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Norton J, Gutierrez LA, Gourdeau C, Amieva H, Bernier P, Berr C. Mapping Cognitive Trajectories and Detecting Early Dementia Using the Mini-Mental State Examination Cognitive Charts: Application to the French Three-City Cohort. J Alzheimers Dis 2024; 98:403-409. [PMID: 38393910 DOI: 10.3233/jad-231176] [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: 02/25/2024]
Abstract
The Cognitive Quotient (QuoCo) classification algorithm monitoring decline on age- and education-adjusted Mini-Mental State Examination (MMSE)-derived cognitive charts has proved superior to the conventionally-used cut-off for identifying incident dementia; however, it remains to be tested in different settings. Data were drawn from the Three-City Cohort to 1) assess the screening accuracy of the QuoCo, and 2) compare its performance to that of serial MMSE tests applying different cut-offs. For the QuoCo, sensitivity was 74.2 (95% CI: 71.4-76.8) and specificity 84.1 (83.6-84.7) and for the MMSE < 24, 64.1 (61.1-67.0) and 94.8 (94.4-95.1), respectively; whereas overall accuracy and sensitivity was highest for MMSE cut-offs <25 and <26. User-friendly charts for mapping cognitive trajectories over visits with an alert for potentially 'abnormal' decline can be of practical use and encourage regular monitoring in primary care where the <24 cut-off is still widely used despite its poor sensitivity.
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Affiliation(s)
- Joanna Norton
- Institute for Neurosciences of Montpellier (INM), Inserm, University of Montpellier, Montpellier, France
| | - Laure-Anne Gutierrez
- Institute for Neurosciences of Montpellier (INM), Inserm, University of Montpellier, Montpellier, France
| | | | - Hélène Amieva
- INSERM, Bordeaux Population Health Research Center, UMR U1219, University of Bordeaux, Bordeaux, France
| | - Patrick Bernier
- Specialised Geriatric Services, CIUSSS Capitale-Nationale, Québec City, Canada
| | - Claudine Berr
- Institute for Neurosciences of Montpellier (INM), Inserm, University of Montpellier, Montpellier, France
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Pang Y, Kukull W, Sano M, Albin RL, Shen C, Zhou J, Dodge HH. Predicting Progression from Normal to MCI and from MCI to AD Using Clinical Variables in the National Alzheimer's Coordinating Center Uniform Data Set Version 3: Application of Machine Learning Models and a Probability Calculator. J Prev Alzheimers Dis 2023; 10:301-313. [PMID: 36946457 PMCID: PMC10033942 DOI: 10.14283/jpad.2023.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Clinical trials are increasingly focused on pre-manifest and early Alzheimer's disease (AD). Accurately predicting clinical progressions from normal to MCI or from MCI to dementia/AD versus non-progression is challenging. Accurate identification of symptomatic progressors is important to avoid unnecessary treatment and improve trial efficiency. Due to large inter-individual variability, biomarker positivity and comorbidity information are often insufficient to identify those destined to have symptomatic progressions. Using only clinical variables, we aimed to predict clinical progressions, estimating probabilities of progressions with a small set of variables selected by machine learning approaches. This work updates our previous work that was applied to the National Alzheimer's Coordinating Center (NACC) Uniform Data Set Version 2 (V2), by using the most recent version (V3) with additional analyses. We generated a user-friendly conversion probability calculator which can be used for effectively pre-screening trial participants.
