scholarly journals Telemedicine assessment of long-term cognitive and functional status in anti-leucine-rich, glioma-inactivated 1 encephalitis

2019 ◽  
Vol 7 (2) ◽  
pp. e652 ◽  
Author(s):  
Nuria Sola-Valls ◽  
Helena Ariño ◽  
Domingo Escudero ◽  
Elisabeth Solana ◽  
Albert Lladó ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Functional Status ◽  
Verbal Memory ◽  
Cognitive Reserve ◽  
Disease Onset ◽  
Cognitive Status ◽  
Functional Activities ◽  
Telephone Interviews ◽  
Status Assessment

ObjectiveTo assess the feasibility of a structured telephone interview examining the long-term cognitive and functional status in anti–leucine-rich, glioma-inactivated 1 (LGI1) encephalitis.MethodsTelephone interviews were conducted with 37 patients after a median follow-up of 87 months from disease onset and 23 healthy controls matched for age and sex. Cognitive status was assessed with the telephone Mini-Mental State Examination (t-MMSE) and 3 tests exploring verbal memory, fluency, and executive function. Functional status was evaluated with the Functional Activities Questionnaire and the modified Rankin Scale (mRS). Patients were classified as normal, with mild cognitive impairment (MCI), or with dementia based on cognitive and functional status. Assessment of the cognitive reserve was performed with a structured questionnaire. Logistic regression analysis was applied to identify predictors of cognitive impairment.ResultsTelephone interviews were successful in 36/37 (97%) patients. Cognitive impairment was detected in 27 (75%) including 17 with MCI and 10 with dementia. Eight (29%) patients would have been misclassified using only the t-MMSE. Twenty-six (72%) patients were functionally independent according to the mRS, but only 9 (35%) were cognitively normal. Independent predictors for long-term cognitive impairment were a low cognitive reserve (OR = 1.36, 95% CI: 1.05–1.76; p = 0.02) and bilateral hippocampal hyperintensity at initial MRI (OR = 27.03, 95% CI: 1.87–390; p = 0.02).ConclusionsTelemedicine is a feasible tool to assess the cognitive and functional outcome in patients with anti-LGI1 encephalitis. Cognitive impairment is often missed if only functional scales are used. Premorbid cognitive reserve and MRI with bilateral hippocampal hyperintensity were predictors for long-term cognitive impairment.

scholarly journals C-27 Neuropsychological Differences in 10 Year Long-Term Stable Mild Cognitive Impairment and Converting Mild Cognitive Impairment

2019 ◽  
Vol 34 (6) ◽  
pp. 1056-1056
Author(s):  
M Sharma ◽  
B Varatharajah ◽  
A Wall ◽  
B Callahan
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Verbal Memory ◽  
Depression Scale ◽  
Cognitive Status ◽  
Semantic Fluency ◽  
Neuropsychological Measures ◽  
Global Cognition

Abstract Objective To examine baseline differences in neuropsychological performance between long-term stable mild cognitive impairment (sMCI) and those who convert from MCI to dementia (cMCI), hypothesizing sMCI will perform better on memory measures. While conversion has been previously examined, none examined sMCI with over 10 years follow-up. Method Data from the National Alzheimer’s Coordinating Center were used. Participants were defined as sMCI (n = 29) if cognitive status was MCI at first visit and at least 9 subsequent visits (10 total) and cMCI (n = 1887) if cognitive status was MCI at first visit and the participant converted to dementia at any subsequent visit. Participants with any history of stroke, traumatic brain injury, alcohol or drug abuse, or other neurological disorder were excluded. Participants completed neuropsychological measures of global cognition, immediate and delayed verbal memory, working memory, mental manipulation, semantic fluency, processing speed, and confrontational naming. Depressive symptoms were assessed using the Geriatric Depression Scale. The Mann-Whitney-U non-parametric test was used to compare both groups at baseline on all measures. Predictors of sMCI were explored using binomial logistic regression. Results Participants did not differ significantly in age, level of education, or depressive symptoms. Comparison between groups at baseline indicate sMCI participants performed significantly better than cMCI on global cognition U = 13673,p < .001, delayed verbal memory U = 14549,p < .001, and semantic fluency U = 15538.5,p < .001. Of these significant measures, none predicted sMCI. Conclusions As hypothesized, sMCI performed better on delayed verbal memory, but also semantic fluency and global cognition, though none predicted sMCI. Future research must examine neuropsychological measures of other cognitive domains and their predictive value.

