scholarly journals Evaluation of Available Cognitive Tools Used to Measure Mild Cognitive Decline: A Scoping Review

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3974
Author(s):  
Chian Thong Chun ◽  
Kirsty Seward ◽  
Amanda Patterson ◽  
Alice Melton ◽  
Lesley MacDonald-Wicks
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Test ◽  
Cognitive Tools ◽  
Cognitive Assessments ◽  
Clock Drawing Test ◽  
Online Databases ◽  
Education Levels ◽  
Administration Time ◽  
Different Populations

Cognitive decline is a broad syndrome ranging from non-pathological/age-associated cognitive decline to pathological dementia. Mild cognitive impairment MCI) is defined as the stage of cognition that falls between normal ageing and dementia. Studies have found that early lifestyle interventions for MCI may delay its pathological progression. Hence, this review aims to determine the most efficient cognitive tools to discriminate mild cognitive decline in its early stages. After a systematic search of five online databases, a total of 52 different cognitive tools were identified. The performance of each tool was assessed by its psychometric properties, administration time and delivery method. The Montreal Cognitive Assessment (MoCA, n = 15), the Mini-Mental State Examination (MMSE, n = 14) and the Clock Drawing Test (CDT, n = 4) were most frequently cited in the literature. The preferable tools with all-round performance are the Six-item Cognitive Impairment Test (6CIT), MoCA (with the cut-offs of ≤24/22/19/15.5), MMSE (with the cut-off of ≤26) and the Hong Kong Brief Cognitive Test (HKBC). In addition, SAGE is recommended for a self-completed survey setting whilst a 4-point CDT is quick and easy to be added into other cognitive assessments. However, most tools were affected by age and education levels. Furthermore, optimal cut-off points need to be cautiously chosen while screening for MCI among different populations.

Abstract 19350: The Decline of the Montreal Cognitive Test Can Detect Post-stroke Cognitive Decline Determined by a Formal Neuropsychological Evaluation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kenny Xu ◽  
Catherine Dong ◽  
Christopher Chen
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Screening Tests ◽  
Cognitive Test ◽  
Cognitive Screening ◽  
Post Stroke ◽  
Diagnostic Status ◽  
Cerebrovascular Events ◽  
Moderate Cognitive Impairment ◽  
Ischemic Attack

Objective: We aimed to establish the association of decline in cognitive screening tests scores, the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE), with the decline in neuropsychological diagnostic status from 3-6 months to a year later. Method: Patients with ischemic stroke/ Transient Ischemic Attack (TIA) received the MoCA and MMSE within 14 days after stroke, then 3-6 months and 1 year later. The decline in MoCA and MMSE scores were defined by reduction of 2 points or more in total scores, while stable/improved MoCA scores referred to reduction of MoCA scores less than 2 or improved scores. The decline in neuropsychological diagnostic status was defined by category transition from no cognitive impairment to any cognitive impairment (≥1 domain), from mild cognitive impairment (impairment in 1-2 domains) to moderate cognitive impairment (impairment >2 domains) and dementia (i.e., functional loss associated with cognitive impairment, DSM-IV criteria), as well as from moderate cognitive impairment to dementia. Results: At baseline, most patients were Chinese (70.3%) and males (69.8%) with age of 59.8 ± 11.6 years and education of 7.7 ± 4.3 years. 327 out of 400 stroke/TIA patients completed neuropsychological assessments at 3-6 months and 275 completed at 1 year after their index cerebrovascular events. Of these, 31 (11.3%) had decline in neuropsychological diagnostic status. Logistic regression was used to model the association between probability of decline in neuropsychological diagnostic status and the decline in MMSE or MoCA scores. There were not significant associations between the decline of neuropsychological diagnostic status and the decline in MMSE scores. Controlling baseline MoCA scores and the change scores of MoCA from baseline to 3-6 months, patients with decline in MoCA scores (reduction of 2 points or more) were associated with higher risks of decline in neuropsychological diagnostic status, relative to those with stable/ improved MoCA scores (odd ratio=3.21, p=0.004). Conclusion: The decline in MoCA scores are associated with a higher risks for decline in neuropsychological diagnostic status from 3-6 months to 1 year, therefore may be used to detect post-stroke cognitive decline.

