scholarly journals Memory complaints at primary care in a middle-income country: clinical and neuropsychological characterization

2021 ◽  
Vol 15 (1) ◽  
pp. 88-97
Author(s):  
Marcos Leandro Pereira ◽  
Thiago Henrique Ferreira de Vasconcelos ◽  
Amanda Aparecida Rocha de Oliveira ◽  
Sarah Bárbara Campagnolo ◽  
Sarah de Oliveira Figueiredo ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Functional Assessment ◽  
The Elderly ◽  
Structured Interview ◽  
Subjective Cognitive Decline ◽  
Middle Income ◽  
Clock Drawing Test ◽  
Memory Complaints ◽  
Diagnosis Of Dementia ◽  
With Memory

ABSTRACT. There are different causes of memory complaints in the elderly, such as subjective cognitive decline (SCD), mild cognitive impairment (MCI) or dementia. Objective: 1) To characterize individuals with memory complaints in a mid-sized city in Brazil, through clinical, cognitive and functional assessment; 2) to compare SCD individuals with MCI and dementia patients in terms of clinical and cognitive variables. Methods: We consecutively included individuals aged ≥50 years, with memory complaints (spontaneous or inquired). Subjects who scored ≥25 on the Memory Complaint Questionnaire or who had spontaneous memory complaints were selected. Participants underwent a semi-structured interview, the Mini-Mental State Examination, Figure Memory Test for visual episodic memory, Clock Drawing Test, Category Fluency (Animals), Neuropsychiatric Inventory, and functional assessment. Individuals were classified as SCD, MCI or dementia. We did not include individuals with previous diagnosis of dementia. Results: The final sample consisted of 91 subjects (73.6% women; mean age 67.6±9.8 years): 14.3% had spontaneous complaints and 85.7% had inquired complaints. The most common comorbidities were hypertension (69.2%), diabetes (36.3%), and dyslipidemia (24.2%). Low levels of vitamin B12 and hypothyroidism were found in 26.4 and 16.5%, respectively. Regarding cognitive diagnosis, 16.5% of the sample were classified as SCD, 49.4% as MCI and 34.1% as dementia. MCI and dementia were identified in five (38.5%) and seven (53.4%) patients with spontaneous complaint, respectively. Conclusions: MCI and dementia are frequently underdiagnosed. Potential reversible causes of cognitive decline are common. The diagnosis of dementia is highly frequent among individuals with spontaneous memory complaints.

scholarly journals Memory Complaint Is a Surrogate for Memory Decline in the Middle-Aged: A Register-Based Study

2019 ◽  
Vol 8 (11) ◽  
pp. 1900 ◽  
Author(s):  
Yah-Yuan Wu ◽  
Wen-Chuin Hsu ◽  
Yu-Hua Huang ◽  
Wei-Min Ho ◽  
Yi-Chun Chen
Keyword(s):  
Neurodegenerative Diseases ◽  
Cognitive Decline ◽  
Subjective Cognitive Decline ◽  
Middle Aged ◽  
Memory Complaint ◽  
Memory Complaints ◽  
Baseline Mmse Score ◽  
Increased Risk ◽  
One Year ◽  
With Memory

Memory complaint is one of the earliest symptoms of dementia. The causes and prognosis of memory complaint in the middle-aged population remain largely unknown. We reviewed the register-based data of 2129 patients with memory complaints. Among them, 404 participants were between 40 and 65 years old. The participants were separated into three groups: subjective cognitive decline (SCD), neurodegenerative diseases (ND), and non-neurodegenerative diseases (NND). One-year decline was defined as a decrease of ≥1 on the mini-mental state examination (MMSE). At baseline, 131 participants (32%) were diagnosed with SCD, 141 (35%) with ND, and 132 (33%) with NND. The 1-year cognitive decline rate was higher among patients with ND (36.8%) than in the SCD (7.3%, p = 1.3 × 10−8) and NND groups (7.6%, p = 1.1 × 10−7). One-year decline did not differ between the SCD and NND groups. Lower baseline MMSE score predicted increased risk of 1-year cognitive decline (odds ratio (OR) = 1.126, 95% confidence interval (CI) = 1.076–1.178, p = 2.52 × 10−7). Memory complaint in middle age carried a risk of 1-year cognitive decline, and baseline MMSE is an independent predictor of decline. An initial diagnosis of SCD held the same risk effect for decline as NND. These findings highlighted the necessity for neuropsychological tests in those with memory complaints presenting to the clinic.

scholarly journals Network analysis of impulse dyscontrol in mild cognitive impairment and subjective cognitive decline