scholarly journals Relationship Between Patient and Informant Assessment of Personality and Cognitive Status

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 260-260
Author(s):  
Magdalena Tolea ◽  
James Galvin
Keyword(s):  
Cognitive Impairment ◽  
Personality Traits ◽  
Caregiver Burden ◽  
Disease Onset ◽  
Cognitive Status ◽  
Cognitively Normal ◽  
Psychotherapeutic Interventions ◽  
State Measure ◽  
Personality Ratings ◽  
Neuropsychological Evaluations

Abstract Personality has been linked to risk of dementia. Most studies ask individuals to rate their own personality traits or for a knowledgeable informant to perform the rating; few collect data from both. When informants are asked to give an estimate of the patient’s lifelong personality traits, they often describe personality before disease onset. When asked to self-rate, patients may instead assess their personality as they see themselves, providing a personality-state measure. The goal of this study was to assess agreement between two independent measures of personality and evaluate whether stage of cognitive impairment and characteristics of patients or caregivers impact concordance. In 79 consecutive patient-caregiver dyads presenting to our center (mean age:76.8±8.4; 44.1% female; 6% cognitively normal, 41% MCI; and 53% dementia) with in-depth psychosocial and neuropsychological evaluations, we found informants rated patients lower on openness (O) (ICC=0.434; 95%CI: 0.235-0.598) and agreeableness (A) (ICC=0.491; 95%CI: 0.302-0.643) and higher on extraversion (O) (ICC=0.396; 95%CI: 0.191-0.568) and neuroticism (N) (ICC=0.444; 95%CI: 0.247-0.607). Greater discordance was observed in established dementia (ICCE=0.497; 95%CI: 0.222-0.700; ICCA=0.337; 95%CI:0.031-0.586; ICCN=0.422; 95%CI: 0.191-0.683), compared with MCI (ICCO=0.568; 95%CI: 0.282-0.762). We explored the effect of patient and caregiver mood and caregiver burden on personality ratings. Although personality is typically described as a trait, we present evidence that in the eyes of patients, personality ratings may represent a state that changes across the spectrum of cognitive impairment. Understanding how patients and caregivers differentially perceive personality may assist in developing novel psychotherapeutic interventions and approaches dealing with behavioral manifestations of dementia.

scholarly journals ATTITUDES AND PREFERENCES FOR ROBOT-LED PIANO COGNITIVE TRAINING: FEASIBILITY IN MILD COGNITIVE IMPAIRMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S946-S946
Author(s):  
George Mois ◽  
Bailley Collette ◽  
Lisa M Renzi-Hammond ◽  
Laura Boccanfuso ◽  
Aditi Ramachandran ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Technology Acceptance ◽  
Cognitive Training ◽  
Neural Plasticity ◽  
Verbal Memory ◽  
Cognitive Status ◽  
Cognitive Domain ◽  
Assistive Robots

Abstract Cognitive training has been shown to improve neural plasticity, increase cognitive reserve and reduce the risk of dementia in older adults. Specifically, learning to play the piano has been shown to be an engaging, multimodal form of cognitive training. However, accessing this form of cognitive training can pose a challenge for older adults. Socially assistive robots present a unique opportunity to increase access to user-tailored piano learning cognitive training. The present study utilized a robot-led four-week piano lesson feasibility intervention for older adults with mild cognitive impairment (N = 11; M= 74.64 ± 6.02 years of age; 72.72% female; 90.1% White/Caucasian). Cognitive Status was assessed during screening via the Telephone Interview for Cognitive Status, and after screening via the Mini-Mental State Exam and the CNS Vital Signs computerized test suite to measure cognitive domain-specific functioning. Perceptions and acceptance of the robot were measured using the Robotic Social Attributes Scale (RoSAS) and Technology Acceptance Scale. Cognitive function improved after four weeks of training in the verbal memory, executive function, reaction time and cognitive flexibility domains, and in the computed neurocognitive index score (p&lt;0.05). Survey data and qualitative interviews show that participants perceived the robot instructor as socially engaging, competent, useful, and easy to use. These results provide insight into the potential of SARs to facilitate cognitive training in the form of piano lessons, as well as recommendations for creating a suitable robot instructor for this application.

