scholarly journals High-Sensitivity Cardiac Troponin T and Cognitive Function in Patients With Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (5) ◽  
pp. 1604-1607 ◽  
Author(s):  
Leonie H.A. Broersen ◽  
Bob Siegerink ◽  
Pia S. Sperber ◽  
Regina von Rennenberg ◽  
Sophie K. Piper ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Telephone Interview ◽  
Troponin T ◽  
High Sensitivity ◽  
Cognitive Status ◽  
State Examination

Background and Purpose— Our study aim was to assess whether high-sensitivity cardiac troponin T (hs-cTnT), a specific biomarker for myocardial injury, is associated with cognitive function in patients after mild-to-moderate first-ever ischemic stroke. Methods— We used data from PROSCIS-B (Prospective Cohort With Incident Stroke Berlin). Cognitive function was assessed by Mini-Mental-State-Examination at baseline, and Telephone Interview for Cognitive Status–modified after 1 to 3 years of follow-up. Patients were categorized according to hs-cTnT quartiles. We performed generalized linear regression to calculate risk ratios of cognitive impairment (Mini-Mental-State-Examination <27; Telephone Interview for Cognitive Status–modified <32). Association of hs-cTnT with cognitive function over time was estimated using a linear mixed model. Results— We included 555 patients (mean age, 67 years, 62% male, median National Institutes of Health Stroke Scale 2 [interquartile range, 1–5], hs-cTnT above upper reference limit 40%, baseline cognitive impairment 28%). Baseline Mini-Mental-State-Examination score and rate of cognitive impairment were lower in patients in the highest versus lowest hs-cTnT quartile (median Mini-Mental-State-Examination 27 versus 29, and 15.3% versus 43.0%, adjusted risk ratio, 1.76 [95% CI, 1.07–2.90], respectively). If anything, cognition seemed to improve in all groups, yet Telephone Interview for Cognitive Status–modified scores were consistently lower in patients within the highest versus lowest hs-cTnT quartile (adjusted β, −1.33 [95% CI, −2.65 to −0.02]), without difference in the rate of change over time. Conclusions— In patients with mild-to-moderate first-ever ischemic stroke without dementia, higher hs-cTnT was associated with higher prevalence of cognitive impairment at baseline and lower Telephone Interview for Cognitive Status–modified during 3-year follow-up. Registration— URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01363856.

Cognitive Functioning in Patients with Cerebral Aneurysms Measured with the Mini Mental State Examination and the Telephone Interview for Cognitive Status

Neurosurgery ◽  
2006 ◽  
Vol 59 (4) ◽  
pp. 803-811 ◽  
Author(s):  
Joseph T. King ◽  
Michael L. DiLuna ◽  
Domenic V. Cicchetti ◽  
Joel Tsevat ◽  
Mark S. Roberts
Keyword(s):  
Cognitive Impairment ◽  
Subarachnoid Hemorrhage ◽  
Cognitive Functioning ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Telephone Interview ◽  
Cerebral Aneurysms ◽  
Cognitive Status ◽  
State Examination

Abstract BACKGROUND: Clinicians and researchers use brief instruments, such as the Mini Mental State Examination (MMSE) and the Telephone Interview for Cognitive Status (TICS), to measure cognitive functioning in patients with cerebral aneurysms. MMSE and TICS scores are often dichotomized to classify patients as cognitively impaired or not. Frequently, after an initial MMSE face-to-face evaluation, the TICS is used for follow-up assessments by telephone. METHODS: A cross-sectional cohort of patients with cerebral aneurysms completed the MMSE at baseline and the MMSE or TICS at the 12-month follow-up examination. Multivariate logistic regression adjusting for demographics was used to model cognitive impairment. MMSE and TICS results were compared using the MMSE as the “gold standard.” RESULTS: Eleven out of 171 (6%) patients had baseline MMSE scores less than 24, indicating cognitive impairment. Multivariate analysis showed that a history of subarachnoid hemorrhage was associated with cognitive impairment measured with the MMSE (odds ratio, 13.9; P = 0.021; C statistic = 0.87); there was no relationship between subarachnoid hemorrhage or treatment and TICS cognitive impairment (i.e., score &lt; 27). In patients without recent or interim invasive interventions that might affect cognition (n = 65), raw baseline MMSE and 12-month TICS scores had fair correlations (r = 0.30, P = 0.015); however, dichotomized scores had poor agreement, and TICS sensitivity and positive predictive value was 0% compared with the MMSE. CONCLUSION: The MMSE may be more sensitive than the TICS to the effects of subarachnoid hemorrhage on cognitive functioning. Raw MMSE and TICS scores are well correlated, but dichotomized MMSE and TICS scores are probably not interchangeable in this patient population.

scholarly journals PERBEDAAN GANGGUAN KOGNITIF SUBJEK STROKE ISKEMIK BERDASARKAN SISI HEMIPARESIS

2020 ◽  
Vol 37 (2) ◽  
Author(s):  
Gabriella Gabriella ◽  
Budi Riyanto Wreksoatmodjo ◽  
Andre Andre
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Mental State ◽  
Significant Relationship ◽  
Mini Mental State Examination ◽  
P Value ◽  
Stroke Patients ◽  
Cross Sectional ◽  
State Examination

