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Zorkina Y, Abramova O, Ushakova V, Andreyuk D, Andriushchenko N, Pavlov K, Savilov V, Soloveva K, Kurmishev M, Syunyakov T, Karpenko O, Andryushchenko A, Gurina O, Kostyuk G, Morozova A. Inflammatory biomarkers and lipid metabolism parameters in women with mild cognitive impairment and dementia. Women Health 2023; 63:285-295. [PMID: 36882933 DOI: 10.1080/03630242.2023.2185750] [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: 03/09/2023]
Abstract
The detection of specific markers of dementia and mild cognitive decline (MCI) could be the key to disease prevention and forehanded treatment. Female gender is one of the major risk factor for dementia. The aim of our study was to compare serum concentration of some factors related to lipid metabolism and the immune system in patients with MCI and dementia. The study was performed on women >65 years old: controls (n = 75), diagnosed with dementia (n = 73) and MCI (n = 142). Patients were evaluated using Mini-Mental State Examination, Clock Drawing Test and Montreal Cognitive Assessment scales in the period 2020-2021. The level of Apo A1 and HDL was significantly decreased in patients with dementia; the level of Apo A1 was also decreased in MCI. EGF, eotaxin-1, GRO-α, and IP-10 were elevated in patients with dementia compared to the controls. IL-8, MIP-1β, sCD40L, and TNF-α levels were decreased in MCI patients and increased in patients with dementia compared to the control. Serum VEGF levels were decreased in MCI and dementia patients in comparison with the control. We hypothesize that no single marker can indicate a neurodegenerative process. Future research should focus on identifying markers to determine possible diagnostic combinations that can reliably predict neurodegeneration.
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Affiliation(s)
- Yana Zorkina
- Research Centre for Neuropsychiatry, Mental-Health Clinic No. 1 named after N.A. Alekseev, Moscow, Russia.,Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
| | - Olga Abramova
- Research Centre for Neuropsychiatry, Mental-Health Clinic No. 1 named after N.A. Alekseev, Moscow, Russia.,Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
| | - Valeria Ushakova
- Research Centre for Neuropsychiatry, Mental-Health Clinic No. 1 named after N.A. Alekseev, Moscow, Russia.,Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
| | - Denis Andreyuk
- Research Centre for Neuropsychiatry, Mental-Health Clinic No. 1 named after N.A. Alekseev, Moscow, Russia
| | - Nika Andriushchenko
- Department of Biology, Shenzhen MSU-BIT University, Shenzhen, Guangdong, China
| | - Konstantin Pavlov
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
| | - Victor Savilov
- Research Centre for Neuropsychiatry, Mental-Health Clinic No. 1 named after N.A. Alekseev, Moscow, Russia
| | - Kristina Soloveva
- Research Centre for Neuropsychiatry, Mental-Health Clinic No. 1 named after N.A. Alekseev, Moscow, Russia
| | - Marat Kurmishev
- Research Centre for Neuropsychiatry, Mental-Health Clinic No. 1 named after N.A. Alekseev, Moscow, Russia
| | - Timur Syunyakov
- Research Centre for Neuropsychiatry, Mental-Health Clinic No. 1 named after N.A. Alekseev, Moscow, Russia
| | - Olga Karpenko
- Research Centre for Neuropsychiatry, Mental-Health Clinic No. 1 named after N.A. Alekseev, Moscow, Russia
| | - Alisa Andryushchenko
- Research Centre for Neuropsychiatry, Mental-Health Clinic No. 1 named after N.A. Alekseev, Moscow, Russia
| | - Olga Gurina
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
| | - Georgiy Kostyuk
- Research Centre for Neuropsychiatry, Mental-Health Clinic No. 1 named after N.A. Alekseev, Moscow, Russia
| | - Anna Morozova
- Research Centre for Neuropsychiatry, Mental-Health Clinic No. 1 named after N.A. Alekseev, Moscow, Russia.,Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Moscow, Russia
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2
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Heyrani R, Sarabi-Jamab A, Grafman J, Asadi N, Soltani S, Mirfazeli FS, Almasi-Dooghaei M, Shariat SV, Jahanbakhshi A, Khoeini T, Joghataei MT. Limits on using the clock drawing test as a measure to evaluate patients with neurological disorders. BMC Neurol 2022; 22:509. [PMID: 36585622 PMCID: PMC9805016 DOI: 10.1186/s12883-022-03035-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/19/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The Clock Drawing Test (CDT) is used as a quick-to-conduct test for the diagnosis of dementia and a screening tool for cognitive impairments in neurological disorders. However, the association between the pattern of CDT impairments and the location of brain lesions has been controversial. We examined whether there is an association between the CDT scores and the location of brain lesions using the two available scoring systems. METHOD One hundred five patients with brain lesions identified by CT scanning were recruited for this study. The Montreal Cognitive Assessment (MoCA) battery including the CDT were administered to all partcipants. To score the CDT, we used a qualitative scoring system devised by Rouleau et