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Sahoo S, Kale A, Basu D, Minz RW. Is there any association between cognitive deficits and immune markers in Acute and Transient psychotic disorders? A pilot study. Asian J Psychiatr 2023; 89:103754. [PMID: 37666028 DOI: 10.1016/j.ajp.2023.103754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/08/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND There are studies to support association between immune function and cognition in patients with schizophrenia (SZ). However, there are no such study which had tried to explore the same in patients with Acute and transient psychotic disorders (ATPDs), which is considered to similar in presentation to SZ. METHODS This is an extended analysis of the study published in which we had recruited 19 subjects with ATPDs in acute phase of illness were age-/gender-matched with patients schizophrenia in remission. Clinical assessment and immune-marker levels (IL-6,IL-8,IL-17) were carried out along with follow -up repeat immune-marker levels assessment in the ATPD group was conducted after remission status was ensured (at least 3 months after resolution of acute phase). Cognitive assessment was done on Montreal Cognitive Assessment Scale (MoCA) in both the groups (ATPD in both phases and in SZ). RESULTS The mean MoCA total score was 12.05 (SD-5.0) in the acute phase and 27.05 (SD-2.46) in the remission phase in the ATPD group which was statistically significant. When compared with patients with SZ in remission, patients with ATPD in remission performed better in all domains of MoCA, however only statistically significant differences in the total MoCA score and in the visuospatial domain scores of MoCA. No significant association between any of the immune marker levels (IL-6, Il-8 and IL-17) with any domains of the MoCA in patients with ATPD neither in the acute phase nor in the remission phase was found. Additionally, no significant association between the cognitive scores in the MoCA domains of the patients with schizophrenia and immune marker levels was found too. CONCLUSION To conclude, the present study's findings suggested that there existed definite cognitive deficits in patients with ATPDs in both acute and remission phase and in patients with SZ. However, the study could not establish any relationship/association between cognitive deficits/scores in patients with ATPDs in both phases as well as in patients with SZ with immune marker levels.
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Affiliation(s)
- Swapnajeet Sahoo
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
| | - Akshayee Kale
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Debasish Basu
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Ranjana W Minz
- Depart of Immunopathology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Nicotra A, Maestri G, Salvadori E, Pantoni L. Brain health assessment. An exploratory review of tools related to its cognitive dimension. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 6:100188. [PMID: 38292014 PMCID: PMC10826206 DOI: 10.1016/j.cccb.2023.100188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/16/2023] [Accepted: 10/01/2023] [Indexed: 02/01/2024]
Abstract
Background Brain health is an evolving concept and relates to physical and mental health, social well-being, productivity, creativity. Brain health has several dimensions (cognitive, motor, functional, social, and emotional), and should be recognized as one top global priorities of health policies. The purpose of this paper is to provide a summary of tools developed for assessing the cognitive dimension of brain health in the out-patient services. Methods A literature search on PubMed was performed (from inception to May 31, 2023). We identified cognitive tests, functional and psychological scales, and focused on screening tools specifically proposed to characterize cognition within the construct of brain health, comparing them with common global screening tests. Results Among 1947 records, we identified 17 cognitive screening tools used in the context of brain health assessment, of which four were ad hoc developed: Brain Health Assessment (BHA), Brain Health Test (BHT), Brain Health Test-7 (BHT-7), and The Cogniciti Brain Health Assessment. The four tests have administration time ranging from 4 to 30 min, and different administration methods (paper-and-pencil or tablet-based). All four tools assess memory and other cognitive domains. Specific cut-offs have been identified for BHT and BHT-7, while the other tools have automated scoring systems. All but one test also assess other dimensions. Compared to commonly used cognitive screening tests, the brain health tools are less widely used, translated, and validated. Conclusions The concept of brain health is new and requires further validation of tools for its assessment, especially for the cognition dimension.
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Affiliation(s)
- Alessia Nicotra
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Giorgia Maestri
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
| | - Emilia Salvadori
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Leonardo Pantoni
- Neurology Unit, Luigi Sacco University Hospital, Milan, Italy
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
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Sun R, Ge B, Wu S, Li H, Lin L. Optimal cut-off MoCA score for screening for mild cognitive impairment in elderly individuals in China: A systematic review and meta-analysis. Asian J Psychiatr 2023; 87:103691. [PMID: 37499366 DOI: 10.1016/j.ajp.2023.103691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 03/16/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
AIM To evaluate the optimal cut-off MoCA score for elderly individuals with MCI. DESIGN A systematic review and meta-analysis. METHOD Articles were retrieved from PubMed, Ovid, Embase, The Cochrane Library, PsycINFO, CBM, CNKI, WanFang and CQVIP and were assessed by using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Figures of the assessment were made by using Review Manager 5.3, and a meta-analysis of the data was conducted by using Bivariate Random-effects Meta-Analysis (BRMA) via Stata 14.0. RESULTS Seventeen articles were retrieved from the database, and when the cut-offs were 24/25 and 25/26, they represented the same diagnostic value; in addition, the AUC was 0.96, which demonstrated high predictive validity for mild cognitive impairment screening. However, the sensitivity was higher with 25/26 (se=0.95, sp=0.80), whereas the specificity was higher with 24/25 (se=0.92, sp=0.89).