DIFFERENCE OF COGNITIVE IMPAIRMENT IN ISCHEMIC STROKE PATIENTS BASED ON HEMIPARESIS SIDEABSTRACTIntroduction: Cognitive impairment in stroke has a significant impact on the quality of life and is different from the location of the lesion. Patients with a lesion in the left cerebral hemisphere tend to have cognitive impairment and dementia.Aim: This study investigates the relationship between the location of the lesion, which is manifested by hemiparesis side, and the occurrence of cognitive impairment in ischemic stroke patients.Method: A cross-sectional study was conducted in the population of ischemic stroke patients at Atma Jaya Hospital, who were registered from January 2014 to December 2018. Cognitive function was measured by the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Indonesian Version (MoCA-Ina). Data were analyzed univariate and bivariate with the software program, statistical package for the social sciences (SPSS) version 25.0.Result: There were 125 patients included in this study, which predominantly was 55 years old and older (62.4%) and had a low education level (58.4%). The proportion of patients with right-sided hemiparesis (54.4%) was slightly higher than the left-side one (45.6%). No significant relationship was observed between the hemiparesis side and every cognitive function domain measured by MMSE and MoCA-Ina (p-value >0.05).Discussion Hemiparesis side indicating hemisphere lateralization in ischemic stroke patients showed no significant relationship with the occurrence of cognitive impairment based on MMSE and MoCA-Ina score.   Keywords: Cognitive impairment, hemisphere lateralization, ischemic stroke, MMSE score, MoCA-Ina scoreABSTRAKPendahuluan: Gangguan kognitif pada stroke menyebabkan penurunan kualitas hidup dan berbeda berdasarkan letak lesi. Berdasarkan letak lesi, lesi di hemisfer serebri kiri lebih sering menyebabkan gangguan kognitif dan demensia.Tujuan: Tujuan penelitian untuk mengetahui pengaruh perbedaan letak lesi dilihat dari sisi hemiparesis terhadap gangguan kognitif pada subjek stroke iskemik.Metode: Studi potong lintang dilakukan pada pasien stroke iskemik di RS Atma Jaya periode tahun 2014- 2018. Fungsi kognitif dinilai dengan menggunakan Mini Mental State Examination(MMSE) danMontreal Cognitive Assesment Indonesian Version(MoCA-Ina). Analisis data dilakukan secara univariat dan bivariat menggunakan menggunakan program sStatistical pPackage for the sSocial sSciences (SPSS) versi 25.0.Hasil: Sebanyak 125 pasien tergabung dalam penelitian ini, yang sebagian besar berusia ≥55 tahun (62,4%) dan memiliki tingkat pendidikan <9 tahun (58,4%). Proporsi pasien dengan hemiparesis kanan (54,4%) lebih besar daripada kiri (45,6%). Tidak terdapat hubungan antara sisi hemiparesis dengan skor MMSE dan MoCA-Ina pada semua ranah (nilai p >0,05).Diskusi: Sisi hemiparesis pasien stroke iskemik yang menunjukkan lateralisasi hemisfer serebri tidak berhubungan dengan gangguan kognitif berdasarkan skor MMSE dan MoCA-Ina.Kata kunci: Gangguan kognitif, lateralisasi hemisfer, skor MMSE, skor MoCA-Ina, stroke iskemik

scholarly journals Preoperative Cognitive Impairment as a Predictor of Postoperative Outcomes in Elderly Patients Undergoing Spinal Surgery for Degenerative Spinal Disease

2021 ◽  
Vol 10 (7) ◽  
pp. 1385
Author(s):  
Hyung Cheol Kim ◽  
Seong Bae An ◽  
Hyeongseok Jeon ◽  
Tae Woo Kim ◽  
Jae Keun Oh ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Elderly Patients ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Operation Time ◽  
Cognitive Status ◽  
Blood Analysis ◽  
Spinal Disease ◽  
Degenerative Spinal Disease ◽  
State Examination

Cognitive status has been reported to affect the peri-operative and post-operative outcomes of certain surgical procedures. This prospective study investigated the effect of preoperative cognitive impairment on the postoperative course of elderly patients (n = 122, >65 years), following spine surgery for degenerative spinal disease. Data on demographic characteristics, medical history, and blood analysis results were collected. Preoperative cognition was assessed using the mini-mental state examination, and patients were divided into three groups: normal cognition, mild cognitive impairment, and moderate-to-severe cognitive impairment. Discharge destinations (p = 0.014) and postoperative cardiopulmonary complications (p = 0.037) significantly differed based on the cognitive status. Operation time (p = 0.049), white blood cell count (p = 0.022), platelet count (p = 0.013), the mini-mental state examination score (p = 0.033), and the Beck Depression Inventory score (p = 0.041) were significantly associated with the length of hospital stay. Our investigation demonstrated that improved understanding of preoperative cognitive status may be helpful in surgical decision-making and postoperative care of elderly patients with degenerative spinal disease.

