The Epoch Effect on Cognitive Function Requires Regular Updating of Cognitive Screening Tests

2020 ◽  
Vol 77 (2) ◽  
pp. 667-674
Author(s):  
Ji-Ping Tan ◽  
Xiaoxiao Wang ◽  
Xiaoyang Lan ◽  
Nan Li ◽  
Shimin Zhang ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Mmse Score ◽  
Characteristic Curve ◽  
Linear Regression Analysis ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Discrimination Ability ◽  
Over Time

Background: Over time, improved cognitive abilities in elderly individuals lead to an overall increase in performance on widely used cognitive screening tests (e.g., Mini-Mental State Examination, MMSE) and impact screening efficacy. Objective: We aimed to examine the epoch effect on cognitive function measured using MMSE, in addition to the influence of demographic characteristics on MMSE. We also evaluated the ability of the MMSE in detecting dementia and examined the discrimination ability and measurement precision of the MMSE. Methods: In a cross-sectional survey, Chinese veterans aged ≥60 years were interviewed. Multiple linear regression analysis was applied to explore the factors affecting the MMSE. The expected MMSE score was calculated to examine the epoch effect. The diagnostic accuracy of the MMSE was determined via receiver operating characteristic curve analyses. Item response theory methods were implemented using Stata 16.0. Results: The MMSE score increased with higher education and decreased with advancing age. The observed MMSE score in this study (26.9) was higher than the expected MMSE score (24.9). It demonstrated 78.3% /84.1% /89.9% sensitivity and 85.8% /79.5% /66.8% specificity in detecting dementia using the cut-off score 25/26/27. The MMSE showed reduced discrimination and provided little information for ability level of −1 and above. Conclusion: Improved cognitive ability over time may increase the performance on cognitive screening tests (e.g., MMSE). This impact of epoch in cognitive function emphasizes the importance of regularly updating cognitive screening tests.

Association between Cerebral Oxygenation, as Evaluated with Near-Infrared Spectroscopy, and Cognitive Function in Patients Undergoing Hemodialysis

Nephron ◽  
2021 ◽  
pp. 1-8
Author(s):  
Susumu Ookawara ◽  
Kiyonori Ito ◽  
Yusuke Sasabuchi ◽  
Yuichiro Ueda ◽  
Hideyuki Hayasaka ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Oxygen Saturation ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Mmse Score ◽  
Linear Regression Analysis ◽  
Density Lipoprotein ◽  
Chronic Glomerulonephritis ◽  
Clinical Factors ◽  
Cross Sectional

<b><i>Introduction:</i></b> The prevalence of cognitive impairment in patients undergoing hemodialysis (HD) is higher than that in healthy controls. To date, studies on the association between cognitive function and cerebral oxygenation in these patients are limited. Therefore, in this study, we aimed to cross-sectionally investigate the association between cognitive assessment scores and clinical factors, including cerebral oxygenation, in patients undergoing HD. <b><i>Methods:</i></b> In this observational study, 193 HD patients were included. Cerebral regional oxygen saturation (rSO<sub>2</sub>) was monitored using an INVOS 5,100c oxygen saturation monitor. Poor cognition was defined as a Mini-Mental State Examination (MMSE) score ≤23. We analyzed the association between MMSE score and clinical factors, including cerebral rSO<sub>2</sub>. <b><i>Results:</i></b> MMSE score in HD patients included in this study was 26.8 ± 3.3. There were 164 patients (85%) with MMSE score ≥24 and 29 patients (15%) with an MMSE score ≤23. In the patients with MMSE score ≥24, cerebral rSO<sub>2</sub> (53.8% ± 8.3%) was significantly higher than that in patients with MMSE score ≤23 (49.5% ± 9.8%; <i>p</i> = 0.013). Multivariable linear regression analysis was performed using the following confounding factors: age, mean blood pressure, cerebral rSO<sub>2</sub>, HD duration, ultrafiltration rate, hemoglobin, serum Cr, serum calcium, serum phosphate, total cholesterol, high-density lipoprotein cholesterol levels, serum albumin, presence of diabetes mellitus or chronic glomerulonephritis, history of comorbid cardiovascular or cerebrovascular disease, and use of renin-angiotensin-aldosterone system inhibitors or vitamin D analogs. MMSE score was independently and significantly associated with age (standardized coefficient: −0.244) and cerebral rSO<sub>2</sub> (standardized coefficient: 0.180). <b><i>Conclusions:</i></b> MMSE score was independently associated with age (negative effect) and cerebral rSO<sub>2</sub> (positive effect) in this cross-sectional study. Further prospective studies are needed to clarify whether maintaining cerebral oxygenation prevents the deterioration of cognitive function in patients undergoing HD.

