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Ding J, Yang Q, Drossinos N, Guo Q. Advances in semantic dementia: Neuropsychology, pathology & neuroimaging. Ageing Res Rev 2024; 99:102375. [PMID: 38866186 DOI: 10.1016/j.arr.2024.102375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/14/2024]
Abstract
Semantic dementia is a kind of neurodegenerative disorder, characterized by prominent semantic impairments and anterior temporal lobe atrophy. Since 2010, more studies have devoted to this rare disorder, revealing that it is more complex than we think. Clinical advances include more specific findings of semantic impairments and other higher order cognitive deficits. Neuroimaging techniques can help revealing the different brain networks affected (both structurally and functionally) in this condition. Pathological and genetic studies have also found more complex situations of semantic dementia, which might explain the huge variance existing in semantic dementia. Moreover, the current diagnosis criteria mainly focus on semantic dementia's classical prototype. We further delineated the features of three subtypes of semantic dementia based on atrophy lateralization with three severity stages. In a broader background, as a part of the continuum of neurodegenerative disorders, semantic dementia is commonly compared with other resembling conditions. Therefore, we summarized the differential diagnosis between semantic dementia and them. Finally, we introduced the challenges and achievements of its diagnosis, treatment, care and cross cultural comparison. By providing a comprehensive picture of semantic dementia on different aspects of advances, we hope to deepen the understanding of semantic dementia and promote more inspirations on both clinical and theoretical studies about it.
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Affiliation(s)
- Junhua Ding
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Qing Yang
- Department of Rehabilitation, Hushan Hospital, Fudan University, Shanghai, China
| | - Niki Drossinos
- Division of Psychology, Communication and Human Neuroscience, University of Manchester, Manchester, UK
| | - Qihao Guo
- Department of Gerontology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Hupfeld KE, Murali-Manohar S, Zöllner HJ, Song Y, Davies-Jenkins CW, Gudmundson AT, Simičić D, Simegn G, Carter EE, Hui SCN, Yedavalli V, Oeltzschner G, Porges EC, Edden RAE. Metabolite T 2 relaxation times decrease across the adult lifespan in a large multi-site cohort. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.19.599719. [PMID: 38979133 PMCID: PMC11230243 DOI: 10.1101/2024.06.19.599719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Purpose Relaxation correction is crucial for accurately estimating metabolite concentrations measured using in vivo magnetic resonance spectroscopy (MRS). However, the majority of MRS quantification routines assume that relaxation values remain constant across the lifespan, despite prior evidence of T2 changes with aging for multiple of the major metabolites. Here, we comprehensively investigate correlations between T2 and age in a large, multi-site cohort. Methods We recruited approximately 10 male and 10 female participants from each decade of life: 18-29, 30-39, 40-49, 50-59, and 60+ years old (n=101 total). We collected PRESS data at 8 TEs (30, 50, 74, 101, 135, 179, 241, and 350 ms) from voxels placed in white-matter-rich centrum semiovale (CSO) and gray-matter-rich posterior cingulate cortex (PCC). We quantified metabolite amplitudes using Osprey and fit exponential decay curves to estimate T2. Results Older age was correlated with shorter T2 for tNAA, tCr3.0, tCr3.9, tCho, Glx, and tissue water in CSO and PCC; rs = -0.21 to -0.65, all p<0.05, FDR-corrected for multiple comparisons. These associations remained statistically significant when controlling for cortical atrophy. T2 values did not differ across the adult lifespan for mI. By region, T2 values were longer in the CSO for tNAA, tCr3.0, tCr3.9, Glx, and tissue water and longer in the PCC for tCho and mI. Conclusion These findings underscore the importance of considering metabolite T2 changes with aging in MRS quantification. We suggest that future 3T work utilize the equations presented here to estimate age-specific T2 values instead of relying on uniform default values.
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Affiliation(s)
- Kathleen E. Hupfeld
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Saipavitra Murali-Manohar
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Helge J. Zöllner
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Yulu Song
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Christopher W. Davies-Jenkins
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Aaron T. Gudmundson
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
- The Malone Center for Engineering in Healthcare, Johns Hopkins University, Baltimore, MD, USA
| | - Dunja Simičić
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Gizeaddis Simegn
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Emily E. Carter
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Steve C. N. Hui
- Developing Brain Institute, Children’s National Hospital, Washington, D.C. USA
- Department of Radiology, The George Washington University School of Medicine and Health Sciences, Washington, D.C. USA
- Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, D.C. USA
| | - Vivek Yedavalli
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Georg Oeltzschner
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Eric C. Porges
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
- Center for Cognitive Aging and Memory, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Richard A. E. Edden
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
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Macdougall A, Whitfield T, Needham K, Schott JM, Frost C, Walker Z. Predicting progression to Alzheimer's disease dementia using cognitive measures. Int J Geriatr Psychiatry 2024; 39:e6067. [PMID: 38323729 DOI: 10.1002/gps.6067] [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: 07/04/2023] [Accepted: 01/27/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVES It is important to determine if cognitive measures identified as being prognostic in dementia research cohorts also have utility in memory clinics. We aimed to identify measures with the greatest power to predict future Alzheimer's disease (AD) dementia in a clinical setting where expensive biomarkers are not widely available. METHODS This study utilized routine Memory Clinic data collected over 18 years. From 2214 patients assessed in the clinic, we selected 328 patients with an initial diagnosis of subjective cognitive decline or mild cognitive impairment. We compared two types of statistical model for the prediction of AD dementia. The first model included baseline cognitive test scores only, while the second model also included change scores between baseline and the first follow-up. RESULTS Baseline scores on tests of global cognitive function (Mini-mental state examination and Cambridge Cognitive Examination-Revised), verbal episodic memory and psychomotor speed were the best predictors of conversion to AD dementia. The inclusion of cognitive change scores over 1 year of follow-up improved predictive accuracy versus baseline scores alone. CONCLUSIONS We found that the best cognitive predictors of AD dementia in a clinical setting were similar to those previously identified using research cohorts. Taking change in cognitive function into account enabled the onset of AD dementia to be predicted with greater accuracy.
