scholarly journals A model of cognitive evaluation battery for diagnosis of mild cognitive impairment and dementia in educated and illiterate Egyptian elderly people

Author(s):  
Nehal ElKholy ◽  
Heba Mohamed Tawfik ◽  
Somaia Ebeid ◽  
Omaima Refat Elsayed Madkor ◽  
Sarah Ahmed Hamza

Abstract Background The high illiteracy rates in the North African and Middle Eastern region make direct cognitive testing challenging. Validated instruments for dementia in Arabic language are lacking specially those targeting low-educated subjects. Objectives The aim of this study was to develop a cognitive evaluation battery suitable for both educated and illiterate Egyptian elderly people. Design A cross-sectional study was conducted. Setting: Ain-Shams University geriatric and ophthalmology wards, geriatrics outpatient clinic, and geriatric clubs. Participants: 159 male and female participants aged ≥ 60 years were recruited. Measurements Cut-off points were determined according to DSM-IV criteria for dementia and MMSE scores which divided the participants into 3 quadrants as normal, having mild cognitive impairment and having dementia then application of the new battery test was done. Results Test re-test reliability ranged from adequate to high in most of its tests with r ≥ 0.7. There was a statistical significance between all battery tests when divided into normal and dementia according to DSM IV criteria except in digit span forward length, digit span backward length, stimulus cue of confrontation naming and judgment. Means and standard deviations were calculated for each battery subset, for the whole sample, for low-educated group and group with > 9 years education according to three quadrants of MMSE. Conclusion A new valid and reliable neurocognitive evaluation battery that can differentiate between normal, mild cognitive impairment, and dementia in both educated and illiterate subjects under the name of Ain Shams Cognitive Assessment (ASCA) scale is now available.

2019 ◽  
Vol 25 (10) ◽  
pp. 1001-1010 ◽  
Author(s):  
Sheina Emrani ◽  
Victor Wasserman ◽  
Emily Matusz ◽  
David Miller ◽  
Melissa Lamar ◽  
...  

AbstractObjective:Previous research in mild cognitive impairment (MCI) suggests that visual episodic memory impairment may emerge before analogous verbal episodic memory impairment. The current study examined working memory (WM) test performance in MCI to assess whether patients present with greater visual versus verbal WM impairment. WM performance was also assessed in relation to hippocampal occupancy (HO), a ratio of hippocampal volume to ventricular dilation adjusted for demographic variables and intracranial volume.Methods:Jak et al. (2009) (The American Journal of Geriatric Psychiatry, 17, 368–375) and Edmonds, Delano-Wood, Galasko, Salmon, & Bondi (2015) (Journal of Alzheimer’s Disease, 47(1), 231–242) criteria classify patients into four groups: little to no cognitive impairment (non-MCI); subtle cognitive impairment (SCI); amnestic MCI (aMCI); and a combined mixed/dysexecutive MCI (mixed/dys MCI). WM was assessed using co-normed Wechsler Adult Intelligence Scale-IV (WAIS-IV) Digit Span Backwards and Wechsler Memory Scale-IV (WMS-IV) Symbol Span Z-scores.Results:Between-group analyses found worse WMS-IV Symbol Span and WAIS-IV Digit Span Backwards performance for mixed/dys MCI compared to non-MCI patients. Within-group analyses found no differences for non-MCI patients; however, all other groups scored lower on WMS-IV Symbol Span than WAIS-IV Digit Span Backwards. Regression analysis with HO as the dependent variable was statistically significant for WMS-IV Symbol Span performance. WAIS-IV Digit Span Backwards performance failed to reach statistical significance.Conclusions:Worse WMS-IV Symbol Span performance was observed in patient groups with measurable neuropsychological impairment and better WMS-IV Symbol Span performance was associated with higher HO ratios. These results suggest that visual WM may be particularly sensitive to emergent illness compared to analogous verbal WM tests.


