scholarly journals Refining sleep measurement using the Motionwatch8©: How many days of monitoring do we need to get reliable estimates of sleep quality for older adults with Mild Cognitive Impairment?

2020 ◽  
Author(s):  
Ryan S. Falck ◽  
Cindy K. Barha ◽  
Patrick C.Y. Chan ◽  
Teresa Liu-Ambrose

Abstract Background Mild cognitive impairment (MCI) is a transition stage between healthy cognition and dementia, and is linked to poorer sleep. Objective, reliable, and low-burden field methods to measure older adult sleep are also currently needed. The MotionWatch8© (MW8) wrist-worn actigraph provides estimates of sleep with 14 days of observation; however, there may be underlying differences in the reliability of sleep estimates based on MCI status. We therefore investigated the number of MW8 monitoring days required to estimate sleep in older adults with MCI and without. Methods Older adults (55+ years; N=151) wore the MW8 for ≥14 days. The Montreal Cognitive Assessment was used to categorize participants with probable MCI (scores of <26/30) and participants without MCI (≥26/30). We calculated intra-class reliability coefficients for 1-, 7-, and 14-days of wear-time, and performed Spearman-Brown predictions to determine the number of monitoring days needed for an ICC=0.80. Results Older adults with MCI were older ( p <0.01), more likely to be male ( p =0.03), and had shorter sleep duration ( p <0.01). Spearman-Brown analyses indicated that the number of monitoring days needed for an ICC=0.80 in older adults with probable MCI was 7 days for sleep duration, 4 days for fragmentation, and 4 days for efficiency; adults without MCI required 4 days for duration, 6 days for fragmentation, and 3 days for efficiency. Conclusions Our results indicate that while the reliability of MW8 estimates of sleep differs based on cognitive status, 7 days of MW8 monitoring provides reliable estimates of sleep for adults with MCI and those without.

2020 ◽  
Author(s):  
Ryan S. Falck ◽  
Cindy K. Barha ◽  
Patrick C.Y. Chan ◽  
Teresa Liu-Ambrose

Abstract BackgroundMild cognitive impairment (MCI) is a transition stage between healthy cognition and dementia, and is linked to poorer sleep. Objective, reliable, and low-burden field methods to measure older adult sleep are also currently needed. The MotionWatch8© (MW8) wrist-worn actigraph provides estimates of sleep with 14 days of observation; however, there may be underlying differences in the reliability of sleep estimates based on MCI status. We therefore investigated the number of MW8 monitoring days required to estimate sleep in older adults with MCI and without. MethodsOlder adults (55+ years; N=151) wore the MW8 for ≥14 days. The Montreal Cognitive Assessment was used to categorize participants with probable MCI (scores of <26/30) and participants without MCI (≥26/30). We calculated intra-class reliability coefficients for 1-, 7-, and 14-days of wear-time, and performed Spearman-Brown predictions to determine the number of monitoring days needed for an ICC=0.80.ResultsOlder adults with MCI were older (p<0.01), more likely to be male (p=0.03), and had shorter sleep duration (p<0.01). Spearman-Brown analyses indicated that the number of monitoring days needed for an ICC=0.80 in older adults with probable MCI was 7 days for sleep duration, 4 days for fragmentation, and 4 days for efficiency; adults without MCI required 4 days for duration, 6 days for fragmentation, and 3 days for efficiency. ConclusionsOur results indicate that while the reliability of MW8 estimates of sleep differs based on cognitive status, 7 days of MW8 monitoring provides reliable estimates of sleep for adults with MCI and those without.


Author(s):  
Vahid Rashedi ◽  
Mahshid Foroughan ◽  
Negin Chehrehnegar

Introduction: The Montreal Cognitive Assessment (MoCA) is a cognitive screening test widely used in clinical practice and suited for the detection of Mild Cognitive Impairment (MCI). The aims were to evaluate the psychometric properties of the Persian MoCA as a screening test for mild cognitive dysfunction in Iranian older adults and to assess its accuracy as a screening test for MCI and mild Alzheimer disease (AD). Method: One hundred twenty elderly with a mean age of 73.52 ± 7.46 years participated in this study. Twenty-one subjects had mild AD (MMSE score ≤21), 40 had MCI, and 59 were cognitively healthy controls. All the participants were administered the Mini-Mental State Examination (MMSE) to evaluate their general cognitive status. Also, a battery of comprehensive neuropsychological assessments was administered. Results: The mean score on the Persian version of the MoCA and the MMSE were 19.32 and 25.62 for MCI and 13.71 and 22.14 for AD patients, respectively. Using an optimal cutoff score of 22 the MoCA test detected 86% of MCI subjects, whereas the MMSE with a cutoff score of 26 detected 72% of MCI subjects. In AD patients with a cutoff score of 20, the MoCA had a sensitivity of 94% whereas the MMSE detected 61%. The specificity of the MoCA was 70% and 90% for MCI and AD, respectively. Discussion: The results of this study show that the Persian version of the MoCA is a reliable screening tool for detection of MCI and early stage AD. The MoCA is more sensitive than the MMSE in screening for cognitive impairment, proving it to be superior to MMSE in detecting MCI and mild AD.


2020 ◽  
pp. 1-11
Author(s):  
Yang Jiang ◽  
Juan Li ◽  
Frederick A. Schmitt ◽  
Gregory A. Jicha ◽  
Nancy B. Munro ◽  
...  

