Cognitive Impairment and Glycemic Control in Elderly Patients Under Health-Care Case Management

We aim to test whether the association between glucose control and cognitive function still holds true in elderly patients with diabetes mellitus (DM) and Alzheimer disease (AD) under health-care case management. We enrolled 100 patients with DM (mean age: 74.6 years; male: 49%) and 102 patients with AD (mean age: 77.9 years; male: 41.2%) consecutively from the Diabetes Shared Care Program and the memory clinic. These patients were followed up every 3 months with scheduled examinations. Most patients with AD were at early stage and DM was a common comorbidity (n = 42). In the DM group, there were 76 patients with subjective cognitive decline and 19 patients with mild cognitive impairment, but none sought further consultation. After adjusting for age, sex, education, and comorbidity, higher levels of glycated hemoglobin (HbA1C) were not associated with lower Mini-Mental State Examination (MMSE) scores in the DM group (coefficient: 0.03; 95% confidence interval [CI]: −0.44 to 0.50) and lower MMSE scores were not associated with higher HbA1C in the AD group either (coefficient: −0.05; 95% CI: −0.11 to 0.01). When additionally accounting for the variability of HbA1C in the DM group, higher standard deviation of HbA1C was associated with poor clock drawing test scores, but not MMSE. The coexistence of AD-DM was common, but the association between hyperglycemia and cognitive impairment was not seen in patients under regular health monitoring.

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The use of clinical case management for early stage Alzheimer' patients and their families

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/153331750001500506 ◽

2000 ◽

Vol 15 (5) ◽

pp. 284-290 ◽

Cited By ~ 30

Author(s):

Paul Chu ◽

Joy Edwards ◽

Ron Levin ◽

Jim Thomson

Keyword(s):

Treatment Group ◽

Case Management ◽

Early Stage ◽

Skill Training ◽

Care Program ◽

Disease Stage ◽

Control Group ◽

Management Service ◽

Community Based Interventions ◽

Training And Education

A number of studies have investigated the effectiveness of community based interventions to delay placement for persons with Alzheimer's disease (AD) and to ease caregiver burden, with mixed results. However, much of this research involved subjects who were in later stages of AD or the disease stage was not specified. Some researchers have suggested that the timing of interventions in these studies contributed to negative outcomes. This paper presents the results of a project which provided a comprehensive home care program to persons with early stage AD and their primary caregivers over a period of 18 months. Results indicated that caregivers in the treatment group felt less burdened at six months than caregivers in the control group and institutionalization was delayed for patients (with mild to moderate impairment) in the treatment group. These differences seem most attributable to the case management service provided to persons in the treatment group which featured supportive counseling, referral, skill training and education.

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Neurogranin as a predictor of memory and executive function decline in MCI patients

Neurology ◽

10.1212/wnl.0000000000005057 ◽

2018 ◽

Vol 90 (10) ◽

pp. e887-e895 ◽

Cited By ~ 18

Author(s):

Alison Headley ◽

Andres De Leon-Benedetti ◽

Chuanhui Dong ◽

Bonnie Levin ◽

David Loewenstein ◽

...

Keyword(s):

Cognitive Impairment ◽

Executive Function ◽

Sex Education ◽

Early Stage ◽

Memory Function ◽

Cognitive Measures ◽

Cross Sectional ◽

Rate Of Decline ◽

Normal Cognition ◽

Poor Memory

ObjectiveTo determine whether high CSF levels of neurogranin (Ng) predict longitudinal decline in memory and executive function during early-stage Alzheimer disease (AD).MethodsBaseline levels of CSF Ng were studied in relation to cross-sectional and longitudinal cognitive performance over 8 years. Data were obtained from the Alzheimer's Disease Neuroimaging Initiative database, and participants with normal cognition (n = 111) and mild cognitive impairment (MCI) (n = 193) were included.ResultsHigh levels of CSF Ng were associated with poor baseline memory scores (β = −0.21, p < 0.0001). CSF Ng predicted both memory and executive function decline over time (β = −0.0313, p = 0.0068 and β = −0.0346, p = 0.0169, respectively) independently of age, sex, education, and APOE ε4 status. When the rate of decline by tertiles was examined, CSF Ng was a level-dependent predictor of memory function, whereby the group with highest levels of Ng showed the fastest rates of decline in both memory and executive function. When examined separately, elevated Ng was associated with cognitive decline in participants with MCI but not in those with normal cognition. The levels of CSF Ng were not associated with cognitive measures when tau and amyloid 42 (Aβ42) were controlled for in these analyses.ConclusionsHigh CSF Ng associates with poor memory scores in participants with MCI cross-sectionally and with poor memory and executive function longitudinally. The association of Ng with cognitive measures disappears when tau and Aβ42 are included in the statistical models. Our findings suggest that CSF Ng may serve as a biomarker of cognition. Synaptic dysfunction contributes to cognitive impairment in early-stage AD.

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Probable sarcopenia is associated with cognitive impairment among community-dwelling older adults: results from the FIBRA study

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x-anp-2020-0186 ◽

2021 ◽

Vol 79 (5) ◽

pp. 376-383

Author(s):

Gabriela Cabett Cipolli ◽

Ivan Aprahamian ◽

Flávia Silva Arbex Borim ◽

Deusivania Vieira Silva Falcão ◽

Meire Cachioni ◽

...

