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Njamnshi WY, Siewe Fodjo JN, Njamnshi KG, Ngarka L, Mengnjo MK, Nfor LN, Tsasse MAF, Njamnshi JNT, Maestre G, Cavazos JE, Seshadri S, Etoundi Ngoa LS, Obama Abena Ondoa MT, Fongang B, Zoung-Kanyi Bissek AC, Njamnshi AK. Dementia Prevalence and Onchocerca volvulus Infection among Rural Elderly Persons in the Ntui Health District, Cameroon: A Population-Based Study. Pathogens 2024; 13:568. [PMID: 39057795 PMCID: PMC11280333 DOI: 10.3390/pathogens13070568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 06/17/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
Recent research suggests that infection with Onchocerca volvulus induces neurocognitive decline. This study sought to compare the cognitive outcomes of elderly persons based on onchocerciasis infection status and report the overall prevalence of dementia in the rural Ntui Health District in Cameroon. A community-based approach was used to recruit 103 participants aged ≥60 years. Dementia screening was done using the Community Screening Interview for Dementia (CSID) tool with a cut-off value of ≤29.5. O. volvulus infection was determined via microscopic examination of skin snips and serological testing of Ov16 antibodies using rapid diagnostic tests. Overall, the prevalence of dementia was 10.7%. Among the tested individuals, 17.9% (15/84) and 62.1% (41/66) were positive for O. volvulus and Ov16 antibodies, respectively. A multivariable linear regression model of CSID scores found a significant positive association with education level (8.654; 95% CI: 2.0870 to 15.222). However, having a positive skin snip for O. volvulus (-3.399; 95% CI: -6.805 to 0.007) and inhaling tobacco (-5.441; 95% CI: -9.137 to -1.744) tended to lower the CSID scores. Ongoing onchocerciasis transmission in the Ntui Health District may constitute a risk factor for dementia. Strengthening onchocerciasis elimination and adopting healthier lifestyles would contribute to dementia prevention among the elderly residing in endemic communities.
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Affiliation(s)
- Wepnyu Yembe Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (W.Y.N.); (K.G.N.); (L.N.); (M.K.M.); (L.N.N.); (J.N.T.N.); (B.F.); (A.-C.Z.-K.B.); (A.K.N.)
- Neuroscience Lab, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon
- Division of Health Operations Research, Ministry of Public Health, Yaoundé P.O. Box 1937, Cameroon
| | - Joseph Nelson Siewe Fodjo
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (W.Y.N.); (K.G.N.); (L.N.); (M.K.M.); (L.N.N.); (J.N.T.N.); (B.F.); (A.-C.Z.-K.B.); (A.K.N.)
- Global Health Institute, University of Antwerp, Doornstraat 331, 2610 Antwerp, Belgium
| | - Kongnyu Gamnsi Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (W.Y.N.); (K.G.N.); (L.N.); (M.K.M.); (L.N.N.); (J.N.T.N.); (B.F.); (A.-C.Z.-K.B.); (A.K.N.)
- Neuroscience Lab, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon
| | - Leonard Ngarka
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (W.Y.N.); (K.G.N.); (L.N.); (M.K.M.); (L.N.N.); (J.N.T.N.); (B.F.); (A.-C.Z.-K.B.); (A.K.N.)
- Neuroscience Lab, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon
- Department of Neurology, Central Hospital Yaoundé, Yaoundé P.O. Box 25625, Cameroon
| | - Michel K. Mengnjo
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (W.Y.N.); (K.G.N.); (L.N.); (M.K.M.); (L.N.N.); (J.N.T.N.); (B.F.); (A.-C.Z.-K.B.); (A.K.N.)
- Neuroscience Lab, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon
- Department of Neurology, Central Hospital Yaoundé, Yaoundé P.O. Box 25625, Cameroon
| | - Leonard N. Nfor
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (W.Y.N.); (K.G.N.); (L.N.); (M.K.M.); (L.N.N.); (J.N.T.N.); (B.F.); (A.-C.Z.-K.B.); (A.K.N.)
- Neuroscience Lab, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon
- Department of Neurology, Central Hospital Yaoundé, Yaoundé P.O. Box 25625, Cameroon
| | - Martine A. F. Tsasse
- Higher Institute for Scientific and Medical Research, Yaoundé P.O. Box 5797, Cameroon;
| | - Julius N. Taryunyu Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (W.Y.N.); (K.G.N.); (L.N.); (M.K.M.); (L.N.N.); (J.N.T.N.); (B.F.); (A.-C.Z.-K.B.); (A.K.N.)
| | - Gladys Maestre
- Department of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX 78520, USA;
| | - Jose E. Cavazos
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA; (J.E.C.); (S.S.)
- Department of Neurology, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA; (J.E.C.); (S.S.)
- Department of Neurology, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA 02118, USA
| | - Laurent S. Etoundi Ngoa
- Neuroscience Lab, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon
| | - Marie-Thérèse Obama Abena Ondoa
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (W.Y.N.); (K.G.N.); (L.N.); (M.K.M.); (L.N.N.); (J.N.T.N.); (B.F.); (A.-C.Z.-K.B.); (A.K.N.)
- Neuroscience Lab, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon
| | - Bernard Fongang
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (W.Y.N.); (K.G.N.); (L.N.); (M.K.M.); (L.N.N.); (J.N.T.N.); (B.F.); (A.-C.Z.-K.B.); (A.K.N.)
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA; (J.E.C.); (S.S.)
- Department of Population Health Sciences, University of Texas Health Science Center, San Antonio, TX 77030, USA
- Department of Biochemistry and Structural Biology, University of Texas Health Science Center, San Antonio, TX 77030, USA
| | - Anne-Cécile Zoung-Kanyi Bissek
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (W.Y.N.); (K.G.N.); (L.N.); (M.K.M.); (L.N.N.); (J.N.T.N.); (B.F.); (A.-C.Z.-K.B.); (A.K.N.)
- Neuroscience Lab, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon
- Division of Health Operations Research, Ministry of Public Health, Yaoundé P.O. Box 1937, Cameroon
| | - Alfred K. Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé P.O. Box 25625, Cameroon; (W.Y.N.); (K.G.N.); (L.N.); (M.K.M.); (L.N.N.); (J.N.T.N.); (B.F.); (A.-C.Z.-K.B.); (A.K.N.)
- Neuroscience Lab, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé P.O. Box 1364, Cameroon
- Department of Neurology, Central Hospital Yaoundé, Yaoundé P.O. Box 25625, Cameroon
- Brain Research Africa Initiative (BRAIN), 1226 Geneva, Switzerland
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Reyes-Ortiz CA, Campo-Arias A. Non-English Language Preference is Part of the US Syndemic for Latin/Hispanic People. Am J Geriatr Psychiatry 2024; 32:787-789. [PMID: 38355312 DOI: 10.1016/j.jagp.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 02/16/2024]
Affiliation(s)
- Carlos A Reyes-Ortiz
- Institute of Public Health (CAR-O), College of Pharmacy and Pharmaceutical Sciences, Florida A & M University, Tallahassee, FL.