2007 ◽  
Vol 1 (2) ◽  
pp. 161-165 ◽  
Author(s):  
Márcio Luiz Figueredo Balthazar ◽  
Fernando Cendes ◽  
Benito Pereira Damasceno

Abstract To study category verbal fluency (VF) for animals in patients with amnestic mild cognitive impairment (aMCI), mild Alzheimer disease (AD) and normal controls. Method: Fifteen mild AD, 15 aMCI, and 15 normal control subjects were included. Diagnosis of AD was based on DSM-IV and NINCDS-ADRDA criteria, while aMCI was based on the criteria of the International Working Group on Mild Cognitive Impairment, using CDR 0.5 for aMCI and CDR 1 for mild AD. All subjects underwent testing of category VF for animals, lexical semantic function (Boston Naming-BNT, CAMCOG Similarities item), WAIS-R forward and backward digit span, Rey Auditory Verbal Learning (RAVLT), Mini-Mental Status Examination (MMSE), and other task relevant functions such as visual perception, attention, and mood state (with Cornell Scale for Depression in Dementia). Data analysis used ANOVA and a post-hoc Tukey test for intergroup comparisons, and Pearson's coefficient for correlations of memory and FV tests with other task relevant functions (statistical significance level was p<0.05). Results: aMCI patients had lower performance than controls on category VF for animals and on the backward digit span subtest of WAIS-R but higher scores compared with mild AD patients. Mild AD patients scored significantly worse than aMCI and controls across all tests. Conclusion: aMCI patients may have poor performance in some non-memory tests, specifically category VF for animals in our study, where this could be attributable to the influence of working memory.


2008 ◽  
Vol 2 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Tíbor Rilho Perroco ◽  
Antonio Eduardo Damin ◽  
Norberto A. Frota ◽  
Mari-Nilva M. Silva ◽  
Viviane Rossi ◽  
...  

Abstract Reaching a diagnosis may be difficult in the initial stages of dementia, especially in low educated individuals, when informant reports may be useful. Objectives: To compare the sensitivity and specificity of the IQCODE against cognitive tests applied in clinical practice and to evaluate the possible cut-off points in Brazil. Methods: Individuals without dementia (CDR=0; N=5), with Mild Cognitive Impairment (MCI) (CDR=0.5; N=15) and demented (CDR³1; N=29) were evaluated using the Short IQCODE, a 16-item questionnaire applied to an informant, and on standard cognitive and functional scales. Diagnosis was reached by a consensus team with expertise in dementia, according to DSM-IV criteria, which was blind to the IQCODE results. Results: IQCODE scores were positively correlated to the CDR (r=0.65, p<0.001) and negatively correlated with years of schooling (r= -0.33, p=0.021). IQCODE scores were positively correlated with CDR controlled by age and education (r=0.61, p<0.001). Linear regression showed that age was associated with the IQCODE (p=0.016) whereas education was not associated (p=0.078). IQCODE means according to the CDR classification were: CDR 0-3.37; CDR 0.5-3.75; CDR 1-4.32; CDR 2-4.61; CDR 3-5.00. The area under the ROC curve for dementia vs. controls was 0.869 (p<0.001), MCI vs. controls, 0.821 (p<0.001); and according to the groups classified by the CDR was: CDR 0.5 vs. CDR 1=0.649 (p=0.089), CDR 1 vs. CDR 2=0.779 (p=0.009), and CDR 2 vs. CDR 3=0.979 (p=0.023). Conclusions: These preliminary findings suggest that the short IQCODE can be used for the screening of MCI and dementia in Brazil.


2021 ◽  
pp. 1-13
Author(s):  
Dong Bai ◽  
Junting Fan ◽  
Mengyue Li ◽  
Cuixia Dong ◽  
Yiming Gao ◽  
...  

