scholarly journals DEVELOPMENT OF THE BRAZILIAN MINI-ADDENBROOKE’S COGNITIVE EXAMINATION (MINI-ACE BR)

2021 ◽  
Author(s):  
Maira Okada De Oliveira ◽  
Maria Carthery- Goulart ◽  
Karolina César Freitas ◽  
Ricardo Nitrini ◽  
Sonia Brucki
Keyword(s):  
Cognitive Impairment ◽  
The Elderly ◽  
Cutoff Score ◽  
Scaling Analysis ◽  
Adequate Treatment ◽  
Cognitively Normal ◽  
Brazilian Version ◽  
Retrograde Memory ◽  
Rapid Tests ◽  
Using Data

Background: Age is the most important risk factor for development of dementia and the recommendation is that the elderly be cognitively tested in order to detect impairment in the initial phase for adequate treatment. The demand for the care of these elderly people is great, drawing attention to the need for rapid tests, with good accuracy and simple application to identify cognitive impairment. Objective: To develop the M-ACE Brazilian version using data from ACE-R deriving sub-items that could better predict the diagnosis of cognitive impairment. Methods: The M-ACE BR was developed using Mokken scaling analysis in 352 participants (cognitively normal = 232, cognitive impairment no dementia (CIND) = 82 and dementia = 38) and validated in an independent sample of 117 participants (cognitively normal = 25, CIND = 88 and dementia = 4). Results: The M-ACE BR has nine items (spatial orientation, anterograde memory, retrograde memory, delayed recall, recognition, verbal fluency letter “P”, repetition of four words, naming 10 items and comprehension) with a max. score of 51 points and average duration time of seven minutes. The cutoff score ≤43/51 for CIND had a sensitivity of 59.09% and a specificity of 80%. For a screening test in which sensitivity is prioritized for further investigation, we suggest using a cutoff of ≤47 (sensitivity 85.23% and specificity 24%), maintaining a good positive predictive value (79.8%) Conclusion: The M-ACE BR is a brief and adequate instrument for detecting cognitive impairment in elderly Brazilians.

Addenbrooke's cognitive examination-revised: normative and accuracy data for seniors with heterogeneous educational level in Brazil

2017 ◽  
Vol 29 (8) ◽  
pp. 1345-1353 ◽  
Author(s):  
Karolina G. César ◽  
Mônica S. Yassuda ◽  
Fabio H. G. Porto ◽  
Sonia M. D. Brucki ◽  
Ricardo Nitrini
Keyword(s):  
Cognitive Impairment ◽  
Educational Level ◽  
Cognitive Tools ◽  
Data Set ◽  
Cognitively Normal ◽  
Brazilian Version ◽  
Lower Education ◽  
Accuracy Data ◽  
Population Segment ◽  
Addenbrooke’S Cognitive Examination

ABSTRACTBackground:Several cognitive tools have been developed aiming to diagnose dementia. The cognitive battery Addenbrooke's Cognitive Examination – Revised (ACE-R) has been used to detect cognitive impairment; however, there are few studies including samples with low education. The aim of the study was to provide ACE-R norms for seniors within a lower education, including illiterates. An additional aim was to examine the accuracy of the ACE-R to detect dementia and cognitive impairment no dementia (CIND).Methods:Data originated from an epidemiological study conducted in the municipality of Tremembé, Brazil. The Brazilian version of ACE-R was applied as part of the cognitive assessment in all participants. Of the 630 participants, 385 were classified as cognitively normal (CN) and were included in the normative data set, 110 individuals were diagnosed with dementia, and 135 were classified as having CIND.Results:ACE-R norms were provided with the sample stratified into age and education bands. ACE-R total scores varied significantly according to age, education, and sex. To distinguish CN from dementia, a cut-off of 64 points was established (sensitivity 91%, specificity 76%) and to differentiate CN from CIND the best cut-off was 69 points (sensitivity 73%, specificity 65%). Cut-off scores varied according to the educational level.Conclusions:This study offers normative and accuracy parameters for seniors with lower education and it should expand the use of the ACE-R for this population segment.

scholarly journals Untreated Depressive Symptoms Significantly Worsen Quality of Life of the Elderly and may Lead to the Misdiagnosis of Dementia: A Cross-Sectional Study

2020 ◽  
Author(s):  
Viktor Voros ◽  
Sandor Fekete ◽  
Tamas Tenyi ◽  
Zoltan Rihmer ◽  
Ilona Szili ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Early Recognition ◽  
The Elderly ◽  
Screening Tools ◽  
Adequate Treatment