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Cardoso S, Barros R, Marôco J, de Mendonça A, Guerreiro M. Different MMSE domains are associated to cognitive decline and education. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:533-539. [PMID: 35234096 DOI: 10.1080/23279095.2022.2041018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The Mini-Mental State Examination (MMSE) is a long-established test to screen for dementia, estimate the severity and monitor the progression of cognitive impairment. The MMSE total score is dependent upon demographic factors, particularly education, but little is known about how education influences the 6 distinct MMSE cognitive domains. The present study aims to understand how the performances in the MMSE cognitive domains reflect clinical diagnosis and educational level. The study recruited 1043 participants, comprising 388 healthy controls, 360 patients with Mild Cognitive Impairment (MCI) and 295 patients with dementia. The association of the MMSE cognitive domains scores with clinical diagnosis (healthy, MCI, dementia) and educational level (primary education, middle school, high school and university/college) was analyzed with a multivariate ordinal regression model. The scores in all MMSE domains were generally higher in healthy controls as compared to patients with MCI, and higher in these as compared to patients with dementia. The MMSE domain Constructional ability was associated to the education level, the domains Orientation, Recall and Language were associated to diagnosis, Attention and calculation was associated to both education level and diagnosis, and Registration was not associated to either education or diagnosis. In conclusion, impairment in specific MMSE domains pinpoints cognitive decline, probably indicating brain areas affected by neurodegeneration, and impairment in others reflects lower education levels and the lack of acquisition of relevant schooling abilities.
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Affiliation(s)
- Sandra Cardoso
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ricardo Barros
- Faculty of Sciences, University of Lisbon, Lisbon, Portugal
| | - João Marôco
- ISPA -Instituto Universitário, Lisbon, Portugal
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Honjo Y, Ide K, Nagai K, Yuri T, Nakai H, Kawasaki I, Harada S, Ogawa N. Attention to the domains of Revised Hasegawa Dementia Scale and Mini-Mental State Examination in patients with Alzheimer's disease dementia. Psychogeriatrics 2024; 24:582-588. [PMID: 38403287 DOI: 10.1111/psyg.13100] [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: 08/11/2023] [Revised: 01/06/2024] [Accepted: 02/15/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND In Japan, Alzheimer's disease dementia (AD) is the most common cognitive disease, and the most widely used dementia screening tests are the Revised Hasegawa Dementia Scale (HDS-R) and Mini-Mental State Examination (MMSE). This study sought to elucidate the relationships of the individual domains of these tests with age and duration of school education in a large group of patients with AD. METHODS Participants were 505 new outpatients diagnosed with AD who completed the HDS-R and MMSE at the first visit. We investigated the relationships of total and individual domains of these tests with age and duration of school education using the least squares method. Next, we plotted regression lines of the individual domain scores against the total test scores. RESULTS Younger age and longer duration of school education were significantly associated with higher total HDS-R and MMSE scores in AD. Domain-specific results indicated that younger age was significantly associated with a higher immediate memory score on both the HDS-R and MMSE and with a higher orientation (time), repetition score on the MMSE. Longer duration of school education was significantly associated with a higher working memory score on the HDS-R and with higher serial 7, repetition and writing scores on the MMSE. In addition, shorter duration of school education was significantly associated with higher naming score on the MMSE. The regression lines of orientation of time, remote memory, visual memory, and verbal frequency hit the bottom on the HDS-R (4/30, 8/30, 4/30, and 6/30, respectively) and of orientation of time, serial 7, remote memory, and writing also hit the bottom on the MMSE (8/30, 9/30, 11/30, and 8/30, respectively). CONCLUSIONS We should pay attention to age, duration of school education, and the individual domains when using the HDS-R or MMSE to assess patients with AD.
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Affiliation(s)
- Yasuyuki Honjo
- Kyoto Kaisei Hospital, Kyoto, Japan
- Kyoto Narabigaoka Hospital, Kyoto, Japan
- Department of Occupational Therapy, Faculty of Health Science, Kyoto Tachibana University, Kyoto, Japan
| | - Kazuki Ide
- Centre for Infectious Disease Education and Research, Osaka University, Osaka, Japan
| | - Kuniaki Nagai
- Department of Occupational Therapy, Faculty of Rehabilitation, Reiwa Health Sciences University, Fukuoka, Japan
| | - Takuma Yuri
- Department of Occupational Therapy, Faculty of Health Science, Kyoto Tachibana University, Kyoto, Japan
| | - Hideaki Nakai
- Department of Occupational Therapy, Faculty of Health Science, Kyoto Tachibana University, Kyoto, Japan
| | - Ippei Kawasaki
- Department of Occupational Therapy, Faculty of Health Science, Kyoto Tachibana University, Kyoto, Japan
| | - Shun Harada
- Department of Occupational Therapy, Faculty of Health Science, Kyoto Tachibana University, Kyoto, Japan
| | - Noriyuki Ogawa
- Department of Occupational Therapy, Faculty of Health Science, Kyoto Tachibana University, Kyoto, Japan
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Chyr LC, Wolff JL, Zissimopoulos JM, Drabo EF. Analysis of agreement between measures of subjective cognitive impairment and probable dementia in the National Health and Aging Trends Study. Alzheimers Dement 2024; 20:2817-2829. [PMID: 38426381 PMCID: PMC11032562 DOI: 10.1002/alz.13758] [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: 07/21/2023] [Revised: 01/03/2024] [Accepted: 01/29/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Subjective cognitive impairment (SCI) measures in population-based surveys offer potential for dementia surveillance, yet their validation against established dementia measures is lacking. METHODS We assessed agreement between SCI and a validated probable dementia algorithm in a random one-third sample (n = 1936) of participants in the 2012 National Health and Aging Trends Study (NHATS). RESULTS SCI was more prevalent than probable dementia (12.2% vs 8.4%). Agreement between measures was 90.0% and of substantial strength. Misclassification rates were higher among older and less-educated subgroups due to higher prevalence of false-positive misclassification but did not vary by sex or race and ethnicity. DISCUSSION SCI sensitivity (63.4%) and specificity (92.5%) against dementia were comparable with similar metrics for the NHATS probable dementia measure against the "gold-standard" Aging, Demographics, and Memory Study-based dementia criteria, implying that population-based surveys may afford cost-effective opportunities for dementia surveillance to assess risk and inform policy. HIGHLIGHTS The prevalence of subjective cognitive impairment (SCI) is generally higher than that of a validated measure of probable dementia, particularly within the youngest age group, females, Whites, and persons with a college or higher degree. Percent agreement between SCI and a validated measure of probable dementia was 90.0% and of substantial strength (prevalence- and bias-adjusted kappa, 0.80). Agreement rates were higher in older and less-educated subgroups, driven by the higher prevalence of false-positive disagreement, but did not vary significantly by sex or race and ethnicity. SCI's overall sensitivity and specificity were 63.4% and 92.5%, respectively, against a validated measure of probable dementia, suggesting utility as a low-cost option for dementia surveillance. Heterogeneity in agreement quality across subpopulations warrants caution in its use for subgroup analyses.