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Affiliation(s)
- Amy Macdougall
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Tim Whitfield
- Division of Psychiatry, University College London, London, UK
| | - Kelly Needham
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Chris Frost
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Zuzana Walker
- Division of Psychiatry, University College London, London, UK
- Essex Partnership University NHS Foundation Trust, Wickford, UK
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Hsu JH, Liu CC, Chen IW, Wu JY, Huang PY, Liu TH, Hung KC. Efficacy of the visual cognitive assessment test for mild cognitive impairment/mild dementia diagnosis: a meta-analysis. Front Public Health 2023; 11:1293710. [PMID: 38026272 PMCID: PMC10644725 DOI: 10.3389/fpubh.2023.1293710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background Mild cognitive impairment (MCI) is an intermediate stage between normal ageing and dementia. The early identification of MCI is important for timely intervention. The visual cognitive assessment test (VCAT) is a brief language-neutral screening tool for detecting MCI/mild dementia. This meta-analysis evaluated the diagnostic efficacy of the VCAT for MCI/mild dementia. Methods Medline, Embase, Google Scholar, and Cochrane Library were searched from their inception until August 2023 to identify studies using VCAT to diagnose MCI/mild dementia. The primary outcome was to assess the diagnostic accuracy of the VCAT for detecting MCI/mild dementia through area under the receiver operating characteristic curve (AU-ROC) analysis. The secondary outcome was to explore the correlation between VCAT scores and MCI/mild dementia presence by comparing scores among patients with and without MCI/mild dementia. Pooled sensitivity, specificity, and area under the curve (AUC) were calculated. Results Five studies with 1,446 older adults (mean age 64-68.3 years) were included. The percentage of participants with MCI/mild dementia versus controls ranged from 16.5% to 87% across studies. All studies were conducted in Asian populations, mostly Chinese, in Singapore and Malaysia. The pooled sensitivity was 80% [95% confidence interval (CI) 68%-88%] and the specificity was 75% (95% CI 68%-80%). The AU-ROCC was 0.77 (95% CI 0.73-0.81). Patients with MCI/mild dementia had lower VCAT scores than the controls (mean difference -6.85 points, p < 0.00001). Conclusion VCAT demonstrated acceptable diagnostic accuracy in distinguishing MCI/mild dementia in cognitively normal older adults. As a language-neutral and culturally unbiased tool, the VCAT shows promise in detecting MCI/mild dementia. Further studies in non-Asian populations are required. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42023453453.
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Affiliation(s)
- Jui-Hung Hsu
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Chien-Cheng Liu
- Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
- Department of Nursing, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
| | - Po-Yu Huang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Ting-Hui Liu
- Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
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Chan MKL, Yeung WKY, Yu JKP, Ng SSW, Tong RKY. Exploratory Study on the Clinical use of EEG for the People with Chronic Stroke and Their Correlation with the Neuropsychological Outcome. Clin EEG Neurosci 2023; 54:534-548. [PMID: 35068216 DOI: 10.1177/15500594221074858] [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] [Indexed: 11/17/2022]
Abstract
Objective. To measure the EEG signals of the people with chronic stroke in eyes-closed and eyes-open condition and study their relationship with the cognitive function and mental wellbeing. Methods. The investigators would conduct cognitive and mental wellbeing tests on recruited subjects. Their EEG signal was acquired by the 16-channel EEG system. The absolute power under different frequency bands and EEG indices (delta alpha ratio and pairwise derived brain symmetry index) in different eye conditions was calculated. Pearson's correlation was conducted to investigate the association between the clinical tests and the EEG index. Results. 32 subjects were recruited for the study. There was a significant correlation between the pairwise derived brain symmetry index (pdBSI) in eyes-open condition with the Stroop Test (p = .002), Paced Auditory Serial Addition Test-3 s (p = .008)/2 s (p = .002) and WHO-5 well-being scale (p = .023). Conclusions. There is a significant correlation between the brain symmetry index and the cognitive and wellbeing assessment. Brain symmetry index over the delta frequency has been found to be the most useful parameter relating to the clinical score.Significance:It is recommended to use EEG as an adjunctive neuropsychological assessment in clinics for people with chronic stroke, especially for clients who could not undertake conventional assessments (eg aphasia, attention problem).Highlights: There is a significant correlation between the EEG index and the clinical neuropsychological assessmentPairwise Derived Brain Symmetry index in delta frequency range correlated with most of the neuropsychological outcome.It is feasible for us to adopt EEG as an adjunctive assessment in clinical settings.
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Affiliation(s)
- Marko Ka Leung Chan
- Community Rehabilitation Service Support Centre, Queen Elizabeth Hospital, Kowloon, Hong Kong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Winnie Ka Yee Yeung
- Community Rehabilitation Service Support Centre, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Jason King Pong Yu
- Community Rehabilitation Service Support Centre, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Serena Sin Wah Ng
- Community Rehabilitation Service Support Centre, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Raymond Kai Yu Tong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, New Territories, Hong Kong
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Völter C, Fricke H, Faour S, Lueg G, Nasreddine ZS, Götze L, Dawes P. Validation of the German Montreal-Cognitive-Assessment-H for hearing-impaired. Front Aging Neurosci 2023; 15:1209385. [PMID: 37539344 PMCID: PMC10394634 DOI: 10.3389/fnagi.2023.1209385] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/26/2023] [Indexed: 08/05/2023] Open
Abstract
Background Hearing loss and dementia are highly prevalent in older age and often co-occur. Most neurocognitive screening tests are auditory-based, and performance can be affected by hearing loss. To address the need for a cognitive screening test suitable for people with hearing loss, a visual version of the Montreal-Cognitive-Assessment was developed and recently validated in English (MoCA-H), with good sensitivity and specificity for identifying cases of dementia. As the MoCA is known to perform differently across languages, revalidation of the German MoCA-H was necessary. The aim of the present study was to assess the diagnostic accuracy of the German MoCA-H among those with normal cognition, mild cognitive impairment (MCI) and dementia and to determine an appropriate performance cut- off. Materials and methods A total of 346 participants aged 60-97 years (M = 77.18, SD = 9.56) were included; 160 were cognitively healthy, 79 with MCI and 107 were living with dementia based on the GPCOG and a detailed medical questionnaire as well as a comprehensive examination by a neurologist in case of cognitive impairment. Performance cut-offs for normal cognition, MCI and dementia were estimated for the MoCA-H score and z-scores using the English MoCA-H cut-off, the balanced cut-off and the Youden's Index. Results A mean score of 25.49 (SD = 3.01) points in the German MoCA-H was achieved in cognitively healthy participants, 20.08 (SD = 2.29) in the MCI and 15.80 (SD = 3.85) in the dementia group. The optimum cut-off for the detection of dementia was ≤21 points with a sensitivity of 96.3% and a specificity of 90%. In the MCI group, a cut-off range between 22 and 24 points is proposed to increase diagnostic accuracy to a sensitivity and specificity of 97.5 and 90%, respectively. Conclusion The German MoCA-H seems to be a sensitive screening test for MCI and dementia and should replace commonly used auditory-based cognitive screening tests in older adults. The choice of a cut-off range might help to better reflect the difficulty in clinical reality in detecting MCI. However, screening test batteries cannot replace a comprehensive cognitive evaluation.