Abstract Background: Several studies demonstrated the role of depressive mood and cognitive impairment in the background of elevated mortality and decreased Quality of Life (QoL) of the elderly.Methods: In the framework of the ICT4Life project self-administered questionnaires and clinical screening tools were used to assess QoL, depressive symptoms and cognitive functions of 60 elderly over the age of 65.Results: Males found to be depressed and cognitively declined more frequently; and had higher scores on the depression and lower on the QoL scales. Depressed elderly had lower cognitive levels and their QoL was significantly poorer than that of the non-depressed subjects. Depressive disorders were detected in a quarter of the elderly, and the majority of them did not receive adequate antidepressant medication.Conclusions: Close correlation between depression and cognitive impairment was confirmed, as well as the key role of depression in the background of QoL decline. Results also highlighted the problems of recognition and adequate treatment of depression and cognitive decline in elderly, which can be further complicated by the common symptoms of depressive pseudo-dementia. Early recognition of depressive symptoms is important not only to treat the underlying mood disorder, but also to improve QoL of the elderly.

Validation of the Chinese version of the memory binding test for distinguishing amnestic mild cognitive impairment from cognitively normal elderly individuals

2019 ◽  
Vol 31 (12) ◽  
pp. 1721-1730 ◽  
Author(s):  
Xiao Wang ◽  
Tao Li ◽  
Haifeng Zhang ◽  
Tingting Sun ◽  
Lingchuan Xiong ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Convergent Validity ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Chinese Version ◽  
Cutoff Score ◽  
Cognitively Normal ◽  
Elderly Individuals ◽  
Memory Binding

ABSTRACTBackground:Episodic memory starts to decline very early in the development of Alzheimer’s disease (AD). Subtle impairments in memory binding may be detected in mild cognitive impairment (MCI). This study aims to examine the psychometric properties of the Chinese version of the memory binding test (MBT).Methods:One hundred and sixty-four subjects (26 individuals with AD, 67 individuals with amnestic MCI (aMCI), 30 individuals with subjective cognitive impairment (SCI), and 41 cognitively normal elderly individuals (NC)) participated in the study. Twenty-two subjects repeated the assessment of the MBT within 6 weeks (± 2 weeks). Pearson correlation was used to calculate the convergent validity. The test––retest reliability was determined by the calculation of the intraclass correlation coefficient (ICC). Discriminative validity was calculated to evaluate the receiver–operating characteristic curves. The optimal index was chosen by comparing the area under the curve for specificity and sensitivity ≥ 0.80. The optimal cutoff score of the index was chosen to maximize the sum of sensitivity and specificity.Results:The absolute value of the convergent validity of the direct indexes of MBT ranged from 0.443 to 0.684. The ICC for each of direct indexes was 0.887–0.958. Total delayed paired recall (TDPR) was the optimal index for discriminating aMCI from NC. The cutoff score for TDPR was ≤25 to distinguish aMCI from NC (sensitivity = 0.896, specificity = 0.707).Conclusion:The Chinese version of MBT is a valid and reliable instrument to detect MCI.

An abbreviated version of Silhouettes test: a brief validated mild cognitive impairment screening tool

2018 ◽  
Vol 31 (06) ◽  
pp. 849-856
Author(s):  
Lin Huang ◽  
Ke-Liang Chen ◽  
Bi-Ying Lin ◽  
Le Tang ◽  
Qian-Hua Zhao ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Space Perception ◽  
The Elderly ◽  
Cognitive Test ◽  
Visual Object ◽  
Neuropsychological Battery ◽  
Cross Sectional ◽  
Chinese Elderly ◽  
Cognitively Normal