al. (1992). For the quantitative scoring system, we adapted the algorithm method used by Mendes-Santos et al. (2015) based on an earlier study by Sunderland et al. (1989). For analyses, a machine learning algorithm was used. RESULTS Remarkably, 30% of the patients were not detected by the CDT. Quantitative and qualitative errors were categorized into different clusters. The classification algorithm did not differentiate the patients with traumatic brain injury 'TBI' from non-TBI, or the laterality of the lesion. In addition, the classification accuracy for identifying patients with specific lobe lesions was low, except for the parietal lobe with an accuracy of 63%. CONCLUSION The CDT is not an accurate tool for detecting focal brain lesions. While the CDT still is beneficial for use with patients suspected of having a neurodegenerative disorder, it should be cautiously used with patients with focal neurological disorders.
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Affiliation(s)
- Raheleh Heyrani
- grid.411746.10000 0004 4911 7066Department of Psychiatry, School of Medicine, Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Atiye Sarabi-Jamab
- grid.418744.a0000 0000 8841 7951School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Jordan Grafman
- grid.477681.bShirly Ryan AbilityLab, Departments of Physical Medicine and Rehabilitation, Neurology, Cognitive Neurology, and Alzheimer’s Center, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Department of Psychiatry, Feinberg School of Medicine and Department of Psychology, Weinberg College of Arts and Sciences, Northwestern University, Chicago, IL USA
| | - Nesa Asadi
- grid.411746.10000 0004 4911 7066Department of Psychiatry, School of Medicine, Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Sarvenaz Soltani
- grid.411746.10000 0004 4911 7066Department of Psychiatry, School of Medicine, Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sadat Mirfazeli
- grid.411746.10000 0004 4911 7066Department of Psychiatry, School of Medicine, Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran ,grid.490421.a0000 0004 0612 3773Faculty of Medicine, Rasool Akram Hospital, Iran Unversity of Medical Sciences, Tehran, Iran
| | - Mostafa Almasi-Dooghaei
- grid.411746.10000 0004 4911 7066Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Vahid Shariat
- grid.411746.10000 0004 4911 7066Department of Psychiatry, School of Medicine, Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Amin Jahanbakhshi
- grid.411746.10000 0004 4911 7066Department of Neurosurgery, Skull Base Research Center, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran ,grid.411746.10000 0004 4911 7066Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Tara Khoeini
- grid.411746.10000 0004 4911 7066Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Taghi Joghataei
- grid.411746.10000 0004 4911 7066Cellular and Molecular Research Center (CMRC), Iran University of Medical Sciences, Tehran, Iran
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3
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Daly JM, Xu Y, Crockett SD, Schmidt ME, Kim P, Levy BT. Clock-Drawing Test as a Screening Tool for Cognitive Impairment Associated With Fecal Immunochemical Test Collection Errors. Ann Fam Med 2022; 20:452-459. [PMID: 36228064 PMCID: PMC9512558 DOI: 10.1370/afm.2855] [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: 05/07/2021] [Revised: 02/28/2022] [Accepted: 05/11/2022] [Indexed: 01/12/2023] Open
Abstract
PURPOSE The purposes of this study were to determine if (1) certain demographic characteristics (potential predictors) of participants, and (2) clock-drawing test results (as a screening test for cognitive impairment) were associated with fecal immunochemical test (FIT) sample collection errors. METHODS Patients scheduled for an upcoming colonoscopy were asked to collect stool samples using 5 different FITs. Patients completed a questionnaire that included the clock-drawing test. Errors included mistakes or omissions in recording the stool collection date and errors in stool collection. Each clock drawing was scored by 2 reviewers using 2 established methods. RESULTS Of the 1,448 participants with a clock drawing, 63% were female with a mean age of 63 years. In this population there were 83% White, 6% Black, and 24% Hispanic persons. Cognitive impairment was found in 292 patients by the Mendes-Santos method. Kappa coefficient for the 2 clock-drawing scores was 0.79 (P <.001). The multivariable generalized linear mixed model for FIT collection errors indicated being female (adjusted odds ratio [AOR], 1.64; 95% CI, 1.09-2.48), having an 8th grade or less education (AOR, 3.40; 95% CI, 1.87-6.18), and having an abnormal Mendes-Santos method clock score (AOR, 1.65; 95% CI, 1.08-2.54) were associated with significantly more errors. CONCLUSION Among the participants who do not have dementia, FIT collection errors were made not only by those who had abnormal clock drawing, but also, by those with normal clock drawings. Subjects being female, having 8th grade education or less, and having an abnormal clock drawing scored by Mendes-Santos's method were associated with FIT collection errors.
