable/ improved MoCA scores (odd ratio=3.21, p=0.004). Conclusion: The decline in MoCA scores are associated with a higher risks for decline in neuropsychological diagnostic status from 3-6 months to 1 year, therefore may be used to detect post-stroke cognitive decline.

scholarly journals EXPRESS: European Stroke Organisation and European Academy Neurology joint guidelines on post-stroke cognitive impairment

2021 ◽  
pp. 239698732110421
Author(s):  
Terence J Quinn ◽  
Edo Richard ◽  
Yvonne Teuschl ◽  
Thomas Gattringer ◽  
Melanie Hafdi ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Screening Tests ◽  
Imaging Features ◽  
Cognitive Screening ◽  
Insufficient Evidence ◽  
European Academy ◽  
Post Stroke ◽  
Consensus Statements ◽  
Randomised Controlled

Introduction: The optimal management of post stroke cognitive impairment remains controversial. These joint European Stroke Organisation (ESO) and European Academy of Neurology (EAN) guidelines provide evidence-based recommendations to assist clinicians in decision making around prevention, diagnosis, treatment, and prognosis. Methods: These guidelines were developed according to ESO standard operating procedure and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. The working group identified relevant clinical questions, performed systematic reviews and, where possible, meta-analyses of the literature, assessed the quality of the available evidence, and made specific recommendations. Expert consensus statements were provided where insufficient evidence was available to provide recommendations based on the GRADE approach. Results: There was limited randomised controlled trial evidence regarding single or multicomponent interventions to prevent post stroke cognitive decline. Interventions to improve lifestyle and treat vascular risk factors may have many health benefits but a beneficial effect on cognition is not proven. We found no evidence around routine cognitive screening following stroke but recognise the importance of targeted cognitive assessment. We described the accuracy of various cognitive screening tests but found no clearly superior approach to testing. There was insufficient evidence to make a recommendation for use of cholinesterase inhibitors, memantine or cognitive rehabilitation for post stroke dementia. We made a weak recommendation against using the nootropics actovegin and cerebrolysin, but quality of evidence was very low. There was limited evidence on the use of prediction tools for post stroke cognitive syndromes (cognitive impairment, dementia and delirium). The association between post stroke cognitive impairment and most acute structural brain imaging features was unclear. Conclusions: These guidelines have highlighted fundamental areas where robust evidence is lacking. Further randomised controlled trials are needed and we suggest priority areas for future research.

scholarly journals Digital Screening for Cognitive Impairment – A Proof of Concept Study

2021 ◽  
pp. 1-8
Author(s):  
V. Bloniecki ◽  
G. Hagman ◽  
M. Ryden ◽  
M. Kivipelto
Keyword(s):  
Cognitive Impairment ◽  
Neurodegenerative Disorder ◽  
Early Stage ◽  
Roc Curves ◽  
University Hospital ◽  
Cognitive Test ◽  
Test Time ◽  
Proof Of Concept ◽  
Cognitive Screening ◽  
Disease Modifying Drugs

Background: Due to an ageing demographic and rapid increase of cognitive impairment and dementia, combined with potential disease-modifying drugs and other interventions in the pipeline, there is a need for the development of accurate, accessible and efficient cognitive screening instruments, focused on early-stage detection of neurodegenerative disorders. Objective: In this proof of concept report, we examine the validity of a newly developed digital cognitive test, the Geras Solutions Cognitive Test (GCST) and compare its accuracy against the Montreal Cognitive Assessment (MoCA). Methods: 106 patients, referred to the memory clinic, Karolinska University Hospital, due to memory complaints were included. All patients were assessed for presence of neurodegenerative disorder in accordance with standard investigative procedures. 66% were diagnosed with subjective cognitive impairment (SCI), 25% with mild cognitive impairment (MCI) and 9% fulfilled criteria for dementia. All patients were administered both MoCA and GSCT. Descriptive statistics and specificity, sensitivity and ROC curves were established for both test. Results: Mean score differed significantly between all diagnostic subgroups for both GSCT and MoCA (p<0.05). GSCT total test time differed significantly between all diagnostic subgroups (p<0.05). Overall, MoCA showed a sensitivity of 0.88 and specificity of 0.54 at a cut-off of <=26 while GSCT displayed 0.91 and 0.55 in sensitivity and specificity respectively at a cut-off of <=45. Conclusion: This report suggests that GSCT is a viable cognitive screening instrument for both MCI and dementia.