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Affiliation(s)
- Y Pang
- Hiroko H. Dodge, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA,
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3
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Bernier PJ, Gourdeau C, Carmichael PH, Beauchemin JP, Voyer P, Hudon C, Laforce R. It's all about cognitive trajectory: Accuracy of the cognitive charts-MoCA in normal aging, MCI, and dementia. J Am Geriatr Soc 2023; 71:214-220. [PMID: 36102601 PMCID: PMC9870845 DOI: 10.1111/jgs.18029] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 07/27/2022] [Accepted: 08/09/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND The Montreal Cognitive Assessment (MoCA) is an established cognitive screening tool in older adults. It remains unclear, however, how to interpret its scores over time and distinguish age-associated cognitive decline (AACD) from early neurodegeneration. We aimed to create cognitive charts using the MoCA for longitudinal evaluation of AACD in clinical practice. METHODS We analyzed data from the National Alzheimer's Coordinating Center (9684 participants aged 60 years or older) who completed the MoCA at baseline. We developed a linear regression model for the MoCA score as a function of age and education. Based on this model, we generated the Cognitive Charts-MoCA designed to optimize accuracy for distinguishing participants with MCI and dementia from healthy controls. We validated our model using two separate data sets. RESULTS For longitudinal evaluation of the Cognitive Charts-MoCA, sensitivity (SE) was 89%, 95% confidence interval (CI): [86%, 92%] and specificity (SP) 79%, 95% CI: [77%, 81%], hence showing better performance than fixed cutoffs of MoCA (SE 82%, 95% CI: [79%, 85%], SP 68%, 95% CI: [67%, 70%]). For current cognitive status or baseline measurement, the Cognitive Charts-MoCA had a SE of 81%, 95% CI: [79%, 82%], SP of 84%, 95% CI: [83%, 85%] in distinguishing healthy controls from mild cognitive impairment or dementia. Results in two additional validation samples were comparable. CONCLUSIONS The Cognitive Charts-MoCA showed high validity and diagnostic accuracy for determining whether older individuals show abnormal performance on serial MoCAs. This innovative model allows longitudinal cognitive evaluation and enables prompt initiation of investigation and treatment when appropriate.
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Affiliation(s)
- Patrick J. Bernier
- Services Gériatriques Spécialisés, CIUSSS de la Capitale-Nationale, QC, Canada
| | | | | | | | - Philippe Voyer
- Centre d’Excellence sur le Vieillissement de Québec, QC, Canada;,Faculté des sciences infirmières, Université Laval, QC, Canada
| | - Carol Hudon
- École de psychologie, Université Laval, QC, Canada;,CERVO Brain Research Centre, QC, Canada
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire du CHU de Québec, QC, Canada
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Cognitive function, daily function and physical and mental health in older adults: A comparison of venue and home-visit community surveys in Metropolitan Tokyo. Arch Gerontol Geriatr 2021; 100:104617. [DOI: 10.1016/j.archger.2021.104617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 12/21/2021] [Accepted: 12/26/2021] [Indexed: 11/22/2022]
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Boutros S, El Hachem E, Mattar J, Hallit S, Mattar H. Arabic version of the Hayling sentence completion test: scale validation, normative data and factors associated with executive functions in a sample of the Lebanese adults. Head Face Med 2020; 16:36. [PMID: 33308273 PMCID: PMC7730776 DOI: 10.1186/s13005-020-00251-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 12/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was conducted for several reasons, primarily because of the lack of an Arabic version of the HSCT that could be beneficial in our clinical practice. Another reason is the need to find potential relationships between various factors with executive functions, especially problematic mobile phone use as suggested by many previous studies, since smartphones have become, nowadays, a daily companion of people from all generations. Thus, it is important to conduct this study in Lebanon to be adapted to the ideas, customs and social behavior of the Lebanese citizens. Hence, the objectives of the current study are to use the Arabic version of the HSCT in healthy community-dwelling Arabic-speaking adults in Lebanon, to check its validity compared to other versions of the test, as well as to identify risk factors that might affect the executive functions in these adults. METHODS Between August-December 2019, 350 participants were randomly selected. The Arabic version of the HSCT, divided into automatic and inhibition conditions, was used; in each condition, participants' response-time and number of errors committed were recorded. RESULTS None of the scale items was removed. For the automatic condition, response-time items converged over one factor (αCronbach = 0.905) and number of errors converged over seven factors (αCronbach = 0.334). For the inhibition condition, response-time converged over one factor (αCronbach = 0.943) and number of errors converged over four factors (αCronbach = 0.728). Using electricity as a heating method inside the house was significantly associated with a lower response-time, whereas higher problematic mobile phone use was associated with higher response-time. Using wood as a heating system inside the house and higher problematic mobile phone use were associated with higher number of errors, while using Arabian incense (bakhour) inside the house was associated with lower number of errors. CONCLUSION We were able to set normative data for the HSCT Arabic version for use in the Lebanese population. Problematic mobile phone use was associated with lower inhibitory control in terms of response-time and errors number.
