Cognitive impairment related to arterial stiffness in cardiovascular disease patients with severe periodontitis

Severe periodontal disease (SPD) associated with systemic peripheral inflammation, cognitive impairment (CI) and arterial stiffness (AS) has been recognized. The aim of this study was to investigate whether CI and arterial stiffness (AS) occur in cardiovascular disease (CVD) patients with SPD. A crosssectional case-control study included hospitalized patients with CVD. Demographic characteristics, CVD and atherogenic risk factors were recorded. SPD was diagnosed by clinical and radiographic dental examinations. Dental clinical attachment level (CAL) and CAL % were recorded. A Mini-Mental State Examination test (MMSE) assessed cognition, a MMSE score of < 27 was set as the cut-off point of CI; a score ≥ 27 was considered as no CI. Patients were categorized into: MMSE< 27 in the three models. The risk of having MMSE < 27 increased an average of 2.404-fold for each 1-unit increase in PWV. SPD and AS had significant and independent associations on the risk for development CI. MMSE negatively correlated with CAL% (r=0.69) and PWV (r=0.70). PWV positively correlated with CAL% (r=0.67). Serum VCAM-1 levels were higher in SPD with lower MMSE scores. In conclusion, SPD increases the risk of development of cognitive decline in CVD patients. PWV was directly associated with the risk of cognitive decline. These findings denote a significant opportunity to improve periodontal health in order to avert CI in CVD patients.

Download Full-text

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) completion on an acute care ward for the elderly: a brief study of informant characteristics

International Psychogeriatrics ◽

10.1017/s1041610212000415 ◽

2012 ◽

Vol 24 (10) ◽

pp. 1700-1701 ◽

Cited By ~ 1

Author(s):

K. Bloomfield ◽

N. John

Keyword(s):

Cognitive Impairment ◽

Cognitive Decline ◽

The Elderly ◽

Confusion Assessment Method ◽

Assessment Method ◽

Cognitive Screening ◽

Screening Algorithm ◽

Drawing Task ◽

The Uk ◽

State Examination

Over recent years in the UK, emphasis has been placed on appropriate diagnosis and referral of patients with dementia. In guidelines published by the British Geriatrics Society (BGS) and Faculty of Old Age Psychiatrists consensus group (Forsyth et al., 2006), a cognitive screening algorithm was developed, which consists of initial screening for cognitive impairment with the Mini-Mental State Examination (MMSE) and CLOX1 (an executive clock drawing task). If the scores meet cut-off points indicated in the algorithm (MMSE <24 or CLOX1 <11), further assessments with the Confusion Assessment Method (CAM) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) are applied with the aim to differentiate between delirium (CAM positive, IQCODE negative), delirium and chronic impairment (CAM positive, IQCODE positive), or chronic cognitive impairment (CAM negative, IQCODE positive).

Download Full-text

Comparison between the accuracy of Montreal Cognitive Assessment and Mini-Mental State Examination in the detection of mild cognitive impairment

10.21203/rs.3.rs-136185/v1 ◽

2021 ◽

Author(s):

Nayyereh Aminisani ◽

Rasoul alimi ◽

Ali Javadpour ◽

Mohhamad Asghari-Jafarabadi ◽

Mozhgan Jourian ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Mental State ◽