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Affiliation(s)
- Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Hannah Fricke
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Sarah Faour
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Gero Lueg
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr University Bochum, Herne, Germany
| | | | - Lisa Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Piers Dawes
- Centre for Hearing Research (CHEAR), School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
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Katsanos AH, Lee SF, Cukierman-Yaffe T, Sherlock L, Muniz-Terrera G, Canavan M, Joundi R, Sharma M, Shoamanesh A, Derix A, Gerstein HC, Yusuf S, O'Donnell MJ, Bosch J, Whiteley WN. World-wide variations in tests of cognition and activities of daily living in participants of six international randomized controlled trials. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100176. [PMID: 37501909 PMCID: PMC10368824 DOI: 10.1016/j.cccb.2023.100176] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/12/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023]
Abstract
Background Better understanding of worldwide variation in simple tests of cognition and global function in older adults would aid the delivery and interpretation of multi-national studies of the prevention of dementia and functional decline. Method In six RCTs that measured cognition with the mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), and activities of daily living (ADL) with the Standardised Assessment of Everyday Global Activities (SAGEA), we estimated average scores by global region with multilevel mixed-effects models. We estimated the proportion of participants with cognitive or functional impairment with previously defined thresholds (MMSE≤24 or MoCA≤25, SAGEA≥7), and with a country-standardised z-score threshold of cognitive or functional score of ≤-1. Results In 91,396 participants (mean age 66.6 years [SD 7.8], 31% females) from seven world regions, all global regions differed significantly in estimated cognitive function (z-score differences 0.11-0.45, p<0.001) after accounting for individual-level factors, centre and study. In different regions, the proportion of trial participants with MMSE≤24 or MoCA≤25 ranged from 23-36%; the proportion below a country-standardised z-score threshold of ≤1 ranged from 10-14%. The differences in prevalence of impaired IADL (SAGEA≥7) ranged from 2-6% and by country-standardised thresholds from 3-6%. Conclusions Accounting for country-level factors reduced large differences between world regions in estimates of cognitive impairment. Measures of IADL were less variable across world regions, and could be used to better estimate dementia prevalence in large studies.
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Affiliation(s)
- Aristeidis H. Katsanos
- Population Health Research Institute, Hamilton, ON, Canada
- Department of Medicine (Neurology), McMaster University, Hamilton, ON, Canada
| | - Shun Fu Lee
- Population Health Research Institute, Hamilton, ON, Canada
| | - Tali Cukierman-Yaffe
- Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Herczeg Institute on Aging, Tel Aviv, Israel
- Division of Endocrinology & Metabolism, Sheba Medical Centre, Tel Hashomer, Ramat Gan, Israel
| | - Laura Sherlock
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Michele Canavan
- HRB-Clinical Research Facility, National University of Ireland, Galway, Ireland
- Department of Geriatric and Stroke Medicine, Galway University Hospital, Newcastle Road, Ireland
| | - Raed Joundi
- Population Health Research Institute, Hamilton, ON, Canada
- Department of Medicine (Neurology), McMaster University, Hamilton, ON, Canada
| | - Mukul Sharma
- Population Health Research Institute, Hamilton, ON, Canada
- Department of Medicine (Neurology), McMaster University, Hamilton, ON, Canada
| | - Ashkan Shoamanesh
- Population Health Research Institute, Hamilton, ON, Canada
- Department of Medicine (Neurology), McMaster University, Hamilton, ON, Canada
| | - Andrea Derix
- Global Program Head Thrombosis, Bayer Pharmaceuticals, Germany
| | - Hertzel C. Gerstein
- Population Health Research Institute, Hamilton, ON, Canada
- Hamilton Health Sciences, Hamilton, ON, Canada
| | - Salim Yusuf
- Population Health Research Institute, Hamilton, ON, Canada
- Department of Medicine (Cardiology), McMaster University, Hamilton, ON, Canada
| | - Martin J. O'Donnell
- HRB-Clinical Research Facility, National University of Ireland, Galway, Ireland
- Department of Geriatric and Stroke Medicine, Galway University Hospital, Newcastle Road, Ireland
| | - Jackie Bosch
- Population Health Research Institute, Hamilton, ON, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - William N. Whiteley
- Population Health Research Institute, Hamilton, ON, Canada
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Nuffield Department of Population Health, University of Oxford, United Kingdom
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Combining Neuropsychological Assessment with Neuroimaging to Distinguish Early-Stage Alzheimer's Disease from Frontotemporal Lobar Degeneration in Non-Western Tonal Native Language-Speaking Individuals Living in Taiwan: A Case Series. J Clin Med 2023; 12:jcm12041322. [PMID: 36835856 PMCID: PMC9961761 DOI: 10.3390/jcm12041322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/25/2022] [Accepted: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
Neuropsychological tests (NPTs), which are routinely used in clinical practice for assessment of dementia, are also considered to be essential for differential diagnosis of Alzheimer's disease (AD) and frontotemporal lobar degeneration (FTLD), especially the behavioral variants of frontotemporal dementia (bvFTD) and primary progressive aphasia (PPA) at their initial clinical presentations. However, the heterogeneous features of these diseases, which have many overlapping signs, make differentiation between AD and FTLD highly challenging. Moreover, NPTs were primarily developed in Western countries and for native speakers of non-tonal languages. Hence, there is an ongoing dispute over the validity and reliability of these tests in culturally different and typologically diverse language populations. The purpose of this case series was to examine which of the NPTs adjusted for Taiwanese society may be used to distinguish these two diseases. Since AD and FTLD have different effects on individuals' brain, we combined NPTs with neuroimaging. We found that participants diagnosed with FTLD had lower scores in NPTs assessing language or social cognition than AD participants. PPA participants also had lower measures in the Free and Cued Selective Reminding Test than those diagnosed with bvFTD, while bvFTD participants showed poorer performances in the behavioral measures than PPA participants. In addition, the initial diagnosis was supported by the standard one-year clinical follow-up.