scholarly journals Sleep Disorders and Cognitive Impairment in Peritoneal Dialysis: A Multicenter Prospective Cohort Study

2019 ◽  
Vol 44 (5) ◽  
pp. 1115-1127 ◽  
Author(s):  
Youlu Zhao ◽  
Yuhui Zhang ◽  
Zhikai Yang ◽  
Jinwei Wang ◽  
Zuying Xiong ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cognitive Impairment ◽  
Peritoneal Dialysis ◽  
Cognitive Function ◽  
Sleep Disorders ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Multicenter Prospective Cohort Study ◽  
State Examination ◽  
Multicenter Prospective Cohort

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.

scholarly journals Ouvrier’s Modified Mini Mental State Examination as a screening test for cognitive impairment in school-aged children with epilepsy

2020 ◽  
Vol 60 (3) ◽  
pp. 136-40
Author(s):  
Hariadi Edi Saputra ◽  
Setyo Handryastuti ◽  
Irawan Mangunatmadja ◽  
Dwi Putro Widodo ◽  
Sudung O. Pardede
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Mental State ◽  
Predictive Value ◽  
Mini Mental State Examination ◽  
Diagnostic Value ◽  
Pediatric Epilepsy ◽  
Diagnostic Study ◽  
Long Time ◽  
State Examination

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.

P4516Incremental prognostic values of cognitive impairment diagnosed by mini-mental state examination and mini-cog in older hospitalized patients with heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Saito ◽  
M Yamashita ◽  
Y Endo ◽  
A Mizukami ◽  
K Yoshioka ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Risk Model ◽  
Heart Failure Patients ◽  
Patients With Heart Failure ◽  
State Examination ◽  
Worse Prognosis

Abstract Introduction Cognitive impairment (CI) is associated with worse prognosis in patients with heart failure, especially in the elderly; however, its incremental prognostic ability in pre-existing prognostic models has not been well elucidated. Moreover, although some tools have been proposed for evaluating cognitive function, their difference in prognostic prediction has not been explicitly compared. Methods A total of 352 heart failure patients aged ≥75 years admitted to three hospitals were evaluated for their cognitive function using the Mini-Mental State Examination (MMSE) and Mini-cog during index hospitalization. We diagnosed CI if MMSE and Mini-cog were ≤23 and ≤2, respectively. The primary endpoint was all-cause death. Results The median age of the entire cohort was 85 (IQR: 80–88) years, and 47.7% of the subjects were male. Based on the MMSE and Mini-cog, the CI was diagnosed in 167 (47.4%) and 159 (45.2%) patients, respectively. The two diagnostic tools showed poor to moderate agreement (Cohen's kappa coefficient: 0.37, 95% CI: 0.27–0.47). During the follow-up period of median 346 (IQR: 195–489) days, 53 patients (15.1%) died. Although the Kaplan-Meier analysis showed that CI diagnosed using Mini-cog (CI-MC) was associated with significantly higher mortality (P=0.001), this association was not significant for CI diagnosed using MMSE (CI-MMSE) (P=0.059). On multivariate Cox regression analysis, CI-MMSE and CI-MC were individually associated with worse prognosis in older heart failure patients even after adjustment for Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk model and log B-type natriuretic peptide levels (CI-MMSE, HR: 2.05 [95% CI: 1.16–3.61]; and CI-MC, HR: 2.57 [95% CI: 1.46–4.53]). The receiver operating characteristic curve analysis for Mini-cog showed significantly higher area under the curve (AUC) than that for MMSE (0.61 vs. 0.52, p=0.045). To test the incremental prognostic capability, models were constructed by individually adding each score to the MAGGIC risk model, and the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were evaluated. CI-MMSE did not show incremental prognostic predictability (NRI: 0.28, p=0.069; IDI: 0.01, p=0.090), whereas CI-MC (NRI: 0.45, p=0.001; IDI: 0.03, p=0.001) did. Adding CI-MC instead of CI-MMSE to the MAGGIC risk model showed significant reclassification improvement (NRI: 0.45, p=0.002, IDI: 0.02, p=0.041). Conclusion In older patients with heart failure, CI defined by Mini-Cog is superior in providing additive prognostic value than that defined by CI based on MMSE. Acknowledgement/Funding This study is partially funded by Japan Heart Foundation Research Grant and Novartis Research Grants.

scholarly journals Ouvrier’s Modified Mini Mental State Examination as a screening test for cognitive impairment in school-aged children with epilepsy

2020 ◽  
Vol 60 (3) ◽  
pp. 137-41
Author(s):  
Hariadi Edi Saputra ◽  
Setyo Handryastuti ◽  
Irawan Mangunatmadja ◽  
Dwi Putro Widodo ◽  
Sudung O. Pardede
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Mental State ◽  
Predictive Value ◽  
Mini Mental State Examination ◽  
Diagnostic Value ◽  
Pediatric Epilepsy ◽  
Diagnostic Study ◽  
Long Time ◽  
State Examination

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.

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