Cross-Sectional Examination of Homocysteine Levels with Sarcopenia and Its Components in Memory Clinic Outpatients

2021 ◽  
pp. 1-10
Author(s):  
Yosuke Yamada ◽  
Hiroyuki Umegaki ◽  
Fumie Kinoshita ◽  
Chi Hsien Huang ◽  
Taiki Sugimoto ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Linear Regression ◽  
Logistic Regression Analysis ◽  
Linear Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Memory Clinic ◽  
Cross Sectional

Background: Homocysteine is a common risk factor for cognitive impairment and sarcopenia. However, very few studies have shown an association between sarcopenia and serum homocysteine levels after adjustment for cognitive function. Objective: The purpose of this study was to investigate the relationship between homocysteine and sarcopenia in memory clinic patients. Methods: This cross-sectional study investigated outpatients in a memory clinic. We enrolled 1,774 participants (≥65 years old) with measured skeletal muscle mass index (SMI), hand grip strength (HGS), and homocysteine. All participants had undergone cognitive assessments and were diagnosed with dementia, mild cognitive impairment, or normal cognition. Patient characteristics were compared according to sarcopenia presence, SMI level, or HGS. Multivariate logistic regression analysis was performed to determine the association of homocysteine with sarcopenia, low SMI, or low HGS. Next, linear regression analysis was performed using HGS as a continuous variable. Results: Logistic regression analysis showed that low HGS was significantly associated with homocysteine levels (p = 0.002), but sarcopenia and low SMI were not. In linear regression analysis, HGS was negatively associated with homocysteine levels after adjustment for Mini-Mental State Examination score (β= –2.790, p <  0.001) or clinical diagnosis of dementia (β= –3.145, p <  0.001). These results were similar for men and women. Conclusion: Our results showed a negative association between homocysteine and HGS after adjustment for cognitive function. Our findings strengthen the assumed association between homocysteine and HGS. Further research is needed to determine whether lower homocysteine levels lead to prevent muscle weakness.

scholarly journals Comparison of screening tests in the evaluation of cognitive status of patients with epilepsy

2021 ◽  
Vol 15 (1) ◽  
pp. 145-152
Author(s):  
Mayla Cristine de Souza ◽  
Carolina Oliveira de Paulo ◽  
Larissa Miyashiro ◽  
Carlos Alexandre Twardowschy
Keyword(s):  
Mmse Score ◽  
Cognitive Status ◽  
Screening Tests ◽  
Cross Sectional ◽  
Immediate Memory ◽  
Unified Health System ◽  
Final Sample ◽  
Tertiary Healthcare ◽  
Patients With Epilepsy ◽  
Moca Score

ABSTRACT. Epilepsy, a chronic neurological condition which is associated with neurobiological and psychosocial changes, affects 0.5 to 1% of the world's population, presenting in most cases a deficit in reasoning, memory and attention. Objective: To contribute to the implementation of screening strategies for cognitive decline and memory deficits in patients with epilepsy. Methods: Two questionnaires, MMSE and MoCA, were used in this cross-sectional and observational study. Fifty-four patients diagnosed with different types of epilepsy (55% refractory) were assessed; they were all over 18 years old, of both genders, with autonomy to answer the questionnaire. They were followed exclusively at an outpatient clinic of the Neurology Service Department, specialized in epilepsy, which is part of the tertiary healthcare level of the Brazilian Unified Health System (SUS). Results: The final sample consisted of 54 patients. There was a significant correlation (p<0.001) between the scores of both tests, indicating that low values in the MMSE score also corresponded to low values in the MoCA score. Sensitivity was 90% (ROC curve adjusted) and 87.5% of the patients with a normal score in the MMSE test obtained alterations in the MoCA scores. None of them showed a low MMSE score with a normal MOCA score. The Spearman correlation coefficient was 0.80. Also, there was a significant relationship between both immediate memory and delayed recall memory and the type of seizure (p<0.03) and level of schooling (p<0.001), respectively. Conclusion: The MoCA is a well-suited test to be performed in epilepsy patients to evaluate their cognition as it seems more extensive and complete compared to MMSE.