scholarly journals Cognitive training in older adults with Mild Cognitive Impairment: Impact on cognitive and functional performance

2009 ◽  
Vol 3 (2) ◽  
pp. 124-131 ◽  
Author(s):  
Paula Schimidt Brum ◽  
Orestes Vicente Forlenza ◽  
Mônica Sanches Yassuda
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Training ◽  
Functional Performance ◽  
Depression Scale ◽  
Cognitive Test ◽  
Age Related ◽  
The Impact

Abstract Aging is associated with cognitive decline, yet this does not prevent older adults from finding ways to compensate for age-related deficits. Earlier studies have shown that cognitively unimpaired older adults can benefit from training programs. The efficacy of cognitive interventions among older adults without dementia but with cognitive decline (mild cognitive impairment, MCI) has not yet been widely tested. Objectives: To evaluate the impact of 8-session cognitive training on the cognitive and functional performance of older adults with MCI. Methods: 16 older adults diagnosed with MCI received cognitive training (18 participated as controls). All participants were assessed pre and post intervention using the Short Cognitive Test (SKT), Direct Assessment of Functional Scale Revised (DAFS-R), Geriatric Depression Scale (GDS), and Clock Drawing Test (CDT). Results: A significant improvement was observed in the study group between pre and post-test in attention (SKT), time orientation, shopping skills and dealing with finances (DAFS-R) along with reduced depressive symptoms (GDS). Conclusion: These results indicate the importance of non-pharmacological interventions for older adults with MCI to help compensate for cognitive decline.

scholarly journals Vaskularni kognitivni upad in vaskularna demenca

2017 ◽  
Vol 86 (7-8) ◽  
Author(s):  
Klavdija Ovčar ◽  
Jure Potočnik ◽  
Martin Rakuša
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Stroke Prevention ◽  
Healthy Lifestyle ◽  
Correct Diagnosis ◽  
Brain Lesion ◽  
Vascular Cognitive Impairment ◽  
Cognitive Test ◽  
Clinical Criteria

In the developed world, five to ten percent of people older than 65 years have dementia. One fifth of dementia etiologies are due to vascular brain lesions (VaD – vascular dementia). A milder form is called vascular cognitive impairment (VCI). The main clinical criteria for VaD are: 1. cognitive decline verified with standardized cognitive test/scale, 2. evidence of the associated vascular brain lesion, 3. excluded reversible causes of cognitive decline. The main risk factors for VaD are age, atherosclerosis, diabetes and hypertension. They play a key role in pathogenesis of the cognitive impairment. Depending on the damaged brain region, different cognitive domains may be affected with or without other neurological signs. These diversities in the clinical picture challenge the correct diagnosis. Unique feature of VaD is its progression, which can be stopped, if patients receive an appropriate treatment.The treatment of VCI and VaD symptoms is similar to that in Alzheimer’s disease. More importantly, VCI may be slowed down or even stopped with proper secondary stroke prevention and good rehabilitation. The most efficient is primary stroke prevention with healthy lifestyle and treatment of acquired risk factors.

scholarly journals Motor and cognitive decline of healthy elderly and elderly with parkinson’s disease - a cross-sectional study

2020 ◽  
pp. 1-5
Author(s):  
Wildja de Lima Gomes ◽  
Neildja Maria da Silva ◽  
Laize Gabriele Castro Silva ◽  
Ênio Walker Azevedo Cacho ◽  
Roberta de Oliveira Cacho ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Deficit ◽  
Rating Scale ◽  
Cognitive Test ◽  
Measurement Instruments ◽  
Healthy Elderly ◽  
Significant Difference