Inhome Service Use by Caregivers and Their Elders: Does Cognitive Status Make a Difference?

2002 ◽  
Vol 21 (2) ◽  
pp. 257-271 ◽  
Author(s):  
Pamela Hawranik
Keyword(s):  
Cognitive Impairment ◽  
Functional Status ◽  
Service Use ◽  
Living Arrangement ◽  
Cognitive Status ◽  
Personal Care ◽  
Care Services ◽  
Significant Factors

ABSTRACTThe intent of this study was to examine the effect of cognitive status on the use of inhome services by caregivers and their elders. Data from the screening, clinical and community-caregiver phases of the Manitoba Study on Health and Aging (MSHA-1) were analysed utilizing a modified Andersen-Newman model. The findings indicated that those with dementia were more likely to use personal care services and use two or more inhome services than caregivers and their elders with no cognitive impairment and those with cognitive impairment but no dementia. Functional status of the elder and living arrangement of the caregiver and elder were strongly associated with the use of specific inhome services and with overall use. Policy and research implications of the findings including other significant factors such as caregiver employment, are presented.

scholarly journals The Delirium and Population Health Informatics Cohort study protocol: ascertaining the determinants and outcomes from delirium in a whole population

2018 ◽  
Author(s):  
Daniel Davis ◽  
Sarah Richardson ◽  
Joanne Hornby ◽  
Helen Bowden ◽  
Katrin Hoffmann ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cognitive Impairment ◽  
Population Health ◽  
Health Informatics ◽  
Social Care ◽  
Population Sample ◽  
Cognitive Status ◽  
Health And Social Care ◽  
The Impact

AbstractBackgroundDelirium affects 25% of older inpatients and is associated with long-term cognitive impairment and future dementia. However, no population studies have systematically ascertained cognitive function before, cognitive deficits during, and cognitive impairment after delirium. Therefore, there is a need to address the following question: does delirium, and its features (including severity, duration, and presumed aetiologies), predict long-term cognitive impairment, independent of cognitive impairment at baseline?MethodsThe Delirium and Population Health Informatics Cohort (DELPHIC) study is an observational population-based cohort study based in the London Borough of Camden. It is recruiting 2000 individuals aged ≥70 years and prospectively following them for two years, including daily ascertainment of all inpatient episodes for delirium. Daily inpatient assessments include the Memorial Delirium Assessment Scale, the Observational Scale for Level of Arousal, and the Hierarchical Assessment of Balance and Mobility. Data on delirium aetiology is also collected. The primary outcome is the change in the modified Telephone Interview for Cognitive Status at two years.DiscussionDELPHIC is the first population sample to assess older persons before, during and after hospitalisation. The cumulative incidence of delirium in the general population aged ≥70 will be described. DELPHIC offers the opportunity to quantify the impact of delirium on cognitive and functional outcomes. Overall, DELPHIC will provide a real-time public health observatory whereby information from primary, secondary, intermediate and social care can be integrated to understand how acute illness is linked to health and social care outcomes.

Abstract TMP113: Long-term Cognitive Decline After Intracerebral Hemorrhage

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Alessandro Biffi ◽  
Christopher D Anderson ◽  
Alison M Ayres ◽  
Steven M Greenberg ◽  
Jonathan Rosand ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Intracerebral Hemorrhage ◽  
Cognitive Decline ◽  
Small Vessel Disease ◽  
Vascular Cognitive Impairment ◽  
Cognitive Status ◽  
Decline Rate ◽  
Severe Manifestation

