Hospital cognitive screening of patients with no related complaints

ABSTRACT Purposes: to characterize the cognitive performance hospitalized adults and elderly patients with no complaints, check the effect of education and age and correlate the results. Methods: cognitive screening was carried out by the Mini Mental State Examination (MEM) and the Verbal Fluency Test, semantics (FVS) and phonological (FVF) in 25 adults and elderly with no cognitive changes complaints admitted in an internal medicine ward. For statistical analyses, the one-way Anova, followed by post hoc Tukey, the bivariate Person correlation and the nonparametric Fisher’s tests were used. Results: a high frequency of cognitive impairment and a moderate correlation among the three tests applied were verified. The educational factor influenced the results of the MEM, the FVF and FVS tests, while the age factor significantly influenced the evidence of MEM and FVS. Conclusion: the data demonstrated that cognitive screening in hospitalized patients without related complaints is important, and that age and education are paramount factors in cognitive performance.

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Abnormality in saccadic eye movement in dementia

European Psychiatry ◽

10.1016/s0924-9338(99)80716-0 ◽

1999 ◽

Vol 14 (1) ◽

pp. 52-53 ◽

Cited By ~ 15

Author(s):

H.J. Schewe ◽

R. Uebelhack ◽

K. Vohs

Keyword(s):

Vascular Dementia ◽

Eye Movement ◽

Cognitive Performance ◽

Mental State ◽

High Frequency ◽

Mini Mental State Examination ◽

Saccadic Eye Movement ◽

Alzheimer Type ◽

Saccadic Intrusions ◽

State Examination

SummaryIn a small (n = 15) clinically heterogeneous group of patients with dementia of the Alzheimer-type or vascular dementia, abnormally high frequency of saccadic intrusions during fixation was significantly correlated to the Mini-Mental-State-Examination (MMSE) scores. In addition, the latency of saccades and hypometric saccades also correlated significantly to MMSE-scores. The results point to the possible use of saccadic eye movement as a physiological marker of cognitive performance.

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Random Forest Model in the Diagnosis of Dementia Patients with Normal Mini-Mental State Examination Scores

Journal of Personalized Medicine ◽

10.3390/jpm12010037 ◽

2022 ◽

Vol 12 (1) ◽

pp. 37

Author(s):

Jie Wang ◽

Zhuo Wang ◽

Ning Liu ◽

Caiyan Liu ◽

Chenhui Mao ◽

...

Keyword(s):

Machine Learning ◽

Cognitive Impairment ◽

Random Forest ◽

Mental State ◽

Mini Mental State Examination ◽

Machine Learning Algorithms ◽

Assessment Model ◽

Test Time ◽

Cognitive Screening ◽

State Examination

Background: Mini-Mental State Examination (MMSE) is the most widely used tool in cognitive screening. Some individuals with normal MMSE scores have extensive cognitive impairment. Systematic neuropsychological assessment should be performed in these patients. This study aimed to optimize the systematic neuropsychological test battery (NTB) by machine learning and develop new classification models for distinguishing mild cognitive impairment (MCI) and dementia among individuals with MMSE ≥ 26. Methods: 375 participants with MMSE ≥ 26 were assigned a diagnosis of cognitively unimpaired (CU) (n = 67), MCI (n = 174), or dementia (n = 134). We compared the performance of five machine learning algorithms, including logistic regression, decision tree, SVM, XGBoost, and random forest (RF), in identifying MCI and dementia. Results: RF performed best in identifying MCI and dementia. Six neuropsychological subtests with high-importance features were selected to form a simplified NTB, and the test time was cut in half. The AUC of the RF model was 0.89 for distinguishing MCI from CU, and 0.84 for distinguishing dementia from nondementia. Conclusions: This simplified cognitive assessment model can be useful for the diagnosis of MCI and dementia in patients with normal MMSE. It not only optimizes the content of cognitive evaluation, but also improves diagnosis and reduces missed diagnosis.

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Comparison of the Mini-Mental State Examination and Computerized Brief Cognitive Screening Test as Cognitive Screening Tools in Patients with Mild Cognitive Impairment

Current Alzheimer Research ◽

10.2174/1567205018666211215151418 ◽

2021 ◽

Vol 18 ◽

Author(s):

Che-Sheng Chu ◽

I-Chen Lee ◽

Chuan-Cheng Hung ◽

I-Ching Lee ◽

Chi-Fa Hung ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Normal Control ◽