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Affiliation(s)
- Jeanette M Daly
- Department of Family Medicine, University of Iowa, Iowa City, Iowa
| | - Yinghui Xu
- Department of Family Medicine, University of Iowa, Iowa City, Iowa
| | - Seth D Crockett
- School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Megan E Schmidt
- Department of Family Medicine, University of Iowa, Iowa City, Iowa
| | - Peter Kim
- Genesis Family Medicine Residency Program, Davenport, Iowa
| | - Barcey T Levy
- Department of Family Medicine, University of Iowa, Iowa City, Iowa.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa
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4
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Takagi S, Yamashiro K, Sugihara G, Matsuura M, Takahashi H. Hippocampal calcification and its effects on cognitive function and symptoms in dementia. Psychogeriatrics 2022; 22:427-432. [PMID: 35445506 DOI: 10.1111/psyg.12831] [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: 02/13/2022] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hippocampal calcification (HC), highly prevalent in older people, has not attracted attention until recently. Despite its potential effects on cognition and behaviour, and its possible impact on the diagnosis and severity of dementia, it has not been investigated. This study aimed to evaluate the prevalence of HC and its influence on cognition and behavioural symptoms in patients with dementia. METHODS Data from consecutive patients who visited a medical centre for dementia, for the first time between April 2016 and September 2018, were extracted and analysed. These data included the patients' demographics, the presence of HC and hippocampal thickness as measured on computed tomography, the diagnosis of dementia and its type, cognitive function measured using the Mini-Mental State Examination and the Clock Drawing Test, and the chief complaints or symptoms prompting the visit. RESULTS A high incidence of HC (85/267 patients) was observed. There was no significant difference in the ages of patients with and without HC. Patients with HC had higher cognitive function than those without HC at their first visit. This result was contrary to our expectations as it was not explained by the chief complaints recorded at the first visit. CONCLUSIONS Our study showed a high prevalence of HC in older patients with dementia. Patients with HC had better cognitive function than did those without HC during their first hospital visit. This study suggests that HC may not affect the cognitive functions related to dementia. However, further research is needed to evaluate the long-term consequences of dementia with HC.
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Affiliation(s)
- Shunsuke Takagi
- Department of Psychiatry and Behavioural Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Ureshinogaoka Samariyabito Hospital, Okinawa, Japan
| | | | - Genichi Sugihara
- Department of Psychiatry and Behavioural Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masato Matsuura
- Ureshinogaoka Samariyabito Hospital, Okinawa, Japan.,Tazaki Hospital, Okinawa, Japan
| | - Hidehiko Takahashi
- Department of Psychiatry and Behavioural Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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5
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Obesity and Neurocognitive Performance of Memory, Attention, and Executive Function. NEUROSCI 2022. [DOI: 10.3390/neurosci3030027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Obesity has been linked to an increased risk of dementia in the future. Obesity is known to affect core neural structures, such as the hippocampus, and frontotemporal parts of the brain, and is linked to memory, attention, and executive function decline. The overwhelming majority of the data, however, comes from high-income countries. In undeveloped countries, there is little evidence of a link between obesity and neurocognition. The aim of this study was to investigate the effects of BMI on the key cognitive functioning tasks of attention, memory, and executive function in a South African cohort. Methods: A total of 175 females (NW: BMI = 18.5–24.9 kg/m2 and OB: BMI > 30.0 kg/m2) aged 18–59 years (M = 28, SD = 8.87 years) completed tasks on memory, attention, and executive functioning. Results: There was a statistically significant difference between the groups. The participants who had a BMI corresponding with obesity performed poorly on the tasks measuring memory (p = 0.01), attention (p = 0.01), and executive function (p = 0.02) compared to the normal-weight group. Conclusions: When compared to normal-weight participants, the findings confirm the existence of lowered cognitive performance in obese persons on tasks involving planning, decision making, self-control, and regulation. Further research into the potential underlying mechanism by which obesity impacts cognition is indicated.