Cognitive Assessment ◽

Mini Mental State Examination ◽

Screening Tools ◽

Montreal Cognitive Assessment ◽

The Impact ◽

State Examination

Abstract Introduction:Ageing can cause major changes in the central nervous system of the body, resulting in cognitive decline and associated disorders. Therefore, there is a growing need for an effective cognitive screening method to enhance the diagnosis of mild cognitive impairments and to prevent occurring dementia and Alzheimer's Disease (AD). Our study aimed to compare the accuracy of MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) while evaluating the independent and interaction effects of age and educational level on these screening tools in a healthy sample.Method: The data for the current study was based on the registration phase of the study during 2016-2018 in Neyshabour Longitudinal Study on Ageing (NeLSA). Both the MoCA and MMSE tests were used to assess cognitive decline among 3326 participants aged 50-94 years of old. The ROC curve analysis and the predictive values were performed to evaluate the diagnostic accuracy of MMSE to discriminate Mild Cognitive Impairment (MCI) from the cognitively healthy adult basis of MoCA scores as a gold test. A two-way ANCOVA was run to examine the effect of Age and Education level on MoCA and MMSE score, while controlling for a gender effect. Data were analyzed using MedCalc Statistical Software version 13.0.6 (MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2014). Results: The chi-square test shows that MoCA ((72% and 90%) significantly (p-value<0.001() classified more persons as cognitively impaired than the MMSE (45.1%), respectively; using a cutoff score of 24 on the MMSE, 23 and 26 on the MoCA. The cut-off point of below 25 yielded the highest Youden J index for the MMSE in discrimination between MCI and healthy basis of MOCA<23 with an AUC of 0.9 (95% CI: 0.89-0.91) and MOCA<26 with an AUC of 0.87 (95% CI: 0.86-0.89). A two-way ANCOVA results show that the effect of education variable on the MMSE and MoCA score is more important than the age variable.Discussion: Although the cut-off scores give a clear indication of the sensitivity and specificity, they are unable to monitor the impact of confounders, which increase the risk of incorrect classification. Taken together, these findings demonstrate the use of demographically adjusted MoCA and MMSE scores that could provide clinicians with a more reliable estimation of the severity of cognitive impairment, thus increasing the instrument's clinical usefulness.

Download Full-text

A Cumulative Muscle Index and Its Parameters for Predicting Future Cognitive Decline: Longitudinal Outcomes of the ASPRA Cohort

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147350 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7350

Author(s):

Ji-Yeon Baek ◽

Eunju Lee ◽

Woo-Jung Kim ◽

Il-Young Jang ◽

Hee-Won Jung

Keyword(s):

Cognitive Impairment ◽

Cognitive Decline ◽

Gait Speed ◽

Working Group ◽

Physical Inactivity ◽

Important Indicator ◽

Longitudinal Outcomes ◽

European Working ◽

Aging Study ◽

State Examination

Sarcopenia and cognitive decline share the major risk factors of physical inactivity; previous studies have shown inconsistent associations. We aimed to identify the association of sarcopenia and its parameters with cognitive decline. The 3-year longitudinal outcomes of 1327 participants from the Aging Study of the Pyeongchang Rural Area (ASPRA) cohort were analyzed. Cognitive performance was evaluated using the Mini-Mental State Examination (MMSE), and sarcopenia was defined by the following: the original and revised Asian Working Group for Sarcopenia (AWGS), the original and revised European Working Group on Sarcopenia in Older People (EWGSOP), and the Cumulative Muscle Index (CMI), a novel index based on the number of impaired domains of sarcopenia. Approximately half of the participants showed meaningful cognitive decline. Sarcopenia by the original EWGSOP and the CMI were associated with cognitive decline. Only the CMI showed consistent predictability for cognitive impairment even with different criteria of the MMSE score (OR 1.23 [1.04–1.46]; OR 1.34 [1.12–1.59]; OR 1.22 [1.01–1.49], using the 1, 2, and 3 cut-off value, respectively). Of the CMI parameters, gait speed was satisfactorily predictive of 3-year cognitive impairment (OR 0.54 [0.30–0.97]). In conclusion, sarcopenia based on the CMI may be predictive of future cognitive impairment. Gait speed was the single most important indicator of cognitive decline.

Download Full-text

Combining functional scales and cognitive tests in screening for mild cognitive impairment at a university-based memory clinic in Brazil

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462008000400008 ◽

2008 ◽

Vol 30 (4) ◽

pp. 346-349 ◽

Cited By ~ 18

Author(s):