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Kim M, Yi D, Byun MS, Ahn H, Jung JH, Kong N, Chang Y, Choi H, Choi J, Kim K, Jung G, Lee DY. Development of a Cognitive Composite for Preclinical Alzheimer's Disease in Korean Older Adults. J Alzheimers Dis 2023; 96:633-641. [PMID: 37807780 PMCID: PMC10657668 DOI: 10.3233/jad-230263] [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] [Accepted: 08/29/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND As tracking subtle cognitive declines in the preclinical stage of Alzheimer's disease (AD) is difficult with traditional individual outcome measures, need for cognitive composite for preclinical AD is widely recognized. OBJECTIVE We aimed to develop culturally appropriate cognitive composite that sensitively identifies subtle cognitive decline of preclinical AD in Korean older adults. METHODS A total 225 cognitively normal elderly individuals from the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease, were included. Tests of episodic memory, orientation, and executive function were carefully selected through review of previously established composites. Three candidate composites including Consortium to Establish a Registry for Alzheimer's Disease Word list recall (WLR), Logical memory (LM) II, and Mini-Mental status examination (MMSE) in common, and Letter fluency test (LF), category fluency test, or Stroop color and word test, were selected. RESULTS Student t-tests demonstrated that only the composite composed of WLR, LM II, MMSE, and LF (Composite 1) showed a significant difference in score decline over two-year follow-up period between Aβ positive and negative group (p = 0.03). Linear mixed model analyses also showed that the Aβ x time interaction effect was significant only for Composite 1 (p = 0.025). Based on the results, Composite 1 was chosen as the final cognitive composite for preclinical Alzheimer's disease (CPAD). CONCLUSIONS CPAD can be used to assess subtle cognitive decline of preclinical AD in clinical research settings, especially in Korean older adults. It also may be used for monitoring progression or treatment benefits in clinical practices.
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Affiliation(s)
- Minjae Kim
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Dahyun Yi
- Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, Korea
| | - Min Soo Byun
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Hyejin Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Joon Hyung Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Nayeong Kong
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Yoonyoung Chang
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Hyeji Choi
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Jungmin Choi
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Kyungtae Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Gijung Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Dong Young Lee
- Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - for the KBASE Research Group
- Department of Psychiatry, Soonchunhyang University Seoul Hospital, Seoul, Korea
- Medical Research Center, Institute of Human Behavioral Medicine, Seoul National University, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
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Williamson M, Maruff P, Schembri A, Cummins H, Bird L, Rosenich E, Lim YY. Validation of a digit symbol substitution test for use in supervised and unsupervised assessment in mild Alzheimer's disease. J Clin Exp Neuropsychol 2022; 44:768-779. [PMID: 36888758 DOI: 10.1080/13803395.2023.2179977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 02/07/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION The Digit-Symbol-Substitution Test (DSST) is used widely in neuropsychological investigations of Alzheimer's Disease (AD). A computerized version of this paradigm, the DSST-Meds, utilizes medicine-date pairings and has been developed for administration in both supervised and unsupervised environments. This study determined the utility and validity of the DSST-Meds for measuring cognitive dysfunction in early AD. METHOD Performance on the DSST-Meds was compared to performance on the WAIS Coding test, and a computerized digit symbol coding test (DSST-Symbols). The first study compared supervised performance on the three DSSTs versions in cognitively unimpaired (CU) adults (n = 104). The second compared supervised DSST performance between CU (n = 60) and mild-symptomatic AD (mild-AD, n = 79) groups. The third study compared performance on the DSST-Meds between unsupervised (n= 621) and supervised settings. RESULTS In Study 1, DSST-Meds accuracy showed high correlations with the DSST-Symbols accuracy (r = 0.81) and WAIS-Coding accuracy (r = 0.68). In Study 2, when compared to CU adults, the mild-AD group showed lower accuracy on all three DSSTs (Cohen's d ranging between 1.39 and 2.56) and DSST-Meds accuracy was correlated moderately with Mini-Mental State Examination scores (r = 0.44, p < .001). Study 3 observed no difference in DSST-meds accuracy between supervised and unsupervised administrations. CONCLUSION The DSST-Meds showed good construct and criterion validity when used in both supervised and unsupervised contexts and provided a strong foundation to investigate the utility of the DSST in groups with low familiarity to neuropsychological assessment.