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Affiliation(s)
- Linda C. Chyr
- Enterprise Analytics Core, Elevance Health, Inc.WilmingtonDelawareUSA
| | - Jennifer L. Wolff
- Department of Health Policy and ManagementJohn Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Julie M. Zissimopoulos
- Sol Price School of Public PolicyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Leonard D. Schaeffer Center for Health PolicyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Emmanuel F. Drabo
- Department of Health Policy and ManagementJohn Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
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Goyal P, Didomenico RJ, Pressler SJ, Ibeh C, White-Williams C, Allen LA, Gorodeski EZ. Cognitive Impairment in Heart Failure: A Heart Failure Society of America Scientific Statement. J Card Fail 2024; 30:488-504. [PMID: 38485295 DOI: 10.1016/j.cardfail.2024.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 03/19/2024]
Abstract
Cognitive impairment is common among adults with heart failure (HF), as both diseases are strongly related to advancing age and multimorbidity (including both cardiovascular and noncardiovascular conditions). Moreover, HF itself can contribute to alterations in the brain. Cognition is critical for a myriad of self-care activities that are necessary to manage HF, and it also has a major impact on prognosis; consequently, cognitive impairment has important implications for self-care, medication management, function and independence, and life expectancy. Attuned clinicians caring for patients with HF can identify clinical clues present at medical encounters that suggest cognitive impairment. When present, screening tests such as the Mini-Cog, and consideration of referral for comprehensive neurocognitive testing may be indicated. Management of cognitive impairment should focus on treatment of underlying causes of and contributors to cognitive impairment, medication management/optimization, and accommodation of deficiencies in self-care. Given its implications on care, it is important to integrate cognitive impairment into clinical decision making. Although gaps in knowledge and challenges to implementation exist, this scientific statement is intended to guide clinicians in caring for and meeting the needs of an increasingly complex and growing subpopulation of patients with HF.
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Affiliation(s)
- Parag Goyal
- Program for the Care and Study of the Aging Heart, Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Robert J Didomenico
- University of Illinois Chicago College of Pharmacy, Department of Pharmacy Practice, Chicago, IL
| | | | - Chinwe Ibeh
- Columbia University Irving Medical Center, New York, NY
| | | | - Larry A Allen
- University of Colorado School of Medicine, Aurora, CO
| | - Eiran Z Gorodeski
- University Hospitals, Harrington Heart & Vascular Institute, and Case Western Reserve University School of Medicine, Cleveland, OH.
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McDaniel SL, Shuster LI, Kennedy MRT. Clock Drawing Test Performance of Young Adults Based on a One-Shot Case Study. Arch Clin Neuropsychol 2024; 39:175-185. [PMID: 37565493 DOI: 10.1093/arclin/acad061] [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] [Accepted: 07/17/2023] [Indexed: 08/12/2023] Open
Abstract
OBJECTIVE The clock drawing test (CDT) is being used regularly by medical professionals in a variety of settings to aid in assessing cognitive functioning in adults of all ages. As our technological environment has changed significantly, because of the inception of this measure, the use of and exposure to the analog clock have diminished. We investigated whether young adults, who have grown up in a mainly digital world, can draw and tell time on an analog clock. METHOD Participants aged 18-30 years (N = 80, Mage = 24.2, SD = 3.93), who self-identified as having normal cognition, completed the CDT, as well as setting hands on a pre-drawn clock and identifying analog clock times. RESULTS About 25% of participants received a CDT score below the expected range. There was a moderate, positive correlation between analog clock hand setting and time identification in the group who scored below the expected range on the CDT only (rs(16) = 0.472, p = .048). Most participants reported not wearing an analog watch. CONCLUSIONS Based on these findings, the CDT should be used with caution to screen cognitive functioning in young adults (i.e., aged 18-30 years). Consideration of an alternative approach to screening cognition and modifying cognitive assessments in which the CDT is embedded is recommended for this population. These findings warrant further investigation into CDT performance in the young adult population.
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Affiliation(s)
- Samantha L McDaniel
- Department of Health and Human Services, Interdisciplinary Health Sciences, Western Michigan University, Kalamazoo, MI 49008, USA
- Georgia Southern University, Communication Sciences and Disorders Program, Savannah, GA 31419, USA
| | - Linda I Shuster
- Department of Speech, Language and Hearing Sciences, Western Michigan University, Kalamazoo, MI 49008, USA
| | - Mary R T Kennedy
- Department of Communication Sciences and Disorders, Chapman University, Irvine, CA 92618, USA
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Bhattacharyya B, Paplikar A, Varghese F, Das G, Shukla V, Arshad F, Gupta A, Mekala S, Mukherjee A, Mukherjee R, Venugopal A, Tripathi M, Ghosh A, Biswas A, Alladi S. Illiterate Addenbrooke's Cognitive Examination-III in Three Indian Languages: An Adaptation and Validation Study. Arch Clin Neuropsychol 2024:acad106. [PMID: 38273465 DOI: 10.1093/arclin/acad106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/15/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Literacy is an important factor that predicts cognitive performance. Existing cognitive screening tools are validated only in educated populations and are not appropriate for older adults with little or no education leading to poor performance on these tests and eventually leading to misdiagnosis. This challenge for clinicians necessitates a screening tool suitable for illiterate or low-literate older individuals. OBJECTIVES The objective was to adapt and validate Addenbrooke's Cognitive Examination-III (ACE-III) for screening general cognitive functions in illiterate and low-literate older populations in the Indian context in three languages. METHOD The Indian illiterate ACE-III was systematically adapted by modifying the original items of the Indian literate ACE-III to assess the cognitive functions of illiterates and low-literates with the consensus of an expert panel of professionals working in the area of dementia and related disorders. A total of 180 illiterate or low-literate participants (84 healthy-controls, 50 with dementia, and 46 with mild cognitive impairment [MCI]) were recruited from three different centers speaking Bengali, Hindi, and Kannada to validate the adapted version. RESULTS The optimal cut-off score for illiterate ACE-III to distinguish controls from dementia in all 3 languages was 75. The optimal cut-off scores in distinguishing between controls and MCI ranged from 79 to 82, with a sensitivity ranging from 93% to 99% and a specificity ranging from 72% to 99%. CONCLUSION The test is found to have good psychometric properties and is a reliable cognitive screening tool for identifying dementia and MCI in older adults with low educational backgrounds in the Indian context.