2021 ◽  
pp. 1-10
Author(s):  
T. Saari ◽  
E. E. Smith ◽  
Z. Ismail
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Observational Study ◽  
Cognitive Decline ◽  
Prospective Observational Study ◽  
Subjective Cognitive Decline ◽  
Behavioral Impairment ◽  
Conditional Dependence ◽  
With Memory ◽  
Central Symptom

ABSTRACT Objectives: To investigate conditional dependence relationships of impulse dyscontrol symptoms in mild cognitive impairment (MCI) and subjective cognitive decline (SCD). Design: A prospective, observational study. Participants: Two hundred and thirty-five patients with MCI (n = 159) or SCD (n = 76) from the Prospective Study for Persons with Memory Symptoms dataset. Measurements: Items of the Mild Behavioral Impairment Checklist impulse dyscontrol subscale. Results: Stubbornness/rigidity, agitation/aggressiveness, and argumentativeness were frequent and the most central symptoms in the network. Impulsivity, the fourth most central symptom in the network, served as the bridge between these common symptoms and less central and rare symptoms. Conclusions: Impulse dyscontrol in at-risk states for dementia is characterized by closely connected symptoms of irritability, agitation, and rigidity. Compulsions and difficulties in regulating rewarding behaviors are relatively isolated symptoms.

scholarly journals Cognitive decline, functional dependency and sociodemographic characteristics in elderly patients with bone fractures

2015 ◽  
Vol 5 (2) ◽  
pp. 221-232
Author(s):  
Ana R. Ortega ◽  
Mª José Calero
Keyword(s):  
Elderly Patients ◽  
Cognitive Decline ◽  
Bone Fractures ◽  
Functional Decline ◽  
The Elderly ◽  
Structured Interview ◽  
Demographic Variables ◽  
Cognitive Status ◽  
Functional Dependency ◽  
Functional Gain

The objective of this paper was to study the evolution of cognitive status and of functional dependency in patients over 65 and how these relate to different demographic variables. The sample consisted of 259 elderly people admitted to the Hospital Neurotraumatológico in Jaen (Spain) with a diagnosis of bone fracture. Sociodemographic data was obtained through a semi-structured interview. Furthermore, the following tests were also administered: Barthel Index, Lawton and Brody’s Scale, Phototest, and Informant Questionnaire on Cognitive Decline in the Elderly. According to the results of this study, elderly patients show increased dependency during hospitalization and a mild recovery at discharge, but without regaining their dependency values prior to hospitalization. There is a differential incidence of functional decline as a function of gender, where women have significantly lower functional dependency at home than men and they do not decline as much as men do from their status prior to hospitalization. Also, we have encountered significant inverse relations between the different levels of dependency and cognitive status, and the age of the elderly patient. Moreover, married patients experienced greater functional gain than did the widowed patients, regardless of gender.

The role of Mediterranean diet in the course of subjective cognitive decline in the elderly population of Greece: results from a prospective cohort study

2021 ◽  
pp. 1-29
Author(s):  
George S. Vlachos ◽  
Mary Yannakoulia ◽  
Costas A. Anastasiou ◽  
Mary H. Kosmidis ◽  
Efthimios Dardiotis ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Mediterranean Diet ◽  
The Elderly ◽  
Protective Role ◽  
Subjective Cognitive Decline ◽  
Preventive Strategy ◽  
Food Groups ◽  
Medical Disorders ◽  
The Mediterranean

Abstract Very few data are available regarding the association of adherence to the Mediterranean Diet (MeDi) with Subjective Cognitive Decline (SCD) evolution over time. A cohort of 939 cognitively normal individuals reporting self-experienced, persistent cognitive decline not attributed to neurological, psychiatric or medical disorders from the Hellenic Epidemiological Longitudinal Investigation of Aging and Diet (HELIAD study) was followed-up for a mean period of 3.10 years. We defined our SCD score as the number of reported SCD domains (memory, language, visuoperceptual and executive), ranging from 0 to 4. Dietary intake at baseline was assessed through a food frequency questionnaire; adherence to the MeDi pattern was evaluated through the Mediterranean Diet Score (MDS) that ranged from 0 to 55, with higher values indicating greater adherence to the MeDi. The mean SCD score in our cohort increased by 0.20 cognitive domains during follow-up. After adjustment for multiple potential confounders, we showed that an MDS higher by 10 points was associated with a 7% reduction in the progression of SCD within one year. In terms of food groups, every additional vegetable serving consumption per day was associated with a 2.3% reduction in SCD progression per year. Our results provide support to the notion that MeDi may have a protective role against the whole continuum of cognitive decline, starting at the first subjective complaints. This finding may strengthen the role of the MeDi as a population-wide, cost-effective preventive strategy targeting the modifiable risk factors for cognitive decline.