Izabella Dutra de Abreu ◽

Paula Villela Nunes ◽

Breno Satler Diniz ◽

Orestes Vicente Forlenza

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Diagnostic Accuracy ◽

Cognitive Decline ◽

Mental State ◽

Mini Mental State Examination ◽

The Elderly ◽

Elderly Subjects ◽

Cognitive State ◽

State Examination

OBJECTIVE: To determine the diagnostic accuracy of the Mini-Mental State Examination combined to the Informant Questionnaire on Cognitive Decline in the Elderly for the identification of mild cognitive impairment. METHOD: 191 elderly subjects were assessed with the Mini-Mental State Examination, and their informants were assessed with the Informant Questionnaire on Cognitive Decline in the Elderly. Subjects were divided into three groups according to their cognitive state (controls: n = 67, mild cognitive impairment: n = 65 and dementia: n = 59), which was ascertained by clinical and neuropsychological evaluation. The diagnostic accuracy of each test in the discrimination of diagnostic groups (mild cognitive impairment vs. controls, mild cognitive impairment vs. dementia and dementia vs. controls) was examined with the aid of ROC curves. We additionally verified if the combination of both tests would increase diagnostic accuracy for mild cognitive impairment and control identification. RESULTS: The combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly scores did not increase the Mini-Mental State Examination diagnostic accuracy in the identification of patients with mild cognitive impairment. CONCLUSIONS: The present data do not warrant the combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly as a sufficient diagnostic tool in the diagnostic screening for mild cognitive impairment.

Download Full-text

Lobar microbleeds are associated with cognitive impairment in patients with lacunar infarction

Scientific Reports ◽

10.1038/s41598-020-73404-6 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Masahiro Nakamori ◽

Naohisa Hosomi ◽

Keisuke Tachiyama ◽

Teppei Kamimura ◽

Hayato Matsushima ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Decline ◽

Mini Mental State Examination ◽

Mmse Score ◽

Univariate Analysis ◽

Lacunar Infarction ◽

Mri Findings ◽

Magnetic Resonance Imaging Mri ◽

State Examination ◽

Periventricular Hyperintensity

Abstract Associations between cognitive decline and cerebral microbleeds (CMBs) have received increasing attention. An association between CMB distribution (deep or lobar) and cognitive decline has been reported, but these findings are controversial. We investigated the association between magnetic resonance imaging (MRI) findings, including CMBs, and cognitive function in patients with first-ever lacunar infarction. We retrospectively included consecutive patients admitted with first-ever lacunar infarction identified by MRI from July 1, 2011, to December 31, 2018. We excluded patients diagnosed with dementia, including strategic single-infarct dementia, before or after the onset of stroke. The Mini-Mental State Examination (MMSE) was performed within 3 days of admission. We searched the records of 273 patients (age 72.0 ± 11.2 years, 95 females). The median MMSE score was 27 (interquartile range 25.5–29). In a univariate analysis, the MMSE score was associated with age, body mass index (BMI), education, dyslipidemia, chronic kidney disease (CKD), periventricular hyperintensity, medial temporal atrophy, lobar CMBs, and mixed CMBs (p < 0.20). The lacunar infarction location was not associated with the MMSE score. In a multivariate analysis of these factors, lobar CMBs (p < 0.001) and mixed CMBs (p = 0.008) were independently associated with the MMSE score. Lobar CMBs were associated with cognitive impairment.

Download Full-text

Association of White Matter Hyperintensity Progression with Cognitive Decline in Patients with Amnestic Mild Cognitive Impairment

Journal of Alzheimer s Disease ◽

10.3233/jad-201451 ◽

2021 ◽

Vol 80 (2) ◽

pp. 877-883

Author(s):

Kentaro Hirao ◽

Fumio Yamashita ◽

Akito Tsugawa ◽

Rieko Haime ◽

Raita Fukasawa ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

White Matter ◽

Cognitive Decline ◽

White Matter Hyperintensity ◽

Final Visit ◽

Amnestic Mci ◽

Entire Duration ◽

Frontal Lobe Function ◽

State Examination

Background: White matter hyperintensities (WMH) on MRI have been reported to increase the risk of conversion from mild cognitive impairment (MCI) to Alzheimer’s disease (AD). However, effects of the progression of WMH on the cognition of patients with MCI remains unclear to date. Objective: To investigate the association between WMH progression and cognitive decline in amnestic MCI patients. Methods: Thirty-eight subjects with amnestic MCI were analyzed prospectively every year for 2 years. Fourteen MCI subjects dropped out on the final visit, and therefore 24 subjects with MCI were analyzed for the entire duration. The volumes of periventricular hyperintensities (PVH) and deep WMH (DWMH) were measured on T2 FLAIR using the 3D-slicer. The associations between PVH/DWMH progression and cognitive decline were investigated. Results: An increase in DWMH volume significantly correlated with changes in Mini-Mental State Examination and category verbal fluency scores, whereas an increase in PVH volume did not correlate with changes in any item. Conclusion: DWMH progression was closely associated with a decline in frontal lobe function and semantic memory, suggesting that WMH progression might affect some AD pathophysiologies in amnestic MCI patients.