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Affiliation(s)
- Michael Williamson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Paul Maruff
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Cogstate Ltd, Melbourne, Victoria, Australia
| | | | - Hannah Cummins
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Laura Bird
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Emily Rosenich
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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Patchitt J, Porffy LA, Whomersley G, Szentgyorgyi T, Brett J, Mouchlianitis E, Mehta MA, Nottage JF, Shergill SS. Alpha3/alpha2 power ratios relate to performance on a virtual reality shopping task in ageing adults. Front Aging Neurosci 2022; 14:876832. [PMID: 36212034 PMCID: PMC9540381 DOI: 10.3389/fnagi.2022.876832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/18/2022] [Indexed: 11/18/2022] Open
Abstract
Background Aspects of cognitive function decline with age. This phenomenon is referred to as age-related cognitive decline (ARCD). Improving the understanding of these changes that occur as part of the ageing process can serve to enhance the detection of the more incapacitating neurodegenerative disorders such as Alzheimer’s disease (AD). In this study, we employ novel methods to assess ARCD by exploring the utility of the alpha3/alpha2 electroencephalogram (EEG) power ratio – a marker of AD, and a novel virtual reality (VR) functional cognition task – VStore, in discriminating between young and ageing healthy adults. Materials and methods Twenty young individuals aged 20–30, and 20 older adults aged 60–70 took part in the study. Participants underwent resting-state EEG and completed VStore and the Cogstate Computerised Cognitive Battery. The difference in alpha3/alpha2 power ratios between the age groups was tested using t-test. In addition, the discriminatory accuracy of VStore and Cogstate were compared using logistic regression and overlying receiver operating characteristic (ROC) curves. Youden’s J statistic was used to establish the optimal threshold for sensitivity and specificity and model performance was evaluated with the DeLong’s test. Finally, alpha3/alpha2 power ratios were correlated with VStote and Cogstate performance. Results The difference in alpha3/alpha2 power ratios between age cohorts was not statistically significant. On the other hand, VStore discriminated between age groups with high sensitivity (94%) and specificity (95%) The Cogstate Pre-clinical Alzheimer’s Battery achieved a sensitivity of 89% and specificity of 60%, and Cogstate Composite Score achieved a sensitivity of 83% and specificity of 85%. The differences between the discriminatory accuracy of VStore and Cogstate models were statistically significant. Finally, high alpha3/alpha2 power ratios correlated strongly with VStore (r = 0.73), the Cogstate Pre-clinical Alzheimer’s Battery (r = -0.67), and Cogstate Composite Score (r = -0.76). Conclusion While we did not find evidence that the alpha3/alpha2 power ratio is elevated in healthy ageing individuals compared to young individuals, we demonstrated that VStore can classify age cohorts with high accuracy, supporting its utility in the assessment of ARCD. In addition, we found preliminary evidence that elevated alpha3/alpha2 power ratio may be linked to lower cognitive performance.
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Affiliation(s)
- Joel Patchitt
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Trafford Centre for Medical Research, University of Sussex, Brighton, United Kingdom
| | - Lilla A. Porffy
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- *Correspondence: Lilla A. Porffy,
| | - Gabriella Whomersley
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Timea Szentgyorgyi
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Jack Brett
- Faculty of Media and Communications, Bournemouth University, Poole, United Kingdom
| | - Elias Mouchlianitis
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- School of Psychology, University of East London, London, United Kingdom
| | - Mitul A. Mehta
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Judith F. Nottage
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| | - Sukhi S. Shergill
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Kent and Medway Medical School, Canterbury, United Kingdom
- Kent and Medway National Health Service and Social Care Partnership Trust, Kent, United Kingdom
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12
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Hampel H, Au R, Mattke S, van der Flier WM, Aisen P, Apostolova L, Chen C, Cho M, De Santi S, Gao P, Iwata A, Kurzman R, Saykin AJ, Teipel S, Vellas B, Vergallo A, Wang H, Cummings J. Designing the next-generation clinical care pathway for Alzheimer's disease. NATURE AGING 2022; 2:692-703. [PMID: 37118137 PMCID: PMC10148953 DOI: 10.1038/s43587-022-00269-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/07/2022] [Indexed: 04/30/2023]
Abstract
The reconceptualization of Alzheimer's disease (AD) as a clinical and biological construct has facilitated the development of biomarker-guided, pathway-based targeted therapies, many of which have reached late-stage development with the near-term potential to enter global clinical practice. These medical advances mark an unprecedented paradigm shift and requires an optimized global framework for clinical care pathways for AD. In this Perspective, we describe the blueprint for transitioning from the current, clinical symptom-focused and inherently late-stage diagnosis and management of AD to the next-generation pathway that incorporates biomarker-guided and digitally facilitated decision-making algorithms for risk stratification, early detection, timely diagnosis, and preventative or therapeutic interventions. We address critical and high-priority challenges, propose evidence-based strategic solutions, and emphasize that the perspectives of affected individuals and care partners need to be considered and integrated.
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Affiliation(s)
| | - Rhoda Au
- Depts of Anatomy & Neurobiology, Neurology and Epidemiology, Boston University Schools of Medicine and Public Health, Boston, MA, USA
| | - Soeren Mattke
- Center for Improving Chronic Illness Care, University of Southern California, San Diego, San Diego, CA, USA
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Depts of Neurology and Epidemiology and Data Science, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Paul Aisen
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, San Diego, CA, USA
| | - Liana Apostolova
- Departments of Neurology, Radiology, Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Christopher Chen
- Memory Aging and Cognition Centre, Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Min Cho
- Neurology Business Group, Eisai, Nutley, NJ, USA
| | | | - Peng Gao
- Neurology Business Group, Eisai, Nutley, NJ, USA
| | | | | | - Andrew J Saykin
- Indiana Alzheimer's Disease Research Center and the Departments of Radiology and Imaging Sciences, Medical and Molecular Genetics, and Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Stefan Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, University Medical Center Rostock, Rostock, Germany
| | - Bruno Vellas
- University Paul Sabatier, Gerontopole, Toulouse University Hospital, UMR INSERM 1285, Toulouse, France
| | | | - Huali Wang
- Dementia Care and Research Center, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Disorders, Beijing, China
| | - Jeffrey Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas (UNLV), Las Vegas, NV, USA
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Esther S, Acharya V. ‘We are not vocational trainers’: Indian occupational therapists’ experiences of working in mental health settings. WORLD FEDERATION OF OCCUPATIONAL THERAPISTS BULLETIN 2022. [DOI: 10.1080/14473828.2022.2095493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Shawn Esther
- Department of Occupational Therapy, MCHP, MAHE, Manipal, India
| | - Vinita Acharya
- Department of Occupational Therapy, MCHP, MAHE, Manipal, India
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Jaff NG, Crowther NJ. The Association of Reproductive Aging with Cognitive Function in Sub-Saharan African Women. Methods Mol Biol 2022; 2343:71-91. [PMID: 34473316 DOI: 10.1007/978-1-0716-1558-4_5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Life expectancy in sub-Saharan African women is increasing, and by the late 2020s an estimated 76% of postmenopausal women globally will be living in developing countries. Menopause transition has been associated with cognitive decline in a wide range of studies, but data on cognition and reproductive aging are lacking in sub-Saharan African women. Approximately 72 million people in the region are expected to suffer from dementias and neurocognitive decline by 2050. Studies show that compromised cognitive health in low-income countries has significant implications for adult quality of life and socioeconomic development. There is now an urgent need to further examine risk factors for cognitive decline in these aging women and to understand the ability of public health programs to diagnose and treat cognitive dysfunction. This review examines studies assessing cognition and aging in sub-Saharan African adults, while addressing the significant research gaps. It examines data on the association of the menopause transition with cognitive function and describes how validated tools should be available to assess both menopausal stage and symptoms. Culturally appropriate and validated neurocognitive measures are required to better understand the relationship of reproductive aging with cognition. Longitudinal population-based studies are needed to assess the effect of lifestyle interventions, such as diet and exercise, on cognitive health in sub-Saharan African populations, with an emphasis on women as they transition into menopause.
