scholarly journals Utility of olfactory identification test for screening of cognitive dysfunction in community-dwelling older adults

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12656
Author(s):  
Satoshi Nogi ◽  
Kentaro Uchida ◽  
Jumpei Maruta ◽  
Hideo Kurozumi ◽  
Satoshi Akada ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Dysfunction ◽  
Screening Test ◽  
Test Score ◽  
Community Dwelling ◽  
Cognitively Impaired ◽  
Healthy Group ◽  
Olfactory Identification ◽  
Impaired Group ◽  
Identification Test

Background There is a need for a large-scale screening test that can be used to detect dementia in older individuals at an early stage. Olfactory identification deficits have been shown to occur in the early stages of dementia, indicating their usefulness in screening tests. This study investigated the utility of an olfactory identification test as a screening test for mild cognitive dysfunction in community-dwelling older people. Methods The subjects were city-dwelling individuals aged over 65 years but under 85 years who had not been diagnosed with dementia or mild cognitive impairment. The Japanese version of the Mild Cognitive Impairment Screen was used to evaluate cognitive function. Based on the results, the subjects were divided into two groups: healthy group and cognitively impaired group. Olfactory identification abilities based on the Japanese version of the University of Pennsylvania Smell Identification Test were compared between the groups. Results There were 182 participants in total: 77 in the healthy group and 105 in the cognitively impaired group. The mean olfactory identification test score of the cognitively impaired group was significantly lower than that of the healthy group. The cognitive impairment test score was significantly correlated with the olfactory identification test score. Conclusions Cross-sectional olfactory identification deficits at baseline in community-dwelling older adults reflected cognitive dysfunction. Assessing olfactory identification ability might be useful as a screening test for mild cognitive dysfunction in community-dwelling older people.

scholarly journals 122 Use of Pimavanserin in Patients With Parkinson’s Disease Psychosis: Subgroup Analysis of Efficacy and Safety in Patients With and Without Cognitive Impairment

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 77-77 ◽  
Author(s):  
Daniel Weintraub ◽  
James Norton ◽  
Bruce Coate ◽  
Candace Andersson ◽  
Doral Fredericks ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Subgroup Analysis ◽  
Serotonin Receptor ◽  
Mmse Score ◽  
Cognitively Impaired ◽  
Efficacy And Safety ◽  
Impaired Group ◽  
Moca Score

AbstractObjectiveA planned subgroup analysis of a phase 3 study was performed to evaluate the efficacy and safety of pimavanserin (PIM) in Parkinson’s disease psychosis (PDP) patients withglobal cognitive impairment.BackgroundPDP is frequent, distressing, a leading cause of institutionalization, complicates PD management and is linked to increased morbidity, incident dementia and mortality. PIM, a selective serotonin receptor (5-HT2A) inverse agonist/antagonist, is newly FDA-approved for the treatment of hallucinations and delusions associated with PDP.MethodsIn Study 020, a 6-week FDA registration study, 199 patients with baseline Mini-Mental State Examination (MMSE) score ≥21, moderate-severe psychosis, and on stable PD meds, were randomized to PIM (34 mg/day) or placebo (PBO) for 6 weeks. This subgroup analysis evaluates efficacy and safety between two groups: those with MMSE total score ≥21 but <25 (cognitively impaired; equivalent to Montreal Cognitive Assessment [MoCA] score 15-19) and those with score ≥25 (cognitively normal; equivalent to MoCA score 20-30). Safety assessments were performed on the full safety dataset (i.e., three 6-week placebo-controlled studies) including 614 subjects (PIM=382, PBO=231).ResultsOverall, patients in the PIM group experienced a statistically significant improvement in SAPS-PD scores from baseline to Day 43 compared with PBO (-5.79 vs. -2.73; p=0.001). In the subgroup analysis stratifying by baseline MMSE score, the change from baseline to Day 43 compared with PBO in the cognitively-impaired group (N=50) was numerically larger (-7.11 vs. -0.47; p=0.002). In the full safety dataset examining cognitively impaired patients, there were no between-group (PIM vs. PBO) differences in any treatment-emergent adverse event (TEAE) (57.6% vs. 56.1%) or serious TEAE (6.8% vs. 5.3%). The most common TEAEs occurring at ≥5% in either group were fall (7.4% vs.10.5%), confusional state (6.5% vs.1.8%), and orthostatic hypotension (0.0% vs. 8.8%).ConclusionsIn this subgroup analysis of PDP patients, the treatment effect of PIM on SAPS-PD was larger in the cognitively-impaired group, with similar TEAE and serious TEAE rates. These results hold promise for cognitively-impaired patients that will be further elucidated in future studies.Funding AcknowledgementsClinical study was funded by ACADIA Pharmaceuticals Inc.