Download Full-text

Parietal Fast Sleep Spindle Density Decrease in Alzheimer’s Disease and Amnesic Mild Cognitive Impairment

Neural Plasticity ◽

10.1155/2016/8376108 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 48

Author(s):

Maurizio Gorgoni ◽

Giulia Lauri ◽

Ilaria Truglia ◽

Susanna Cordone ◽

Simone Sarasso ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Healthy Elderly ◽

Density Decrease ◽

State Examination ◽

Maximum Expression ◽

Polysomnographic Recording

Several studies have identified two types of sleep spindles: fast (13–15 Hz) centroparietal and slow (11–13 Hz) frontal spindles. Alterations in spindle activity have been observed in Alzheimer’s disease (AD) and Mild Cognitive Impairment (MCI). Only few studies have separately assessed fast and slow spindles in these patients showing a reduction of fast spindle count, but the possible local specificity of this phenomenon and its relation to cognitive decline severity are not clear. Moreover, fast and slow spindle density have never been assessed in AD/MCI. We have assessed fast and slow spindles in 15 AD patients, 15 amnesic MCI patients, and 15 healthy elderly controls (HC). Participants underwent baseline polysomnographic recording (19 cortical derivations). Spindles during nonrapid eye movements sleep were automatically detected, and spindle densities of the three groups were compared in the derivations where fast and slow spindles exhibited their maximum expression (parietal and frontal, resp.). AD and MCI patients showed a significant parietal fast spindle density decrease, positively correlated with Minimental State Examination scores. Our results suggest that AD-related changes in spindle density are specific for frequency and location, are related to cognitive decline severity, and may have an early onset in the pathology development.

Download Full-text

Periodontal care may improve systemic inflammation

Clinical & Investigative Medicine ◽

10.25011/cim.v30i3.1079 ◽

2007 ◽

Vol 30 (3) ◽

pp. 114 ◽

Cited By ~ 19

Author(s):

Arnon Blum ◽

Eran Front ◽

Aviva Peleg

Keyword(s):

Cardiovascular Disease ◽

Periodontal Disease ◽

Healthy Volunteers ◽

High Sensitivity ◽

Control Group ◽

Probing Depth ◽

Severe Periodontitis ◽

Pre Treatment ◽

Hs Crp ◽

Attachment Level

Background: Periodontitis is an infectious chronic insidious disease of the tooth supporting structures that causes a general inflammatory response. The aims of the study were to determine whether periodontitis is associated with markers of general inflammation high-sensitivity (hs) C-reactive protien (CRP) leading to cardiovascular disease, and whether proper management of the periodontal disease would improve inflammation and thus, may prevent cardiovascular disease in the future. Methods: This was a prospective case-controlled pilot study. Nine patients (3 women, 6 men; 40±5 yr) took part. All had severe periodontitis, without systemic disorders, and were all treated conservativelly without surgical intervention. All had a 2nd visit after 3 months of treatment at the Outpatient Dental Clinic of the Hospital. Periodontal status and hs-CRP were evaluated on entry to the study and 3 months after treatment. Nine age and sex-matched healthy volunteers without periodontal disease served as the control group. Results: Periodontal clinical parameters were improved after 3 months' treatment: probing depth (PD) (mean) at baseline was 4.3 and after 3 months’ treatment improved to 3.2 (P=0.001), clinical attachment level (CAL) (mean) was 4.6 and changed to 3.7 (P=0.01), bleeding on probing (BOP %) changed from 64% to 33% (P=0.001), and Plaque index (Pi) changed from 49% to 25% (P=0.001). hs-CRP level was different between the patients’group (pre treatment) and the healthy volunteers: 2.97±0.58 mg/L vs. 0.25±0.14 mg/L (P=0.00002). After completing 3 months' treatment, hs-CRP levels were decreased from 2.97±0.58 mg/L to 2.3±0.7 mg/L (P=0.009). Conclusions: Periodontitis is an infectious condition that may be an insidious cause of chronic inflammation and may be a risk factor for future cardiovascular disease. Treating periodontitis improved inflammation, and might be used as an important prevention tool for cardiovascular disease.