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Affiliation(s)
- Bidisha Bhattacharyya
- Department of Neurology, Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Avanthi Paplikar
- Department of Speech and Language Studies, Dr. S. R. Chandrasekhar Institute of Speech and Hearing, Bengaluru, India
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Feba Varghese
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Gautam Das
- Department of Neurology, Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Vasundhara Shukla
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Faheem Arshad
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Aakansha Gupta
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Shailaja Mekala
- Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Adreesh Mukherjee
- Department of Neurology, Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Ruchira Mukherjee
- Department of Neurology, Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Aparna Venugopal
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
- Department of Speech Language Pathology and Audiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Amitabha Ghosh
- Department of Neurology, Apollo Multispecialty Hospital, Kolkata, India
| | - Atanu Biswas
- Department of Neurology, Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Kaļva K, Zdanovskis N, Šneidere K, Kostiks A, Karelis G, Platkājis A, Stepens A. Whole Brain and Corpus Callosum Fractional Anisotropy Differences in Patients with Cognitive Impairment. Diagnostics (Basel) 2023; 13:3679. [PMID: 38132263 PMCID: PMC10742911 DOI: 10.3390/diagnostics13243679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/20/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Diffusion tensor imaging (DTI) is an MRI analysis method that could help assess cognitive impairment (CI) in the ageing population more accurately. In this research, we evaluated fractional anisotropy (FA) of whole brain (WB) and corpus callosum (CC) in patients with normal cognition (NC), mild cognitive impairment (MCI), and moderate/severe cognitive impairment (SCI). In total, 41 participants were included in a cross-sectional study and divided into groups based on Montreal Cognitive Assessment (MoCA) scores (NC group, nine participants, MCI group, sixteen participants, and SCI group, sixteen participants). All participants underwent an MRI examination that included a DTI sequence. FA values between the groups were assessed by analysing FA value and age normative percentile. We did not find statistically significant differences between the groups when analysing CC FA values. Both approaches showed statistically significant differences in WB FA values between the MCI-SCI and MCI-NC groups, where the MCI group participants showed the highest mean FA and highest mean FA normative percentile results in WB.
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Affiliation(s)
- Kalvis Kaļva
- Department of Radiology, Riga Stradins University, LV-1007 Riga, Latvia; (K.K.)
- Department of Radiology, Riga East Clinical University Hospital, LV-1038 Riga, Latvia
| | - Nauris Zdanovskis
- Department of Radiology, Riga Stradins University, LV-1007 Riga, Latvia; (K.K.)
- Department of Radiology, Riga East Clinical University Hospital, LV-1038 Riga, Latvia
- Military Medicine Research and Study Centre, Riga Stradins University, LV-1007 Riga, Latvia
| | - Kristīne Šneidere
- Military Medicine Research and Study Centre, Riga Stradins University, LV-1007 Riga, Latvia
- Department of Health Psychology and Paedagogy, Riga Stradins University, LV-1007 Riga, Latvia
| | - Andrejs Kostiks
- Department of Neurology and Neurosurgery, Riga East University Hospital, LV-1038 Riga, Latvia; (A.K.)
| | - Guntis Karelis
- Department of Neurology and Neurosurgery, Riga East University Hospital, LV-1038 Riga, Latvia; (A.K.)
- Department of Infectology, Riga Stradins University, LV-1007 Riga, Latvia
| | - Ardis Platkājis
- Department of Radiology, Riga Stradins University, LV-1007 Riga, Latvia; (K.K.)
- Department of Radiology, Riga East Clinical University Hospital, LV-1038 Riga, Latvia
| | - Ainārs Stepens
- Military Medicine Research and Study Centre, Riga Stradins University, LV-1007 Riga, Latvia
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Sepúlveda-Ibarra C, Chaparro FH, Marcotti A, Soto G, Slachevsky A. Normalization of Rowland Universal Dementia Assessment Scale (RUDAS) in Chilean older people. Dement Neuropsychol 2023; 17:e20230033. [PMID: 38089173 PMCID: PMC10715235 DOI: 10.1590/1980-5764-dn-2023-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/12/2023] [Indexed: 02/01/2024] Open
Abstract
Rowland Universal Dementia Assessment Scale (RUDAS) is a cognitive screening that evaluates older people with low educational levels. In Chile, there are no normative data to assess this population. Objective To obtain normative data on RUDAS in older Chilean people with up to 12 years of schooling, and to determine whether age and schooling years influence a person's performance on RUDAS and on the items that constitute it. Methods A group of cognitively healthy people 60 years old or over, with up to 12 schooling years was evaluated (n=135). Multiple regression models were applied to obtain normative data on RUDAS, according to age and schooling years, and to measure the effects of schooling on different items. Results Regression analysis showed that none of the items had schooling as a significant predictor, except for the visuoconstruction item. The variables age and schooling explained 12.6% (R^2=0.126) of the RUDAS total score variance. The item visuoconstruction was the most associated with the educational level (OR=1,147). Conclusion This study showed that RUDAS is a recommended instrument for evaluating older people with low educational levels. However, more studies are needed to prove the validity of the RUDAS on Chilean older people.
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Affiliation(s)
- Consuelo Sepúlveda-Ibarra
- Universidad Bernardo O’Higgins, Facultad de Ciencias de la Salud, Escuela de Fonoaudiología, Santiago, Chile
- Universidad de Chile, Facultad de Filosofía y Humanidades, Santiago, Chile
| | - Fernando Henríquez Chaparro
- Geroscience Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Program Institute of Biomedical Sciences, Neuroscience and East Neuroscience Departments, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador Neurology Department, Memory and Neuropsychiatric Center, Santiago, Chile
- Pontificia Universidad Católica de Chile, Facultad de Medicina, Laboratorio de Neurociencia Cognitiva y Evolutiva, Santiago, Chile
| | - Anthony Marcotti
- Universidad San Sebastián, Facultad de Odontología y Ciencias de la Rehabilitación, Escuela de Fonoaudiología, Santiago, Chile
- Pontificia Universidad Católica de Chile, Facultad de Ciencias Sociales, Escuela de Psicología, Programa de Doctorado en Psicología, Santiago, Chile
| | - Guillermo Soto
- Universidad de Chile, Facultad de Filosofía y Humanidades, Santiago, Chile
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Program Institute of Biomedical Sciences, Neuroscience and East Neuroscience Departments, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador Neurology Department, Memory and Neuropsychiatric Center, Santiago, Chile
- Clínica Alemana-Universidad del Desarrollo, Departamento de Medicina, Servicio de Neurología, Santiago, Chile
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Brown MT, Brangman SA, Smith NH. Early Identification of Cognitive Impairment: Utility of the Mini-Cog in Non-Clinical Settings. J Appl Gerontol 2023; 42:2139-2147. [PMID: 37224462 DOI: 10.1177/07334648231175606] [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] [Indexed: 05/26/2023] Open
Abstract
While we currently cannot cure Alzheimer's disease or change the course of the disease, there are advantages to early detection. Routine, evidence based, brief cognitive screens offer destigmatized opportunities for diagnosis and improve the possibility of early identification of cognitive impairment. This community-based participatory research project evaluated the use of the Mini-Cog™ instrument to detect cognitive impairment in vulnerable community-dwelling older adults when administered by trained social services providers. Over 9 months, a case manager screened 69 clients ages 65 to 94 (mean 74.67) who met inclusion criteria for the pilot; 84.1% were female, 53.6% were Black, 26% were living with undetected cognitive impairment. Although participants agreed to Mini-Cog™ screening, two-thirds with Mini-Cog™ scores indicating cognitive impairment refused referrals for further evaluation. Future interventions should reduce stigma by educating the public about dementia and engaging members of racial and cultural communities in outreach.