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Affiliation(s)
- Nicole G Jaff
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Nigel J Crowther
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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15
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Wicklund M. Clinical Approach to Cognitive and Neurobehavioral Symptoms. Continuum (Minneap Minn) 2021; 27:1518-1548. [PMID: 34881724 DOI: 10.1212/con.0000000000001008] [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: 11/15/2022]
Abstract
PURPOSE OF REVIEW This article provides a framework for the approach to patients with cognitive or neurobehavioral concerns. RECENT FINDINGS Recent advances in structural neuroimaging, functional neuroimaging, and disease biomarkers have greatly expanded knowledge of brain-behavior relationships, neural networks and functional connectivity, and pathophysiologic processes leading to cognitive and neurobehavioral disorders. However, any one of these studies is subject to misinterpretation if not applied in the appropriate clinical context. SUMMARY A systematic approach to the history and examination in patients with cognitive and neurobehavioral symptoms is important in marrying clinical assessments with contemporary diagnostic studies and treatments.
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Cova I, Nicotra A, Maestri G, Canevelli M, Pantoni L, Pomati S. Translations and cultural adaptations of the Montreal Cognitive Assessment: a systematic and qualitative review. Neurol Sci 2021; 43:113-124. [PMID: 34750686 DOI: 10.1007/s10072-021-05716-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/30/2021] [Indexed: 12/21/2022]
Abstract
This study provides a systematic review of linguistically and culturally adapted versions of the original Montreal Cognitive Assessment (MoCA) full version. Adapted versions were identified through a systematic review in 3 databases and on the MoCA website. Overall, 86 culturally different versions of MoCA are available: 74 versions on the MoCA website (25 of them have a corresponding paper concerning the translation process found with the systematic review) and 12 additional versions identified only with the search in biomedical databases. Culturally different adapted versions of the MoCA were unevenly distributed across different geographic areas. The quality of the process of cultural adaptation of MoCA differs considerably among different available versions as well as the number of items adapted in the various language versions. The potential availability of many culturally adapted and translated versions of the MoCA increases the chance of offering a linguistically and culturally sensitive screening for cognitive impairment to diverse populations; further studies are needed to identify if MoCA can be considered a truly cross-cultural fair test.
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Affiliation(s)
- Ilaria Cova
- Neurology Unit, "Luigi Sacco" Hospital, University of Milan, Via G.B. Grassi, 74, 20157, Milan, Italy.
| | - Alessia Nicotra
- Neurology Unit, "Luigi Sacco" Hospital, University of Milan, Via G.B. Grassi, 74, 20157, Milan, Italy
| | - Giorgia Maestri
- Neurology Unit, "Luigi Sacco" Hospital, University of Milan, Via G.B. Grassi, 74, 20157, Milan, Italy
| | - Marco Canevelli
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Leonardo Pantoni
- Stroke and Dementia Lab, Department of Biomedical and Clinical Sciences, Luigi Sacco, University of Milan, Milan, Italy
| | - Simone Pomati
- Neurology Unit, "Luigi Sacco" Hospital, University of Milan, Via G.B. Grassi, 74, 20157, Milan, Italy
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Stothart G, Smith LJ, Milton A, Coulthard E. A passive and objective measure of recognition memory in Alzheimer's disease using Fastball memory assessment. Brain 2021; 144:2812-2825. [PMID: 34544117 PMCID: PMC8564696 DOI: 10.1093/brain/awab154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 01/02/2023] Open
Abstract
Earlier diagnosis of Alzheimer's disease requires biomarkers sensitive to associated structural and functional changes. While considerable progress has been made in the development of structural biomarkers, functional biomarkers of early cognitive change, unconfounded by effort, practice and level of education, are still needed. We present Fastball, a new EEG method for the passive and objective measurement of recognition memory, that requires no behavioural memory response or comprehension of the task . Younger adults, older adults and Alzheimer's disease patients (n = 20 per group) completed the Fastball task, lasting just under 3 min. Participants passively viewed rapidly presented images and EEG assessed their automatic ability to differentiate between images based on previous exposure, i.e. old/new. Participants were not instructed to attend to previously seen images and provided no behavioural response. Following the Fastball task, participants completed a two-alternative forced choice (2AFC) task to measure their explicit behavioural recognition of previously seen stimuli. Fastball EEG detected significantly impaired recognition memory in Alzheimer's disease compared to healthy older adults (P < 0.001, Cohen's d = 1.52), whereas behavioural recognition was not significantly different between Alzheimer's disease and healthy older adults. Alzheimer's disease patients could be discriminated with high accuracy from healthy older adult controls using the Fastball measure of recognition memory (AUC = 0.86, P < 0.001), whereas discrimination performance was poor using behavioural 2AFC accuracy (AUC = 0.63, P = 0.148). There were no significant effects of healthy ageing, with older and younger adult controls performing equivalently in both the Fastball task and behavioural 2AFC task. Early diagnosis of Alzheimer's disease offers potential for early treatment when quality of life and independence can be retained through disease modification and cognitive enhancement. Fastball provides an alternative way of testing recognition responses that holds promise as a functional marker of disease pathology in stages where behavioural performance deficits are not yet evident. It is passive, non-invasive, quick to administer and uses cheap, scalable EEG technology. Fastball provides a new powerful method for the assessment of cognition in dementia and opens a new door in the development of early diagnosis tools.