scholarly journals Effect of FOXO3 and Air Pollution on Cognitive Function: A Longitudinal Cohort Study of Older Adults in China from 2000 to 2014

2022 ◽  
Author(s):  
John S Ji ◽  
Linxin Liu ◽  
Yi Zeng ◽  
Lijing L Yan
Keyword(s):  
Air Pollution ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Mmse Score ◽  
Fine Particulate Matter ◽  
Human Longevity ◽  
Cross Sectional ◽  
Positive Effects ◽  
Minor Alleles

Abstract Forkhead Box O 3 (FOXO3) genotype is strongly associated with human longevity and may be protective against neurodegeneration. Air pollution is a risk factor for cognitive decline and dementia. We aimed to study the individual and combined effects of FOXO3 and air pollution on cognitive function in a large prospective cohort with up to 14 years of follow-up. We measured cognitive function and impairment using the Mini-Mental State Examination (MMSE). We used tagging SNPs rs2253310, rs2802292, and rs4946936 to identify the FOXO3 gene, of which roughly half of the population had the longevity associated polymorphism. We matched annual average fine particulate matter (PM2.5) concentrations within 1 km^2 grid. We conducted cross-sectional and longitudinal analyses using multivariable linear and logistic regression models and generalized estimating equation. At baseline, carriers of the longevity associated homozygous minor alleles of FOXO3 SNPs had a higher MMSE score than the carriers of homozygous major alleles. In the longitudinal follow-up, carriers of FOXO3 homozygous minor alleles had lower odds of cognitive impairment compared to non-carriers. Higher PM2.5 was associated with a lower MMSE score and higher odds of cognitive impairment. The positive effects of FOXO3 were the strongest in females, older people, and residents in areas with lower air pollution.

scholarly journals Methods of conduct and reporting of living systematic reviews: a protocol for a living methodological survey

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 221 ◽  
Author(s):  
Assem M. Khamis ◽  
Lara A. Kahale ◽  
Hector Pardo-Hernandez ◽  
Holger J. Schünemann ◽  
Elie A. Akl
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Evidence Synthesis ◽  
Cochrane Library ◽  
Cross Sectional Survey ◽  
Systematic Review Methodology ◽  
Cross Sectional ◽  
Prospective Longitudinal ◽  
Over Time

Background: The living systematic review (LSR) is an emerging approach for improved evidence synthesis that uses continual updating to include relevant new evidence as soon as it is published. The objectives of this study are to: 1) assess the methods of conduct and reporting of living systematic reviews using a living study approach; and 2) describe the life cycle of living systematic reviews, i.e., describe the changes over time to their methods and findings. Methods: For objective 1, we will begin by conducting a cross-sectional survey and then update its findings every 6 months by including newly published LSRs. For objective 2, we will conduct a prospective longitudinal follow-up of the cohort of included LSRs. To identify LSRs, we will continually search the following electronic databases: Medline, EMBASE and the Cochrane library. We will also contact groups conducting LSRs to identify eligible studies that we might have missed. We will follow the standard systematic review methodology for study selection and data abstraction. For each LSR update, we will abstract information on the following: 1) general characteristics, 2) systematic review methodology, 3) living approach methodology, 4) results, and 5) editorial and publication processes. We will update the findings of both the surveys and the longitudinal follow-up of included LSRs every 6 months. In addition, we will identify articles addressing LSR methods to be included in an ‘LSR methods repository’. Conclusion: The proposed living methodological survey will allow us to monitor how the methods of conduct, and reporting as well as the findings of LSRs change over time. Ultimately this should help with ensuring the quality and transparency of LSRs.