Introduction: Cerebral small vessel disease (CSVD) is the leading cause of Vascular Cognitive Impairment (VCI). Although Intracerebral Hemorrhage (ICH) is the most severe manifestation of CSVD, VCI among ICH survivors has been the subject of limited investigations. Hypothesis: We sought to test these hypotheses: 1) long-term cognitive decline rates are substantial even among initially non-demented ICH survivors; 2) underlying CSVD plays a substantial role in determining post-ICH long-term cognitive decline. Methods: We enrolled survivors of primary ICH, with no evidence of dementia 6 months post-hemorrhage, in a single-center longitudinal observational study. Presence and severity of CSVD was assessed at enrollment using two established markers of CSVD on CT (CT-defined white hatter hypodensity [CT-WMH]) and MRI (cerebral microbleeds [CMBs]). We captured blood pressure measurements during follow-up via review of medical records. Cognitive performance was assessed using the Modified Telephone Interview for Cognitive Status (TICS-m), a standardized validated telephone-based cognitive battery. We constructed multivariate models of cognitive decline rate, defined as slope of TICS-m scores over time. Results: A total of 275 ICH survivors qualified for inclusion in our analyses; of these 83 (30%) developed incident dementia and 33 (12%) developed incident Mild Cognitive Impairment (MCI) at 5 years (Figure). CSVD imaging markers were associated with cognitive decline rate (CT-WMH: p=0.001, CMBs: p=0.003), as were pulse pressure (p=0.003) and systolic blood pressure variation coefficient (p=0.034). Conclusions: Long-term cognitive decline is frequent and substantial among ICH survivors not demented at time of ICH, and strongly associates with severity of underlying CSVD. Our findings suggest that it is the extent of CSVD and not particular ICH characteristics that are most associated with long-term cognitive decline in survivors of ICH.

scholarly journals Cognitive Reserve Characteristics and Occupational Performance Implications in People with Mild Cognitive Impairment

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1266
Author(s):  
Cristina Mendoza-Holgado ◽  
Jesús Lavado-García ◽  
Fidel López-Espuela ◽  
Raúl Roncero-Martín ◽  
María Luz Canal-Macías ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Leisure Time ◽  
Cognitive Reserve ◽  
Protective Factor ◽  
Cognitive Status ◽  
Occupational Performance ◽  
Cognitive Assessments ◽  
Elderly Individuals ◽  
Level Of Education

The Cognitive Reserve hypothesis suggests that there are individual differences in the ability to cope with the pathologic changes in Alzheimer’s Disease. The proportion of elderly individuals has increased in recent years; this increase emphasizes the importance of early detection of mild cognitive impairment and the promotion of healthy ageing. The purpose of our study is to characterize cognitive reserve and occupational performance implications in people with mild cognitive impairment. 125 patients with mild cognitive impairment were enrolled. The Montreal Cognitive Assessments (MoCA) was used to evaluate cognitive status and the Cognitive Reserve Index Questionnaire (CRIq) as an indicator of cognitive reserve. Higher level of education was associated with higher MoCA scores (r = 0.290, p = 0.001). Positive significant correlations were observed between MoCA and total CRIq (r = 0.385, p < 0.001) as well as its three sub-domains, education (r = 0.231, p = 0.010), working activity (r = 0.237, p = 0.008) and leisure time (r = 0.319, p < 0.001). This study findings provide the importance of considering socio-behavioral factors in cognitive status. This research helps to describe the importance of engaging occupationally along the whole life-course as a potential protective factor in ageing, and includes a perspective of occupational therapy regarding the hypothesis of cognitive reserve.

Cognitive reserve in multiple sclerosis

2013 ◽  
Vol 19 (9) ◽  
pp. 1122-1127 ◽  
Author(s):  
James F Sumowski ◽  
Victoria M Leavitt
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Disease Burden ◽  
Cognitive Reserve ◽  
Cerebral Atrophy ◽  
White Matter Lesions ◽  
Cognitive Status ◽  
Vocabulary Knowledge ◽  
Future Research ◽  
Brain Growth

Cognitive impairment is common among persons with multiple sclerosis (MS), but some patients are able to withstand considerable disease burden (e.g. white matter lesions, cerebral atrophy) without cognitive impairment (cognitive inefficiency, memory decline). What protects these patients from cognitive impairment? We review the literature on cognitive reserve in MS, which shows that heritable (larger maximal lifetime brain growth) and environmental (greater intellectual enrichment) factors attenuate the negative effect of disease burden on cognitive status. That is, persons with larger maximal lifetime brain growth, greater vocabulary knowledge, and/or greater early life participation in cognitive leisure activities (e.g. reading, hobbies) are better able to cope with MS disease without cognitive impairment. We review evidence that benefits of intellectual enrichment on cognitive status may stem from more efficient patterns of brain function. We discuss clinical implications and highlight important unanswered questions for future research on reserve against cognitive impairment in MS.