Background: Early prognosis of high-risk older adults for amnestic mild cognitive impairment (aMCI), using noninvasive and sensitive neuromarkers, is key for early prevention of Alzheimer’s disease. We have developed individualized measures in electrophysiological brain signals during working memory that distinguish patients with aMCI from age-matched cognitively intact older individuals. Objective: Here we test longitudinally the prognosis of the baseline neuromarkers for aMCI risk. We hypothesized that the older individuals diagnosed with incident aMCI already have aMCI-like brain signatures years before diagnosis. Methods: Electroencephalogram (EEG) and memory performance were recorded during a working memory task at baseline. The individualized baseline neuromarkers, annual cognitive status, and longitudinal changes in memory recall scores up to 10 years were analyzed. Results: Seven of the 19 cognitively normal older adults were diagnosed with incident aMCI for a median 5.2 years later. The seven converters’ frontal brainwaves were statistically identical to those patients with diagnosed aMCI (n = 14) at baseline. Importantly, the converters’ baseline memory-related brainwaves (reduced mean frontal responses to memory targets) were significantly different from those who remained normal. Furthermore, differentiation pattern of left frontal memory-related responses (targets versus nontargets) was associated with an increased risk hazard of aMCI (HR = 1.47, 95% CI 1.03, 2.08). Conclusion: The memory-related neuromarkers detect MCI-like brain signatures about five years before diagnosis. The individualized frontal neuromarkers index increased MCI risk at baseline. These noninvasive neuromarkers during our Bluegrass memory task have great potential to be used repeatedly for individualized prognosis of MCI risk and progression before clinical diagnosis.


2021 ◽  
Vol 15 (9) ◽  
pp. 2272-2275
Author(s):  
Hafsah Arshad ◽  
Kinza Anwar ◽  
Hafsah Gul Khattak ◽  
Imran Amjad ◽  
Yaser Majeed

Aim: To determine effects of Kinect- based games on neurocognitive functions in older adults with mild cognitive impairment. Methodology: A quasi experimental pre-post trail was conducted on 18 mild cognitive impairment (MCI) older adults. The subjects were recruited to access cognitive impairment through purposive sampling technique. The inclusion criteria were elderly aged ≥ 50 years, both genders, able to read and write, whereas older adults with severe cognitive impairments, neurological disorders and un controlled comorbidities were excluded. Brain training was provided for 30 minutes with 5-minute warm-up time and 5-minute cool-down time for 6 weeks. Blind assessor measured readings at baseline and after six weeks. The outcome measures were Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MOCA), Trail making test A & B and verbal fluency test (Semantic &Phonemic). The data was analyzed at baseline and after six weeks of intervention Results: Significant improvements were observed in post-test measurements (p <0.05) in MMSE, MoCA, TMT A & B and verbal fluency (Semantic &Phonemic) tests after 6 weeks of treatment. Conclusion: Kinect-based virtual reality games are beneficial in improving cognitive abilities of older adults with mild cognitive impairment. Keywords: Cognitive training, Mild cognitive impairment, Montreal Cognitive Assessment


2020 ◽  
Vol 35 ◽  
pp. 153331752096087
Author(s):  
Kalpana P. Padala ◽  
Christopher M. Parkes ◽  
Prasad R. Padala

We present a case report to showcase that behavioral, cognitive, and functional decline may be associated with COVID-19 stay-home guidance among older adults with pre-existent cognitive impairment. In a functionally independent and physically active older adult with Mild Cognitive Impairment, there was worsening in depression and anxiety symptoms associated with the restrictions of COVID-19. Functional decline was also noted as assessed by Instrumental Activities of Daily Living. We discuss solutions to mitigate the effects of COVID-19 restrictions in this vulnerable population.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S946-S946
Author(s):  
George Mois ◽  
Bailley Collette ◽  
Lisa M Renzi-Hammond ◽  
Laura Boccanfuso ◽  
Aditi Ramachandran ◽  
...  

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.


2020 ◽  
Vol 37 (4) ◽  
pp. 561-567
Author(s):  
William E Mansbach ◽  
Ryan A Mace ◽  
Melissa A Tanner ◽  
Steven P Simmons

Abstract Background Barriers to the early detection of mild cognitive impairment (MCI) and dementia can delay diagnosis and treatment. myMemCheck® was developed as a rapid free cognitive self-assessment tool that can be completed at home to identify older adults that would benefit from a more comprehensive cognitive evaluation. Objective Two prospective cross-sectional studies were conducted to examine the psychometric properties and clinical utility of myMemCheck®. Methods In Study 1, participants were independent living residents referred to an outpatient memory clinic (N = 59); older adults in the community and post-acute nursing home residents (N = 357) comprised Study 2. Results Psychometric analyses were performed on cognitive and psychological testing data, including myMemCheck®. myMemCheck® evidenced adequate reliability and strong construct validity. Receiver operating characteristic analysis evidenced an optional myMemCheck® cut score for identifying older adults at risk for MCI or dementia. myMemCheck® explained 25% of cognitive status beyond basic patient information. Conclusions myMemCheck® may help fast-track the diagnostic process, facilitate appropriate referrals for cognitive and neuropsychological evaluation, reduce assessment burden in health care and prevent negative outcomes associated with undetected cognitive impairment.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S333-S333
Author(s):  
Lorenzo M Donini ◽  
Alberto Rainoldi ◽  
Luca C Feletti ◽  
Gianluca Zia ◽  
Eleonora Poggiogalle ◽  
...  

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.


2015 ◽  
Vol 12 (3) ◽  
pp. 341 ◽  
Author(s):  
YongSoo Shim ◽  
Hui Jin Ryu ◽  
Dong Woo Lee ◽  
Jun-Young Lee ◽  
Jee Hyang Jeong ◽  
...  

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