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Affiliation(s)
- Sarah Boutros
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Emilio El Hachem
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Joseph Mattar
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.
| | - Hanna Mattar
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
- Department of Neurology, Notre Dame des Secours University Hospital, Byblos, Lebanon
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Tang‐Wai DF, Smith EE, Bruneau M, Burhan AM, Chatterjee A, Chertkow H, Choudhury S, Dorri E, Ducharme S, Fischer CE, Ghodasara S, Herrmann N, Hsiung GR, Kumar S, Laforce R, Lee L, Massoud F, Shulman KI, Stiffel M, Gauthier S, Ismail Z. CCCDTD5 recommendations on early and timely assessment of neurocognitive disorders using cognitive, behavioral, and functional scales. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12057. [PMID: 33209972 PMCID: PMC7657153 DOI: 10.1002/trc2.12057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 07/09/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Earlier diagnosis of neurocognitive disorders and neurodegenerative disease is needed to implement preventative interventions, minimize harm, and reduce risk of exploitation in the context of undetected disease. Along the spectrum from subjective cognitive decline (SCD) to dementia, evidence continues to emerge with respect to detection, staging, and monitoring. Updates to previous guidelines are required for clinical practice. METHODS A subcommittee of the 5th Canadian Consensus Conference on Diagnosis and Treatment of Dementia (CCCDTD) reviewed emerging evidence to address the following: (1) Is there a role for screening at-risk patients without clinical concerns? In what context is assessment for dementia appropriate? (2) What tools can be used to evaluate patients in whom cognitive decline is suspected? (3) What important information can be gained from an informant, using which measures? (4) What instruments can be used to get more in-depth information to diagnose mild cognitive impairment (MCI) or dementia? (5) What is the approach to those with cognitive concerns but without objective changes (ie, SCD)? (6) How do we track response to treatment and change over time? The Grading of Recommendations Assessment, Development, and Evaluation system was used to rate quality of the evidence and strength of the recommendations. RESULTS We recommend instruments to assess and monitor cognition, behavior, and function across the cognitive spectrum, including reports from patient and informant. We recommend against screening asymptomatic older adults but recommend investigation for self- or informant reports of changes in cognition, emergence of behavioral or psychiatric symptoms, or decline in function or self-care. Standardized assessments should be used for cognitive and behavioral change that have sufficient validity for use in clinical practice. DISCUSSION The CCCDTD5 provides evidence-based recommendations for detection, assessment, and monitoring of neurocognitive disorders. Although these guidelines were developed for use in Canada, they may also be useful in other jurisdictions.
