Atrial fibrillation and risk of dementia in non-demented elderly subjects with and without mild cognitive impairment

2006 ◽  
Vol 28 (6) ◽  
pp. 625-629 ◽  
Author(s):  
Paola Forti ◽  
Fabiola Maioli ◽  
Nicoletta Pisacane ◽  
Elisa Rietti ◽  
Fausta Montesi ◽  
...  
BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045896
Author(s):  
Elizabeth L Potter ◽  
Satish Ramkumar ◽  
Leah Wright ◽  
Thomas H Marwick

ObjectivesEffective identification and management of subclinical left ventricular (LV) dysfunction (LVD) and subclinical atrial fibrillation (AF) by screening elderly populations might be compromised by mild cognitive impairment (MCI). We sought to characterise the prevalence and profile of MCI and evaluate associations with LV and left atrial (LA) dysfunction and AF, in a trial of screening for subclinical LVD and AF.DesignCross-sectional.SettingAustralian, community-based intervention trial.ParticipantsAdults aged ≥65 years with ≥1 LVD risk factors without ischaemic heart disease (n=337).Outcome measuresThe Montreal cognitive assessment (MoCA) was obtained. Subclinical LVD was defined as echocardiographic global longitudinal strain ≤16%, diastolic dysfunction or LV hypertrophy; abnormal LA reservoir strain (LARS) was defined as <24%. Subclinical AF was detected using a single-lead portable electrocardiographic device in those without pre-existing AF who gave consent (n=293).ResultsSubclinical LVD was found in 155 (46%), abnormal LARS in 9 (3.6%) and subclinical AF in 11 (3.8%). MoCA score consistent with MCI (<26) was found in 101 (30%); executive function (69%) and delayed recall (93%), were the most frequently abnormal domains. Compared with normal cognition, MCI was associated with non-adherence to AF screening (25% vs 40%, p=0.01). In multivariable logistic regression modelling, educational achievement, systolic blood pressure, body mass index and waist-to-hip ratio were independently associated with MCI. However, neither subclinical AF nor any measure of cardiac dysfunction, were associated with MCI.ConclusionsThe 30% prevalence of MCI among elderly subjects with risk factors for subclinical LVD and AF has important implications for screening strategies and management. However, MCI is not associated with subclinical myocardial dysfunction nor subclinical AF.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12617000116325).


2013 ◽  
Vol 5 (3) ◽  
pp. 16 ◽  
Author(s):  
Fábio Henrique De Gobbi Porto ◽  
Lívia Spíndola ◽  
Maira Okada De Oliveira ◽  
Patrícia Helena Figuerêdo Do Vale ◽  
Marco Orsini ◽  
...  

It is not easy to differentiate patients with mild cognitive impairment (MCI) from subjective memory complainers (SMC). Assessments with screening cognitive tools are essential, particularly in primary care where most patients are seen. The objective of this study was to evaluate the diagnostic accuracy of screening cognitive tests and to propose a score derived from screening tests. Elderly subjects with memory complaints were evaluated using the Mini Mental State Examination (MMSE) and the Brief Cognitive Battery (BCB). We added two delayed recalls in the MMSE (a delayed recall and a late-delayed recall, LDR), and also a phonemic fluency test of letter P fluency (LPF). A score was created based on these tests. The diagnoses were made on the basis of clinical consensus and neuropsychological testing. Receiver operating characteristic curve analyses were used to determine area under the curve (AUC), the sensitivity and specificity for each test separately and for the final proposed score. MMSE, LDR, LPF and delayed recall of BCB scores reach statistically significant differences between groups (P=0.000, 0.03, 0.001 and 0.01, respectively). Sensitivity, specificity and AUC were MMSE: 64%, 79% and 0.75 (cut off &lt;29); LDR: 56%, 62% and 0.62 (cut off &lt;3); LPF: 71%, 71% and 0.71 (cut off &lt;14); delayed recall of BCB: 56%, 82% and 0.68 (cut off &lt;9). The proposed score reached a sensitivity of 88% and 76% and specificity of 62% and 75% for cut off over 1 and over 2, respectively. AUC were 0.81. In conclusion, a score created from screening tests is capable of discriminating MCI from SMC with moderate to good accurancy.


