Medical Complications Predict Cognitive Decline in Nondemented Hip Fracture Patients—Results of a Prospective Observational Study

2018 ◽  
Vol 31 (2) ◽  
pp. 84-89 ◽  
Author(s):  
Juliana Hack ◽  
Daphne Eschbach ◽  
Rene Aigner ◽  
Ludwig Oberkircher ◽  
Steffen Ruchholtz ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Influencing Factors ◽  
Hip Fractures ◽  
Mental State ◽  
Mini Mental State Examination ◽  
University Hospital ◽  
Medical Complications ◽  
Consecutive Series ◽  
State Examination

Objective: The aim of this study was to identify factors that are associated with cognitive decline in the long-term follow-up after hip fractures in previously nondemented patients. Methods: A consecutive series of 402 patients with hip fractures admitted to our university hospital were analyzed. After exclusion of all patients with preexisting dementia, 266 patients were included, of which 188 could be examined 6 months after surgery. Additional to several demographic data, cognitive ability was assessed using the Mini-Mental State Examination (MMSE). Patients with 19 or less points on the MMSE were considered demented. Furthermore, geriatric scores were recorded, as well as perioperative medical complications. Mini-Mental State Examination was performed again 6 months after surgery. Results: Of 188 previously nondemented patients, 12 (6.4%) patients showed a cognitive decline during the 6 months of follow-up. Multivariate regression analysis showed that age ( P = .040) and medical complications ( P = .048) were the only significant independent influencing factors for cognitive decline. Conclusions: In our patient population, the incidence of dementia exceeded the average age-appropriate cognitive decline. Significant independent influencing factors for cognitive decline were age and medical complications.

scholarly journals Oxytocin and elderly MRI-based hippocampus and amygdala volume: a 7-year follow-up study

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Ryuzo Orihashi ◽  
Yoshito Mizoguchi ◽  
Yoshiomi Imamura ◽  
Shigeto Yamada ◽  
Takefumi Ueno ◽  
...  
Keyword(s):  
Elderly People ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Brain Volume ◽  
Brain Mri ◽  
Statistical Parametric Mapping ◽  
Clinical Dementia Rating ◽  
Amygdala Volume ◽  
State Examination

Abstract Oxytocin is deeply involved in human relations. In recent years, it is becoming clear that oxytocin is also involved in social cognition and social behaviour. Oxytocin receptors are also thought to be present in the hippocampus and amygdala, and the relationship between oxytocin and the structure and function of the hippocampus and amygdala has been reported. However, a few studies have investigated oxytocin and its relationship to hippocampus and amygdala volume in elderly people. The aim of this study is to investigate the association between serum oxytocin levels and hippocampus and amygdala volume in elderly people. The survey was conducted twice in Kurokawa-cho, Imari, Saga Prefecture, Japan, among people aged 65 years and older. We collected data from 596 residents. Serum oxytocin level measurements, brain MRI, Mini–Mental State Examination and Clinical Dementia Rating were performed in Time 1 (2009–11). Follow-up brain MRI, Mini–Mental State Examination and Clinical Dementia Rating were performed in Time 2 (2016–17). The interval between Time 1 and Time 2 was about 7 years. Fifty-eight participants (14 men, mean age 72.36 ± 3.41 years, oxytocin 0.042 ± 0.052 ng/ml; 44 women, mean age 73.07 ± 4.38 years, oxytocin 0.123 ± 0.130 ng/ml) completed this study. We analysed the correlation between serum oxytocin levels (Time 1) and brain volume (Time 1, Time 2 and Times 1–2 difference) using voxel-based morphometry implemented with Statistical Parametric Mapping. Analysis at the cluster level (family-wise error; P < 0.05) showed a positive correlation between serum oxytocin levels (Time 1) and brain volume of the region containing the left hippocampus and amygdala (Time 2). This result suggests that oxytocin in people aged 65 years and older may be associated with aging-related changes in hippocampus and amygdala volume.

scholarly journals Medium-Chain Triglycerides (8:0 and 10:0) Increase Mini-Mental State Examination (MMSE) Score in Frail Elderly Adults in a Randomized Controlled Trial

2020 ◽  
Vol 150 (9) ◽  
pp. 2383-2390 ◽  
Author(s):  
Sakiko Abe ◽  
Osamu Ezaki ◽  
Motohisa Suzuki
Keyword(s):  
Mental State ◽  
Frail Elderly ◽  
Mini Mental State Examination ◽  
Mmse Score ◽  
Medium Chain Triglycerides ◽  
Elderly Individuals ◽  
Intention To Treat ◽  
Randomized Controlled ◽  
State Examination