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Affiliation(s)
- David F. Tang‐Wai
- Department of Medicine, Divisions of Neurology and Geriatric MedicineUniversity of Toronto, University Health Network Memory Clinic, Krembil Brain InstituteTorontoOntarioCanada
| | - Eric E. Smith
- Department of Clinical Neurosciences and Hotchkiss Brain InstituteUniversity of CalgaryCalgaryAlbertaCanada
| | - Marie‐Andrée Bruneau
- Department of Psychiatry and AddictologyUniversity of Montreal, Geriatric Institute of Montreal Research CenterMontrealQuebecCanada
| | - Amer M. Burhan
- Department of PsychiatrySchulich School of Medicine and DentistryWestern Universityand Parkwood Institute‐Mental HealthLondonOntarioCanada
| | - Atri Chatterjee
- Division of NeurologyUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Howard Chertkow
- Department of Medicine NeurologyRotman Research InstituteUniversity of TorontoTorontoOntarioCanada
| | - Samira Choudhury
- Centre for Addiction and Mental HealthUniversity of TorontoTorontoOntarioCanada
| | - Ehsan Dorri
- Department of PsychiatryUniversity of AlbertaEdmontonAlbertaCanada
| | - Simon Ducharme
- Department of Psychiatry, Montreal QC, McConnell Brain ImagingMcGill University Health CentreMcGill University, Montreal Neurological InstituteMontrealQuebecCanada
| | - Corinne E. Fischer
- Keenan Research Centre for Biomedical ScienceSt. Michael's HospitalLi Ka Shing Knowledge Institute, University of TorontoTorontoOntarioCanada
| | - Sheena Ghodasara
- Department of Psychiatry, Schulich School of Medicine and DentistryWestern UniversityLondonOntarioCanada
| | - Nathan Herrmann
- Sunnybrook Health Sciences CentreDepartment of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | | | - Sanjeev Kumar
- Centre for Addiction and Mental Health, University of TorontoTorontoOntarioCanada
| | - Robert Laforce
- Clinique Interdisciplinaire de MémoireDépartement des Sciences NeurologiquesCHU de Québec, Université LavalQuebecCanada
| | - Linda Lee
- Department of Family MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Fadi Massoud
- Centre Hospitalier Charles LeMoyne and Institut Universitaire de Gériatrie de Montréal, Department of MedicineUniversity of Sherbrooke and Department of MedicineUniversity of MontrealMontrealQuebecCanada
| | - Kenneth I. Shulman
- Sunnybrook Health Sciences CentreDepartment of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | | | - Serge Gauthier
- McGill Center for Studies in AgingAlzheimer Disease Research UnitMontrealQuebecCanada
| | - Zahinoor Ismail
- Departments of PsychiatryClinical Neurosciences, Community Health SciencesHotchkiss Brain Institute and O'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
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Sadigh-Eteghad S, Vatandoust SM, Mahmoudi J, Rahigh Aghsan S, Majdi A. Cotinine ameliorates memory and learning impairment in senescent mice. Brain Res Bull 2020; 164:65-74. [PMID: 32818583 DOI: 10.1016/j.brainresbull.2020.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/29/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
This study aimed to assess the effects of cotinine on age-induced memory and learning impairment and related downstream pathways in mice. Thirty aged (18-month old) and 10 young mice (8-week old) were randomly divided into 4 groups (n = 10 each) and subjected to cotinine at 5 mg/kg dose and/or methyllycaconitine (MLA) at 1 mg/kg, i.p. dose (α7 nAChRs antagonist) for 4 weeks. Morris water maze (MWM) and novel object recognition (NOR) tasks were used to assess spatial and recognition learning and memories of the mice, respectively. Levels of oxidative stress, apoptosis, neuroinflammation, and structural synaptic plasticity, and also neurotrophic factors and α7 nAChRs were assessed in the hippocampus using either ELISA or Western blotting. Aging was associated with learning and memory disabilities and dysregulation of the assessed pathways in the hippocampus of mice. Chronic cotinine treatment improved learning and memory in aged animals, indicated by decreased latency time, and increased time spent in the target quadrant and discrimination index (DI) in the MWM and NOR tasks. Also, chronic cotinine injection increased total antioxidant capacity (TAC), SOD and GSH-px activity, PSD-95, GAP-43, SYN, brain-derived neurotrophic factor, and neural growth factor levels and decreased malondialdehyde, TNF-α, and IL-1β in the hippocampus of aged mice. Conversely, MLA treatment reversed most of the mentioned effects via the blockade of α7 nAChRs. Cotinine improves age-induced memory and learning impairment via its modulatory effects on α7 nAChRs and subsequent activation/deactivation of the mentioned pathways in the hippocampus of aged mice.