scholarly journals Cognitive Impairment, Sexual Activity and Physical Tenderness in Community-Dwelling Older Adults: A Cross-Sectional Exploration

Gerontology ◽  
2018 ◽  
Vol 64 (6) ◽  
pp. 589-602 ◽  
Author(s):  
Rosanne Freak-Poli ◽  
Silvan Licher ◽  
Joanne Ryan ◽  
M. Arfan Ikram ◽  
Henning Tiemeier
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cognitive Functioning ◽  
Sexual Activity ◽  
Community Dwelling ◽  
Cognitively Impaired ◽  
Cross Sectional ◽  
Partner Status ◽  
Weak Evidence ◽  
Community Dwelling Older Adults

Background: The ability to engage in sexual activity and better cognitive functioning are both associated with better health. However, the association between cognitive functioning and sexual activity is understudied. Objective: To examine the association between cognitive functioning with sexual activity and physical tenderness among community-dwelling older adults. Methods: From the Rotterdam Study, cognitive impairment and sexual activity were assessed in 4,201 community-dwelling, 60+ year olds between 2008 and 2014 in the Netherlands. Mild cognitive impairment (MCI) was based upon subjective complaints related to age and education-adjusted test scores. Mini-Mental State Examination (MMSE) impairment was defined by a score of < 26. Sexual activity and physical tenderness (e.g., fondling or kissing) in the last 6 months were assessed at an interview. Analyses were stratified by gender and partner status, with prevalence rates for the “no impairment” categories weighted based on age from the cognitive impairment categories. Inter-rater reliability was examined utilising 74 cohabiting couples of opposite gender. Results: It was found that 14% were categorised as having cognitive impairment, and < 1% as dementia (excluded from subsequent analyses). There was strong evidence that the odds of engaging in physical tenderness (observed through MMSE < 26, OR 2.14, 95% CI 1.32–3.48, p = 0.002) and sexual activity (MCI, OR 2.36, 95% CI 1.35–4.12, p = 0.003) among partnered females with no impairment was twice that observed among cognitively impaired partnered females. There was weak evidence that the odds of engaging in physical tenderness (MMSE < 26, OR 1.59, 95% CI 1.04–2.42, p = 0.03) and sexual activity (MMSE < 26, OR 1.51, 95% CI 1.02–2.24, p = 0.04) among partnered males with no impairment was 50% greater than observed among cognitively impaired partnered males. The associations between cognitive functioning and physical tenderness continued to remain after adjustment for physical function, diabetes, cardiovascular disease and cancer. There was no clear evidence of a difference between amnestic and non-amnestic MCI for sexual behaviour. There was moderate to substantial agreement among the coupled adults who had 1 partner categorised with MCI. Conclusion: Having no cognitive impairment was associated with more engagement in sexual activity and physical tenderness among community-dwelling older adults. Sexuality is an important aspect of active aging and our findings illustrate a potential barrier to maintaining or instigating intimate relationships as we age. Longitudinal analyses are required to explore the direction of effect.

scholarly journals Deep Learning-Based Screening Test for Cognitive Impairment Using Basic Blood Test Data for Health Examination

2020 ◽  
Vol 11 ◽  
Author(s):  
Kaoru Sakatani ◽  
Katsunori Oyama ◽  
Lizhen Hu
Keyword(s):  
Deep Learning ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Patient Group ◽  
Screening Test ◽  
Blood Test ◽  
Metabolic Disorders ◽  
Ground Truth ◽  
Health Examination ◽  
Healthy Group