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Grip Strength ◽

Sex Education ◽

Leisure Time Physical Activity ◽

Community Dwelling ◽

Clock Drawing Test ◽

Community Dwelling Older Adults ◽

The Relationship ◽

State Examination

ABSTRACT Background: The link between sarcopenia and cognitive impairment has not yet been thoroughly evaluated, especially among older adults. Objective: To evaluate the relationship between probable sarcopenia and cognitive impairment among community-dwelling older adults in two Brazilian cities. Methods: Probable sarcopenia was assessed using the EWGSOP2 (2018) criteria. Thus, participants were classified as probably having sarcopenia if they had SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs and Falls) ≥4 points and low grip strength. Cognitive function was evaluated through the Mini-Mental State Examination (MMSE), verbal fluency (VF) and clock drawing test (CDT). Results: In a sample of 529 older adults (mean age 80.8±4.9 years; mean education 4.2±3.67 years; 70.1% women), 27.3% of the participants had SARC-F≥4, 38.3% had low grip strength and 13.6% were classified as probable sarcopenia cases. After adjusting for possible confounders (age, sex, education, depression, diabetes, hypertension, leisure-time physical activity and obesity), probable sarcopenia was found to be associated with impairment in the MMSE (OR 2.52; 95%CI 1.42‒4.47; p=0.002) and in VF (OR 2.17; 95%CI 1.17‒4.01; p=0.014). Low grip strength was found to be associated with impairment in the MMSE (OR 1.83; 95%CI 1.18‒2.82; p=0.006) and in the CDT (OR 1.79; 95%CI 1.18‒2.73; p=0.006). SARC-F scores were found to be associated with impairment in the MMSE (OR 1.90; 95%CI 1.18‒3.06; p=0.008). Conclusion: The results suggested that probable sarcopenia and its components present a significant association with cognitive deficits among community-dwelling older adults. Future longitudinal studies will further explore the causal relationship.

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Association Between Sarcopenia and Mild Cognitive Impairment Using the Japanese Version of the SARC-F in Elderly Patients With Diabetes

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2017.06.012 ◽

2017 ◽

Vol 18 (9) ◽

pp. 809.e9-809.e13 ◽

Cited By ~ 12

Author(s):

Satoshi Ida ◽

Mari Nakai ◽

Sho Ito ◽

Yuki Ishihara ◽

Kanako Imataka ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Elderly Patients ◽

Japanese Version ◽

Patients With Diabetes

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FACTORS ASSOCIATED WITH COGNITIVE IMPAIRMENT IN ELDERLY PATIENTS WITH DIABETES MELLITUS

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2006.00643_11.x ◽

2006 ◽

Vol 54 (3) ◽

pp. 558-559 ◽

Cited By ~ 12

Author(s):

Mari Suzuki ◽

Hiroyuki Umegaki ◽

Satsuki Ieda ◽

Nanaka Mogi ◽

Akihisa Iguchi

Keyword(s):

Diabetes Mellitus ◽

Cognitive Impairment ◽

Elderly Patients ◽

Factors Associated ◽

Patients With Diabetes

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The Use of MoCA and Other Cognitive Tests in Evaluation of Cognitive Impairment in Elderly Patients Undergoing Arthroplasty

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/2151458516669203 ◽

2016 ◽

Vol 7 (4) ◽

pp. 183-187 ◽

Cited By ~ 9

Author(s):

Jukka Puustinen ◽

Liisa Luostarinen ◽

Markku Luostarinen ◽

Veijo Pulliainen ◽

Heini Huhtala ◽

...

Keyword(s):

Higher Education ◽

Cognitive Impairment ◽

Elderly Patients ◽

Care Center ◽

Cognitive Tests ◽

Clock Drawing Test ◽

Health Care Center ◽

Clock Drawing ◽

Primary Arthroplasty

Objective: To examine the prevalence and effect of cognitive impairment on treatment outcomes in elderly patients undergoing arthroplasty and to describe the feasibility of cognitive tests. Materials and Methods: The participants were 52 patients with a mean age of 78 years 11 months (SD: 3.3), waiting for primary arthroplasty. We translated Montreal Cognitive Assessment (MoCA) into Finnish and compared it with Mini-Mental State Examination (MMSE), Mini-Cog, and clock-drawing tests prior to and 3 months after the surgery. The ability to perform activities of daily living, depression, quality of life, and years of education were evaluated. Results: The mean MoCA score on the first visit was 20.7 (SD: 4.1). The pre- and postoperative cognitive tests implied there were no changes in cognitive functioning. Unambiguous delirium was detected in 6 patients. Delirium was not systematically assessed and consequently hypoactive delirium cases were possibly missed. Both MMSE and Mini-Cog found 3/6 of those and clock drawing and MoCA 6/6. Low preoperative MoCA, MMSE, and Mini-Cog scores predicted follow-up treatment in health-care center hospitals ( P = .02, .011, and .044, respectively). During the 5-year follow-up period, 11/52 patients died. Higher education was the only variable associated with survival. The survivors had attained the median of 8 (range: 4-19) years of education compared with 6 (range: 4-8) years among the deceased. Conclusion: The prevalence of cognitive impairment among older patients presenting for arthroplasty is high and mostly undiagnosed. It is feasible to use the MoCA to identify cognitive impairment preoperatively in this group. The clock-drawing test was abnormal in all patients with postoperative delirium, which could be used as a screening test. Higher education predicted survival on a 5-year follow-up period.

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