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Affiliation(s)
| | - Laura J Smith
- School of Psychology, University of Kent, Canterbury, UK
| | - Alexander Milton
- School of Psychological Science, University of Bristol, Bristol, UK
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Menzies O, Dudley M, Garrett N, Elder H, Daniels P, Wilson D. He Tūhononga Whaiaro: A Kaupapa Māori Approach to Mate Wareware (Dementia) and Cognitive Assessment of Older Māori. J Appl Gerontol 2021; 41:1066-1073. [PMID: 34365859 DOI: 10.1177/07334648211037504] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIM The aim of this study is to investigate Māori (Indigenous peoples of Aotearoa New Zealand) understandings of dementia (mate wareware) and develop a framework to inform assessment of cognitive impairment. METHOD Qualitative, kaupapa Māori (Māori approach) research with 241 older Māori (kaumātua) involving 17 focus groups across Aotearoa New Zealand (NZ) and eight families (whānau) from one region. We thematically analyzed transcribed data from audio-recorded interviews. RESULTS Two overarching themes, namely, connection (Tūhononga) and self (Whaiaro), and eight subthemes in particular mind (hinengaro), spirit (wairua), body (tinana), family (whānau), social connection (whanaungatanga), identity and role (tuakiri), place (wāhi), and ancestors (tūpuna) emerged. Māori language (Te Reo Māori) was important for cognitive health. CONCLUSION The findings embedded in cultural values improve understanding of dementia (mate wareware) in Māori. These themes can inform the assessment of older Māori with cognitive impairment. For those without cognitive impairment, the Tūhononga Whaiaro framework suggests factors potentially crucial for healthy aging in Māori.
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Affiliation(s)
- Oliver Menzies
- Auckland City Hospital, New Zealand.,The University of Auckland, New Zealand
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Huo Z, Lin J, Bat BKK, Chan JYC, Tsoi KKF, Yip BHK. Diagnostic accuracy of dementia screening tools in the Chinese population: a systematic review and meta-analysis of 167 diagnostic studies. Age Ageing 2021; 50:1093-1101. [PMID: 33625478 DOI: 10.1093/ageing/afab005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The rate of undetected dementia is high in China. However, the performance of dementia screening tools may differ in the Chinese population due to the lower education level and cultural diversity. This study aimed to evaluate the diagnostic accuracy of dementia screening tools in the Chinese population. METHODS Eleven electronic databases were searched for studies evaluating the diagnostic accuracy of dementia screening tools in older Chinese adults. The overall diagnostic accuracy was estimated using bivariate random-effects models, and the area under the summary receiver operating characteristic curve was presented. RESULTS One hundred sixty-seven studies including 81 screening tools were identified. Only 134 studies qualified for the meta-analysis. The Mini-Mental State Examination (MMSE) was the most commonly studied tool, with a combined sensitivity (SENS) and specificity (SPEC) of 0.87 (95%CI 0.85-0.90) and 0.89 (95%CI 0.86-0.91), respectively. The Addenbrooke's Cognitive Examination-Revised (ACE-R) (SENS: 0.96, 95%CI 0.89-0.99; SPEC: 0.96, 95%CI 0.89-0.98) and Montreal Cognitive Assessment (MoCA) (SENS: 0.93, 95%CI 0.88-0.96; SPEC: 0.90, 95%CI 0.86-0.93) showed the highest performance. The General Practitioner Assessment of Cognition (GPCOG), Hasegawa's Dementia Scale and Cognitive Abilities Screening Instrument had performances comparable to that of the MMSE. The cut-off scores ranged widely across studies, especially for the MMSE (range: 15-27) and MoCA (range: 14-26). CONCLUSIONS A number of dementia screening tools were validated in the Chinese population after cultural and linguistical adaptations. The ACE-R and MoCA had the best diagnostic accuracy, whereas the GPCOG, with an administration time < 5 minutes, could be considered as a rapid screening tool.
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Affiliation(s)
- Zhaohua Huo
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jiaer Lin
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Baker K K Bat
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Joyce Y C Chan
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kelvin K F Tsoi
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Benjamin H K Yip
- JC School of Public Health and Primary Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
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20
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Walker JD, O'Connell ME, Pitawanakwat K, Blind M, Warry W, Lemieux A, Patterson C, Allaby C, Valvasori M, Zhao Y, Jacklin K. Canadian Indigenous Cognitive Assessment (CICA): Inter-rater reliability and criterion validity in Anishinaabe communities on Manitoulin Island, Canada. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12213. [PMID: 34136637 PMCID: PMC8190538 DOI: 10.1002/dad2.12213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/12/2021] [Accepted: 05/19/2021] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Despite increasing dementia rates, few culturally informed cognitive assessment tools exist for Indigenous populations. The Canadian Indigenous Cognitive Assessment (CICA) was adapted with First Nations on Manitoulin Island, Canada, and provides a brief, multi-domain cognitive assessment in English and Anishinaabemowin. METHODS Using community-based participatory research (CBPR) methods, we assessed the CICA for inter-rater and test-retest reliability in 15 individuals. We subsequently evaluated validity and established meaningful CICA cut-off scores in 55 individuals assessed by a geriatrician. RESULTS The CICA demonstrated strong reliability (intra-class coefficient = 0.95 [0.85,0.98]). The area under the curve (AUC) was 0.98 (0.94, 1.00), and the ideal cut-point to identify likely cases of dementia was a score of less than or equal to 34 with sensitivity of 100% and specificity of 85%. DISCUSSION When used with older First Nations men and women living in First Nations communities, the CICA offers a culturally safe, reliable, and valid assessment to support dementia case-finding.