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Affiliation(s)
- Saeed Sadigh-Eteghad
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Mehdi Vatandoust
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javad Mahmoudi
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sepideh Rahigh Aghsan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Majdi
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran.
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Ismail Z, Black SE, Camicioli R, Chertkow H, Herrmann N, Laforce R, Montero‐Odasso M, Rockwood K, Rosa‐Neto P, Seitz D, Sivananthan S, Smith EE, Soucy J, Vedel I, Gauthier S. Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia. Alzheimers Dement 2020; 16:1182-1195. [PMID: 32725777 PMCID: PMC7984031 DOI: 10.1002/alz.12105] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/03/2020] [Accepted: 04/09/2020] [Indexed: 12/13/2022]
Abstract
Since 1989, four Canadian Consensus Conferences on the Diagnosis and Treatment of Dementia (CCCDTD) have provided evidence-based dementia guidelines for Canadian clinicians and researchers. We present the results of the 5th CCCDTD, which convened in October 2019, to address topics chosen by the steering committee to reflect advances in the field, and build on previous guidelines. Topics included: (1) utility of the National Institute on Aging research framework for clinical Alzheimer's disease (AD) diagnosis; (2) updating diagnostic criteria for vascular cognitive impairment, and its management; (3) dementia case finding and detection; (4) neuroimaging and fluid biomarkers in diagnosis; (5) use of non-cognitive markers of dementia for better dementia detection; (6) risk reduction/prevention; (7) psychosocial and non-pharmacological interventions; and (8) deprescription of medications used to treat dementia. We hope the guidelines are useful for clinicians, researchers, policy makers, and the lay public, to inform a current and evidence-based approach to dementia.
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Affiliation(s)
- Zahinoor Ismail
- Department of PsychiatryHotchkiss Brain Institute and O'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
| | - Sandra E. Black
- Department of Medicine (Neurology) Sunnybrook Health Sciences CentreUniversity of TorontoTorontoOntarioCanada
| | - Richard Camicioli
- Neuroscience and Mental Health InstituteUniversity of AlbertaEdmontonAlbertaCanada
| | - Howard Chertkow
- University of TorontoBaycrest Health SciencesTorontoOntarioCanada
| | | | - Robert Laforce
- Clinique Interdisciplinaire de MémoireDépartement des Sciences NeurologiquesCHU de Québec, and Faculté de MédecineUniversité LavalLavalQuébecCanada
| | - Manuel Montero‐Odasso
- Departments of Medicine, and Epidemiology and BiostatisticsUniversity of Western OntarioLondonOntarioCanada
- Gait and Brain Lab, Parkwood InstituteLondonOntarioCanada
| | | | - Pedro Rosa‐Neto
- Neurosurgery and PsychiatryMcGill Centre for Studies in AgingMontrealQuebecCanada
| | - Dallas Seitz
- Hotchkiss Brain InstituteUniversity of CalgaryCalgaryAlbertaCanada
| | | | - Eric E. Smith
- Hotchkiss Brain InstituteUniversity of CalgaryCalgaryAlbertaCanada
| | - Jean‐Paul Soucy
- McConnell Brain Imaging CentreMontreal Neurological InstituteMcGill UniversityPERFORM CentreConcordia UniversityMontrealQuebecCanada
| | - Isabelle Vedel
- Department of Family MedicineMcGill UniversityMontrealQuebecCanada
| | - Serge Gauthier
- Alzheimer Disease Research UnitMcGill Center for Studies in AgingMontrealQuebecCanada
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Carr S, Pichora-Fuller MK, Li KZ, Phillips N, Campos JL. Multisensory, Multi-Tasking Performance of Older Adults With and Without Subjective Cognitive Decline. Multisens Res 2019; 32:797-829. [DOI: 10.1163/22134808-20191426] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/28/2019] [Indexed: 11/19/2022]
Abstract
Abstract
