Comparison of the Sensitivity of Three Instruments for the Detection of Cognitive Decline in Elderly Living at Home

1987 ◽  
Vol 150 (6) ◽  
pp. 808-814 ◽  
Author(s):  
A. Little ◽  
D. Hemsley ◽  
K. Bergmann ◽  
J. Volans ◽  
R. Levy
Keyword(s):  
Cognitive Decline ◽  
Rating Scale ◽  
Cognitive Change ◽  
Screening Tools ◽  
Associate Learning ◽  
Mental Test Score ◽  
Learning Test ◽  
Elderly Living ◽  
At Home

We followed up 181 elderly living at home over 2 years. The changes shown on a brief dementia rating scale (the Abbreviated Mental Test Score (AMTS)) were monitored. At follow-up, subjects were classified as organic or non-organic by three potential screening tools-a screening questionnaire (the Psychogeriatric Assessment Schedule), a psychometric test (the Inglis' Paired Associate Learning Test) and a dementia scale (the AMTS). The value of these as screening tools for community samples was considered as a function of their sensitivity to cognitive decline. The classifications made by each were significantly related to previous cognitive change, but all were conservative, missing many subjects who had declined. Of the three, the AMTS appeared the most useful as a predictor of previous change on the AMTS. It remains to be seen whether it is equally useful with different samples and with different measures of outcome.

scholarly journals Change in Depression Symptomatology and Cognitive Function in Twins: A 10-Year Follow-Up Study

2016 ◽  
Vol 19 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Inge Petersen ◽  
Matt McGue ◽  
Qihua Tan ◽  
Kaare Christensen ◽  
Lene Christiansen
Keyword(s):  
Cognitive Decline ◽  
Cognitive Abilities ◽  
Depressive Symptomatology ◽  
Twin Studies ◽  
Cognitive Change ◽  
Depression Symptoms ◽  
Cross Sectional ◽  
The Mean ◽  
Depression Symptomatology

A complex interrelation exists between change in depression symptomatology and cognitive decline. Studies indicate either that depression is a direct risk factor for cognitive change over time, or vice versa. Longitudinal twin studies provide the possibility to unravel cause and effect of correlated traits. Here, we have applied twin modeling approaches to shed light on the genetic correlation between both level and change of depression symptomatology and cognitive functioning, and to further explore the bidirectionality of any such correlation using assessments of both phenotypes at two occasions 10 years apart. The study included 2,866 Danish twins with a mean age of 56.8 years at intake (range: 45–68 years). Of these, 1,267 were intact pairs. A total number of 1,582 twins (55%), of whom 557 were intact pairs, participated in the follow-up survey. We found stable cross-sectional heritability estimates of approximately 60% for general cognitive abilities and 30% for affective depressive symptoms. There was a considerable decline in the mean cognitive performance over 10 years, whereas the mean affective depression symptoms score was stable and with no genetic contribution to any individual change. Additionally, we saw a small but significant cross-trait correlation at both occasions (-0.11 and -0.09, respectively), but cross-trait cross-occasion analysis revealed no evidence that either of the two traits predicts the other over a 10-year interval. Thus, our study was not able to detect any causal association between change in depressive symptomatology and cognitive decline in middle-aged and elderly people over a 10-year interval.

scholarly journals Rates of diagnostic transition and cognitive change at 18-month follow-up among 1,112 participants in the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing (AIBL)

2013 ◽  
Vol 26 (4) ◽  
pp. 543-554 ◽  
Author(s):  
Kathryn A. Ellis ◽  
Cassandra Szoeke ◽  
Ashley I. Bush ◽  
David Darby ◽  
Petra L. Graham ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Transition Rate ◽  
Healthy Aging ◽  
Retention Rate ◽  
Severe Disease ◽  
Cognitive Change ◽  
Disease Stage ◽  
Imaging Biomarkers ◽  
Amyloid Pet