Abstract T P160: Influence of Polyunsaturated Fatty Acids on Cognition in Elderly Alzheimer's Disease Patients

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Takashi Yamazaki ◽  
Ken Nagata ◽  
Daiki Takano ◽  
Tetsuya Maeda
Keyword(s):  
Alzheimer’S Disease ◽  
Blood Pressure ◽  
Alzheimer's Disease ◽  
Cognitive Function ◽  
Mmse Score ◽  
Characteristic Curve ◽  
Follow Up Study ◽  
Cognitive Stability ◽  
The Relationship

Background: Many genes and environmental factors linked to Alzheimer’s disease (AD) risk affect lipid metabolism or the cardiovascular system, strongly implicating cerebrovascular and metabolic dysfunction in AD pathogenesis. Although some PUFAs may improve cognitive function in aging individuals, it is still unclear how different PUFAs influence AD neuropathology and cognitive function. Objective: To examine the influence of polyunsaturated fatty acid (PUFA) metabolism on AD-associated cognitive decline, we investigated the relationship between serum PUFA profile and neuropsychological test performance. Methods: Cognitive functioning in patients with probable AD (n = 174, mean age 77.6 years) was examined using the Mini-Mental State Exam (MMSE) and clock drawing test (CDT). Serum samples were obtained for PUFA profile, including the eicosapentaenoic acid/arachidonic acid (EPA/AA) ratio, and measurement of brain natriuretic peptide (BNP) concentration. In the follow-up study, 47 subjects repeated MMSE and CDT after 1 year, According to the second MMSE score, the subjects were divided into the following 2 groups: those with unchanged or improved MMSE score and those with lower MMSE score. A receiver operating characteristic curve was used to evaluate the relationship between the EPA/AA ratio and 1-year cognitive stability. Results: In the cross-sectional study, total MMSE score correlated positively with the EPA/AA ratio and systolic blood pressure (SBP), and negatively with age and diastolic blood pressure (DBP) (p < 0.05). In the follow-up study, the MMSE score was lower than baseline in 20 subjects, whereas it was improved or unchanged in 29 patients. The EPA/AA ratio in the stable group was significantly greater than that in the deteriorating group, suggesting an association between higher EPA/AA ratio and cognitive stability over 1 year. The EPA/AA ratio predicted stability of cognitive performance with a sensitivity of 66% and specificity of 70% (odds ratio = 4.43) when the cut-off was 0.67. Conclusion: Our results suggest that serum EPA concentration strongly influences cognitive performances in AD patients. The EPA/AA ratio was a sensitive indicator of cognitive stability in this patient group.

A Cross Sectional Survey on Breast Self Examination Practice, Utilization of Breast Professional Examination, Mammography and Associated Factors in Romagna, Italy

1992 ◽  
Vol 78 (2) ◽  
pp. 98-105 ◽  
Author(s):  
Salvatore Ferro ◽  
Annalisa Caroli ◽  
Oriana Nanni ◽  
Annibale Biggeri ◽  
Angelo Gambi
Keyword(s):  
Breast Disease ◽  
Screening Tests ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Breast Self Examination ◽  
Positive History ◽  
Breast Examination ◽  
History Of ◽  
Self Examination ◽  
The Relationship

In 1988, a cross-sectional survey was carried out in the Romagna region (Italy) to evaluate the association between knowledge of breast pathophysiology and preventive attitudes and screening tests practice for breast cancer. A self-administered questionnaire was distributed to a sample of asymptomatic women aged 20–64 years living in the city of Faenza (Northern Italy). Of the 657 responders, 58 % reported that they practiced breast self-examination; 55% had had a professional breast examination, and only 9 % had had a mammogram as a screening test. Logistic regression analysis (including variables such as age, education, employment) was performed to explore the relationship between screening tests practice and factors associated with their use. Breast self-examination practice (n = 590) was associated with preventive attitudes (aOR = 1.67, 95°/o CI = 1.09–2.53) and with a positive history of breast disease (aOR = 3.48, 95 % CI = 1.72–7.04). Professional breast examination (n = 480) was related to preventive attitudes (aOR = 2.37, 95 % CI = 1.51–3.71), knowledge of breast pathophysiology (aOR = 2.07, 95 % CI = 1.31–3.28), and use of oral contraceptives (aOR = 1.81, 95% CI = 1.12–2.91). Mammography use (n = 540) was associated with preventive attitudes (aOR = 3.08, 95 % CI = 1.40–6.76). The results show an inadequate utilization of screening tests in our population. Breast self-examination is strongly related to a positive history of breast disease, and this could reflect the lack of health educational programs aimed at the general population.