ABSTRACTObjectives:To revise an abbreviated version of the Silhouettes subtest of the Visual Object and Space Perception (VOSP) battery in order to recognize mild cognitive impairment (MCI) and determine the optimal cutoffs to differentiate among cognitively normal controls (NC), MCI, and Alzheimer’s Disease (AD) in the Chinese elderly.Design:A cross-sectional validation study.Setting:Huashan Hospital, Shanghai, China.Subjects:A total of 591 participants: Individuals with MCI (n = 211), AD (n = 139) and NC (n = 241) were recruited from the Memory Clinic, Huashan Hospital, Shanghai, China.Methods:Baseline neuropsychological battery (including VOSP) scores were collected from firsthand data. An abbreviated version of silhouettes test (Silhouettes-A) was revised from the original English version more suitable for the elderly, including eight silhouettes of animals and seven silhouettes of inanimate objects, with a score ranging from 0 to 15.Results:Silhouettes-A was an effective test to screen MCI in the Chinese elderly with good sensitivity and specificity, similar to the Montreal cognitive assessment and superior to other single tests reflecting language, spatial, or executive function. However, it had no advantage in distinguishing MCI from AD. The corresponding optimal cutoff scores of Silhouettes-A were 10 for screening MCI and 8 for AD.Conclusion:Silhouettes-A is a quick, simple, sensitive, and dependable cognitive test to distinguish among NC, MCI, and AD patients.

scholarly journals Risk and Protective Factors for the Onset of Cognitive Impairment in Korea: A 10-Year Longitudinal Panel Study

2020 ◽  
Vol 17 (8) ◽  
pp. 769-776
Author(s):  
Yujin Kim
Keyword(s):  
Cognitive Impairment ◽  
Protective Factors ◽  
Panel Study ◽  
Population Based ◽  
Cognitively Normal ◽  
Exercise Participation ◽  
Modifiable Factors ◽  
Nationally Representative ◽  
Using Data ◽  
Observation Period

Objective This study aimed to examine the associations between multiple modifiable risk/protective factors and the onset of cognitive impairment, using nationally representative panel data spanning 10 years.Methods A total of 7,568 respondents who were cognitively normal at baseline were included and followed up for 10 years using data from the 2006–2016 Korean Longitudinal Study of Ageing. The data were converted into 28,113 person-year observations, and a life table approach and a series of event history models were used to estimate the transition rates to cognitive impairment over time and to examine the influence of time-varying factors on the onset of cognitive impairment. Cognitive impairment was measured using the Korean version of the Mini-Mental State Exam.Results About half of the respondents without cognitive impairment at baseline had experienced cognitive impairment by the end of the last interview, and women were more likely than men to experience cognitive impairment during the observation period. Vascular risk factors, hearing loss, socioeconomic status, regular exercise, participation in social activities, and frequent contact with close friends were significantly associated with the onset of cognitive impairment.Conclusion This investigation of modifiable factors for cognitive impairment using population-based data may lead to the identification of preventive strategies that people could integrate into their lifestyles.

Informant questionnaire on cognitive decline in the elderly (IQCODE) for classifying cognitive dysfunction as cognitively normal, mild cognitive impairment, and dementia

2017 ◽  
Vol 29 (9) ◽  
pp. 1461-1467 ◽  
Author(s):  
Moon Ho Park
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Dysfunction ◽  
Roc Curve ◽  
Roc Curves ◽  
The Elderly ◽  
Youden Index ◽  
Cognitively Normal ◽  
Dichotomous Classification

ABSTRACTBackground:The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) is a reliable, validated informant-based instrument in screening for cognitive dysfunction. However, previous studies have evaluated only the ability to discriminate dichotomously, such as dementia from cognitively normal (CN) individuals or mild cognitive impairment (MCI) from CN. This study investigated the ability of the IQCODE to classify not only dichotomous but also multiple stages of cognitive dysfunction.Methods:We examined 228 consecutive participants (76 CN, 76 with MCI, and 76 with dementia). Receiver operating characteristic (ROC) curves determined dichotomous classification parameters. Multi-category ROC surfaces were evaluated to classify three stages of cognitive dysfunction.Results:Dichotomous classification using the ROC curve analyses showed that the area under the ROC curve was 0.91 for dementia from participants without dementia and 0.71 for MCI from CN. Simultaneous multi-category classification analyses showed that the volume under the ROC surface was 0.61 and the derived optimal cut-off points were 3.15 and 3.73 for CN, MCI, and dementia. The Youden index for the IQCODE was estimated as 0.51 and the derived optimal cut-off points were 3.33 and 3.70. The overall classification accuracy by the VUS was 58.3% and that by the Youden index 61.8%.Conclusions:IQCODE is useful to classify the dichotomous and multi-category stages of cognitive dysfunction.

scholarly journals Optimal Cutoff Scores for Dementia and Mild Cognitive Impairment in the Brazilian Version of the Montreal Cognitive Assessment among the Elderly