ABSTRACTBackground:The Australian Imaging, Biomarkers and Lifestyle (AIBL) Flagship Study of Ageing is a prospective study of 1,112 individuals (211 with Alzheimer's disease (AD), 133 with mild cognitive impairment (MCI), and 768 healthy controls (HCs)). Here we report diagnostic and cognitive findings at the first (18-month) follow-up of the cohort. The first aim was to compute rates of transition from HC to MCI, and MCI to AD. The second aim was to characterize the cognitive profiles of individuals who transitioned to a more severe disease stage compared with those who did not.Methods:Eighteen months after baseline, participants underwent comprehensive cognitive testing and diagnostic review, provided an 80 ml blood sample, and completed health and lifestyle questionnaires. A subgroup also underwent amyloid PET and MRI neuroimaging.Results:The diagnostic status of 89.9% of the cohorts was determined (972 were reassessed, 28 had died, and 112 did not return for reassessment). The 18-month cohort comprised 692 HCs, 82 MCI cases, 197 AD patients, and one Parkinson's disease dementia case. The transition rate from HC to MCI was 2.5%, and cognitive decline in HCs who transitioned to MCI was greatest in memory and naming domains compared to HCs who remained stable. The transition rate from MCI to AD was 30.5%.Conclusion:There was a high retention rate after 18 months. Rates of transition from healthy aging to MCI, and MCI to AD, were consistent with established estimates. Follow-up of this cohort over longer periods will elucidate robust predictors of future cognitive decline.

scholarly journals EARLY RECOGNITION OF COGNITIVE ABILITY AND NUTRITIONAL MARKERS FOR DEMENTIA IN PARKINSON’S DISEASE

2018 ◽  
pp. 1-7
Author(s):  
L. Håglin ◽  
L. Bäckman ◽  
J. Linder ◽  
L. Forsgren ◽  
M. Domellöf
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Nutritional Status ◽  
Cognitive Decline ◽  
Iron Homeostasis ◽  
Rating Scale ◽  
Cox Regression ◽  
Nutritional Deficiencies ◽  
Iron Intake

Background: Cognitive decline and dementia are common non-motor problems in Parkinson’s disease (PD). The underlying aetiology is multifaceted and both chronic and reversible causes for cognitive decline are likely to be present. Malnutrition is frequent in the Parkinson population, both early and late in the disease, and nutritional deficiencies could play a role in some cognitive deficits. Objectives: The objective is to study the association between nutritional status with focus on iron intake and homeostasis, mild cognitive impairment (MCI), and PD dementia (PDD). Setting and Participants: This study included 73 out of 145 patients with PD participating in a population-based study in northern Sweden. Measurements: Registration of nutritional status by laboratory analyses of blood plasma and neuropsychological assessments at time of diagnosis were performed. MCI and PDD were assessed yearly up to ten years after diagnosis. Mini Nutritional Assessments (Full-MNA score) and plasma variables detecting iron homeostasis were compared between patients with MCI and patients with normal cognition (NC). Motor severity was measured using the Unified Parkinson´s disease rating scale III, (UPDRS III) and Hoehn and Yahr (H&Y) staging scale. Cox proportional Hazard model were performed to see if any variables that differed between MCI and NC could predict PDD at follow-up. Results: Patients with MCI at time of diagnosis had lower levels of plasma iron (P-Fe) and albumin (P-Albumin) as well as a lower score on Full-MNA score. Dietary intake of iron was higher in patients with MCI than in patients with NC (p = 0.012). In logistic regression models adjusted for age, sex, and UPDRS III, lower levels of P-Fe (p = 0.025) and P-Albumin (p = 0.011) and higher dietary iron intake (p = 0.019) were associated with MCI at baseline. A Cox regression model with dementia as endpoint revealed that lower levels of P-Fe increase the risk of dementia at follow-up with adjustments for age, sex, UPDRS III, and MCI at baseline (HR 95% CI = 0.87 (0.78-0.98), p = 0.021). Conclusions: Low P-Fe was associated with cognitive disturbance at baseline and predicted dementia up to ten years after diagnosis in patients with PD. Low P-Albumin and malnutrition assessed with Full-MNA score were associated with MCI at baseline but did not predict dementia at follow-up.

