scholarly journals Prevalence and Causes of Cognitive Impairment and Dementia in a Population-Based Cohort From Northern Portugal

2018 ◽  
Vol 34 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Luis Ruano ◽  
Natália Araújo ◽  
Mariana Branco ◽  
Rui Barreto ◽  
Sandra Moreira ◽  
...  

Background: Vascular disease may play an important role in the epidemiology of dementia in countries with high stroke incidence, such as Portugal. Objective: To assess the prevalence and etiology of cognitive impairment in a population-based cohort from Portugal. Methods: Individuals ≥55 years (n = 730) from the EPIPorto cohort were assessed using the Mini-Mental State Examination and the Montreal Cognitive Assessment. Those scoring below the age-/education-adjusted cutoff points were further evaluated to identify dementia or mild cognitive impairment (MCI) and to define its most common causes. Results: Thirty-six cases of MCI/dementia were identified, corresponding to adjusted prevalences of 4.1% for MCI and 1.3% for dementia. The most common cause of MCI/dementia was vascular (52.8%), followed by Alzheimer’s disease (36.1%). Conclusion: These findings highlight the importance of vascular cognitive impairment in the epidemiology of dementia in Portugal and carry an important public health message regarding its prevention and management, possibly extending to other countries with a high-stroke burden.

2013 ◽  
Vol 25 (11) ◽  
pp. 1831-1838 ◽  
Author(s):  
YanHong Dong ◽  
Wah Yean Lee ◽  
Saima Hilal ◽  
Monica Saini ◽  
Tien Yin Wong ◽  
...  

ABSTRACTBackground:We examined the discriminant validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in detecting multiple-domain mild cognitive impairment (md-MCI) in a Chinese sub-sample drawn from elderly population-based study.Methods:This study included Chinese participants from the Epidemiology of Dementia in Singapore (EDIS) study aged ≥ 60 years who underwent cognitive screening with the Abbreviated Mental Test and Progressive Forgetfulness Questionnaire. Screen-positive participants subsequently underwent MoCA, MMSE, and a comprehensive formal neuropsychological battery. MCI was defined by Petersen's criteria and further classified into single-domain MCI (sd-MCI) and md-MCI. Area under the receiver operating characteristic curve (AUC) with 95% confidence intervals (CIs) was computed for the MoCA and the MMSE in detecting md-MCI.Results:A total of 300 participants were recruited: 128 (42.7%) were diagnosed with no cognitive impairment (NCI), 47 (15.7%) with sd-MCI, and 83 (28.0%) with md-MCI. Forty-one participants were excluded, 7 (2.3%) had dementia, and 34 (11.3%) had only objective cognitive impairment without subjective complaints. Although the MoCA had a significantly larger AUC than the MMSE (0.94 (95% CI = 0.91–0.97) vs. 0.91 (95% CI = 0.86–0.95), p= 0.04), at optimal cut-off points, the MoCA (19/20) was equivalent to the MMSE (25/26) in detecting md-MCI (sensitivity: 0.80 vs. 0.87, specificity: 0.92 vs. 0.80).Conclusion:Both screening tests had good discriminant validity and can be used in detecting md-MCI in a sub-sample of Chinese drawn from a population-based study.


2018 ◽  
Vol 52 (5) ◽  
pp. 1801137 ◽  
Author(s):  
Katia Gagnon ◽  
Andrée-Ann Baril ◽  
Jacques Montplaisir ◽  
Julie Carrier ◽  
Sirin Chami ◽  
...  

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.


2008 ◽  
Vol 66 (3a) ◽  
pp. 524-528 ◽  
Author(s):  
Érico Castro-Costa ◽  
Cíntia Fuzikawa ◽  
Elizabeth Uchoa ◽  
Josélia Oliveira Araújo Firmo ◽  
Maria Fernanda Lima-Costa

OBJECTIVE: To estimate the prevalence of cognitive impairment in an elderly population-based cohort, using several Mini-Mental State Examination (MMSE) cut-off points recommended by Brazilian authors and to examine the percentile distribution of MMSE scores in the study population. METHOD: A total of 1558 subjects aged >60 years (89.4% of the total), living in the city of Bambuí, MG, completed the MMSE and were included in the present study. RESULTS: The estimated prevalences of cognitive impairment varied from 13.2% to 27.0% depending on the cut-off point and agreement varied widely between them (kappa range: 0.38 to 0.88). Cut-off point 13/14 corresponded to the 5th percentile and 21/22 corresponded to the lower quartile of the MMSE score distribution. CONCLUSION: In the absence of comparable cut-off points, percentile distributions are more adequate for population-based studies of elderly with low schooling level.


2011 ◽  
Vol 23 (7) ◽  
pp. 1107-1115 ◽  
Author(s):  
Lisa Koski ◽  
Haiqun Xie ◽  
Susanna Konsztowicz

ABSTRACTBackground: The Montreal Cognitive Assessment (MoCA) can be used to quantify cognitive ability in older persons undergoing screening for cognitive impairment. Although highly sensitive in detecting mild cognitive impairment, its measurement precision is weakest among persons with milder forms of impairment. We sought to overcome this limitation by integrating information from the Mini-Mental State Examination (MMSE) into the calculation of cognitive ability.Methods: Data from 185 geriatric outpatients screened for cognitive impairment with the MoCA and the MMSE were Rasch analyzed to evaluate the extent to which the MMSE items improved measurement precision in the upper ability ranges of the population.Results: Adding information from the MMSE resulted in a 13.8% (13.3–14.3%) reduction in measurement error, with significant improvements in all quartiles of patient ability. The addition of three-word repetition and recall, copy pentagons, repeat sentence, and write sentence improved measurement of cognition in the upper levels of ability.Conclusions: The algorithm presented here maximizes the yield of available clinical data while improving measurement of cognitive ability, which is particularly important for tracking changes over time in patients with milder levels of impairment.


2019 ◽  
Vol 13 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Krisly Arguedas Vásquez ◽  
Erick Miranda Valverde ◽  
Daniel Valerio Aguilar ◽  
Henri-Jacques Hernández Gabarain

ABSTRACT. Several screening tests have been used for cognitive evaluation in Parkinson’s disease (PD). Objective: To evaluate the usefulness of the Montreal Cognitive Assessment (MoCA) in patients with Parkinson’s disease and no cognitive impairment complaints. Methods: A total of 40 PD patients with no complaints of cognitive problems were included. Patients were selected using the Mini-Mental State Examination (MMSE) and the MoCA was then administered. Results: 80% of patients exhibited Mild Cognitive Impairment (MCI) according to the MoCA. Statistically significant differences in visuospatial, attention and delayed recall functions were evident between the normal and abnormal MoCA groups. Conclusion: The study results suggest that MoCA may be a good screening test in patients with PD who do not present cognitive complaints.


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