2019 ◽  
Vol 9 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Tiago C.C. Pinto ◽  
Marília S.P. Santos ◽  
Leonardo Machado ◽  
Tatiana M. Bulgacov ◽  
Antônio L. Rodrigues-Junior ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Elderly People ◽  
Roc Curve ◽  
Cognitive Assessment ◽  
The Elderly ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Brazilian Version ◽  
Cutoff Scores

Objective: To propose cutoff scores for the Brazilian version of the Montreal Cognitive Assessment (MoCA-BR) stratified by education in order to detect mild cognitive impairment (MCI) and mild Alzheimer’s disease (AD) in the elderly. Method: A transversal study in health centers was performed on 159 elderly people with 4–12 years of education and 70 of their peers with over 12 years of schooling. The MoCA-BR cutoff scores for screening cognitive impairment were determined based on an ROC curve analysis. Results: The ROC curve analysis indicated that cutoff scores under 20 were good for screening elderly people with cognitive impairment with more than 12 years of education, and scores under 21 were good for screening those with 4–12 years of education. Conclusions: MoCA-BR scores under 21 points (after adding 1 point to the elderly with ≤12 years of education) indicate a need to continue the diagnostic investigation with regular follow-ups.

scholarly journals MoCA Test: normative and diagnostic accuracy data for seniors with heterogeneous educational levels in Brazil

2019 ◽  
Vol 77 (11) ◽  
pp. 775-781 ◽  
Author(s):  
Karolina G. Cesar ◽  
Mônica S. Yassuda ◽  
Fabio H. G. Porto ◽  
Sonia M. D. Brucki ◽  
Ricardo Nitrini
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Education Level ◽  
Cutoff Score ◽  
Good Tool ◽  
Data Set ◽  
Cognitively Normal ◽  
Lower Education Level ◽  
Accuracy Data ◽  
Lower Cutoff

ABSTRACT The Montreal Cognitive Assessment (MoCA) has been described as a good tool to detect cognitive impairment. The ideal MoCA cutoff score is still under debate. The aim was to provide MoCA norms and accuracy data for seniors with a lower education level, including illiterates. Methods: Data originated from an epidemiological study conducted in the municipality of Tremembe, Brazil. The Brazilian MoCA test was applied as part of the cognitive assessment in all participants. Of the 630 participants, 385 were classified as cognitively normal (CN) and were included in the normative data set, 110 individuals were diagnosed with dementia and 135 were classified as having cognitive impairment no dementia (CIND). Results: The total scores varied significantly according to age and education among the three diagnostic groups: CN, CIND and dementia (p < 0.001). To distinguish participants with CN from dementia, the best MoCA cutoff was 15 points (sensitivity 90%, specificity 77%) and to differentiate those with CN from CIND, the MoCA cutoff was 19 points (sensitivity 84%, specificity 49%). Those scores varied according to education level. Conclusions: The MoCA test did not have a high accuracy for detecting CIND in the population with a low educational level. Nevertheless, this tool may be used to detect dementia, especially in individuals with more than five years of education, if a lower cutoff score is adopted.

scholarly journals Stroke occurring in patients with cognitive impairment or dementia

2017 ◽  
Vol 75 (2) ◽  
pp. 117-121 ◽  
Author(s):  
Solène Moulin ◽  
Didier Leys
Keyword(s):  
Cognitive Impairment ◽  
Systematic Approach ◽  
Stroke Care ◽  
The Elderly ◽  
Mortality Rates ◽  
Brain Lesions ◽  
Optimal Management ◽  
Cognitively Normal ◽  
Search Results ◽  
Mixed Origin

ABSTRACT One in six patients admitted for stroke was previously demented. These patients have less access to appropriate stroke care, although little is known about their optimal management. Objective To determine how pre-stroke cognitive impairment can be detected, its mechanism, and influence on outcome and management. Methods Literature search. Results (i) A systematic approach with the Informant Questionnaire of Cognitive Decline in the Elderly is recommended; (ii) Pre-stroke cognitive impairment may be due to brain lesions of vascular, degenerative, or mixed origin; (iii) Patients with pre-stroke dementia, have worse outcomes, more seizures, delirium, and depression, and higher mortality rates; they often need to be institutionalised after their stroke; (iv) Although the safety profile of treatment is not as good as that of cognitively normal patients, the risk:benefit ratio is in favour of treating these patients like others. Conclusion Patients with cognitive impairment who develop a stroke have worse outcomes, but should be treated like others.

Sign in / Sign up

Export Citation Format

Share Document