Constipation Predicts Cognitive Decline in Parkinson’s Disease: Results from the COPPADIS Cohort at 2-Year Follow-up and Comparison with a Control Group

2021 ◽  
pp. 1-17
Author(s):  
Diego Santos García ◽  
Lucía García Roca ◽  
Teresa de Deus Fonticoba ◽  
Carlos Cores Bartolomé ◽  
Lucía Naya Ríos ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Rating Scale ◽  
Cognitive Status ◽  
Control Group ◽  
Cognitive Changes ◽  
Non Motor Symptoms

Background: Constipation has been linked to cognitive impairment development in Parkinson’s disease (PD). Objective: Our aim was to analyze cognitive changes observed in PD patients and controls from a Spanish cohort with regards to the presence or not of constipation. Methods: PD patients and controls recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017 were followed-up during 2 years. The change in cognitive status from baseline (V0) to 2-year follow-up was assessed with the PD-CRS (Parkinson’s Disease Cognitive Rating Scale). Subjects with a score ≥1 on item 21 of the NMSS (Non-Motor Symptoms Scale) at baseline (V0) were considered as “with constipation”. Regression analyses were applied for determining the contribution of constipation in cognitive changes. Results: At V0, 39.7% (198/499) of PD patients presented constipation compared to 11.4% of controls (14/123) (p < 0.0001). No change was observed in cognitive status (PD-CRS total score) neither in controls without constipation (from 100.24±13.72 to 100.27±13.68; p = 0.971) and with constipation (from 94.71±10.96 to 93.93±13.03; p = 0.615). The PD-CRS total score decreased significantly in PD patients with constipation (from 89.14±15.36 to 85.97±18.09; p < 0.0001; Coehn’s effect = –0.35) compared to patients without constipation (from 93.92±15.58 to 93.14±17.52; p = 0.250) (p = 0.018). In PD patients, to suffer from constipation at V0 was associated with a decrease in the PD-CRS total score from V0 to V2 (β= –0.1; 95% CI, –4.36 – –0.27; p = 0.026) and having cognitive impairment at V2 (OR = 1.79; 95% CI, 1.01 – 3.17; p = 0.045). Conclusion: Constipation is associated with cognitive decline in PD patients but not in controls.

A longitudinal study of factors predicting change in cognitive test scores over time, in an older hypertensive population

1996 ◽  
Vol 26 (3) ◽  
pp. 555-568 ◽  
Author(s):  
M. Prince ◽  
G. Lewis ◽  
A. Bird ◽  
R. Blizard ◽  
A. Mann
Keyword(s):  
Cognitive Decline ◽  
Medical Research Council ◽  
Paired Associate ◽  
Advanced Age ◽  
Cognitive Test ◽  
Rural Residence ◽  
Associate Learning ◽  
Male Sex ◽  
Learning Test ◽  
The Impact

SynopsisThis study aims to describe factors associated with cognitive decline among 2584 subjects, aged 65–74, who were followed up for 54 months in the Medical Research Council Elderly Hypertension Trial (1982–1989). The subjects completed a cognitive test, the Paired Associate Learning Test (PALT), five times over this period. Decline on the PALT was associated with advanced age, male sex, rural residence, depression and low intelligence. These effects were modified by gender and level of pre-morbid intelligence. Advanced age, rural residence and number of cigarettes smoked daily were only associated with PALT decline among women of below median intelligence. The association between depression and PALT decline was only apparent in women of below median intelligence and men of above median intelligence. While these findings are consistent with other research into cognitive decline, they differ in some ways from reported risk factors for dementia, suggesting aetiological separateness. That women were more vulnerable than men to the effects of age and smoking raises the question of the impact on cognition of accelerated atherosclerosis after the menopause.

Longitudinal personality change associated with cognitive decline in multiple sclerosis

2018 ◽  
Vol 24 (14) ◽  
pp. 1909-1912 ◽  
Author(s):  
Shumita Roy ◽  
Allison Drake ◽  
Tom Fuchs ◽  
Michael G Dwyer ◽  
Robert Zivadinov ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Decline ◽  
Cognitive Assessment ◽  
Cognitive Change ◽  
Personality Change ◽  
Cognitive Deterioration ◽  
Time Interaction ◽  
Personality Dysfunction ◽  
Neo Five Factor Inventory

We previously reported that personality and cognition were stable over 3 years in patients with multiple sclerosis (MS). This study examined whether a longer duration would reveal evidence of emerging personality dysfunction. The NEO Five-Factor Inventory and Brief International Cognitive Assessment for MS was used to assess personality and cognition, respectively. Patients were classified as “Cog Stable” or “Cog Decline” based on cognitive deterioration over 5 years. Extraversion and Conscientiousness declined across pooled groups. Follow-up of a group by time interaction found that decline in these traits was more evident in the Cog Decline group, demonstrating a link between personality and cognitive change.