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Affiliation(s)
- Rui Sun
- International Medical Services, Peking Union Medical College Hospital, Beijing, China
| | - Binqian Ge
- School of Nursing, Suzhou Vocational Health College, Suzhou, China
| | - Shiyu Wu
- International Medical Services, Peking Union Medical College Hospital, Beijing, China
| | - Huiling Li
- School of Nursing, Soochow University and The First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Lu Lin
- The First Affiliated Hospital of Soochow University, Suzhou, China.
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Li C, Hong Y, Yang X, Zeng X, Ocepek-Welikson K, Eimicke JP, Kong J, Sano M, Zhu C, Neugroschl J, Aloysi A, Cai D, Martin J, Loizos M, Sewell M, Akrivos J, Evans K, Sheppard F, Greenberg J, Ardolino A, Teresi JA. The use of subjective cognitive complaints for detecting mild cognitive impairment in older adults across cultural and linguistic groups: A comparison of the Cognitive Function Instrument to the Montreal Cognitive Assessment. Alzheimers Dement 2023; 19:1764-1774. [PMID: 36222321 PMCID: PMC10090224 DOI: 10.1002/alz.12804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/26/2022] [Accepted: 08/11/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION This pilot study aims to explore the psychometric properties of the Cognitive Function Instrument (CFI) as a measure of subjective cognitive complaints (SCC) and its performance in distinguishing mild cognitive impairment (MCI) from normal control (NC) compared to an objective cognitive screen (Montreal Cognitive Assessment [MoCA]). METHODS One hundred ninety-four community-dwelling non-demented older adults with racial/ethnic diversity were included. Unidimensionality and internal consistency of the CFI were examined using factor analysis, Cronbach's alpha, and McDonald's omega. Logistic regression models and receiver operating characteristic (ROC) analysis were used to examine the performance of CFI. RESULTS The CFI demonstrated adequate internal consistency; however, the fit for a unidimensional model was suboptimal. The CFI distinguished MCI from NC alone or in combination with MoCA. ROC analysis showed comparable performance of the CFI and the MoCA. DISCUSSION Our findings support the use of CFI as a brief and easy-to-use screen to detect MCI in culturally/linguistically diverse older adults. HIGHLIGHT What is the key scientific question or problem of central interest of the paper? Subjective cognitive complaints (SCCs) are considered the earliest sign of dementia in older adults. However, it is unclear if SCC are equivalent in different cultures. The Cognitive Function Instrument (CFI) is a 14-item measure of SCC. This study provides pilot data suggesting that CFI is sensitive for detecting mild cognitive impairment in a cohort of older adults with racial/ethnic diversity. Comparing performance, CFI demonstrates comparable sensitivity to the Montreal Cognitive Assessment, an objective cognitive screening test. Overall, SCC may provide a non-invasive, easy-to-use method to flag possible cognitive impairment in both research and clinical settings.