2010 ◽  
Vol 6 ◽  
pp. S357-S357
Author(s):  
Lívia G. Rodrigues ◽  
Ana Luiza Camozzato ◽  
Renata Kochhann ◽  
Claudia Godinho ◽  
Maria Otilia Cerveira ◽  
...  

2009 ◽  
Vol 15 (5) ◽  
pp. 751-757 ◽  
Author(s):  
ANA ESPINOSA ◽  
MONTSERRAT ALEGRET ◽  
MERCÈ BOADA ◽  
GEORGINA VINYES ◽  
SERGI VALERO ◽  
...  

AbstractAlthough memory deficits are typically the earliest and most profound symptoms of Alzheimer’s disease (AD) and mild cognitive impairment (MCI), there is increasing recognition of subtle executive dysfunctions in these patients. The purpose of the present study was to determine the sensitivity of the Behavioral Assessment of the Dysexecutive Syndrome (BADS), and to detect early specific signs of the dysexecutive syndrome in the transition from normal cognition to dementia. The BADS was administered to 50 MCI subjects, 50 mild AD patients, and 50 normal controls. Statistically significant differences were found among the three groups with the AD patients performing most poorly, and the MCI subjects performing between controls and AD patients. The Rule Shift Cards and the Action Program subtests were the most highly discriminative between MCI and controls; the Zoo Map and Modified Six Elements between MCI and AD; and the Action Program, Zoo Map, and Modified Six Elements between AD and controls. These results demonstrate that the BADS is clinically useful in discriminating between normal cognition and progressive neurodegenerative conditions. Furthermore, these data confirm the presence of a dysexecutive syndrome even in mildly impaired elderly subjects. (JINS, 2009, 15, 751–757.)


2002 ◽  
Vol 106 (3) ◽  
pp. 148-154 ◽  
Author(s):  
T. Hänninen ◽  
M. Hallikainen ◽  
S. Tuomainen ◽  
M. Vanhanen ◽  
H. Soininen

2017 ◽  
Vol 44 (5-6) ◽  
pp. 320-327 ◽  
Author(s):  
Yunier Broche-Pérez ◽  
Héctor Alejandro López-Pujol

Background/Aims: The diagnostic accuracy of the Cuban version of the revised Addenbrooke’s Cognitive Examination (ACE-R) in identifying mild cognitive impairment (MCI) in comparison with the Mini-Mental State Examination (MMSE) was assessed. Methods: The Cuban ACE-R was administered to a group of 129 elderly subjects (92 cognitively healthy and 37 subjects with MCI). The t tests for independent samples were used to compare scores of different psychometric scales between groups, and effect sizes (Cohen’s d) were calculated. Cronbach’s coefficient α was used to evaluate the reliability of psychometric scales. The validity of ACE-R to screen for MCI was assessed by receiver operating characteristic (ROC) curves. Results: The Cuban ACE-R had reliable internal consistency (Cronbach’s coefficient α = 0. 879). The optimal cut-off score for ACE-R for detecting MCI was 84/85. The sensitivity and specificity of ACE-R to screen for MCI was superior to those of MMSE. The area under the ROC curve of the Cuban ACE-R was much larger than that of MMSE (0.93 and 0.63) for detecting MCI. Conclusion: The Cuban ACE-R is a valid screening tool for detecting cognitive impairment. It is more sensitive and accurate in screening for MCI than MMSE.


2000 ◽  
Vol 21 ◽  
pp. 101 ◽  
Author(s):  
Tuomo Hanninen ◽  
Merja Hallikainen ◽  
Matti Vanhanen ◽  
Hilkka Soininen

Sign in / Sign up

Export Citation Format

Share Document