ABSTRACT Background Supplementation with medium-chain triglycerides (MCTs) was previously shown to increase muscle function in frail elderly individuals. Objective We aimed to assess effects of MCTs on cognition in such individuals. Methods We enrolled 64 elderly nursing home residents (85.5 ± 6.8 y; 13 men, 51 women; BMI 18.6 ± 2.5 kg/m2) in a 3-mo randomized, controlled, single-blinded, intervention trial. Participants were randomly allocated to 3 groups: the first group received supplemental L-leucine (1.2 g) and cholecalciferol (20 μg) enriched with 6 g/d of MCTs (LD + MCT group) as a positive control, the second group received 6 g/d of MCTs (MCT group) as the test nutrient, and the third group received 6 g/d of long-chain triglycerides (LCT group) as a negative control. Cognition (secondary outcome) was monitored 4 times: baseline, 1.5 and 3 mo after initiation of the intervention (intervention), and 1.5 mo after termination of the intervention (postintervention follow-up). Cognition scores were assessed by a linear mixed model (intention-to-treat analysis). Results MCT supplementation increased the Mini-Mental State Examination (MMSE) score by 3.5 points at the 3-mo intervention from baseline (P < 0.001) [intention-to-treat adjusted means: baseline 17.5 points (95% CI: 14.9, 20.2), 3-mo intervention 21.0 points (18.3, 23.7)], whereas LCT supplementation decreased the MMSE score by −0.7 points [baseline 17.0 points (95% CI: 14.4, 19.6), 3-mo intervention 16.3 points (13.6, 18.9)]. At the 3-mo intervention, the difference in MMSE score between the MCT (21.0 points) and LCT (16.3 points) groups became significant (P < 0.05). The increase in MMSE score in response to MCTs was 2.1-fold greater at 3 mo than at 1.5 mo and had returned to baseline value at the 4.5-mo postintervention follow-up visit. Conclusion Supplementation with 6 g MCTs/d may improve the cognition of frail elderly individuals. This trial was registered at umin.ac.jp as UMIN000023302.

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 < 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 HUBUNGAN PENINGKATAN KADAR C-REACTIVE PROTEIN DENGAN PENURUNAN FUNGSI KOGNITIF PASIEN GERIATRI RAWAT JALAN

2019 ◽  
Vol 37 (1) ◽  
Author(s):  
Stefanus Erdana Putra ◽  
Muhammad Hafizhan ◽  
Raden Ajeng Hanindia Riani Prabaningtyas
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Mental State ◽  
Geriatric Patients ◽  
Mini Mental State Examination ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Neurology Clinic ◽  
Serum Crp ◽  
State Examination