Internal Consistency ◽

Mental State ◽

Screening Test ◽

Mini Mental State Examination ◽

Cognitive Screening ◽

Validity And Reliability ◽

State Examination

Background: The aim of this study was to establish the validity and reliability of the Computerized Brief Cognitive Screening Test (CBCog) for early detection of cognitive impairment. Method: One hundred and sixty participants, including community-dwelling and out-patient volunteers (both men and women) aged ≥ 65 years, were enrolled in the study. All participants were screened using the CBCog and Mini-Mental State Examination (MMSE). The internal consistency of the CBCog was analyzed using Cronbach’s α test. Areas under the curves (AUCs) of receiver operating characteristic analyses were used to test the predictive accuracy of the CBCog in detecting mild cognitive impairment (MCI) in order to set an appropriate cutoff point. Results: The CBCog scores were positively correlated with the MMSE scores of patients with MCI-related dementia (r = 0.678, P < .001). The internal consistency of the CBCog (Cronbach’s α) was 0.706. It was found that the CBCog with a cutoff point of 19/20 had a sensitivity of 97.5% and a specificity of 53.7% for the diagnosis of MCI with education level ≥ 6 years. The AUC of the CBCog for discriminating the normal control elderly from patients with MCI (AUC = 0.827, P < 0.001) was larger than that of the MMSE for discriminating the normal control elderly from patients with MCI (AUC= 0.819, P < .001). Conclusion: The CBCog demonstrated to have sufficient validity and reliability to evaluate mild cognitive impairment, especially in highly educated elderly people.

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Prestroke Physical Activity and Poststroke Cognitive Performance

Cerebrovascular Diseases ◽

10.1159/000511490 ◽

2020 ◽

Vol 49 (6) ◽

pp. 632-638

Author(s):

Andreas Gammelgaard Damsbo ◽

Janne Kaergaard Mortensen ◽

Kristian Lundsgaard Kraglund ◽

Søren Paaske Johnsen ◽

Grethe Andersen ◽

...

Keyword(s):

Physical Activity ◽

Cognitive Impairment ◽

Functional Outcome ◽

Cognitive Performance ◽

Mini Mental State Examination ◽

The Elderly ◽

Protective Measure ◽

Multivariable Analyses ◽

State Examination ◽

Physical Activity Scale

Introduction: Physical activity (PA) is associated with a lower risk of stroke and stroke mortality as well as a favorable stroke outcome. PA may also prevent general cognitive decline. Poststroke cognitive impairment is both common and disabling, and focusing on all possible preventive measures is important. Studies on the effect of PA on poststroke cognitive performance are sparse, however. We therefore aimed to examine the association between prestroke PA and poststroke cognitive performance. Methods: We studied the correlation between prestroke PA and poststroke cognitive performance in a prespecified analysis in The Efficacy of Citalopram Treatment in Acute Ischemic Stroke (TALOS) trial. We used the Physical Activity Scale for the Elderly (PASE) to collect information on PA during the 7-day period before stroke. PA was quantified, and patients were stratified into quartiles based on their PASE score. Cognitive performance was measured using the Symbol Digit Modalities Test (SDMT) at 1 and 6 months and the Mini-Mental State Examination (MMSE) at 6 months. The functional outcome was assessed using the modified Rankin Scale (mRS). Results: In total, 625 of 642 patients (97%) completed the PASE questionnaire. The median age was 69 (interquartile range [IQR]: 60–77), and the median PASE score was 137 (82–205). Higher prestroke PASE quartiles (2nd, 3rd, and 4th, each compared to the 1st) were independently associated with a higher SDMT score at 1 month in the both the univariable and multivariable analyses (2nd: 3.99 points, 95% confidence interval [CI]: 1.01–6.97; 3rd: 3.6, CI: 0.6–6.61; 4th: 4.1, CI: 0.95–7.24). This association remained at 6 months. PA was not statistically associated with the MMSE score or mRS. Conclusion: Higher prestroke PA was associated with a better cognitive performance as measured by the SDMT at 1 and 6 months poststroke. We found no significant association between prestroke PA and functional outcome. Our results are encouraging and support further investigations of PA as a protective measure against poststroke cognitive impairment.

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Do cognitive complaints either predict future cognitive decline or reflect past cognitive decline? A longitudinal study of an elderly community sample

Psychological Medicine ◽

10.1017/s0033291796003923 ◽

1997 ◽

Vol 27 (1) ◽

pp. 91-98 ◽

Cited By ~ 128

Author(s):

A. F. JORM ◽

H. CHRISTENSEN ◽

A. E. KORTEN ◽

A. S. HENDERSON ◽

P. A. JACOMB ◽

...