Background: Parkinson’s disease (PD) was initially described as a movement disorder, however there is now recognition that its clinical features also include non-motor symptoms such as cognitive impairment and dementia, which are frequent even in the early stages of the disease and, especially in the advanced stages. Cognitive deficits in PD include impairments in executive functions, attention, memory, and visuospatial skills. Cognitive impairment may manifest as mild cognitive impairment (MCI) or dementia, in which MCI refers to the stage between normal cognitive functioning and dementia. Factors associated with cognitive dysfunction in PD include advanced age, low schooling, worse motor scores, stiffness, postural instability and increased daytime sleepiness. Objective: To track cognitive decline and to correlate measurement instruments in subjects with PD by comparing them to healthy subjects. Methods: Study conducted at the Faculty of Health Sciences of Trairi / UFRN. The sample consisted of 20 old people (10 healthy elderlies and 10 elderlies with PD). It was applied the socio-demographic record, Unified Parkinson’s Disease Rating Scale (UPDRS II and III), Hoehn & Yahr Scale, Mini Mental State Examination, Leganés Cognitive Test (LCT) and Montreal Cognitive Assessment (MoCA). Results: It was observed cognitive decline in both groups by MoCA (90% of the PD group and 80% of the healthy group), with no statistically significant difference (p=0.10). It was also verified association between UPDRS II and LCT (r= -0.69, p=0.03) and between UPDRS III and LCT (r=-0.66, p=0.04). Conclusion: We found a cognitive deficit in the elderly group with PD, with no significant difference when compared to the healthy elderly. There was an association between motor and cognitive function in subjects with PD. MoCA was more sensitive in the screening of cognitive deficit in subjects with PD.

scholarly journals Resting heart rate variability as a possible marker of cognitive decline

Kinesiology ◽  
2020 ◽  
Vol 52 (1) ◽  
pp. 72-84
Author(s):  
Bernhard Grässler ◽  
Anita Hökelmann ◽  
Richard Halti Cabral
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Nervous System ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Early Stage ◽  
Cognitive Test

Cognition is a major subject to be addressed nowadays due to the increasing number of cognitively affected people in most societies. Because of a lack of pharmaceutical therapies treating cognitive decline, its indicators should be diagnosed before it becomes prevalent. Scientific evidence indicates a relationship between cognition and the nervous system, especially its autonomic part. Heart rate variability (HRV) as an indicator of the autonomic nervous system functioning has been studied as a biological marker for the evaluation of cognitive performance. Therefore, HRV is a possible indicator of cognitive impairment. The aim was to provide a systematic literature review about the association between resting HRV and the cognitive performance. Five cognitive functions were analysed separately: executive functions, memory and learning, language abilities, visuospatial functioning, and processing speed. Furthermore, the global cognitive function evaluated with cognitive test batteries was considered too. An electronic database search was conducted with five databases. Three search fields comprised HRV, cognitive performance, and adult subjects. The final dataset consisted of 27 articles. Significant correlations in each cognitive function were found, except for processing speed, suggesting a positive association between resting HRV and cognitive performance. Mechanisms underlying this association between cardiovascular health and cognition are discussed. For the future, HRV could be used in diagnostics as an indicator of cognitive impairment before symptoms of dementia get apparent. With a timely diagnosis, preventative tools could be initiated at an early stage of dementia.

scholarly journals Chronic kidney disease biomarkers, cognitive impairment and incident dementia in an older healthy cohort

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0005672021
Author(s):  
Anne M. Murray ◽  
Le Thi Phuong Thao ◽  
Joanne Ryan ◽  
Rory Wolfe ◽  
James B. Wetmore ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cognitive Impairment ◽  
Kidney Disease ◽  
Cognitive Decline ◽  
Test Scores ◽  
Older Persons ◽  
Cognitive Test ◽  
Cognitive Tests ◽  
Incident Dementia ◽  
Increased Risk

