scholarly journals Hypo-perfusion and hyper-resistance affect different cognitive functions

2021 ◽  
Author(s):  
Hideyuki Hoshi ◽  
Yoshihito Shigihara
Keyword(s):  
Cognitive Impairment ◽  
Executive Function ◽  
Learning And Memory ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Cognitive Impairments ◽  
Cognitive Status ◽  
Frontal Assessment Battery ◽  
Assessment Battery ◽  
State Examination

Abstract Cognitive impairment and dementia are conventionally categorised according to their causative disease, such as Alzheimer's disease and cerebrovascular disease. Cognitive impairments of different aetiologies often share pathological cerebral blood circulation patterns, characterised by perfusion and resistance. Here, we show that these two features are associated with distinct types of cognitive impairment. Using carotid ultrasonography, we evaluated the circulation status of individuals with little to no subjective cognitive symptoms. We assessed individuals’ cognitive status using the Frontal Assessment Battery for executive function and Mini-Mental State Examination for learning and memory. Regression analysis showed that the hyper-resistance and hypo-perfusion components predicted the Frontal Assessment Battery and Mini Mental State Examination scores, respectively. These results are consistent with previous findings of hyper-resistance being associated with atherosclerosis, which disproportionately affects the frontal lobe and contributes to executive function impairments; meanwhile, hypo-perfusion disproportionately affects temporal lobe functions associated with learning and memory. We propose a novel concept that cognitive impairments fall into two subtypes regardless of the brain disease: hyper-resistance and hypo-perfusion subtypes. As these subtypes can be measured noninvasively and are treatable, this distinction would help design preventive and therapeutic strategies for dementia.

scholarly journals Preoperative Cognitive Impairment as a Predictor of Postoperative Outcomes in Elderly Patients Undergoing Spinal Surgery for Degenerative Spinal Disease

2021 ◽  
Vol 10 (7) ◽  
pp. 1385
Author(s):  
Hyung Cheol Kim ◽  
Seong Bae An ◽  
Hyeongseok Jeon ◽  
Tae Woo Kim ◽  
Jae Keun Oh ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Elderly Patients ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Operation Time ◽  
Cognitive Status ◽  
Blood Analysis ◽  
Spinal Disease ◽  
Degenerative Spinal Disease ◽  
State Examination

Cognitive status has been reported to affect the peri-operative and post-operative outcomes of certain surgical procedures. This prospective study investigated the effect of preoperative cognitive impairment on the postoperative course of elderly patients (n = 122, >65 years), following spine surgery for degenerative spinal disease. Data on demographic characteristics, medical history, and blood analysis results were collected. Preoperative cognition was assessed using the mini-mental state examination, and patients were divided into three groups: normal cognition, mild cognitive impairment, and moderate-to-severe cognitive impairment. Discharge destinations (p = 0.014) and postoperative cardiopulmonary complications (p = 0.037) significantly differed based on the cognitive status. Operation time (p = 0.049), white blood cell count (p = 0.022), platelet count (p = 0.013), the mini-mental state examination score (p = 0.033), and the Beck Depression Inventory score (p = 0.041) were significantly associated with the length of hospital stay. Our investigation demonstrated that improved understanding of preoperative cognitive status may be helpful in surgical decision-making and postoperative care of elderly patients with degenerative spinal disease.

Cognitive Functioning in Patients with Cerebral Aneurysms Measured with the Mini Mental State Examination and the Telephone Interview for Cognitive Status

Neurosurgery ◽  
2006 ◽  
Vol 59 (4) ◽  
pp. 803-811 ◽  
Author(s):  
Joseph T. King ◽  
Michael L. DiLuna ◽  
Domenic V. Cicchetti ◽  
Joel Tsevat ◽  
Mark S. Roberts
Keyword(s):  
Cognitive Impairment ◽  
Subarachnoid Hemorrhage ◽  
Cognitive Functioning ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Telephone Interview ◽  
Cerebral Aneurysms ◽  
Cognitive Status ◽  
State Examination

Abstract BACKGROUND: Clinicians and researchers use brief instruments, such as the Mini Mental State Examination (MMSE) and the Telephone Interview for Cognitive Status (TICS), to measure cognitive functioning in patients with cerebral aneurysms. MMSE and TICS scores are often dichotomized to classify patients as cognitively impaired or not. Frequently, after an initial MMSE face-to-face evaluation, the TICS is used for follow-up assessments by telephone. METHODS: A cross-sectional cohort of patients with cerebral aneurysms completed the MMSE at baseline and the MMSE or TICS at the 12-month follow-up examination. Multivariate logistic regression adjusting for demographics was used to model cognitive impairment. MMSE and TICS results were compared using the MMSE as the “gold standard.” RESULTS: Eleven out of 171 (6%) patients had baseline MMSE scores less than 24, indicating cognitive impairment. Multivariate analysis showed that a history of subarachnoid hemorrhage was associated with cognitive impairment measured with the MMSE (odds ratio, 13.9; P = 0.021; C statistic = 0.87); there was no relationship between subarachnoid hemorrhage or treatment and TICS cognitive impairment (i.e., score < 27). In patients without recent or interim invasive interventions that might affect cognition (n = 65), raw baseline MMSE and 12-month TICS scores had fair correlations (r = 0.30, P = 0.015); however, dichotomized scores had poor agreement, and TICS sensitivity and positive predictive value was 0% compared with the MMSE. CONCLUSION: The MMSE may be more sensitive than the TICS to the effects of subarachnoid hemorrhage on cognitive functioning. Raw MMSE and TICS scores are well correlated, but dichotomized MMSE and TICS scores are probably not interchangeable in this patient population.