scholarly journals Prevalence of cognitive impairment among hill-tribe older people in the Northern part of Thailand

2018 ◽  
Vol 32 (6) ◽  
pp. 478-484
Author(s):  
Supaporn Trongsakul ◽  
Thapakorn Ruanjai ◽  
Wilawan Chaiut ◽  
Ratipark Tamornpark ◽  
Tawatchai Apidechkul
Keyword(s):  
Cognitive Impairment ◽  
Older People ◽  
Cognitive Decline ◽  
Health Care Professionals ◽  
Cultural Bias ◽  
Cognitive Screening ◽  
Content Type ◽  
Hill Tribe ◽  
History Of ◽  
Amphetamine Use

Purpose The purpose of this paper is to investigate the prevalence and factors related to cognitive impairment among hill-tribe older people in Chiang Rai province, Thailand. Design/methodology/approach A cross-sectional study was carried out amongst 459 hill-tribe older people aged 60 years and above. A Mini Mental State Examination (MMSE) Thai 2002 version was used for cognitive screening. A questionnaire and medical records were used for demographic and clinical data collection while descriptive statistics were used to analyze characteristic data. Potential factors related to cognitive impairment were analyzed by using univariate logistic regression analysis. Findings The prevalence of cognitive impairment amongst the participants was 49.89 percent (95% CI 45.32%, 53.47 percent). Factors related to cognitive decline included no occupation (OR=1.49, 95% CI 1.10–2.03, p<0.04) and a history of amphetamine use (OR=1.57, 95% CI 1.09–2.33, p<0.04). Originality/value Cognitive decline should be a cause for concern amongst Thai hill-tribe older people, especially amongst those in the group with a history of amphetamine use. However, Thai health care professionals need to be aware of the potential cultural bias in the MMSE Thai 2002 version as a cognition test targeted at the hill-tribe population as the questionnaire may not provide a true reflection of their cultural experience and background.

scholarly journals Cognitive Impairment in Patients with Ankylosing Spondylitis

2020 ◽  
Vol 47 (2) ◽  
pp. 219-225
Author(s):  
Bruno Kusznir Vitturi ◽  
Enrico Stefano Suriano ◽  
Ana Beatriz Pereira de Sousa ◽  
Dawton Yukito Torigoe
Keyword(s):  
Cognitive Impairment ◽  
Ankylosing Spondylitis ◽  
Cognitive Decline ◽  
Cognitive Assessment ◽  
Neuropsychiatric Symptoms ◽  
Functional Limitations ◽  
Healthy Controls ◽  
Cognitive Screening ◽  
Clinical Predictors ◽  
Screening Battery