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Affiliation(s)
- Maria Teresa Brown
- School of Social Work and Aging Studies Institute, Syracuse University, Syracuse, NY, USA
| | - Sharon A Brangman
- Department of Geriatrics, State University of New York Upstate Medical University, Syracuse, NY, USA
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O’Donovan MR, Cornally N, O’Caoimh R. Validation of a Harmonised, Three-Item Cognitive Screening Instrument for the Survey of Health, Ageing and Retirement in Europe (SHARE-Cog). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6869. [PMID: 37835139 PMCID: PMC10572728 DOI: 10.3390/ijerph20196869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 10/15/2023]
Abstract
More accurate and standardised screening and assessment instruments are needed for studies to better understand the epidemiology of mild cognitive impairment (MCI) and dementia in Europe. The Survey of Health, Ageing and Retirement in Europe (SHARE) does not have a harmonised multi-domain cognitive test available. The current study proposes and validates a new instrument, the SHARE cognitive instrument (SHARE-Cog), for this large European longitudinal cohort. Three cognitive domains/sub-tests were available across all main waves of the SHARE and incorporated into SHARE-Cog; these included 10-word registration, verbal fluency (animal naming) and 10-word recall. Subtests were weighted using regression analysis. Diagnostic accuracy was assessed from the area under the curve (AUC) of receiver operating characteristic curves. Diagnostic categories included normal cognition (NC), subjective memory complaints (SMC), MCI and dementia. A total of 20,752 participants were included from wave 8, with a mean age of 75 years; 55% were female. A 45-point SHARE-Cog was developed and validated and had excellent diagnostic accuracy for identifying dementia (AUC = 0.91); very good diagnostic accuracy for cognitive impairment (MCI + dementia), (AUC = 0.81); and good diagnostic accuracy for distinguishing MCI from dementia (AUC = 0.76) and MCI from SMC + NC (AUC = 0.77). SHARE-Cog is a new, short cognitive screening instrument developed and validated to assess cognition in the SHARE. In this cross-sectional analysis, it has good-excellent diagnostic accuracy for identifying cognitive impairment in this wave of SHARE, but further study is required to confirm this in previous waves and over time.
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Affiliation(s)
- Mark R. O’Donovan
- Health Research Board Clinical Research Facility, University College Cork, Mercy University Hospital, T12WE28 Cork, Ireland;
| | - Nicola Cornally
- Catherine McAuley School of Nursing and Midwifery, University College Cork, T12AK54 Cork, Ireland;
| | - Rónán O’Caoimh
- Health Research Board Clinical Research Facility, University College Cork, Mercy University Hospital, T12WE28 Cork, Ireland;
- Department of Geriatric Medicine, Mercy University Hospital, T12WE28 Cork, Ireland
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13
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Monteiro AM, Borges MK. Association of frailty with cognitive impairment and functional disability in older adults with affective disorders: a brief research report. Front Psychiatry 2023; 14:1181997. [PMID: 37496684 PMCID: PMC10366589 DOI: 10.3389/fpsyt.2023.1181997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/20/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction The Clinical-Functional Vulnerability Index (IVCF-20) is a validated multidimensional instrument that has been used in Brazil to evaluate functional disability in frail older adults. The main aim of this study was to assess frailty using this novel screening tool. In addition, to investigate whether frailty was associated with cognitive impairment and functional disability in older adults with affective disorders. Methods Participants included were over 60 years old, with affective disorders (depressive or anxiety disorders), from two specialized outpatient clinics. The sample was comprised of 46 patients (30% of a total from 153). The following instruments were applied: Clock Drawing Test (CDT), Mini Mental State Examination (MMSE); Verbal Fluency Test (VFT); Pfeffer Questionnaire or Functional Assessment Questionnaire (FAQ); Katz Index; Geriatric Depression Scale (GDS-15); Geriatric Anxiety Inventory (GAI), and IVCF-20 as well as sociodemographic and clinical questionnaires. The association between the variables of interest was estimated using Spearman correlation. Results This study found a negative correlation between frailty and cognitive decline (MMSE; rs = -0.58; p < 0.001); (VFT; rs = -0.60; p < 0.001); (CDT; rs = -0.47; p = 0.001) and a positive correlation between frailty and depressive symptoms (GDS-15; rs = 0.34; p = 0.019) as well as disability for IADLs (FAQ; rs = 0.69; p < 0.001). However, there was no statistical difference in the association between frailty and anxiety symptoms (GAI; rs = 0.24; p = 0.103) or disability for BADLs (Katz; rs = -0.02; p = 0.895). Discussion Our data support that the associations between frailty, cognitive and functional disability are prevalent issues in Psychogeriatrics. Assessing frailty in a multidimensional context is essential using a rapid assessment frailty tool in clinical practice.