Download Full-text

Frailty and cognitive impairment among community-dwelling elderly

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130039 ◽

2013 ◽

Vol 71 (6) ◽

pp. 362-367 ◽

Cited By ~ 39

Author(s):

Mariana Asmar Alencar ◽

Joao Marcos Domingues Dias ◽

Luisa Costa Figueiredo ◽

Rosangela Correa Dias

Keyword(s):

Cognitive Impairment ◽

Cognitive Decline ◽

Mini Mental State Examination ◽

Rating Scale ◽

Community Dwelling ◽

Clinical Dementia Rating ◽

Frailty Status ◽

Level Of Activity ◽

Short Period ◽

State Examination

The aim was to evaluate associations between frailty status and cognitive decline and the incidence of cognitive impairment over 12-month period. Two hundred seven older adults were assessed. Frailty was defined as having at least three of the following criteria: weight loss, weakness, exhaustion, slowness, and low level of activity. Cognitive decline was assessed using the Mini Mental State Examination (MMSE) and Clinical Dementia Rating Scale (CDR). Relative risk (RR) was calculated with a 95% confidence interval (CI). Frailty was associated with subsequent cognitive decline in 12-month when assessed using the MMSE (p=;0.005; RR=;4.6; 95%CI 1.93–11.2). No association was found between frailty and cognitive decline measured by the CDR (p=;0.393; RR=;2.1; 95%CI 0.68–6.7) or between frailty and the incidence of cognitive impairment (p=;0.675; RR=;1.2; 95%CI 0.18–8.3). These findings reveal an association between frailty and subsequent cognitive decline when measured by the MMSE, even within a short period of time.

Download Full-text

Serum Daytime Melatonin Levels Reflect Cerebrospinal Fluid Melatonin Levels in Alzheimer’s Disease but Are Not Correlated with Cognitive Decline

Journal of Alzheimer s Disease ◽

10.3233/jad-210562 ◽

2021 ◽

pp. 1-12

Author(s):

Amber Nous ◽

Mandy Melissa Jane Wittens ◽

Yannick Vermeiren ◽

Peter Paul De Deyn ◽

Christine Van Broeckhoven ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cerebrospinal Fluid ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Healthy Controls ◽

Night Time ◽

Cross Sectional ◽

State Examination

Background: Nocturnal cerebrospinal fluid (CSF) and blood melatonin levels are altered in Alzheimer’s disease (AD). However, literature remains inconclusive on daytime blood melatonin levels. A positive correlation between melatonin levels and Mini-Mental State Examination (MMSE) scores in AD subjects has been evidenced following cross-sectional analyses. Whereas a correlation between serum and spinal CSF melatonin has been shown in healthy volunteers, an equal investigation in AD patients still has to be undertaken. Objective: 1) To evaluate whether serum melatonin levels correlate with spinal CSF melatonin levels in AD. 2) To compare daytime CSF and serum melatonin levels between patients with AD dementia, mild cognitive impairment due to AD, and healthy controls, and to evaluate whether melatonin can affect cognitive decline in AD. Methods: Subjects with AD and healthy controls included in two existing cohorts, of whom a CSF and serum sample was available at the neurobiobank and had at least 6 months of neuropsychological follow-up, were included in the present study. Melatonin concentrations were measured with liquid chromatography-mass spectrometry. Results: Daytime serum melatonin levels correlated with spinal CSF melatonin levels in AD (r = 0.751, p < 0.001). No significant differences regarding daytime melatonin levels were found between patients and controls. No correlations were observed between daytime melatonin levels and MMSE score changes. Conclusion: Daytime serum melatonin accurately reflects CSF melatonin levels in AD, raising the possibility to assess melatonin alterations by solely performing blood sampling if also confirmed for night-time values. However, daytime melatonin levels are not associated with changes of cognitive impairment.

Download Full-text