Informant-Reported Discrimination, Dementia, and Cognitive Impairment in Older Brazilians

2021 ◽  
pp. 1-9
Author(s):  
Jose M. Farfel ◽  
Lisa L. Barnes ◽  
Ana Capuano ◽  
Maria Carolina de Moraes Sampaio ◽  
Robert S. Wilson ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Sex Education ◽  
The Elderly ◽  
Structured Interview ◽  
Racially Diverse ◽  
Clinical Dementia Rating ◽  
Community Based ◽  
Poor Cognitive Function ◽  
Diagnosis Of Dementia ◽  
Everyday Discrimination

Background: Self-reported discrimination is a source of psychosocial stress that has been previously associated with poor cognitive function in older African Americans without dementia. Objective: Here, we examine the association of discrimination with dementia and cognitive impairment in racially diverse older Brazilians. Methods: We included 899 participants 65 years or older (34.3% Black) from the Pathology, Alzheimer’s and Related Dementias Study (PARDoS), a community-based study of aging and dementia. A structured interview with informants of the deceased was conducted. The interview included the Clinical Dementia Rating (CDR) Scale for the diagnosis of dementia and cognitive impairment proximate to death and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a second measure of cognitive impairment. Informant-reported discrimination was assessed using modified items from the Major and Everyday Discrimination Scales. Results: Discrimination was reported by informants of 182 (20.2%) decedents and was more likely reported by informants of Blacks than Whites (25.3% versus 17.6%, p = 0.006). Using the CDR, a higher level of informant-reported discrimination was associated with higher odds of dementia (OR: 1.24, 95% CI 1.08 –1.42, p = 0.002) and cognitive impairment (OR: 1.21, 95% CI: 1.06 –1.39, p = 0.004). Similar results were observed using the IQCODE (estimate: 0.07, SE: 0.02, p = 0.003). The effects were independent of race, sex, education, socioeconomic status, major depression, neuroticism, or comorbidities. Conclusion: Higher level of informant-reported discrimination was associated with higher odds of dementia and cognitive impairment in racially diverse older Brazilians.

scholarly journals Prevalence of dementia according to DSM–III–R and ICD–10

2001 ◽  
Vol 179 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Steffi G. Riedel-Heller ◽  
Anja Busse ◽  
Conny Aurich ◽  
Herbert Matschinger ◽  
Matthias C. Angermeyer
Keyword(s):  
Age Groups ◽  
The Elderly ◽  
Structured Interview ◽  
Population Based ◽  
Alzheimer Type ◽  
Dementia Diagnosis ◽  
Case Definitions ◽  
Diagnosis Of Dementia ◽  
Icd 10 ◽  
Prevalence Of Dementia

BackgroundThe prevalence of dementia diagnosis according to ICD–10 and DSM–III–R in population surveys remains poorly understood.AimsTo report and compare prevalence rates according to DSM–III–R and ICD–10.MethodA population-based sample (n=1692, age 75+ years) was investigated by a Structured Interview for Diagnosis of Dementia of Alzheimer Type, Multiinfarct Dementia and Dementia of other Aetiology according to DSM–III–R and ICD–10 (SIDAM).ResultsWhereas 17.4% (95% CI=15.9–19.5) of individuals aged 75+ years suffer from dementia according to DSM–III–R, only 12.4% (95% CI=10.6–14.2) are diagnosed as having dementia according to ICD–10. The results revealed lower ICD–10 rates in all investigated age groups. The largest differences appear in the oldest of the elderly.ConclusionsThe ICD–10 sets a higher threshold for dementia diagnosis. Larger differences in the eldest age groups might reflect difficulties in applying case definitions, especially in those beyond 90 years old.

scholarly journals The Clock Drawing Test A review of its accuracy in screening for dementia

2009 ◽  
Vol 3 (2) ◽  
pp. 74-80 ◽  
Author(s):  
Ivan Aprahamian ◽  
José Eduardo Martinelli ◽  
Anita Liberalesso Neri ◽  
Mônica Sanches Yassuda
Keyword(s):  
Scoring Systems ◽  
The Elderly ◽  
The Other ◽  
Early Screening ◽  
Clock Drawing Test ◽  
The Past ◽  
Clock Drawing ◽  
Dementia Screening ◽  
Drawing Test ◽  
Diagnosis Of Dementia