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Affiliation(s)
- Ariane M. Monteiro
- Department of Internal Medicine, Post-Graduate Program of Internal Medicine and Health Sciences (PPGMICS), Complexo do Hospital de Clínicas, Universidade Federal do Paraná (CHC-UFPR), Curitiba, Brazil
| | - Marcus K. Borges
- Department of Internal Medicine and Psychiatry (Geriatric Psychiatry), Post-Graduate Program of Internal Medicine and Health Sciences (PPGMICS), Complexo do Hospital de Clínicas, Universidade Federal do Paraná (CHC-UFPR), Curitiba, Brazil
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Fakoury MK, Schmidt SL, Brandão Mello CE, Filho ADC, Amendola Pires MM. Cognitive Performance in Asymptomatic Elderly People with Hepatitis C: The Role of Education. J Clin Med 2023; 12:4588. [PMID: 37510703 PMCID: PMC10380825 DOI: 10.3390/jcm12144588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Neurotropism of the hepatitis C virus (HCV) can be the source of subtle neuropsychological symptoms in non-cirrhotic patients. Age is a risk factor for cognitive impairment (CI). Thus, asymptomatic elderly people who carry HCV might be at a greater risk of CI. Education can influence test performance. OBJECTIVES (1) To verify whether elderly people with HCV performed poorer than controls on cognitive tests. (2) To analyze how education affects performance. (3) To verify whether the extent of the effect of education on performance depends on the group (HCV vs. controls) and the type of cognitive test. METHODS Asymptomatic HCV carriers older than 60 years (n = 41) were matched with 41 corresponding controls. All participants performed the following tests: Mini-Cog, Mini Mental State Examination, clock drawing test (CDT), and verbal fluency. RESULTS (1) There were no significant differences in cognitive performance between the two groups. (2) Higher education was always associated with better performance. (3) There was a significant group difference in the slopes of the regression lines between years of education and CDT performance. No differences were found for the other three tests. CONCLUSION Considering the scores on the CDT, the rate of improvement in performance when schooling increases is higher in HCV carriers.
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Affiliation(s)
- Max Kopti Fakoury
- Department of Internal Medicine, Gaffrée and Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
- Graduate Program in Neurology, Department of Neurology, PPGNEURO-UNIRIO, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
- Laboratory of Behavioral Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
- RENASCER Multidisciplinary Program of the Third Age, Gaffrée and Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
| | - Sergio Luis Schmidt
- Graduate Program in Neurology, Department of Neurology, PPGNEURO-UNIRIO, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
- Laboratory of Behavioral Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
- RENASCER Multidisciplinary Program of the Third Age, Gaffrée and Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
| | - Carlos Eduardo Brandão Mello
- Department of Internal Medicine, Gaffrée and Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
- Graduate Program in Neurology, Department of Neurology, PPGNEURO-UNIRIO, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
- Graduate Program in HIV/AIDS Infection and Viral Hepatitis, PPGHIV/HV-UNIRIO, School of Medicine and Surgery, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
| | - Aureo do Carmo Filho
- Graduate Program in Neurology, Department of Neurology, PPGNEURO-UNIRIO, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
- Laboratory of Behavioral Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
| | - Marcia Maria Amendola Pires
- Graduate Program in Neurology, Department of Neurology, PPGNEURO-UNIRIO, Federal University of the State of Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
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15
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Huang X, Deng J, Liu W. Sex differences in cognitive function among Chinese older adults using data from the Chinese longitudinal healthy longevity survey: a cross-sectional study. Front Public Health 2023; 11:1182268. [PMID: 37457255 PMCID: PMC10343959 DOI: 10.3389/fpubh.2023.1182268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Objective To compare the sex differences in cognitive function and its influencing factors among Chinese older adults. Method We conducted a cross-sectional study by using data from the China Longitudinal Healthy Longevity Survey (CLHLS). According to the 32 provinces and 4 municipalities directly under the Central Government of China, 3-5 counties or districts were randomly selected in each province or city (except Tibet), and then 1-3 villages or streets were randomly selected in each county or district, from which the target population was sampled. Mini Mental State Examination (MMSE) was used to assess the cognitive function of 9,262 older adults aged 65 and above in China. Descriptive analysis was applied to demonstrate the participants' demographic characteristics, health-related behaviors, social and non-social activity, disease status, mental and sleep condition. And then, univariate and multifactor analyses were performed to validate different risk factors for cognitive function, respectively in the general population, male older adults and female older adults. Result The older adults with cognitive impairment accounted for 10.4% of the total population. There are significant differences in cognitive function between male and female older adults. The odds of cognitive impairment in older adult women was 1.291 times that of older adult men (OR = 1.291, 95%CI: 1.084-1.538). Among the male older adults, those who were older, highly educated, spouseless, had depressive symptoms, and lacked social activities were more likely to have cognitive impairment, whereas among the female older adults, those who were older, highly educated, and lacked social activities were more likely to have cognitive impairment. Conclusion Overall, there are subtle differences in potential influencing factors for cognitive function between the male older adults and female older adults. Attention should be paid to the different cognitive protection measures for the older adults with different sexes.
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Affiliation(s)
- Xiao Huang
- School of Health Management, Fujian Medical University, Fuzhou, Fujian, China
| | - Jiahui Deng
- Centre for Health Management and Policy Research, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Wenbin Liu
- School of Health Management, Fujian Medical University, Fuzhou, Fujian, China
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16
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Mailliez A, Ternynck C, Jannin A, Lemaître M, Chevalier B, Le Mapihan K, Defrance F, Mackowiak MA, Rollin A, Mehdi M, Chetboun M, Pattou F, Pasquier F, Vantyghem MC. Cognitive Outcome After Islet Transplantation. Transplant Direct 2023; 9:e1493. [PMID: 37250488 PMCID: PMC10219717 DOI: 10.1097/txd.0000000000001493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/21/2023] [Accepted: 04/07/2023] [Indexed: 05/31/2023] Open
Abstract
Severe or repeated hypoglycemia events may favor memory complaints in type 1 diabetes (T1D). Pancreatic islet transplantation (IT) is an alternative option to exogenous insulin therapy in case of labile T1D, implying a maintenance immunosuppression regimen based on sirolimus or mycophenolate, associated with tacrolimus, that may also have neurological toxicity. The objective of this study was to compare a cognitive rating scale Mini-Mental State Examination (MMSE) between T1D patients with or without IT and to identify parameters influencing MMSE. Methods This retrospective cross-sectional study compared MMSE and cognitive function tests between islet-transplanted T1D patients and nontransplanted T1D controls who were transplant candidates. Patients were excluded if they refused. Results Forty-three T1D patients were included: 9 T1D patients before IT and 34 islet-transplanted patients (14 treated with mycophenolate and 20 treated with sirolimus). Neither MMSE score (P = 0.70) nor higher cognitive function differed between islet versus non-islet-transplanted patients, whatever the type of immunosuppression. In the whole population (N = 43), MMSE score was negatively correlated to glycated hemoglobin (r = -0.30; P = 0.048) and the time spent in hypoglycemia on the continuous glucose monitoring (r = -0.32; P = 0.041). MMSE score was not correlated to fasting C-peptide level, time spent in hyperglycemia, average blood glucose, time under immunosuppression, duration of diabetes, or beta-score (success score of IT). Conclusions This first study evaluating cognitive disorders in islet-transplanted T1D patients argues for the importance of glucose balance on cognitive function rather than of immunosuppressive treatment, with a favorable effect of glucose balance improvement on MMSE score after IT.