scholarly journals Randomized placebo-controlled trial of the effects of aspirin on dementia and cognitive decline

Neurology ◽  
2020 ◽  
Vol 95 (3) ◽  
pp. e320-e331 ◽  
Author(s):  
Joanne Ryan ◽  
Elsdon Storey ◽  
Anne M. Murray ◽  
Robyn L. Woods ◽  
Rory Wolfe ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Low Dose ◽  
Controlled Trial ◽  
Verbal Learning ◽  
Cognitive Change ◽  
Community Dwelling ◽  
Older Individuals ◽  
Dose Aspirin ◽  
Low Dose Aspirin

ObjectiveTo determine the effect of low-dose aspirin vs placebo on incident all-cause dementia, incident Alzheimer disease (AD), mild cognitive impairment (MCI), and cognitive decline in older individuals.MethodsAspirin in Reducing Events in the Elderly (ASPREE) was a double-blind, placebo-controlled trial of low-dose aspirin. In the United States and Australia, community-dwelling individuals aged ≥70 years (US minorities ≥65 years) and free of cardiovascular disease, physical disability, and diagnosed dementia were enrolled. Participants were randomized 1:1–100 mg daily aspirin or placebo. The Modified Mini-Mental State Examination, Hopkins Verbal Learning Test–Revised, Symbol Digit Modalities Test, and Controlled Oral Word Association Test assessed cognition at baseline and over follow-up. Additional cognitive testing was performed in participants with suspected dementia (“trigger”) based on within-study assessments or clinical history. Dementia was adjudicated according to DSM-IV criteria. National Institute on Aging–Alzheimer’s Association criteria were used for AD and MCI subclassification.ResultsA total of 19,114 participants were followed over a median 4.7 years and 964 triggered further dementia assessments. There were 575 adjudicated dementia cases, and 41% were classified as clinically probable AD. There was no substantial difference in the risk of all dementia triggers (hazard ratio [HR], 1.03; 95% confidence interval [CI], 0.91–1.17), probable AD (HR, 0.96; 95% CI, 0.74–1.24), or MCI (HR, 1.12; 95% CI, 0.92–1.37) between aspirin and placebo. Cognitive change over time was similar in the aspirin and placebo groups.ConclusionsThere was no evidence that aspirin was effective in reducing risk of dementia, MCI, or cognitive decline. Follow-up of these outcomes after initial exposure is ongoing.Classification of evidenceThis study provides Class II evidence that for healthy older individuals, low-dose aspirin does not significantly reduce the incidence of dementia, probable AD, MCI, or cognitive decline.Clinicaltrials.gov identifierNCT01038583.

Association of Malnutrition with Functional and Cognitive Trajectories in People Living with Dementia: A Five-Year Follow-Up Study

2021 ◽  
Vol 79 (4) ◽  
pp. 1713-1722
Author(s):  
Miguel Germán Borda ◽  
Ana María Ayala Copete ◽  
Diego Alejandro Tovar-Rios ◽  
Alberto Jaramillo-Jimenez ◽  
Lasse Melvær Giil ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Cognitive Decline ◽  
Rating Scale ◽  
Functional Decline ◽  
Lewy Body Dementia ◽  
Severe Malnutrition ◽  
Disability Rating Scale ◽  
Disability Rating ◽  
Moderate Malnutrition

Background: In dementia, functional status depends on multiple factors in addition to cognition. Nutritional status is a potentially modifiable factor related to homeostasis and proper functioning of body systems and may contribute to cognitive and functional decline. Objective: This paper aims to analyze the association of malnutrition with the course of cognitive and functional decline in people living with dementia. Methods: This is an analysis of a longitudinal cohort study, the Dementia Study of Western Norway. Data of 202 patients diagnosed with mild dementia were analyzed; Alzheimer’s disease (AD) (n = 103), Lewy body dementia (LBD) (n = 74), and other dementias (OD) (n = 25). Cognition was assessed with the Mini-Mental State Examination and functional decline through the activities of daily living included in the Rapid Disability Rating Scale. The Global Leadership Initiative on Malnutrition Index was used to determine nutritional status. Associations of nutritional status with cognitive and functional decline were evaluated through adjusted linear mixed models. Results: At baseline, the prevalence of general malnutrition was 28.7%; 17.3% were classified as moderate malnutrition and 11.38% as severe malnutrition (there were no significant differences between AD and LBD). Malnutrition at diagnosis and over follow-up was a significant predictor of functional-decline, but not of cognitive decline. Conclusion: According to our results malnutrition was associated with faster functional loss but, not cognitive decline in older adults with dementia. A more comprehensive dementia approach including nutritional assessments could improve prognosis.