THE RELATIONSHIP BETWEEN ELEVATED C-REACTIVE PROTEIN AND COGNITIVE FUNCTION DETERIORATION OF GERIATRIC OUTPATIENTSABSTRACTIntroduction: Geriatric patients have different characteristics compared to other patients in general, in which they potentially experiencing cognitive impairment, decreasing of physiological and functional status, also the immunological system. This situation causes various inflammatory reactions that play a role in the development of neurodegenerative diseases, including the increase production of acute phase protein called C-reactive protein (CRP).Aims: To determine the association  between the CRP serum concentration  elevation and the deterioration  of geriatric outpatients’s cognitive function at Neurology Clinic Sebelas Maret University Hospital.Methods: A cross-sectional study of geriatric patients at the Neurology Clinic of Sebelas Maret University Hospital, Surakarta.   The cognitive state was evaluated using Mini-Mental State Examination (MMSE) and those with MMSE score<24 were considered cognitively declined. Concentrations of serum CRP were measured. Multiple logistic regression analysis was used to calculate Odds ratios (ORs) for cognitive decline, adjusted for the covariates of age, sex, body mass index, and disease history.Results: There were 73 participants with mean age was 65.6 years old. There were 56,2% who were experiencing a cognitive decline. Relative to the lowest (first) quartile of CRP concentration, adjusted ORs were 1,44 for the second, 1,97 for the third, and 2,33 for the highest quartiles (p=0,035). The association between CRP levels and decreased cognitive function was found to be significant after adjusting for covariates. When data were stratified by sex, the association between CRP concentration and cognitive decline was observed in women.Discussions: This research  suggested an association  between higher CRP concentration  and lower cognitive function. Chronic inflammation might affect cognitive function in geriatric, particularly in women.Keywords: C-reactive protein, cognitive function, geriatric outpatientsABSTRAKPendahuluan: Pasien geriatri memiliki karakteristik yang berbeda dengan pasien pada umumnya, yaitu selain berpotensi mengalami gangguan fungsi kognitif juga menurunnya daya cadangan fisiologis serta status fungsional dan sistem imunologi. Keadaan ini menimbulkan berbagai reaksi inflamasi yang berperan dalam perkembangan penyakit neurodegeneratif, antara lain peningkatan produksi protein fase akut bernama C-reactive protein (CRP) oleh hepar.Tujuan: Mengetahui hubungan antara peningkatan kadar CRP dengan penurunan fungsi kognitif pasien geriatri rawat jalan di Poliklinik Saraf RS Universitas Sebelas Maret.Metode: Penelitian potong lintang terhadap pasien geriatri di Poli Saraf RS Universitas Sebelas Maret, Surakarta. Evaluasi fungsi kognitif menggunakan Mini-Mental State Examination (MMSE); dengan skor <24 dikategorikan mengalami penurunan fungsi kognitif. Kadar serum CRP masing-masing subjek juga diukur. Analisis regresi logistik berganda digunakan dalam menghitung rasio Odds (RO) untuk penurunan fungsi kognitif, dengan pengaturan kovariat usia, jenis kelamin, indeks massa tubuh, dan riwayat penyakit sebelumnya.Hasil: Didapatkan 73 subjek dengan rerata usia 65,6 tahun. Sebanyak 56,2% subjek mengalami penurunan fungsi kognitif. Dengan perbandingan relatif terhadap kuartil konsentrasi CRP terendah (pertama), RO yang telah diatur adalah 1,44 untuk kuartil kedua; 1,97 untuk kuartil ketiga; serta 2,33 untuk kuartil keempat (p=0,035). Hubungan kadar CRP dan penurunan fungsi kognitif ditemukan signifikan setelah disesuaikan dengan kovariat. Setelah dilakukan sub-analisis berdasarkan jenis kelamin, peningkatan kadar CRP terhadap penurunan kognitif secara signifikan terjadi pada subjek perempuan.Diskusi: Penelitian ini menunjukkan adanya hubungan antara peningkatan kadar CRP dengan penurunan fungsi kognitif. Inflamasi kronis memengaruhi fungsi kognitif geriatri khususnya perempuan.Kata kunci: C-reactive protein, fungsi kognitif pasien rawat jalan, geriatri

Comparison between the accuracy of Montreal Cognitive Assessment and Mini-Mental State Examination in the detection of mild cognitive impairment

2021 ◽  
Author(s):  
Nayyereh Aminisani ◽  
Rasoul alimi ◽  
Ali Javadpour ◽  
Mohhamad Asghari-Jafarabadi ◽  
Mozhgan Jourian ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Screening Tools ◽  
Montreal Cognitive Assessment ◽  
The Impact ◽  
State Examination

Abstract Introduction:Ageing can cause major changes in the central nervous system of the body, resulting in cognitive decline and associated disorders. Therefore, there is a growing need for an effective cognitive screening method to enhance the diagnosis of mild cognitive impairments and to prevent occurring dementia and Alzheimer's Disease (AD). Our study aimed to compare the accuracy of MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) while evaluating the independent and interaction effects of age and educational level on these screening tools in a healthy sample.Method: The data for the current study was based on the registration phase of the study during 2016-2018 in Neyshabour Longitudinal Study on Ageing (NeLSA). Both the MoCA and MMSE tests were used to assess cognitive decline among 3326 participants aged 50-94 years of old. The ROC curve analysis and the predictive values were performed to evaluate the diagnostic accuracy of MMSE to discriminate Mild Cognitive Impairment (MCI) from the cognitively healthy adult basis of MoCA scores as a gold test. A two-way ANCOVA was run to examine the effect of Age and Education level on MoCA and MMSE score, while controlling for a gender effect. Data were analyzed using MedCalc Statistical Software version 13.0.6 (MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2014). Results: The chi-square test shows that MoCA ((72% and 90%) significantly (p-value<0.001() classified more persons as cognitively impaired than the MMSE (45.1%), respectively; using a cutoff score of 24 on the MMSE, 23 and 26 on the MoCA. The cut-off point of below 25 yielded the highest Youden J index for the MMSE in discrimination between MCI and healthy basis of MOCA<23 with an AUC of 0.9 (95% CI: 0.89-0.91) and MOCA<26 with an AUC of 0.87 (95% CI: 0.86-0.89). A two-way ANCOVA results show that the effect of education variable on the MMSE and MoCA score is more important than the age variable.Discussion: Although the cut-off scores give a clear indication of the sensitivity and specificity, they are unable to monitor the impact of confounders, which increase the risk of incorrect classification. Taken together, these findings demonstrate the use of demographically adjusted MoCA and MMSE scores that could provide clinicians with a more reliable estimation of the severity of cognitive impairment, thus increasing the instrument's clinical usefulness.

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