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Affiliation(s)
- Clara Li
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yue Hong
- Salem Hospital, Mass General Brigham, Salem, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Xiao Yang
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Xiaoyi Zeng
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katja Ocepek-Welikson
- Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY, USA
| | | | - Jian Kong
- Research Division, The Hebrew Home at Riverdale, Riverdale, NY, USA
| | - Mary Sano
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, New York, NY, USA
| | - Carolyn Zhu
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, New York, NY, USA
| | - Judith Neugroschl
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amy Aloysi
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dongming Cai
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, New York, NY, USA
| | - Jane Martin
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maria Loizos
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Margaret Sewell
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jimmy Akrivos
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kirsten Evans
- James J. Peters VA Medical Center, New York, NY, USA
| | - Faye Sheppard
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan Greenberg
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Allison Ardolino
- Alzheimer’s Disease Research Center, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jeanne A. Teresi
- Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY, USA
- Research Division, The Hebrew Home at Riverdale, Riverdale, NY, USA
- Mount Sinai Pepper Older Americans Independence Center, Department of Geriatrics and Palliative Medicine, Mount Sinai Medical Center, New York, NY, USA
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Jesse MT, Haver DB. Current recommendations regarding evaluation of cognitive functioning in organ transplant candidates. Curr Opin Organ Transplant 2022; 27:523-529. [PMID: 36094545 DOI: 10.1097/mot.0000000000001021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW Cognitive impairment is associated with negative effects on solid organ transplant candidates, recipients, and their care partners. However, because of the heterogeneity of mechanisms, presentations, and assessment measures, research suggests a wide array of impairments, patterns of impairments, and unclear trajectories posttransplant. This review provides an abbreviated synthesis of recent research on cognitive impairments observed in organ-eligible candidates and potential trajectories through posttransplant, current clinical recommendations regarding integration of assessment into routine clinical transplant practice, as well as recommendations for future research. RECENT FINDINGS Transplantation may resolve certain disease-contributing factors to cognitive impairments but also introduces new potential neurocognitive assaults. Recent studies in kidney and lung recipients document continued impairments in subsets of patients, particularly those identified as frail. For liver candidates, new assessment measures of hepatic encephalopathy have been developed and preliminarily tested with potential for translation into routine clinical care. Clinical implications, as well as ethical considerations are discussed. SUMMARY Although guidelines agree that cognitive assessment is an important part of the organ transplantation process, many questions remain of how to best assess cognition and intervene when cognitive impairment is identified in transplant populations. Further research should focus on prospective, longitudinal assessments in transplant-eligible populations through posttransplant.
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Affiliation(s)
- Michelle T Jesse
- Transplant Institute
- Internal Medicine, Henry Ford Health, Detroit, Michigan
| | - D Brian Haver
- Bio-behavioral Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
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Núñez-Fernández S, Rivera D, Arroyo-Anlló EM, Ortiz Jiménez XA, Camino-Pontes B, Salinas Martínez R, Arango-Lasprilla JC. Validation of the Norma Latina Neuropsychological Assessment Battery in Patients with Alzheimer's Disease in Mexico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11322. [PMID: 36141594 PMCID: PMC9517570 DOI: 10.3390/ijerph191811322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
To our knowledge, this is the first study reported in the literature that has validated the Norma Latina Battery in a population of people with Alzheimer's disease (AD) in Mexico. The objective of the study was to determine the discriminant validity of the Norma Latina Battery in a group of Mexican individuals with AD and a group of heathy controls (HC). The Norma Latina Battery was administered to 234 Mexican participants (117 HC and 117 individuals with AD). Results show that: (1) the Norma Latina Battery has high discriminative capacity between groups in all domains; (2) participants with AD presented worse scores in each of the cognitive domains compared to the HC and a greater number of low scores in each of the established thresholds or cut-off points; and finally, (3) the Norma Latina Battery had optimal sensitivity and specificity, especially when a set was observed ≥5 scores below the 10th percentile or ≥4 scores below the 5th percentile. In conclusion, it is recommended that both clinicians and researchers use this battery in the evaluation of Mexican people with AD to better understand the prognosis of the disease and its subsequent treatment.
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Affiliation(s)
- Silvia Núñez-Fernández
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Neuroscience Institute of Castilla-León, University of Salamanca, 37007 Salamanca, Spain
| | - Diego Rivera
- Department of Health Sciences, Public University of Navarre, 31006 Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Eva María Arroyo-Anlló
- Department of Psychobiology, Neuroscience Institute of Castilla-León, University of Salamanca, 37007 Salamanca, Spain
| | | | - Borja Camino-Pontes
- Biocruces Bizkaia Health Research Institute, 48903 Barakaldo, Spain
- Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Ricardo Salinas Martínez
- Department of Geriatrics, “José Eleuterio González” University Hospital, Autonomous University of Nuevo León, Monterrey 64460, Mexico
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Tanveer S, Croucher MJ, Porter R. Cultural modification of neuropsychiatric assessment: complexities to consider. BJPsych Open 2022; 8:e68. [PMID: 35287781 PMCID: PMC8935941 DOI: 10.1192/bjo.2022.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Cognitive screening tests are culture bound and have been shown to perform differently depending on the culture, even with adequate translation. Khan et al examine in detail ways in which the Montreal Cognitive Assessment (MoCA) has been modified for different languages and cultures and produce a systematic guide for future modifications. However, questions arise regarding the availability of the MoCA. Other important issues in the transcultural use and modification of neuropsychiatric tests include providing a culturally safe context for testing, understanding the cultural context in which screening takes place and assessing other neuropsychiatric conditions, which may manifest differently in different cultural contexts and which affect cognition.
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Affiliation(s)
- Sandila Tanveer
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Matthew J Croucher
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand; and Canterbury District Health Board, Christchurch, New Zealand
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand; and Canterbury District Health Board, Christchurch, New Zealand
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