Abstract The Clock Drawing Test (CDT) is a simple neuropsychometric instrument that can be easily applied to assess several cognitive functions. Over the past 20 years, the CDT has aroused considerable interest in its role for the early screening of cognitive impairment, especially in dementia. Although the CDT is considered an accurate test for dementia screening, recent studies including comparisons with structured batteries such as the CAMCOG have shown mixed results. Objectives: To investigate the importance of the CDT compared to other commonly used tests, in the diagnosis of dementia in the elderly; (2) to evaluate the reliability and correlation between available CDT scoring scales from recent studies. Methods: A systematic search in the literature was conducted in September 2008 for studies comparing CDT scoring systems and comparing the CDT with neuropsychiatric batteries. Results: Twelve studies were selected for analyses. Seven of these studies compared CDT scoring scales while five compared the CDT against the CAMCOG and the MMSE. Eight studies found good correlation and reliability between the scales and the other tests. Conclusion: Despite the mixed results in these studies, the CDT appears to be a good screening test for dementia.

scholarly journals Repetitive Negative Thinking is associated with Subjective Cognitive Decline in older adults: a cross-sectional study

2020 ◽  
Author(s):  
Marco Schlosser ◽  
Harriet Demnitz-King ◽  
Tim Whitfield ◽  
Miranka Wirth ◽  
Natalie L. Marchant
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Subjective Cognitive Decline ◽  
Repetitive Negative Thinking ◽  
Cross Sectional ◽  
Negative Thinking ◽  
Memory Complaints ◽  
Dementia Risk ◽  
Perceived Cognitive Function

Abstract Background: In the absence of a cure or effective treatment for dementia, attention has shifted towards identifying risk factors for prevention. Subjective Cognitive Decline (SCD) describes self-perceived worsening of cognition despite unimpaired performance on neuropsychological tests. SCD has been associated with an increased dementia risk and steeper memory decline. Repetitive negative thinking (RNT) is a transdiagnostic process that manifests across several mental health disorders associated with increased vulnerability to dementia. RNT has thus been proposed as a candidate marker of risk for dementia and, relatedly, could contribute to the manifestation of SCD. We aimed to investigate the relationship between SCD and RNT alongside other proposed psychological risk/protective factors for dementia and cognitive decline. Methods: In a cross-sectional online survey, 491 older adults (mean=64.9 years, SD=4.2; 63.1% female) completed measures of RNT, personality traits, purpose in life, worry, rumination, and meditation practice. SCD was assessed continuously via self-perceived cognitive function (Neuro-QoL) and categorically via endorsement (yes/no) of memory complaints. Regression models, using a stepwise backwards elimination, were built to assess associations between SCD, demographics, and all risk/protective factors.Results: A total of 24.2% of participants reported memory complaints. In the final prediction models, RNT was the only psychological variable associated with lower self-perceived cognitive function and with a higher likelihood of memory complaints. Conclusions: This study empirically corroborates the theoretical relationship between SCD and RNT. Longitudinal studies are needed to establish whether RNT is a prodromal symptom or an independent risk factor, and whether RNT can be a promising construct for future research on SCD and dementia risk.

scholarly journals Repetitive negative thinking is associated with subjective cognitive decline in older adults: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Marco Schlosser ◽  
Harriet Demnitz-King ◽  
Tim Whitfield ◽  
Miranka Wirth ◽  
Natalie L. Marchant
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Subjective Cognitive Decline ◽  
Repetitive Negative Thinking ◽  
Cross Sectional ◽  
Negative Thinking ◽  
Memory Complaints ◽  
Dementia Risk ◽  
Perceived Cognitive Function

Abstract Background In the absence of a cure or effective treatment for dementia, attention has shifted towards identifying risk factors for prevention. Subjective Cognitive Decline (SCD) describes self-perceived worsening of cognition despite unimpaired performance on neuropsychological tests. SCD has been associated with an increased dementia risk and steeper memory decline. Repetitive negative thinking (RNT) is a transdiagnostic process that manifests across several mental health disorders associated with increased vulnerability to dementia. RNT has thus been proposed as a candidate marker of risk for dementia and, relatedly, could contribute to the manifestation of SCD. We aimed to investigate the relationship between SCD and RNT alongside other proposed psychological risk/protective factors for dementia and cognitive decline. Methods In a cross-sectional online survey, 491 older adults (mean = 64.9 years, SD = 4.2; 63.1% female) completed measures of RNT, personality traits, purpose in life, worry, rumination, and meditation practice. SCD was assessed continuously via self-perceived cognitive function (Neuro-QoL) and categorically via endorsement (yes/no) of memory complaints. Regression models, using a stepwise backwards elimination, were built to assess associations between SCD, demographics, and all risk/protective factors. Results A total of 24.2% of participants reported memory complaints. In the final prediction models, RNT was the only psychological variable associated with lower self-perceived cognitive function and with a higher likelihood of memory complaints. Conclusions This study empirically corroborates the theoretical relationship between SCD and RNT. Longitudinal studies are needed to establish whether RNT is a prodromal symptom or an independent risk factor, and whether RNT can be a promising construct for future research on SCD and dementia risk.

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