Background: Chronic kidney disease is a risk factor for cognitive impairment (CI),but reports of individual associations of estimated glomerular filtration rate (eGFR) and albuminuria with CI and incident dementia in healthier older longitudinal populations are lacking. Our goal was to estimate these associations in a large cohort of older healthy persons. Methods: In a longitudinal cohort study of older persons without prior cardiovascular disease, we estimated the associations between baseline eGFR (in mL/min per 1.73 m2) and albuminuria, measured as urine albumin-to-creatinine ratio (UACR, in mg/mmol) and cognitive test scores, declines in cognitive test scores and incident dementia, using adjusted linear and linear mixed models. Cox proportional hazards regression models assessed the association between baseline kidney function and incident CI no dementia (CIND) or dementia at a median of 4.7 years. Results: At baseline, among 18,131 participants, median age was 74 years, eGFR 74 (IQR 63, 84), UACR 0.8 (IQR 0.5, 1.5; (7.1 (4.4- 13.3 mg/g and 56% were female. Baseline eGFR was not associated with performance on any cognitive tests in cross-sectional analysis, nor incident CIND or dementia over median follow-up of 4.7 years. However, baseline UACR ≥ 3 (≥ 26.6 mg/g) was significantly associated with lower baseline scores and larger declines on the Modified Mini Mental State Exam, verbal memory and processing speed tests, and with incident CIND [(hazard ratio, HR, 1.19; 95% confidence interval, CI,1.07 - 1.33)] and dementia (HR 1.32;1.06 - 1.66). Conclusion: Mild albuminuria was associated with worse baseline cognitive function, cognitive decline, and increased risk for incident CIND and dementia. Screening global cognitive tests for older persons with UACR ≥ 3 mg/mmol could identify those at elevated risk of cognitive decline and dementia.

scholarly journals The Clock Drawing Test as a predictor of cognitive decline in non-demented stroke patients

2021 ◽  
Author(s):  
Ilaria Cova ◽  
Francesco Mele ◽  
Federica Zerini ◽  
Laura Maggiore ◽  
Silvia Rosa ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Assessment ◽  
Stroke Patients ◽  
Term Care ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Drawing Test ◽  
Incident Cases

Abstract Background The early detection of patients at risk of post-stroke cognitive impairment (PSCI) may help planning subacute and long-term care. We aimed to determine the predictivity of two screening cognitive tests on the occurrence of mild cognitive impairment or dementia in acute stroke patients. Methods A cognitive assessment within a few days of ischemic or hemorrhagic stroke was performed in patients consecutively admitted to a stroke unit over 14 months by means of the Clock Drawing Test (CDT) and the Montreal Cognitive Assessment-Basic (MoCA-B). Results Out of 191 stroke survivors who were non-demented at baseline, 168 attended at least one follow-up visit. At follow-up (mean duration ± SD 12.8 ± 8.7 months), 28 (18.9%) incident cases of MCI and 27 (18%) cases of dementia were recorded. In comparison with patients who remained cognitively stable at follow-up, these patients were older, less educated, had more comorbidities, a higher score on the National Institutes of Health Stroke Scale (NIHSS) at admission, more severe cerebral atrophy, and lower MoCA-B and CDT scores at baseline. In multi-adjusted (for age, education, comorbidities score, NIHSS at admission and atrophy score) model, a pathological score on baseline CDT (< 6.55) was associated with a higher risk of PSCI at follow-up (HR 2.022; 95% CI 1.025–3.989, p < 0.05) with respect to non-pathological scores. A pathological baseline score on MoCA-B (< 24) did not predict increased risk of cognitive decline at follow-up nor increased predictivity of stand-alone CDT. Conclusion A bedside cognitive screening with the CDT helps identifying patients at higher risk of PSCI.

Memory Processes, Aging, Cognitive Decline, and Neurodegenerative Diseases

2006 ◽  
Vol 11 (4) ◽  
pp. 304-311 ◽  
Author(s):  
Lars-Göran Nilsson
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Neurodegenerative Disease ◽  
Genetic Markers ◽  
Brain Activity ◽  
Memory Performance ◽  
Modeling And Simulations ◽  
Aging And Health ◽  
Explained Variance ◽  
Different Levels

This paper presents four domains of markers that have been found to predict later cognitive impairment and neurodegenerative disease. These four domains are (1) data patterns of memory performance, (2) cardiovascular factors, (3) genetic markers, and (4) brain activity. The critical features of each domain are illustrated with data from the longitudinal Betula Study on memory, aging, and health ( Nilsson et al., 1997 ; Nilsson et al., 2004 ). Up to now, early signs regarding these domains have been examined one by one and it has been found that they are associated with later cognitive impairment and neurodegenerative disease. However, it was also found that each marker accounts for only a very small part of the total variance, implying that single markers should not be used as predictors for cognitive decline or neurodegenerative disease. It is discussed whether modeling and simulations should be used as tools to combine markers at different levels to increase the amount of explained variance.

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