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Affiliation(s)
- Aurélie Mailliez
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
- Univ Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de Risque et Déterminants Moléculaires des Maladies Liées au Vieillissement, Lille, France
| | - Camille Ternynck
- Univ Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des technologies de santé et des pratiques médicales, Lille, France
| | - Arnaud Jannin
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
| | - Madleen Lemaître
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
| | - Benjamin Chevalier
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
| | - Kristell Le Mapihan
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
| | - Frédérique Defrance
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
| | | | | | | | - Mikael Chetboun
- CHU Lille, Department of Endocrine Surgery, Lille, France
- Inserm U1190, Lille, France
| | - François Pattou
- CHU Lille, Department of Endocrine Surgery, Lille, France
- Inserm U1190, Lille, France
- Univ Lille, European Genomic Institute for Diabetes, Lille, France
| | | | - Marie-Christine Vantyghem
- CHU Lille, Department of Endocrinology, Diabetology, Metabolism and Nutrition, Lille, France
- Inserm U1190, Lille, France
- Univ Lille, European Genomic Institute for Diabetes, Lille, France
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Pelegrini LNDC, Casemiro FG, Bregola A, Ottaviani AC, Pavarini SCI. Performance of older adults in a digital change detection task: The role of heterogeneous education. APPLIED NEUROPSYCHOLOGY: ADULT 2023:1-9. [DOI: 10.1080/23279095.2023.2189520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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18
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Petri M, Messinis L, Patrikelis P, Nousia A, Nasios G. Illiteracy, Neuropsychological Assessment, and Cognitive Rehabilitation: A Narrative Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:477-484. [PMID: 37581821 DOI: 10.1007/978-3-031-31986-0_46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
OBJECT Νeuropsychological assessment is particularly important for the accurate discrimination of cognitive abilities and weaknesses of patients in order to determine the appropriate therapeutic intervention. However, the reliability and validity of neuropsychological assessment appears to be influenced by a wide range of factors, including literacy and educational level. AIM This systematic review evaluates neuropsychological tests appropriate for the valid assessment of illiterate individuals and the effectiveness of cognitive rehabilitation programs for illiterate and/or low-educated individuals according to the results of English language studies that have been published in the PubMed/Medline electronic database until August 2022 (no initiation date). RESULTS 49 studies were included for neuropsychological assessment and 4 studies for cognitive rehabilitation. In terms of investigating the validity and reliability of neuropsychological tests for the assessment of healthy illiterate individuals, most studies concluded that for the majority of neuropsychological tests there is a significant difference in performance between healthy illiterate and literate individuals. However, there was consensus among studies that the performance of illiterate subjects was equivalent to the performance of literate subjects on tasks depicting colored and real objects. Regarding cognitive rehabilitation programs, all four studies concluded that they are effective in improving the cognitive functions of illiterate and/or low-literate patients with mild cognitive impairment and/or mild dementia. CONCLUSIONS For the assessment of illiterate individuals, it is imperative that neuropsychological tests with high ecological validity (i.e., tests related to activities of daily living) be administered so as not to underestimate their cognitive functioning. At the same time, cognitive enhancement/stimulation programs seem to be effective in this population group; however, this area needs further investigation.
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Affiliation(s)
- Maria Petri
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lambros Messinis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Panayiotis Patrikelis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Nousia
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Ramos-Henderson M, Calderón C, Domic-Siede M. Education bias in typical brief cognitive tests used for the detection of dementia in elderly population with low educational level: a critical review. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-9. [PMID: 36519252 DOI: 10.1080/23279095.2022.2155521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Dementia is a significant decline in cognition that interfere with independent, daily functioning. Dementia is a syndrome caused by a myriad and include primary neurologic, neuropsychiatric, and medical conditions. It has been projected that the prevalence of dementia will triple in the elderly population by the year 2050. Despite the benefits of early diagnosis, there is an effective under-detection of around 62% of people with mild cognitive impairment (MCI) or dementia. One of the factors associated with this problem is that diagnostic techniques are affected by the educational level of those evaluated. This is an important aspect to consider in the use of brief cognitive tests for the detection of dementia. This review presents and critically analyzes the available evidence regarding the effect of educational level on the diagnostic utility of three of the most widely used tools in the clinical setting: the Mini-mental Test Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Addenbrooke's Cognitive Examination (ACE). Previous evidence shows that the tasks that require reading, writing, calculation, phonological fluency, and visuoconstruction are affected by educational level. These results lead to discourage the use of these tests in older people with less than 6 years of schooling. The development of brief cognitive tests appropriate for people with a low educational level is recommended. We posit that adequate cognitive tests should not consider tasks or items that resemble characteristics of academic contexts and should be more analogous to daily activities situations.
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Affiliation(s)
- Miguel Ramos-Henderson
- Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Facultad de Humanidades, Universidad Católica del Norte, Antofagasta, Chile
- Centro de Investigación e Innovación en Gerontología Aplicada CIGAP, Facultad de Salud, Universidad Santo Tomás, Antofagasta, Chile
| | - Carlos Calderón
- Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Facultad de Humanidades, Universidad Católica del Norte, Antofagasta, Chile
| | - Marcos Domic-Siede
- Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Facultad de Humanidades, Universidad Católica del Norte, Antofagasta, Chile
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Giaquinto F, Battista P, Angelelli P. Touchscreen Cognitive Tools for Mild Cognitive Impairment and Dementia Used in Primary Care Across Diverse Cultural and Literacy Populations: A Systematic Review. J Alzheimers Dis 2022; 90:1359-1380. [PMID: 36245376 DOI: 10.3233/jad-220547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Touchscreen cognitive tools opened new promising opportunities for the early detection of cognitive impairment; however, most research studies are conducted in English-speaking populations and high-income countries, with a gap in knowledge about their use in populations with cultural, linguistic, and educational diversity. OBJECTIVE To review the touchscreen tools used in primary care settings for the cognitive assessment of mild cognitive impairment (MCI) and dementia, with a focus on populations of different cultures, languages, and literacy. METHODS This systematic review was conducted following the PRISMA guidelines. Studies were identified by searching across MEDLINE, EMBASE, EBSCO, OVID, SCOPUS, SCIELO, LILACS, and by cross-referencing. All studies that provide a first-level cognitive assessment for MCI and dementia with any touchscreen tools suitable to be used in the context of primary care were included. RESULTS Forty-two studies reporting on 30 tools and batteries were identified. Substantial differences among the tools emerged, in terms of theoretical framework, clinical validity, and features related to the application in clinical practice. A small proportion of the tools are available in multiple languages. Only 7 out of the 30 tools have a multiple languages validation. Only two tools are validated in low-educated samples, e.g., IDEA and mSTS-MCI. CONCLUSION General practitioners can benefit from touchscreen cognitive tools. However, easy requirements of the device, low dependence on the examiner, fast administration, and adaptation to different cultures and languages are some of the main features that we need to take into consideration when implementing touchscreen cognitive tools in the culture and language of underrepresented populations.