Background: The neuroprotective benefits of combined folic acid and docosahexaenoic acid (DHA) on cognitive function in mild cognitive impairment (MCI) patients are suggested but unconfirmed. Objective: To explore the effects of 6-month folic acid + DHA on cognitive function in patients with MCI. Methods: Our randomized controlled trial (trial number ChiCTR-IOR-16008351) was conducted in Tianjin, China. We divided 160 MCI patients aged >  60 years into four regimen groups randomly: folic acid (0.8 mg/day) + DHA (800 mg/day), folic acid (0.8 mg/day), DHA (800 mg/day), and placebo, for 6 months. Cognitive function and blood amyloid-β peptide (Aβ) biomarker levels were measured at baseline and 6 months. Cognitive function was also measured at 12 months. Results: A total of 138 patients completed this trial. Folic acid improved the full-scale intelligence quotient (FSIQ), arithmetic, and picture complement scores; DHA improved the FSIQ, information, arithmetic, and digit span scores; folic acid + DHA improved the arithmetic (difference 1.67, 95% CI 1.02 to 2.31) and digital span (1.33, 0.24 to 2.43) scores compared to placebo. At 12 months, all scores declined in the intervention groups. Folic acid and folic acid + DHA increased blood folate (folic acid + DHA: 7.70, 3.81 to 11.59) and S-adenosylmethionine (23.93, 1.86 to 46.00) levels and reduced homocysteine levels (–6.51, –10.57 to –2.45) compared to placebo. DHA lower the Aβ40 levels (–40.57, –79.79 to –1.35) compared to placebo (p <  0.05), and folic acid + DHA reduced the Aβ42 (–95.59, –150.76 to –40.43) and Aβ40 levels (–45.75, –84.67 to –6.84) more than DHA (p <  0.05). Conclusion: Folic acid and DHA improve cognitive function and reduce blood Aβ production in MCI patients. Combination therapy may be more beneficial in reducing blood Aβ-related biomarkers.


2007 ◽  
Vol 65 (3a) ◽  
pp. 619-622 ◽  
Author(s):  
Marcio L.F. Balthazar ◽  
José E. Martinelli ◽  
Fernando Cendes ◽  
Benito P. Damasceno

OBJECTIVE: To study lexical semantic memory in patients with amnestic mild cognitive impairment (aMCI), mild Alzheimer's disease (AD) and normal controls. METHOD: Fifteen mild AD, 15 aMCI, and 15 normal control subjects were included. Diagnosis of AD was based on DSM-IV and NINCDS-ADRDA criteria, and that of aMCI, on the criteria of the International Working Group on Mild Cognitive Impairment, using CDR 0.5 for aMCI and CDR 1 for mild AD. All subjects underwent semantic memory tests (Boston Naming-BNT, CAMCOG Similarities item), Rey Auditory Verbal Learning Test (RAVLT), Mini-Mental Status Examination (MMSE), neuropsychological tests (counterproofs), and Cornell Scale for Depression in Dementia. Data analysis used Mann-Whitney test for intergroup comparisons and Pearson's coefficient for correlations between memory tests and counterproofs (statistical significance level was p<0.05). RESULTS: aMCI patients were similar to controls on BNT and Similarities, but worse on MMSE and RAVLT. Mild AD patients scored significantly worse than aMCI and controls on all tests. CONCLUSION: aMCI impairs episodic memory but tends to spare lexical semantic system, which can be affected in the early phase of AD.


2018 ◽  
Vol 12 (2) ◽  
pp. 165-172 ◽  
Author(s):  
Ana Iza Gomes da Penha Sobral ◽  
Cláudia Marina Tavares de Araújo ◽  
Marcos Felipe Falcão Sobral

Abstract Mild Cognitive Impairment is characterized as an intermediate form between age-related change and dementia. For the elderly, autonomy and independence are related to the ability to remain active in conducting their social activities and, for this to occur, communication is fundamental in this process. Objective: To assess the association between communication and the abilities of elderly people with mild cognitive impairment to perform instrumental activities of daily living. Methods: A cross-sectional, quantitative, analytical, correlational study was conducted at the Open University of the Third Age (UnATI), a program of the Federal University of Pernambuco. This study included 92 people, comprising 46 elderly with mild cognitive impairment and a caregiver or family member who met the inclusion criteria. The elderly were asked to complete a sociodemographic questionnaire and Lawton-Brody’s Instrumental Activities of Daily Living Scale. The caregivers were asked to complete the Functional Assessment of Communication Skills. The following variables were studied: social communication skills and instrumental activities of daily living. Data were stored in an Excel® 2007 spreadsheet, and the Pearson correlation test was used for the statistical analysis. Results: There were statistically significant correlations in four domains of social communication: referring to family members by name (p=0.0033); requesting information about people or events (p=0.0355); understanding conversations in a noisy environment (p=0.0448); and understanding what they watch on television or listen to on the radio (p=0.0127). Conclusion: Changes in the communication of elderly people with mild cognitive impairment interfere with their ability to perform instrumental activities autonomously and independently.