ABSTRACT:Background:Little is known about the potential systemic effects of ankylosing spondylitis (AS) on the nervous system. We designed a study aiming to assess the frequency and clinical predictors of cognitive impairment in AS patients.Methods:We carried out a cross-sectional case–control study composed of consecutive patients with AS. Trained and blinded interviewers registered clinical-epidemiological data and applied a standardized neurological assessment for each subject of the study. At baseline, functional limitations were characterized using the Health Assessment Questionnaire. Cognitive impairment was evaluated with the Brief Cognitive Screening Battery, the Montreal Cognitive Assessment, and the Clinical Dementia Rating, while neuropsychiatric symptoms were investigated with the Hospital Anxiety and Depression Scale. Healthy controls were matched for age, educational attainment, sex, and comorbidities. We compared the neurological outcomes between case and controls, and we determined the clinical predictors of cognitive decline.Results:We included 40 patients (mean: 49.3 years) with AS and 40 healthy controls (mean: 48.8 years) in our study. In Brief Cognitive Screening Battery, patients with AS presented a statistically significant poor performance in the clock drawing test and in the verbal fluency. The mean Montreal Cognitive Assessment (MoCA) scores were significantly lower in AS subjects compared to the control group. Also, the prevalence of subjects classified as cognitively impaired according to MoCA was significantly higher in the AS group (90.0% vs. 57.5%, p = 0.02). Moreover, neuropsychiatric symptoms were more prevalent in AS patients. Worse functional limitations were associated with poor cognitive performance as well.Conclusions:Patients with AS might be more vulnerable to cognitive decline.

scholarly journals Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) completion on an acute care ward for the elderly: a brief study of informant characteristics

2012 ◽  
Vol 24 (10) ◽  
pp. 1700-1701 ◽  
Author(s):  
K. Bloomfield ◽  
N. John
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
The Elderly ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Cognitive Screening ◽  
Screening Algorithm ◽  
Drawing Task ◽  
The Uk ◽  
State Examination

Over recent years in the UK, emphasis has been placed on appropriate diagnosis and referral of patients with dementia. In guidelines published by the British Geriatrics Society (BGS) and Faculty of Old Age Psychiatrists consensus group (Forsyth et al., 2006), a cognitive screening algorithm was developed, which consists of initial screening for cognitive impairment with the Mini-Mental State Examination (MMSE) and CLOX1 (an executive clock drawing task). If the scores meet cut-off points indicated in the algorithm (MMSE <24 or CLOX1 <11), further assessments with the Confusion Assessment Method (CAM) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) are applied with the aim to differentiate between delirium (CAM positive, IQCODE negative), delirium and chronic impairment (CAM positive, IQCODE positive), or chronic cognitive impairment (CAM negative, IQCODE positive).

scholarly journals Prevalence of dementia and cognitive impairment with no dementia in a primary care setting in southern Brazil

2021 ◽  
Vol 79 (7) ◽  
pp. 565-570
Author(s):  
Sérgio Ferreira de Ferreira-Filho ◽  
Wyllians Vendramini Borelli ◽  
Rodrigo Mantovani Sguario ◽  
Gustavo Fiorentin Biscaia ◽  
Vitória Schneider Müller ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Medical Records ◽  
Care Setting ◽  
Primary Care Setting ◽  
Cognitive Screening ◽  
Southern Brazil ◽  
Symptoms Of Depression

ABSTRACT Background: Cognitive decline is a common condition, but is still underrepresented in studies conducted in developing countries. Objective: To calculate the prevalence of cognitive decline and depression in an elderly community-dwelling population in a city in southern Brazil. Methods: We calculated the prevalences of dementia, cognitive impairment with no dementia (CIND) and symptoms of depression in an elderly population relying on the public healthcare system. This epidemiological study in Pelotas, Brazil, was conducted within the primary care setting. It included 299 older adults (mean age = 69.75 ± 7.6 years) who presented low levels of education (mean = 4.16 ± 3.17 years of education). They underwent cognitive screening and their medical records were analyzed. Results: Among these older adults, 142 (47.5%) presented cognitive decline: 104 (34.8%) matching the cognitive criteria for CIND and 38 (12.7%) matching the cognitive criteria for dementia. Among all the individuals who completed the cognitive screening, 141 (48.4%) were positive for symptoms of depression, of whom 99 (34%) did not have any previous diagnosis in their medical records. Conclusion: There was high prevalence of cognitive impairment among these older adults in a primary care setting. A large number of older adults were found to have symptoms of depression without any diagnosis.