As the population ages, it is increasingly important to detect non-normative cognitive declines as early as possible. Measures of combined sensory–motor–cognitive functioning may be early markers for identifying individuals who are at increased risk of developing dementia. Further, older adults experiencing subjective cognitive decline (SCD) may have elevated risk of dementia compared to those without SCD. Tasks involving complex, multisensory interactions reflective of everyday challenges may be particularly sensitive to subjectively perceived, pre-clinical declines. In the current study, older adults with and without SCD were asked to simultaneously perform a standing balance task and a listening task under increasingly challenging sensory/cognitive/motor conditions using a dual-task paradigm in a realistic, immersive virtual environment. It was hypothesized that, compared to older adults without SCD, those with SCD would exhibit greater decrements in postural control and listening response accuracy as sensory/motor/cognitive loads increased. However, counter to predictions, older adults with SCD demonstrated greater reductions in postural sway under more challenging dual-task conditions than those without SCD. Across both groups, poorer postural task performance was associated with poorer cognitive function and speech-in-noise thresholds measured with standard baseline tests. Poorer listening task performance was associated with poorer global cognitive function, poorer mobility, and poorer speech-in-noise detection. Overall, the results provide additional support for the growing evidence demonstrating associations between sensory, motor, and cognitive functioning and contribute to an evolving consideration of how best to categorize and characterize SCD in a way that guides strategies for screening, assessment, and intervention.
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Affiliation(s)
- Sophie Carr
- 1KITE—Toronto Rehabilitation Institute, University Health Network, Canada
- 2Department of Psychology, University of Toronto, Canada
| | - M. Kathleen Pichora-Fuller
- 2Department of Psychology, University of Toronto, Canada
- 4Centre for Research in Human Development, Concordia University, Canada
| | - Karen Z. H. Li
- 3Department of Psychology, Concordia University, Canada
- 4Centre for Research in Human Development, Concordia University, Canada
| | - Natalie Phillips
- 3Department of Psychology, Concordia University, Canada
- 4Centre for Research in Human Development, Concordia University, Canada
| | - Jennifer L. Campos
- 1KITE—Toronto Rehabilitation Institute, University Health Network, Canada
- 2Department of Psychology, University of Toronto, Canada
- 4Centre for Research in Human Development, Concordia University, Canada
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Abstract
INTRODUCTION White matter hyperintensities (WMHs) were commonly seen in brain magnetic resonance imaging (MRI) of the elderly. Many studies found that WMHs were associated with cognitive decline and dementia. However, the association between WMHs in different brain regions and cognitive decline remains debated. METHODS We explored the association of the severity of WMHs and cognitive decline in 115 non-demented elderly (≥50 years old) sampled from the Wuliqiao Community located in urban area of Shanghai. MRI scans were done during 2009-2011 at the beginning of the study. Severity of WMHs in different brain regions was scored by Improved Scheltens Scale and Cholinergic Pathways Hyperintensities Scale (CHIPS). Cognitive function was evaluated by Mini-Mental State Examination (MMSE) every 2 to 4 years during 2009-2018. RESULTS After adjusting for confounding factors including age, gender, education level, smoking status, alcohol consumption, depression, hypertension, diabetes, hyperlipidemia, brain infarcts, brain atrophy, apoE4 status, and baseline MMSE score, periventricular and subcortical WMH lesions as well as WMHs in cholinergic pathways were significantly associated with annual MMSE decline ( p < 0.05), in which the severity of periventricular WMHs predicted a faster MMSE decline (-0.187 points/year, 95% confidence interval: -0.349, -0.026, p = 0.024). CONCLUSIONS The severity of WMHs at baseline was associated with cognitive decline in the non-demented elderly over time. Interventions on WMH lesions may offer some benefits for cognitive deterioration.