Background: In order to develop a new screening test of cognitive impairment, we studied whether cognitive function can be estimated from basic blood test data by applying deep learning models. This model was constructed based on the effects of systemic metabolic disorders on cognitive function.Methods: We employed a deep neural network (DNN) to predict cognitive function based on subject's age and blood test items (23 items). We included 202 patients (73.48 ± 13.1 years) with various systemic metabolic disorders for training of the DNN model, and the following groups for validation of the model: (1) Patient group, 65 patients (73.6 ± 11.0 years) who were hospitalized for rehabilitation after stroke; (2) Healthy group, 37 subjects (62.0 ± 8.6 years); (3) Health examination group, 165 subjects (54.0 ± 8.6 years) admitted for a health examination. The subjects underwent the Mini-Mental State Examination (MMSE).Results: There were significant positive correlations between the predicted MMSE scores and ground truth scores in the Patient and Healthy groups (r = 0.66, p &lt; 0.001). There were no significant differences between the predicted MMSE scores and ground truth scores in the Patient group (p &gt; 0.05); however, in the Healthy group, the predicted MMSE scores were slightly, but significantly, lower than the ground truth scores (p &lt; 0.05). In the Health examination group, the DNN model classified 94 subjects as normal (MMSE = 27–30), 67 subjects as having mild cognitive impairment (24–26), and four subjects as having dementia (≤ 23). In 37 subjects in the Health examination group, the predicted MMSE scores were slightly lower than the ground truth MMSE (p &lt; 0.05). In contrast, in the subjects with neurological disorders, such as subarachnoid hemorrhage, the ground truth MMSE scores were lower than the predicted scores.Conclusions: The DNN model could predict cognitive function accurately. The predicted MMSE scores were significantly lower than the ground truth scores in the Healthy and Health examination groups, while there was no significant difference in the Patient group. We suggest that the difference between the predicted and ground truth MMSE scores was caused by changes in atherosclerosis with aging, and that applying the DNN model to younger subjects may predict future cognitive impairment after the onset of atherosclerosis.

scholarly journals Relationship between Olfactory Identification Test and Cognitive Function in a Community-dwelling Population in Japan

2021 ◽  
Vol 60 (4) ◽  
pp. 509-515
Author(s):  
Yuki Mikuniya ◽  
Reiko Kudo ◽  
Kazutaka Yamauchi ◽  
Naomi Kudo ◽  
Akira Sasaki ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Community Dwelling ◽  
Olfactory Identification ◽  
Identification Test

A Safe Mobilisation Program to Improve Functional Mobility and Reduce Fall Risks in Cognitively Impaired Older Adults with Higher Level Gait Disorders: A Pilot Study

2021 ◽  
pp. 1-8
Author(s):  
Weihong Zhang ◽  
Lee-Fay Low ◽  
Josephine Diana Gwynn ◽  
Alexander Harry Beveridge ◽  
Elizabeth Harper ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Intervention Program ◽  
Community Dwelling ◽  
Gait Disorders ◽  
Functional Mobility ◽  
Cognitively Impaired ◽  
Post Intervention ◽  
Mobility Assessment ◽  
Fall Risks

<b><i>Background:</i></b> The association between gait and cognition, and their combined impact on postural stability may underlie the increased fall risk in older adults with dementia. However, there are few interventions to improve functional mobility and reduce fall risks in people with cognitive impairment. <b><i>Objectives:</i></b> This study aims to investigate the feasibility and acceptability of a Safe Mobilisation Program for cognitively impaired older adults with higher level gait disorders. It also explores the potential effectiveness of the program on mobility and fall risks. <b><i>Methods:</i></b> Fifteen community-dwelling older adults participated in a 3-week pre-post intervention study. They were trained to take steady steps in transfers and mobilization using errorless learning and spaced retrieval teaching techniques. <b><i>Results:</i></b> The intervention program was feasible, all the participants completed the program and were able to mobilize safely. The program was acceptable and participants reported an increase in safety awareness, improvement in confidence while transferring and mobilising, and better quality of life. There was a trend of improvement in Falls Efficacy Scale-international (FES-I), 360° turn and Tinetti Performance Oriented Mobility Assessment (POMA), which may indicate improvement in balance and mobility. <b><i>Conclusion:</i></b> The Safe Mobilisation Program was feasible and acceptable in older adults with cognitive impairment and gait disorders and warrants further evaluation.