Levels of anxiety and distress following receipt of positive screening tests in Australia’s HPV-based cervical screening programme: a cross-sectional survey

2020 ◽  
Vol 96 (3) ◽  
pp. 166-172 ◽  
Author(s):  
Rachael Helen Dodd ◽  
Olivia Mac ◽  
Julia M L Brotherton ◽  
Erin Cvejic ◽  
Kirsten J McCaffery
Keyword(s):  
Online Survey ◽  
Screening Program ◽  
Cervical Screening ◽  
Screening Tests ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
General Distress ◽  
Hpv Test ◽  
Hpv Screening ◽  
Test Result

ObjectiveFrom December 2017, the Australian National Cervical Screening Program commenced 5 yearly primary human papillomavirus (HPV) screening; one of the first high-income countries to implement primary HPV screening. This study aimed to examine the psychosocial impact of self-reporting testing HPV positive in a sample of women screened since the renewal of the programme.MethodsWomen in Australia aged 25–74 years who reported participating in cervical screening since December 2017 were recruited through an online market research company to complete a cross-sectional survey. The primary outcomes were anxiety and general distress.Results1004 women completed the online survey; 80.9% reported testing HPV negative (HPV−), 6.5% reported testing HPV positive (HPV+) and 12.9% did not know/remember their test result. Women who reported testing HPV+ had significantly poorer psychological outcomes on a range of measures. Those who reported testing HPV+ had higher anxiety scores (53.03 vs 43.58 out of 80, p<0.001), showed more general distress (3.94 vs 2.52 out of 12, p=0.004), concern about their test result (5.02 vs 2.37, p<0.001), expressed greater distress about their test result (7.06 vs 4.74, p<0.001) and cancer worry (quite or very worried 35.4% vs 11.6%, p<0.001) than women who reported testing HPV−. Concern regarding test results was also significantly higher in women who did not know/remember their test result (3.20 vs 2.37, p<0.001) compared with women who reported testing HPV−. Women who reported testing HPV+ had greater knowledge of HPV (9.25 vs 6.62, p<0.001) and HPV testing (2.44 vs 1.30, p<0.001) than women who reported testing HPV−.ConclusionsReceipt of an HPV+ test result was associated with high levels of anxiety and distress, which reached clinical significance. Further work is needed to understand whether distress and concern could be reduced by ensuring all women receive high-quality standardised information with their results or by other interventions.

scholarly journals Utility of MemTrax and Machine Learning Modeling in Classification of Mild Cognitive Impairment

2020 ◽  
Vol 77 (4) ◽  
pp. 1545-1558
Author(s):  
Michael F. Bergeron ◽  
Sara Landset ◽  
Xianbo Zhou ◽  
Tao Ding ◽  
Taghi M. Khoshgoftaar ◽  
...  
Keyword(s):  
Machine Learning ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Performance Metrics ◽  
Early Stage ◽  
Characteristic Curve ◽  
Classification Performance ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
Machine Learning Classification

Background: The widespread incidence and prevalence of Alzheimer’s disease and mild cognitive impairment (MCI) has prompted an urgent call for research to validate early detection cognitive screening and assessment. Objective: Our primary research aim was to determine if selected MemTrax performance metrics and relevant demographics and health profile characteristics can be effectively utilized in predictive models developed with machine learning to classify cognitive health (normal versus MCI), as would be indicated by the Montreal Cognitive Assessment (MoCA). Methods: We conducted a cross-sectional study on 259 neurology, memory clinic, and internal medicine adult patients recruited from two hospitals in China. Each patient was given the Chinese-language MoCA and self-administered the continuous recognition MemTrax online episodic memory test on the same day. Predictive classification models were built using machine learning with 10-fold cross validation, and model performance was measured using Area Under the Receiver Operating Characteristic Curve (AUC). Models were built using two MemTrax performance metrics (percent correct, response time), along with the eight common demographic and personal history features. Results: Comparing the learners across selected combinations of MoCA scores and thresholds, Naïve Bayes was generally the top-performing learner with an overall classification performance of 0.9093. Further, among the top three learners, MemTrax-based classification performance overall was superior using just the top-ranked four features (0.9119) compared to using all 10 common features (0.8999). Conclusion: MemTrax performance can be effectively utilized in a machine learning classification predictive model screening application for detecting early stage cognitive impairment.

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