Keyword(s):

Longitudinal Study ◽

Cognitive Decline ◽

Mini Mental State Examination ◽

Community Sample ◽

Cognitive Change ◽

Cognitive Disorder ◽

Anxiety And Depression ◽

Cognitive Complaints ◽

Cognitive Changes ◽

State Examination

Data from a two-wave longitudinal study of an elderly community sample were used to assess whether cognitive complaints either predict subsequent cognitive decline or reflect past cognitive decline. Cognitive complaints and cognitive functioning were assessed on two occasions three and a half years apart. Cognitive complaints at Wave 1 were found not to predict future cognitive change on the Mini-Mental State Examination, an episodic memory test or a test of mental speed. Similarly, cognitive complaints at Wave 2 were unrelated to past cognitive changes on these tests after statistically controlling for the effects of anxiety and depression. Furthermore, cognitive complaints did not predict either mortality (after controlling for anxiety and depression) or future dementia. These results are evidence against the inclusion of cognitive complaints in diagnostic criteria for proposed disorders such as age-associated memory impairment, mild cognitive disorder and ageing-associated cognitive decline.

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36 Cognitive functioning in patients aged 60 and older with chronic non- communicable diseases

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2020-bnpa.53 ◽

2020 ◽

Vol 91 (8) ◽

pp. e23-e23

Author(s):

¹Jurate Peceliuniene ◽

²Guntis Karelis ◽

³Irena Zukauskaite ◽

Zane Kalnina ◽

Diana Blagovescenska ◽

...

Keyword(s):

Mini Mental State Examination ◽

Cross Sectional Study ◽

Communicable Diseases ◽

Chi Square ◽

Cross Sectional ◽

Non Communicable Diseases ◽

Cognitive Failures ◽

Cognitive Failures Questionnaire ◽

State Examination ◽

One Way Anova

ObjectiveIt is well established that chronic non-communicable diseases (CND) are linked to early cognitive impairment (CI) before or at the beginning of the old age, bringing those patients at higher risk for dementia.The aim: to evaluate CI of aged 60 or older cognitively healthy patients visiting doctors due to different CNDMethods107 patients aged 60 or older (mean age 74 years; 44 male, 63 female; 25 were visiting general practitioner (GP), 21 – neurologist (NE), 23 – pulmonologist (PU), 38 – otorhinolaryngologist (OT)) for their CND took part in pilot cross sectional study. They filled The Cognitive Failures Questionnaire (CFQ), Subjective Cognitive Complaints (SCCs), Mini-Mental State Examination (MMSE). Results were compared using Pearson Chi-Square and one-way ANOVA.ResultsOT patients had higher CFQ results (M=30.7) comparing to all groups (GP M=24.3; NE M=22.6, PU M=18.3, p=0.001). PU patients had less problems with Forgetfulness (M=8.6), comparing to GP (M=11.4) or OT (M=12.4) groups (p=0.022). OT (M=9.3) had more problems with Distractibility comparing to PU (M=5.7) and GP (M=6.7) groups (p=0.011). OT had higher scores in False Triggering (M=7.9) comparing to GP (M=5.92), NE (M=5.8) and PU (4.8) groups (p=0.011).The cut-off point of row score 45 was overstepped in18.9% of OT group, 8% of GP group, but none in NE or PU group (p=0.026). Results of MMSE showed alike tendencies: PU patients (M=27.8) had higher results than GP (M=25.7) or OT (M=25.6) groups (p=0.029). CI was found in 39.1% of GP and 35.1% of OT, comparing to 19.0% in NE and 3.7% in PU groups (p=0.020). But groups did not differ by SCCs scores, even if 3 or more complains were found in 50.0% of GP, 52.2% of PU, 42.9% of NE and 71.1% OT groups. The only SCCs question where found differences between groups – limitation of daily activities: concerning about possible mistakes 62.5% of GP and PU groups would ask somebody’s help, while it would be done by 52.4% of NE and only 15.8% of OT group (p<0.001).ConclusionsCognitive health in elderly people with CND is not monitored well. About 2/3 of them have subjective cognitive complains (3 or more by SCCs), 1/4 would be named as having CI by MMSE, 8.5% have problems due to forgetfulness, distractibility, false triggering. Cognitive functions are predominantly impaired in OT group patients, however, they declare less need for helping them.

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Is the Mini-Mental State Examination the best cognitive screening test for less educated people?

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20190043 ◽

2019 ◽

Vol 77 (5) ◽

pp. 330-334 ◽

Cited By ~ 1

Author(s):

Luis Felipe Scarabelot ◽

Mariane de Moraes Monteiro ◽

Mauren Carneiro da Silva Rubert ◽

Viviane de Hiroki Flumignan Zetola

Keyword(s):

Verbal Fluency ◽

Mini Mental State Examination ◽

Recall Test ◽

Cognitive Screening ◽

Delayed Recall ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test ◽

State Examination ◽

Fluency Test

ABSTRACT Mini-Mental State Examination (MMSE) results are strongly influenced by educational level. The Brief Cognitive Screening Battery (BCSB) is an alternative assessment tool that provides more accurate results in individuals with less education. Objective: Our aim was to compare the MMSE and BCSB as screening tests. Methods: The MMSE and BCSB were assessed in 112 participants by two evaluators blind to the other test's result. Participants were classified according to their level of education. The influence of education level was analyzed using the Kruskal-Wallis and multiple comparison tests. Results: Scores of the MMSE (p < 0.0001) and the clock-drawing test (p < 0.0001) were influenced by education level but the delayed recall test score was not (p = 0.0804). The verbal fluency test (p = 0.00035) was influenced only by higher educational levels. It took three minutes less to apply the MMSE than to apply the BCSB (p < 0.0001). Conclusions: These findings suggest that the delayed recall test and the verbal fluency test of the BCSB are better than the MMSE and clock-drawing test as tools for evaluating cognition in people with limited education.

