The effect of schooling on reported age of onset of cognitive decline: A collaborative study

Normative data of the Portuguese version of the Mini-Addenbrooke's Cognitive Examination

Introduction:

Mini-Addenbrooke's Cognitive Examination (M-ACE) is a screening neurocognitive test with diagnostic accuracy for mild cognitive impairment and dementia. The present study aims to determine the construct validity, concurrent and divergent validity and to determine the normative equation for the Portuguese version of M-ACE.

Method:

The sample is composed by 130 participants without any subjective complaint of memory loss and completely independent in daily life activities, recruited in health units, day care centers and religious and civic associations, from several districts of Portugal. The ACE-III, from which the M-ACE was extracted, and the Geriatric Depression Scale (GDS) were administered to all participants.

Results:

Reliability is considered good (α = 0.844) and the item-total correlations of the M-ACE were highly significant. M-ACE showed a positive correlation with ACE-III and a negative correlation with GDS. Schooling and age were the only variables related to M-ACE performance. The obtained model from the multiple regression was significant. A normative equation was extracted from this model.

Conclusions:

The Portuguese version of M-ACE has solid psychometric properties enabling its clinical use. The availability of M-ACE normative equation based on a healthy sample according to age and education enables the use of a brief screening tool for cognitive functioning. M-ACE does not require formal specialized training, it is a quick test which can be an advantage, for instance, in primary health care consultations.

Impact of Depression and Anxiety on Dimensions of Health-Related Quality of Life in Subjects with Parkinson's Disease Enrolled in an Association of Patients

Parkinson's disease (PD) is a complex disorder characterized by a wide spectrum of symptoms. Depression and anxiety are common manifestations in PD and may be determinants of health-related quality of life (HRQoL). The objective of this study is to determine the association of depression and anxiety with the dimensions of HRQoL in subjects with PD enrolled in an association of patients. Ninety-five community-based patients with PD diagnosis at different disease stages were studied. HRQoL was assessed using the Parkinson's Disease Questionnaire (PDQ-39); depression and anxiety were assessed using the Beck Depression Inventory (BDI-II) and the State-Trait Anxiety Inventory (STAI), respectively. Our results showed that depression and anxiety were negatively associated with HRQoL measured by PDSI. Higher motor dysfunction measured by Hoehn and Yahr (H&Y) staging was also associated with worse HRQoL. Depression was the most influential variable in the model. All PDQ-39 dimensions except social support and bodily discomfort were associated with depression. Anxiety was associated with the emotional well-being and bodily discomfort dimensions. These results suggest that physicians should pay attention to the presence of psychiatric symptoms and treat them appropriately.

Influence of Mild Cognitive Impairment, Depression, and Anxiety on the Quality of Life of Patients with Parkinson Disease

Background

Neuropsychiatric symptoms (NPS) and mild cognitive impairment (MCI) are common in Parkinson disease (PD) and have a negative impact on the patient's quality of life (QoL). We aim to describe the effect of NPS and MCI on each other and on QoL.

Methods

Sixteen MCI and 37 non-MCI PD patients completed different self-assessment questionnaires including the Parkinson's Disease Questionnaire (PDQ-39), the Beck Depression Inventory (BD), the Beck Anxiety Inventory (BAI), and the Self-Report Manic Inventory (SRMI). Linear regression with stepwise elimination was used to select the significant predictors of QoL and to control for confounding factors.

Results

The significant linear regression model (R² = 0.68, p ≤ 0.01) revealed significant effects of MCI (p = 0.03), BDI (p ≤ 0.01), BAI (p ≤ 0.01), age (p = 0.03), a trend of SRMI (p = 0.06), and disease duration (p = 0.08) on QoL.

Conclusions

MCI, anxiety, depression, and age decrease QoL in patients with PD. NPS has the main influence in the prediction of QoL in patients with PD, whereas MCI is only of minor importance.