Cognitive Dysfunction and Gait Abnormalities in CKD

2021 ◽  
pp. CJN.16091020
Author(s):  
Melanie J. Koren ◽  
Helena M. Blumen ◽  
Emmeline I. Ayers ◽  
Joe Verghese ◽  
Matthew K. Abramowitz
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Confidence Interval ◽  
Cognitive Dysfunction ◽  
Gray Matter ◽  
Community Dwelling ◽  
Gray Matter Atrophy ◽  
Gait Abnormalities

Background and objectivesCognitive impairment is a major cause of morbidity in CKD. We hypothesized that gait abnormalities share a common pathogenesis with cognitive dysfunction in CKD, and therefore would be associated with impaired cognitive function in older adults with CKD, and focused on a recently defined gait phenotype linked with CKD.Design, setting, participants, & measurementsGait assessments and neuropsychological testing were performed in 312 nondisabled, community-dwelling older adults (aged ≥65 years). A subset (n=115) underwent magnetic resonance imaging. The primary cognitive outcome was the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) total scale score. Associations with cognitive function were tested using multivariable linear regression and nearest-neighbor matching. The risk of developing mild cognitive impairment syndrome was assessed using Cox proportional hazards models.ResultsLower eGFR was associated with lower RBANS score only among participants with the gait phenotype (P for interaction =0.04). Compared with participants with neither CKD nor the gait phenotype, adjusted RBANS scores were 5.4 points (95% confidence interval, 1.8 to 9.1) lower among participants with both, who demonstrated poorer immediate memory, visuospatial ability, delayed memory, and executive function. In a matched analysis limited to participants with CKD, the gait phenotype was similarly associated with lower RBANS scores (−6.9; 95% confidence interval, −12.2 to −1.5). Neuroimaging identified a pattern of gray matter atrophy common to both CKD and the gait phenotype involving brain regions linked with cognition. The gait phenotype was associated with higher risk of mild cognitive impairment (hazard ratio, 3.91; 95% confidence interval, 1.46 to 10.44) independent of eGFR.ConclusionsThe gait phenotype was associated with poorer function in a number of cognitive domains among older adults with CKD, and was associated with incident mild cognitive impairment independent of eGFR. CKD and the gait phenotype were associated with a shared pattern of gray matter atrophy.

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 Exploring Language Learning as a Potential Tool against Cognitive Impairment in Late-Life Depression: Two Meta-Analyses and Suggestions for Future Research

2020 ◽  
Vol 10 (9) ◽  
pp. 132
Author(s):  
Jelle Brouwer ◽  
Floor van den Berg ◽  
Remco Knooihuizen ◽  
Hanneke Loerts ◽  
Merel Keijzer
Keyword(s):  
Cognitive Impairment ◽  
Foreign Language ◽  
Language Learning ◽  
Cognitive Dysfunction ◽  
Foreign Language Learning ◽  
Late Life ◽  
Community Dwelling ◽  
Future Research ◽  
Late Life Depression ◽  
Meta Analyses

Late-life depression (LLD) affects about an eighth of community-dwelling seniors. LLD impacts well-being, with loneliness and small social networks being typical. It has also been linked to cognitive dysfunction and an increased risk of developing dementia. Safety and efficacy of pharmacological treatments for LLD have been debated, and cognitive dysfunction often persists even after remission. Various cognitive interventions have been proposed for LLD. Among these, one has received special attention: foreign language learning could serve as a social intervention that simultaneously targets brain structures affected in LLD. Lifelong bilingualism may significantly delay the onset of cognitive impairment symptoms by boosting cognitive reserve. Even late-life foreign language learning without lifelong bilingualism can train cognitive flexibility. It is then counterintuitive that the effects of language learning on LLD have never been examined. In order to create a theoretical basis for further interdisciplinary research, this paper presents a status quo of current work through two meta-analyses investigating cognitive functioning in LLD on the one hand and in senior bilinguals or seniors following a language course on the other hand. While LLD was consistently associated with cognitive dysfunction, inconsistent results were found for bilingualism and language learners. Possible reasons for this and suggestions for future research are subsequently discussed.

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