2018 ◽  
Vol 30 (10) ◽  
pp. 1455-1463 ◽  
Author(s):  
Jin-Hyuck Park ◽  
Minye Jung ◽  
Jongbae Kim ◽  
Hae Yean Park ◽  
Jung-Ran Kim ◽  
...  

ABSTRACTBackground:The mobile screening test system for screening mild cognitive impairment (mSTS-MCI) was developed for clinical use. However, the clinical usefulness of mSTS-MCI to detect elderly with MCI from those who are cognitively healthy has yet to be validated. Moreover, the comparability between this system and traditional screening tests for MCI has not been evaluated.Objective:The purpose of this study was to examine the validity and reliability of the mSTS-MCI and confirm the cut-off scores to detect MCI.Method:The data were collected from 107 healthy elderly people and 74 elderly people with MCI. Concurrent validity was examined using the Korean version of Montreal Cognitive Assessment (MoCA-K) as a gold standard test, and test–retest reliability was investigated using 30 of the study participants at four-week intervals. The sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were confirmed through Receiver Operating Characteristic (ROC) analysis, and the cut-off scores for elderly people with MCI were identified.Results:Concurrent validity showed statistically significant correlations between the mSTS-MCI and MoCA-K and test–rests reliability indicated high correlation. As a result of screening predictability, the mSTS-MCI had a higher NPV than the MoCA-K.Conclusions:The mSTS-MCI was identified as a system with a high degree of validity and reliability. In addition, the mSTS-MCI showed high screening predictability, indicating it can be used in the clinical field as a screening test system for mild cognitive impairment.


2018 ◽  
Vol 268 ◽  
pp. 211-216 ◽  
Author(s):  
Javier Oltra-Cucarella ◽  
Sandra Delgado ◽  
Pablo Duque ◽  
José Antonio Pérez-Vicente ◽  
Luís Cabello-Rodríguez

2019 ◽  
Vol 33 (8) ◽  
pp. 965-974 ◽  
Author(s):  
Teodoro del Ser ◽  
María-Ascensión Zea ◽  
Meritxell Valentí ◽  
Javier Olazarán ◽  
Jorge López-Álvarez ◽  
...  

Background:Chronic drug intake has been associated with negative and positive cognitive effects in elderly people, although subjacent conditions may be confounding factors.Aim:To study the effects on cognitive performance of commonly prescribed medications in a cohort of cognitively normal older adults.Methods:Medication intake was recorded during two years in 1087 individuals 70–85 years old, without neurological or psychiatric conditions. The influence of every drug, drug family and therapeutic group on six cognitive scores and on the conversion to mild cognitive impairment over two years was ascertained by cross-sectional and longitudinal analyses controlling for demographic and clinical variables.Results:Small effects of several drugs on information processing were found in cross-sectional analyses but only confirmed for a positive effect of vitamin D in case–control analyses. Longitudinal analyses showed no drug effects on the cognitive slopes. Several hypotensive drugs reduced, whereas bromazepam and glucose lowering drugs increased, the conversion rate to mild cognitive impairment with very small effects ( R2=0.3–1%).Conclusions:Cognitively healthy elderly individuals show minimal negative effects on information processing associated with chronic intake of some drugs probably related to the subjacent condition. Some drugs slightly affect the rate of conversion to mild cognitive impairment. Positive effects of vitamin D, chondroitin, atorvastatin and antihypertensive drugs, and negative effects of antidepressants and benzodiazepines, should be further explored in studies with longer follow-up.


Sign in / Sign up

Export Citation Format

Share Document