scholarly journals High Chili Intake and Cognitive Function among 4582 Adults: An Open Cohort Study over 15 Years

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 1183 ◽  
Author(s):  
Zumin Shi ◽  
Tahra El-Obeid ◽  
Malcolm Riley ◽  
Ming Li ◽  
Amanda Page ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Positive Association ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Food Record ◽  
Chinese Adults ◽  
Nutrition Survey ◽  
Memory Decline ◽  
Health And Nutrition

We aimed to examine the association between chili intake and cognitive function in Chinese adults. This is a longitudinal study of 4852 adults (age 63.4 ± 7.7) attending the China Health and Nutrition Survey during 1991 and 2006. Cognitive function was assessed in 1997, 2000, 2004 and 2006. In total, 3302 completed cognitive screening tests in at least two surveys. Chili intake was assessed by a 3-day food record during home visits in each survey between 1991 and 2006. Multivariable mixed linear regression and logistic regression were used. Chili intake was inversely related to cognitive function. In fully adjusted models, including sociodemographic and lifestyle factors, compared with non-consumers, those whose cumulative average chili intake above 50 g/day had the regression coefficients (and 95% CI) for global cognitive function of −1.13 (−1.71–0.54). Compared with non-consumers, those with chili consumption above 50 g/day had the odds ratio (and 95% CI) of 2.12(1.63–2.77), 1.56(1.23–1.97) for self-reported poor memory and self-reported memory decline, respectively. The positive association between chili intake and cognitive decline was stronger among those with low BMI than those with high BMI. The longitudinal data indicate that higher chili intake is positively associated with cognitive decline in Chinese adults in both genders.

scholarly journals A comparative study on the validations of three cognitive screening tests in identifying subtle cognitive decline

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Feng-Feng Pan ◽  
Lin Huang ◽  
Ke-liang Chen ◽  
Qian-hua Zhao ◽  
Qi-hao Guo
Keyword(s):  
Comparative Study ◽  
Cognitive Decline ◽  
Screening Tests ◽  
Cognitive Screening

Test Accuracy of Cognitive Screening Tests for Diagnosis of Dementia and Multidomain Cognitive Impairment in Stroke

Stroke ◽  
2014 ◽  
Vol 45 (10) ◽  
pp. 3008-3018 ◽  
Author(s):  
Rosalind Lees ◽  
Johann Selvarajah ◽  
Candida Fenton ◽  
Sarah T. Pendlebury ◽  
Peter Langhorne ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Screening Tests ◽  
Test Accuracy ◽  
Cognitive Screening ◽  
Diagnosis Of Dementia

The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): a review

2004 ◽  
Vol 16 (3) ◽  
pp. 275-293 ◽  
Author(s):  
Anthony F. Jorm
Keyword(s):  
Cognitive Decline ◽  
High Reliability ◽  
The Elderly ◽  
Cognitive Testing ◽  
Screening Tests ◽  
General Factor ◽  
Cognitive Tests ◽  
Cognitive Screening ◽  
Wide Range ◽  
The Subject

Background and aims: The IQCODE is widely used as a screening test for dementia, particularly where the subject is unable to undergo direct cognitive testing or for screening in populations with low levels of education and literacy. This review draws together research on the psychometric properties and validity of the IQCODE.Method: A systematic search of the literature was carried out using three databases.Results: The review shows that the questionnaire has high reliability and measures a single general factor of cognitive decline. It validly reflects past cognitive decline, performs at least as well at screening as conventional cognitive screening tests, predicts incident dementia, and correlates with a wide range of cognitive tests. A particular strength is that the IQCODE is relatively unaffected by education and pre-morbid ability or by proficiency in the culture's dominant language. The disadvantage of the IQCODE is that it is affected by informant characteristics such as depression and anxiety in the informant and the quality of the relationship between the informant and the subject.Conclusions: Because the IQCODE provides information complementary to brief cognitive tests, harnessing them together can improve screening accuracy.

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