scholarly journals Trends in antibiotics use among long-term US nursing-home residents

2020 ◽  
pp. 1-7
Author(s):  
Catherine C. Cohen ◽  
Andrew W. Dick ◽  
Mansi Agarwal ◽  
Tadeja Gracner ◽  
Susan Mitchell ◽  
...  
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Nursing Homes ◽  
Antibiotic Stewardship ◽  
Nursing Home Residents ◽  
Antibiotic Use ◽  
Cognitive Status ◽  
Cross Sectional ◽  
Data Set

Abstract Objectives: Antibiotics are overly prescribed in nursing homes. Recent antibiotic stewardship efforts attempt to reduce inappropriate use. Our objective was to describe antibiotic use from 2012 to 2016 among nursing-home residents with various health conditions. Design: Retrospective, repeated cross-sectional analysis. Setting and participants: All long-term residents in a random 10% sample of national nursing homes: 2,092,809 assessments from 319,615 nursing-home residents in 1,562 nursing homes. Measurements: We calculated a 1-day antibiotic prevalence using all annual and quarterly clinical assessments in the Minimum Data Set (MDS) from April 2012 through December 2016. We calculated prevalence of antibiotic use overall and within conditions of interest: Alzheimer’s disease and related dementias (ADRD), advanced cognitive impairment (ACI), and infections likely to be treated with antibiotics. We applied logistic regressions with nursing-home cluster, robust standard errors to assess changes in conditions and antibiotic use 2012–2016. Results: Overall, antibiotic use did not change (2012 vs 2016, adjusted odds ratio [AOR], 1.00; 95% CI, 0.97–1.03). Antibiotic use was higher in 2016 versus 2012 among assessments with any infection (AOR, 1.10; 95% CI, 1.04–1.16), urinary tract infection (AOR, 1.18; 95% CI, 1.12–1.25), and no infection (AOR, 1.13; 95% CI, 1.09–1.17). Results were similar by cognitive status. Conclusions: The increased proportion of assessments recording antibiotics but no infection may not be clinically appropriate. Higher antibiotic use among infected residents with advanced cognitive impairment is also concerning. Further efforts to understand mechanisms driving these trends and to promote antibiotic stewardship in nursing homes are warranted.

scholarly journals LONG-TERM GAIT SPEED TELEMONITORING IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT OR MILD DEMENTIA. THE DECI STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S333-S333
Author(s):  
Lorenzo M Donini ◽  
Alberto Rainoldi ◽  
Luca C Feletti ◽  
Gianluca Zia ◽  
Eleonora Poggiogalle ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Physical Function ◽  
Gait Speed ◽  
Walking Speed ◽  
Cognitive Status ◽  
Activity Level ◽  
Mild Dementia

Abstract Non-intrusive telemonitoring of physical activity in Older Adults suffering from Mild Cognitive Impairment (MCI), or Mild Dementia (MD), was implemented as part of a 6-month multicomponent digital intervention in the DECI study (EU Horizon2020 grant No 643588). Methods: To estimate gait speed long-term trajectory, a processing algorithm was applied on individual accelerometry data continuously recorded via the ADAMO wrist-watch accelerometer. Speed Trend Analysis was performed if patients wore the device ≥90 days. Only outdoor activity was analyzed to reflect patients’ own natural gait speed. Only time spent in high or very-high-activity level is used, to eliminate rest periods (e.g. sitting on a bench, on a bus or driving). A raw mean walking speed was computed. Stride was computed from gender and height and walked distance from stride and step count. Mean walking speed was estimated by walking distance and duration. A rolling mean algorithm was applied to the computed mean 15-day baseline series, resulting in a new series representing normalized patient’s gait speed trajectory during the study. Results: Baseline characteristics: F/M=21/19; MCI/MD=36/4; age=75.4±6.0 years; BMI= 24.6±5,2; MMSE=26.5±2.4; education=8.9±4.0 years. Monitoring days=147±29. Overall three main patterns of gait speed trajectory were identified: “relative stability”, “improving trend” and “progressive decline”: No evident correlation with cognitive status was observed in the sample. Examples of individual patterns are shown. Conclusions: Gait Speed Analysis can describe physical function trajectory over time and identify decliners from stable or improving older adults. Further analyses may clarify the relationship between physical function changes and cognitive status.

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