scholarly journals Mini-mental state exam for children (MMC) in children with hemiplegic cerebral palsy

2017 ◽  
Vol 11 (3) ◽  
pp. 287-296 ◽  
Author(s):  
Ricardo Moura ◽  
Peterson Marco Oliveira Andrade ◽  
Patrícia Lemos Bueno Fontes ◽  
Fernanda Oliveira Ferreira ◽  
Larissa de Souza Salvador ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Cognitive Impairment ◽  
Mental State ◽  
Cognitive Abilities ◽  
Mini Mental State Examination ◽  
Cognitive Impairments ◽  
Typical Development ◽  
Moderate Correlation ◽  
Hemiplegic Cerebral Palsy ◽  
State Examination

ABSTRACT Cognitive impairment is frequent in cerebral palsy (CP) and there is a lack of multiprofessional screening instruments. OBJECTIVE: The aim of this study was to investigate the utility of the Mini-Mental State Examination for Children (MMC), an adapted version of the Mini-Mental State Examination, in screening for cognitive impairments in children with CP. METHODS: We assessed 397 Brazilian children, 310 with typical development and 87 with CP (hemiplegic and quadriplegic forms), aged 5-16 years. Association between the MMC and general intelligence was assessed by the Colored Progressive Matrices instrument. RESULTS: Psychometric indexes for the MMC were adequate. ROC analyses revealed effective diagnostic accuracy in all ages assessed. Cut-off values are reported. Major difficulties on the MMC were observed in children with CP, particularly individuals with the quadriplegic form. Moreover, the MMC showed moderate correlation with the intelligence test, and was reliable in discriminating, among clinical cases, those with poorer cognitive abilities. CONCLUSION: The MMC could be useful as a multiprofessional screening instrument for cognitive impairment in children with hemiplegic CP. Results of the MMC in quadriplegic CP children should be interpreted with caution. Diagnosis should be confirmed by further psychological testing.

Mini-Mental State Examination sentence writing among community-dwelling elderly adults in Brazil: text fluency and grammar complexity

2012 ◽  
Vol 24 (11) ◽  
pp. 1732-1737 ◽  
Author(s):  
Anita Liberalesso Neri ◽  
Lia Lopes Ongaratto ◽  
Mônica Sanches Yassuda
Keyword(s):  
Cognitive Impairment ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Cognitively Impaired ◽  
Simple Sentence ◽  
Textual Production ◽  
Probabilistic Sample ◽  
State Examination

ABSTRACTBackground: In normal aging, the decrease in the syntactic complexity of written production is usually associated with cognitive deficits. This study was aimed to analyze the quality of older adults' textual production indicated by verbal fluency (number of words) and grammatical complexity (number of ideas) in relation to gender, age, schooling, and cognitive status.Methods: From a probabilistic sample of community-dwelling people aged 65 years and above (n = 900), 577 were selected on basis of their responses to the Mini-Mental State Examination (MMSE) sentence writing, which were submitted to content analysis; 323 were excluded as they left the item blank or performed illegible or not meaningful responses. Education adjusted cut-off scores for the MMSE were used to classify the participants as cognitively impaired or unimpaired. Total and subdomain MMSE scores were computed.Results: 40.56% of participants whose answers to the MMSE sentence were excluded from the analyses had cognitive impairment compared to 13.86% among those whose answers were included. The excluded participants were older and less educated. Women and those older than 80 years had the lowest scores in the MMSE. There was no statistically significant relationship between gender, age, schooling, and textual performance. There was a modest but significant correlation between number of words written and the scores in the Language subdomain.Conclusions: Results suggest the strong influence of schooling and age over MMSE sentence performance. Failing to write a sentence may suggest cognitive impairment, yet, instructions for the MMSE sentence, i.e. to produce a simple sentence, may limit its clinical interpretation.

scholarly journals High-Sensitivity Cardiac Troponin T and Cognitive Function in Patients With Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (5) ◽  
pp. 1604-1607 ◽  
Author(s):  
Leonie H.A. Broersen ◽  
Bob Siegerink ◽  
Pia S. Sperber ◽  
Regina von Rennenberg ◽  
Sophie K. Piper ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Telephone Interview ◽  
Troponin T ◽  
High Sensitivity ◽  
Cognitive Status ◽  
State Examination