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Affiliation(s)
- Francesco Giaquinto
- Department of History, Laboratory of Applied Psychology and Intervention, Society and Human Studies, University of Salento, Lecce, Italy
| | - Petronilla Battista
- Clinical and Scientific Institutes Maugeri Pavia, Scientific Institute of Bari, IRCCS, Italy
| | - Paola Angelelli
- Department of History, Laboratory of Applied Psychology and Intervention, Society and Human Studies, University of Salento, Lecce, Italy
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21
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Nyholm E, Torkpoor R, Frölich K, Londos E, Cicognola C. A Retrospective Study on Clinical Assessment of Cognitive Impairment in a Swedish Cohort: Is There Inequality Between Natives and Foreign-Born? J Alzheimers Dis 2022; 89:1403-1412. [PMID: 36057817 PMCID: PMC9661324 DOI: 10.3233/jad-220177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND People with a migration background are underrepresented in dementia research and disfavored in assessment and treatment, and many foreign-born individuals with dementia remain undiagnosed. OBJECTIVE The aim of this study was to examine whether there is inequality in the clinical assessment of dementia between native and foreign-born individuals in Sweden. METHODS Information was gathered retrospectively from a cohort of 91 native and 36 foreign-born patients attending four memory clinics in Skåne, Sweden. Data included information on cognitive test results, cerebrospinal fluid biomarkers, scores at structural imaging scales of global cortical atrophy (GCA), medial temporal lobe atrophy (MTA) and the Fazekas scale, laboratory measures of thyroid-stimulating hormone, calcium, albumin, homocysteine, hemoglobin, cobalamin (vitamin B12), and folate (vitamin B9), contact with health care, and treatment. RESULTS Foreign-born patients had lower educational level and scored lower on Mini-Mental State Examination and Clock Drawing Test (p < 0.001-0.011). Relatives initiated contact with health care to a higher extent in the foreign-born group (p = 0.031). Foreign-born patients had less white matter lesions (p = 0.018). Additionally, Alzheimer's disease (AD) biomarkers were significantly less used in foreign-born patients to support an AD diagnosis (p = 0.001). No significant differences were found for scores on GCA and MTA, laboratory measures, or initiated treatment. CONCLUSION Although native and foreign-born patients were predominantly homogenous regarding examined variables, differences in the diagnostic process and underlying biological correlates of dementia exist and need to be further investigated in a larger sample.
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Affiliation(s)
- Ebba Nyholm
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Rozita Torkpoor
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Kristin Frölich
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Elisabet Londos
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Claudia Cicognola
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden,Memory Clinic, Skåne University Hospital, Malmö, Sweden,Correspondence to: Claudia Cicognola, Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden. E-mail:
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22
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Pelegrini LNDC, Casemiro FG, Zanarelli P, Rodrigues RAP. Socio-cognitive mindfulness predicts memory complaint and cognitive performance of older adults with different years of education. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-8. [PMID: 36121110 DOI: 10.1080/23279095.2022.2124374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Even though the effect of education on cognitive performance has been widely reported, the relationship between socio-cognitive mindfulness, cognitive performance, and memory complaint among the elderly with heterogeneous educational levels has not yet been investigated. AIM This study aimed to analyze the potential relationship between cognitive performance, memory complaint, and socio-cognitive mindfulness in a sample of healthy older adults with different years of education. METHODS In this quantitative, cross-sectional, observational, and analytical study, participants (n = 68) were assessed with a sociodemographic questionnaire, cognitive performance test (ACE-III), levels of socio-cognitive mindfulness (LSM-21), and memory complaint (Memory Complaint Scale). Descriptive statistics, as well as Pearson's correlation, and linear regression analysis were performed, and significance was assumed if p < .05. RESULTS Years of education correlated with cognitive performance and socio-cognitive mindfulness, but not with memory complaint. Socio-cognitive mindfulness had a positive correlation with cognitive performance and a negative correlation with memory complaint. Also, socio-cognitive mindfulness predicted cognitive performance and memory complaint both in bivariate analysis and when controlling for years of education. CONCLUSION Our findings suggested that older adults with higher levels of socio-cognitive mindfulness showed better cognitive performance and less memory complaint.
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Affiliation(s)
| | | | - Paloma Zanarelli
- Department of Gerontology, Federal University of São Carlos, Sao Carlos, Brazil
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23
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Liu Y, Wu Y, Cai J, Huang Y, Chen Y, Venkatraman TM, Lobanov‐Rostovsky S, Bandosz P, Yang Y, Wu Y, Liao J, Hao Y, Brunner EJ. Is there a common latent cognitive construct for dementia estimation across two Chinese cohorts? ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2022; 14:e12356. [PMID: 36177152 PMCID: PMC9473486 DOI: 10.1002/dad2.12356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/19/2022] [Accepted: 08/09/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Yuyang Liu
- Department of Medical Statistics School of Public Health Sun Yat‐sen University Guangzhou People's Republic of China
- Sun Yat‐sen Global Health Institute School of Public Health and Institute of State Governance Sun Yat‐sen University Guangzhou People's Republic of China
| | - Yanjuan Wu
- Department of Medical Statistics School of Public Health Sun Yat‐sen University Guangzhou People's Republic of China
- Sun Yat‐sen Global Health Institute School of Public Health and Institute of State Governance Sun Yat‐sen University Guangzhou People's Republic of China
| | - Jingheng Cai
- Department of Statistics Sun Yat‐sen University Guangzhou People's Republic of China
| | - Yun Huang
- Guangdong Provincial Center for Disease Control and Prevention Guangzhou People's Republic of China
| | - Yuntao Chen
- Department of Epidemiology & Public Health University College London London UK
| | | | | | - Piotr Bandosz
- Department of Public Health and Policy University of Liverpool Liverpool UK
- Department of Prevention and Medical Education Medical University of Gdansk Gdansk Poland
| | - Yung‐Jen Yang
- Social Research Institute Institute of Education University College London London UK
| | - Yu‐Tzu Wu
- Population Health Sciences Institute Newcastle University Newcastle UK
| | - Jing Liao
- Department of Medical Statistics School of Public Health Sun Yat‐sen University Guangzhou People's Republic of China
- Sun Yat‐sen Global Health Institute School of Public Health and Institute of State Governance Sun Yat‐sen University Guangzhou People's Republic of China
| | - Yuantao Hao
- Department of Medical Statistics School of Public Health Sun Yat‐sen University Guangzhou People's Republic of China
- Sun Yat‐sen Global Health Institute School of Public Health and Institute of State Governance Sun Yat‐sen University Guangzhou People's Republic of China
- Peking University Center for Public Health and Epidemic Preparedness & Response Beijing People's Republic of China
| | - Eric J. Brunner
- Department of Epidemiology & Public Health University College London London UK
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