scholarly journals A Critical Review of the Study of Neuroprotective Diets to Reduce Cognitive Decline

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2264
Author(s):  
Sally C. Duplantier ◽  
Christopher D. Gardner
Keyword(s):  
Cognitive Decline ◽  
Randomized Clinical Trials ◽  
Scoring Systems ◽  
Complementary Therapy ◽  
Cognitive Change ◽  
Biological Mechanisms ◽  
Lifestyle Choices ◽  
The Mediterranean ◽  
The Cost

Alzheimer’s disease (AD) and other dementias are now the seventh leading cause of death in the world and are projected to affect 115.4 million people by 2050. Delaying the onset of AD by just five years is estimated to reduce the cost and prevalence of the disease by half. There is no cure for AD nor any drug therapies to halt its progression once the disease begins. Lifestyle choices including diet are being seen as a viable complementary therapy to reduce cognitive decline, the hallmark of AD. Mediterranean, DASH (Dietary Approaches to Stop Hypertension), and MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diets have biological mechanisms supporting their potential neuroprotective benefits, but the findings of study outcomes about these benefits have been inconsistent. This paper analyzed five Randomized Clinical Trials (RCTs) (from 2000 to 2021) and 27 observational studies (from 2010 to 2021) focused on the link between cognitive health and the Mediterranean/DASH/MIND diets to identify gaps and challenges that could lead to inconsistent results. These include a lack of accuracy in assessing food intake, multiple dietary pattern scoring systems, a shifting metric among studies focused on the Mediterranean diet, a lack of standards in the tools used to assess cognitive decline, and studies that were underpowered or had follow-up periods too short to detect cognitive change. Insights from these gaps and challenges are summarized in recommendations for future RCTs, including both pragmatic and explanatory RCTs.

scholarly journals The Heterogeneity of Longitudinal Cognitive Decline in Euthymic Bipolar I Disorder With Clinical Characteristics and Functional Outcomes

2021 ◽  
Vol 12 ◽  
Author(s):  
Wen-Yin Chen ◽  
Ming-Chyi Huang ◽  
Ya-Chin Lee ◽  
Chiao-Erh Chang ◽  
Shih-Ku Lin ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Functional Outcomes ◽  
Mood Stabilizer ◽  
Cognitive Change ◽  
World Health ◽  
Type I ◽  
Correlation Pattern ◽  
Cognitive Domains ◽  
Biological Studies

We characterized the heterogeneity and risk factors of cognitive decline in euthymic bipolar disorder (BD), and their magnitude of associations with subjective daily functions. In this retrospective cohort, BD type I patients (N = 128) were followed for an average of 6.5 years. Intelligence quotient (IQ) at index date was recorded, and premorbid IQ was estimated. We used Brief Assessment of Cognition in Affective Disorders (BAC-A) to assess cognition at follow-up. We evaluated current functions with World Health Organization Disability Assessment Schedule 2.0. Clinical and sociodemographic factors were examined for their independent effects on longitudinal cognitive decline. In addition, we employed multivariate adaptive regression spline to detect inflection points for the nature of slope changes in cognitive decline among BD patients. During follow-up years, 21 BD patients (16.4%) showed longitudinal cognitive decline. In cognitive decline group, all cognitive domains of BAC-A were significantly worsened. We found that density of episodes with psychotic features was an independent risk factor for cognitive decline after adjusted for age, gender and dose of mood stabilizer. After the age of 42 years, a steeper cognitive change was observed in the cognitive decline group. The correlation pattern between cognitive domains and functional outcomes differed between patients with and without cognitive decline. The present study characterized cognitive heterogeneity longitudinally in BD patients. As density of episodes play roles for cognitive decline, our results emphasize the importance of relapse prevention. Our findings provide hints for future personalized interventions and facilitating genetic and biological studies for dissecting the heterogeneity of bipolar illness.

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