Background and Purpose— Our study aim was to assess whether high-sensitivity cardiac troponin T (hs-cTnT), a specific biomarker for myocardial injury, is associated with cognitive function in patients after mild-to-moderate first-ever ischemic stroke. Methods— We used data from PROSCIS-B (Prospective Cohort With Incident Stroke Berlin). Cognitive function was assessed by Mini-Mental-State-Examination at baseline, and Telephone Interview for Cognitive Status–modified after 1 to 3 years of follow-up. Patients were categorized according to hs-cTnT quartiles. We performed generalized linear regression to calculate risk ratios of cognitive impairment (Mini-Mental-State-Examination <27; Telephone Interview for Cognitive Status–modified <32). Association of hs-cTnT with cognitive function over time was estimated using a linear mixed model. Results— We included 555 patients (mean age, 67 years, 62% male, median National Institutes of Health Stroke Scale 2 [interquartile range, 1–5], hs-cTnT above upper reference limit 40%, baseline cognitive impairment 28%). Baseline Mini-Mental-State-Examination score and rate of cognitive impairment were lower in patients in the highest versus lowest hs-cTnT quartile (median Mini-Mental-State-Examination 27 versus 29, and 15.3% versus 43.0%, adjusted risk ratio, 1.76 [95% CI, 1.07–2.90], respectively). If anything, cognition seemed to improve in all groups, yet Telephone Interview for Cognitive Status–modified scores were consistently lower in patients within the highest versus lowest hs-cTnT quartile (adjusted β, −1.33 [95% CI, −2.65 to −0.02]), without difference in the rate of change over time. Conclusions— In patients with mild-to-moderate first-ever ischemic stroke without dementia, higher hs-cTnT was associated with higher prevalence of cognitive impairment at baseline and lower Telephone Interview for Cognitive Status–modified during 3-year follow-up. Registration— URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01363856.

Comparison of Mini-Mental State Examination and Montreal Cognitive Assessment Ratings Across Levels of Parkinson’s Disease Severity

2021 ◽  
pp. 1-9
Author(s):  
Allison Snyder ◽  
Ann L. Gruber-Baldini ◽  
F. Rainer von Coelln ◽  
Joseph M. Savitt ◽  
Stephen G. Reich ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Disease Severity ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Cognitive Status ◽  
Montreal Cognitive Assessment ◽  
State Examination

Background: Cognitive impairment (CI) is common in Parkinson’s disease (PD) and an important cause of disability. Screening facilitates early detection of CI and has implications for management. Preclinical disability is when patients have functional limitations but maintain independence through compensatory measures. Objective: The objective of this study was to investigate the relationship between scores on the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) with levels of PD severity and disability. Methods: PD patients (n = 2,234) in a large observational study were stratified by disease severity, based on Total Unified Parkinson’s Disease Rating Scale (Total UPDRS) and Hoehn and Yahr (HY) stage. Using MMSE (n = 1,184) or MoCA (n = 1,050) and basic (ADL) and instrumental activities of daily living (IADL) scales for disability, linear regression analysis examined associations between cognitive status and disability. Results: Cognition and disability were highly correlated, with the strongest correlation between IADL and MoCA. Only 16.0% of mean MMSE scores were below threshold for CI (28) and only in advanced PD (Total UPDRS 60+, HY≥3). MoCA scores fell below CI threshold (26) in 66.2% of the sample and earlier in disease (Total UPDRS 30+, HY≥2), corresponding with impairments in ADLs. Conclusion: In a large clinical dataset, a small fraction of MMSE scores fell below cutoff for CI, reinforcing that MMSE is an insensitive screening tool in PD. MoCA scores indicated CI earlier in disease and coincided with disability. This study shows that MoCA, but not MMSE is sensitive to the emergence of early cognitive impairment in PD and correlates with the concomitant onset of disability.

scholarly journals Application of the Mini-Mental State Examination (MMSE) Scale in Cognitive Assessment of Elderly Patients in a General Ward

2021 ◽  
Vol 5 (3) ◽  
pp. 153-157
Author(s):  
Huiling Liu ◽  
Cuiqing Liu ◽  
Chuang Hu ◽  
Xuling Li ◽  
Yahui Zhao ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Elderly Patients ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Cognitive Status ◽  
General Ward ◽  
P Value ◽  
And Gender ◽  
State Examination

Objective: To analyze the application of the Mini-Mental State Examination (MMSE) scale in cognitive assessment of elderly patients in a general ward. Methods: Elderly patients who underwent nephrosurgery and thoracic surgery between July 2015 to June 2019 were eligible for the study. A total of 713 patients enrolled and data were collected for the assessment of cognitive status. We analyzed the relationship between cognitive impairment, degree of cognitive impairment, age, and gender. Result: In the 713 cases of cognitive ability assessment by the MMSE, there was cognitive impairment in 21 (4.04%) male patients, and 10 (5.18%) female patients. In addition, the analysis of the correlation between cognitive impairment and gender showed a P value of 0.51, which was not statistically significant. In the participants age research, the average age of the patients in the cognitive normal group was 72.30±6.50 years old, and the average age of the patients in the cognitive impairment group was 78.61±6.90 years old. Their p value was <0.0001, which was statistically significant. Conclusion: There is a correlation between cognitive impairment and age. Therefore, the MMSE helps detect cognitive impairment and potential safety hazards in elderly patients. It is convenient for medical staff to take corresponding measures in time to ensure the safety of the patients.

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