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Sellami L, Meilleur-Durand S, Chouinard AM, Bergeron D, Verret L, Poulin S, Jean L, Fortin MP, Nadeau Y, Molin P, Caron S, Macoir J, Hudon C, Bouchard RW, Laforce R. The Dépistage Cognitif de Québec: A New Clinician's Tool for Early Recognition of Atypical Dementia. Dement Geriatr Cogn Disord 2019; 46:310-321. [PMID: 30481754 DOI: 10.1159/000494348] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/05/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Early recognition of atypical dementia remains challenging partly because of lack of cognitive screening instruments precisely tailored for this purpose. METHODS We assessed the validity and reliability of the Dépistage Cognitif de Québec (DCQ; www.dcqtest.org), a newly developed cognitive screening test, to detect atypical dementia using a multicenter cohort of 628 participants. Sensitivity and specificity were compared to the Montreal Cognitive Assessment (MoCA). A predictive diagnostic algorithm for atypical dementia was determined using classification tree analysis. RESULTS The DCQ showed excellent psychometric properties. It was significantly more accurate than the MoCA to detect atypical dementia. All correlations between DCQ indexes and standard neuropsychological measures were significant. A statistical model distinguished typical from atypical dementia with a predictive power of 79%. DISCUSSION The DCQ is a better tool to detect atypical dementia than standard cognitive screening tests. Expanding the clinician's tool kit with the DCQ could reduce missed/delayed identification of atypical dementia and accelerate therapeutic intervention.
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Affiliation(s)
- Leila Sellami
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Synthia Meilleur-Durand
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Anne-Marie Chouinard
- CERVO Brain Research Centre, École de psychologie, Université Laval, Québec, Québec, Canada
| | - David Bergeron
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Louis Verret
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Stéphane Poulin
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Léonie Jean
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Marie-Pierre Fortin
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Yannick Nadeau
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Pierre Molin
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Stéphanie Caron
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Joël Macoir
- Département de Réadaptation, CERVO Brain Research Centre, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Carol Hudon
- CERVO Brain Research Centre, École de psychologie, Université Laval, Québec, Québec, Canada
| | - Rémi W Bouchard
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire (CIME), Département des Sciences Neurologiques, CHU de Québec, Faculté de médecine, Université Laval, Québec, Québec, Canada,
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Brito VV, Manhães AG, França AI, Marins M. Avaliação do Programa de Treinamento para Memória de Trabalho em Idosos. Codas 2019; 31:e20180089. [DOI: 10.1590/2317-1782/20182018089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 10/30/2018] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Verificar os benefícios do Treinamento de Memória de Trabalho em DVD para idosos. Método Participaram do estudo 16 voluntários com idade superior a 60 anos (média etária de 67,43 anos) sem queixas de perda auditiva, problemas neurológicos ou psiquiátricos, avaliados inicialmente com o MEEM e posteriormente com a avaliação específica para memória de trabalho. Em seguida, os quatro participantes que não tinham disponibilidade para comparecer à Universidade formaram o grupo controle e os doze restantes foram incluídos no grupo experimental. O grupo experimental foi exposto aos três DVDs que compõem o primeiro conjunto de exercícios e reavaliado com o teste específico para memória de trabalho em intervalos regulares. O grupo controle também foi submetido às reavaliações nos mesmos períodos do grupo experimental. Resultados Enquanto o grupo controle não apresentou qualquer alteração nas avaliações, o desempenho no teste de memória do grupo experimental melhorou significativamente após a apresentação dos DVDs. Além disso, o grupo experimental relatou os benefícios do treinamento para suas atividades cotidianas. Conclusão O estudo demonstra os benefícios do Treinamento de Memória de Trabalho em DVD para idosos, que se revela uma ferramenta promissora para novos estudos longitudinais com populações maiores.
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Affiliation(s)
- Andrew Costa
- Department of Health Research Methods, Evidence, and Impact; Department of Medicine, McMaster University, Hamilton, Ont.
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