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Use of benzodiazepines and cognitive performance in primary care patients with first cognitive complaints

International Psychogeriatrics ◽

10.1017/s104161021700223x ◽

2017 ◽

Vol 30 (4) ◽

pp. 597-601 ◽

Cited By ~ 2

Author(s):

G. Grande ◽

I. Tramacere ◽

D. L. Vetrano ◽

S. Pomati ◽

C. Mariani ◽

...

Keyword(s):

Primary Care ◽

Cognitive Performance ◽

Mini Mental State Examination ◽

Cognitive Complaints ◽

Logistic Regression Models ◽

Benzodiazepine Use ◽

Primary Care Patients ◽

Long Acting ◽

The Impact ◽

State Examination

ABSTRACTThe aim of the present study is to investigate the impact of benzodiazepine use on cognitive performance in primary care patients with first cognitive complaints. The association between the exposition to benzodiazepines (short and long half-life) and cognitive performance, evaluated through the Mini Mental State Examination (MMSE), was tested through analysis of the covariance and logistic regression models. Within the 4,249 participants (mean age 77.0 ± 8.2, 66.4% women), 732 (17%) were on benzodiazepines. When compared with non-users, short- and long-acting benzodiazepine users presented overlapping adjusted MMSE mean scores (respectively, mean MMSE score: 25.3, 95%CI 25.2–25.5; 25.4, 95%CI 25.1–25.7, and 25.9, 95%CI 25.3–26.4; p = 0.156). When tested according to the logistical regression model, after adjusting for potential confounders, no association was found between short and long acting benzodiazepine use and a MMSE < 24 (respectively, OR 0.9, 95%CI 0.7–1.2; OR 0.8, 95%CI 0.7–1.3) as compared with non-users. In conclusion, according to the results of our study, benzodiazepine use seems not to impact on cognitive performance- as assessed with the MMSE- of primary care patients referring to GPs for first cognitive complaints.

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Pharmacotherapy of Alzheimer Disease

The Canadian Journal of Psychiatry ◽

10.1177/070674370705201003 ◽

2007 ◽

Vol 52 (10) ◽

pp. 620-629 ◽

Cited By ~ 22

Author(s):

Dennis Seow ◽

Serge Gauthier

Keyword(s):

Clinical Trials ◽

Alzheimer Disease ◽

English Language ◽

Mini Mental State Examination ◽

Randomized Clinical Trials ◽

Primary Analysis ◽

Aspartate Receptor ◽

Asymptomatic Individuals ◽

Post Hoc ◽

State Examination

Objective: To systematically review published clinical trials of the pharmacotherapy of Alzheimer disease (AD). Method: We searched MEDLINE for published English-language medical literature, using Alzheimer disease and treatment as key words. No other search engine was used. Our review focused on randomized clinical trials (RCTs) and corresponding metaanalyses. Results: Although there are many RCTs for the treatment of mild cognitive impairment (MCI), none have been successful in their primary analysis. The cholinesterase inhibitors donepezil, rivastigmine, and galantamine have demonstrated efficacy in 3- to 12-month placebo-controlled RCTs assessing cognitive, functional, behavioural, and global outcomes in patients with mildly to moderately severe AD. Recent data from patients with severe stages of AD demonstrate the efficacy of donepezil on cognitive and functional measures but not on behaviour. The N-methyl-D-aspartate receptor antagonist memantine has been demonstrated to be effective in 6-month, placebo-controlled RCTs of 6 months duration assessing cognitive, functional, and global outcomes of inpatients with moderate-to-severe AD (defined as a Mini Mental State Examination score below 20). Post hoc analyses have demonstrated a benefit in regard to agitation and (or) aggression, but this needs to be confirmed in a prospective RCT across Canada. Disease-modifying treatments are being tested in mild stages of AD in 18-month RCTs with cognitive and global outcomes as primary efficacy outcomes, primarily with drugs reducing amyloid synthesis or aggregation. Successful treatment in mild stages of AD could lead to RCTs in MCI and, possibly, in genetically high-risk asymptomatic individuals. Conclusion: The significant advances in the symptomatic pharmacotherapy of AD may be followed by disease-modification treatments.

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