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Affiliation(s)
- Jennifer D. Walker
- School of Rural and Northern HealthLaurentian UniversitySudburyOntarioCanada
| | | | | | - Melissa Blind
- Memory Keepers Medical Discovery TeamUniversity of Minnesota Medical SchoolDuluthMinnesotaUSA
| | - Wayne Warry
- Memory Keepers Medical Discovery TeamUniversity of Minnesota Medical SchoolDuluthMinnesotaUSA
- Department of Family Medicine and Biobehavioral HealthUniversity of Minnesota Medical SchoolDuluthMinnesotaUSA
| | - Andrine Lemieux
- Memory Keepers Medical Discovery TeamUniversity of Minnesota Medical SchoolDuluthMinnesotaUSA
| | | | | | - Meghan Valvasori
- School of Rural and Northern HealthLaurentian UniversitySudburyOntarioCanada
| | - Yantao Zhao
- School of Rural and Northern HealthLaurentian UniversitySudburyOntarioCanada
| | - Kristen Jacklin
- Memory Keepers Medical Discovery TeamUniversity of Minnesota Medical SchoolDuluthMinnesotaUSA
- Department of Family Medicine and Biobehavioral HealthUniversity of Minnesota Medical SchoolDuluthMinnesotaUSA
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Diagnostic Accuracy of 10/66 Dementia Protocol in Fijian-Indian Elders Living in New Zealand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094870. [PMID: 34063626 PMCID: PMC8124794 DOI: 10.3390/ijerph18094870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/08/2021] [Accepted: 04/30/2021] [Indexed: 11/16/2022]
Abstract
The 10/66 dementia protocol was developed as a language and culture-fair instrument to estimate the prevalence of dementia in non-English speaking communities. The aim of this study was to validate the 10/66 dementia protocol in elders of Indian ethnicity born in the Fiji Islands (Fijian-Indian) living in New Zealand. To our knowledge, this is the first time a dementia diagnostic tool has been evaluated in the Fijian-Indian population in New Zealand. We translated and adapted the 10/66 dementia protocol for use in in Fijian-Indian people. Individuals (age ≥ 65) who self-identified as Fijian-Indian and had either been assessed for dementia at a local memory service (13 cases, eight controls) or had participated in a concurrent dementia prevalence feasibility study (eight controls) participated. The sensitivity, specificity, positive predictive value, and Youden’s index were obtained by comparing the 10/66 diagnosis and its sub-components against the clinical diagnosis (reference standard). The 10/66 diagnosis had a sensitivity of 92.3% (95% CI 70.3–99.5), specificity of 93.8% (95% CI 75.3–99.6), positive predictive value of 92.3% (95% CI 70.3–99.5), and negative predictive value of 93.8% (95% CI 75.3–99.6). The study results show that the Fijian-Indian 10/66 dementia protocol has adequate discriminatory abilities to diagnose dementia in our sample. This instrument would be suitable for future dementia population-based studies in the Fijian-Indian population living in Aotearoa/New Zealand or the Fiji-Islands.
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Bonnechère B, Sahakian BJ. Can Mobile Technology Help Prevent the Burden of Dementia in Low- and Mid-Income Countries? Front Public Health 2020; 8:554938. [PMID: 33282809 PMCID: PMC7689265 DOI: 10.3389/fpubh.2020.554938] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/08/2020] [Indexed: 12/29/2022] Open
Affiliation(s)
- Bruno Bonnechère
- Department of Psychiatry and Behavioural, Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom.,Public Health School, Université Libre de Bruxelles, Brussels, Belgium
| | - Barbara J Sahakian
- Department of Psychiatry and Behavioural, Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
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Effendi-Tenang I, Tan MP, Khaliddin N, Jamaluddin Ahmad M, Amir NN, Kamaruzzaman SB, Ramli N. Vision impairment and cognitive function among urban-dwelling malaysians aged 55 years and over from the Malaysian Elders Longitudinal Research (MELoR) study. Arch Gerontol Geriatr 2020; 90:104165. [PMID: 32650156 DOI: 10.1016/j.archger.2020.104165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/17/2020] [Accepted: 06/25/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Published literature on vision impairment and cognitive function amongst older Malaysians remains scarce. This study investigates the association between vision impairment and cognitive function in an older Malaysian population. METHODS Subjects aged 55 years and above from the Malaysian Elders Longitudinal Research (MELoR) study with available information on vision and Montreal Cognitive Assessment (MoCA) scores were included. Data were obtained through a home-based interview and hospital-based health check by trained researchers. Visual acuity (VA) was assessed with logMAR score with vision impairment defined as VA 6/18 or worse in the better-seeing eye. Cognition was evaluated using the MoCA-Blind scoring procedure. Those with a MoCA-Blind score of <19/22 were considered to have cognitive impairment. RESULTS Data was available for 1144 participants, mean (SD) age = 68.57 (±7.23) years. Vision impairment was present in 143 (12.5 %) and 758 (66.3 %) had MoCA-Blind score of <19. Subjects with vision impairment were less likely to have a MoCA-Blind score of ≥19 (16.8 % vs 36.2 %, p < 0.001). Vision impairment was associated with poorer MoCA-Blind scores after adjustments for age, gender, and ethnicity (β = 2.064; 95 % CI, -1.282 to 3.320; P = 0.003). In those who had > 6 years of education attainment, vision impairment was associated with a significant reduction of cognitive function and remained so after adjustment for age and gender (β = 1.863; 95 % CI, 1.081-3.209; P = 0.025). CONCLUSION Our results suggest that vision impairment correlates with cognitive decline. Therefore, maintaining good vision is an important interventional strategy for preventing cognitive decline in older adults.
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Affiliation(s)
- I Effendi-Tenang
- Department of Ophthalmology, University Malaya Medical Centre, Kuala Lumpur, Malaysia; University of Malaya Eye Research Centre (UMERC), Department of Ophthalmology, University of Malaya, Malaysia.
| | - M P Tan
- Division of Geriatric Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia; Department of Medical Sciences, Faculty of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Malaysia.
| | - N Khaliddin
- Department of Ophthalmology, University Malaya Medical Centre, Kuala Lumpur, Malaysia; University of Malaya Eye Research Centre (UMERC), Department of Ophthalmology, University of Malaya, Malaysia.
| | - M Jamaluddin Ahmad
- Department of Ophthalmology, University Malaya Medical Centre, Kuala Lumpur, Malaysia; University of Malaya Eye Research Centre (UMERC), Department of Ophthalmology, University of Malaya, Malaysia.
| | - N N Amir
- Department of Ophthalmology, University Malaya Medical Centre, Kuala Lumpur, Malaysia; University of Malaya Eye Research Centre (UMERC), Department of Ophthalmology, University of Malaya, Malaysia.
| | - S B Kamaruzzaman
- Division of Geriatric Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
| | - N Ramli
- Department of Ophthalmology, University Malaya Medical Centre, Kuala Lumpur, Malaysia; University of Malaya Eye Research Centre (UMERC), Department of Ophthalmology, University of Malaya, Malaysia.
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