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Matos ADMB, Dahy FE, de Moura JVL, Marcusso RMN, Gomes ABF, Carvalho FMM, Fernandes GBP, Felix AC, Smid J, Vidal JE, Frota NAF, Casseb J, Easton A, Solomon T, Witkin SS, Malta Romano C, de Oliveira ACP. Subacute Cognitive Impairment in Individuals With Mild and Moderate COVID-19: A Case Series. Front Neurol 2021; 12:678924. [PMID: 34421788 PMCID: PMC8371908 DOI: 10.3389/fneur.2021.678924] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Previous reported neurologic sequelae associated with SARS-CoV-2 infection have mainly been confined to hospital-based patients in which viral detection was restricted to nasal/throat swabs or to IgM/IgG peripheral blood serology. Here we describe seven cases from Brazil of outpatients with previous mild or moderate COVID-19 who developed subacute cognitive disturbances. Methods: From June 1 to August 15, 2020, seven individuals 18 to 60 years old, with confirmed mild/moderate COVID-19 and findings consistent with encephalopathy who were observed >7 days after respiratory symptom initiation, were screened for cognitive dysfunction. Paired sera and CSF were tested for SARS-CoV-2 (IgA, IgG ELISA, and RT-PCR). Serum and intrathecal antibody dynamics were evaluated with oligoclonal bands and IgG index. Cognitive dysfunction was assessed by the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Clock Drawing Test (CDT). Results: All but one of our patients were female, and the mean age was 42.6 years. Neurologic symptoms were first reported a median of 16 days (IQR 15–33) after initial COVID-19 symptoms. All patients had headache and altered behavior. Cognitive dysfunction was observed mainly in phonemic verbal fluency (MoCA) with a median of six words/min (IQR 5.25–10.75) and altered visuospatial construction with a median of four points (IQR 4–9) (CDT). CSF pleocytosis was not detected, and only one patient was positive for SARS-Co Conclusions: A subacute cognitive syndrome suggestive of SARS-CoV-2-initiated damage to cortico-subcortical associative pathways that could not be attributed solely to inflammation and hypoxia was present in seven individuals with mild/moderate COVID-19.
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Affiliation(s)
| | | | | | | | - Andre Borges Ferreira Gomes
- Hospital Geral de Fortaleza, Serviço de Neurologia, Fortaleza, Brazil.,Programa de Pós-Graduação em Ciências Médicas, Universidade de Fortaleza, Fortaleza, Brazil
| | - Fernanda Martins Maia Carvalho
- Hospital Geral de Fortaleza, Serviço de Neurologia, Fortaleza, Brazil.,Programa de Pós-Graduação em Ciências Médicas, Universidade de Fortaleza, Fortaleza, Brazil
| | | | - Alvina Clara Felix
- Faculdade de Medicina, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
| | - Jerusa Smid
- Instituto de Infectologia Emilio Ribas, São Paulo, Brazil
| | - Jose Ernesto Vidal
- Faculdade de Medicina, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil.,Instituto de Infectologia Emilio Ribas, São Paulo, Brazil
| | - Norberto Anizio Ferreira Frota
- Hospital Geral de Fortaleza, Serviço de Neurologia, Fortaleza, Brazil.,Programa de Pós-Graduação em Ciências Médicas, Universidade de Fortaleza, Fortaleza, Brazil
| | - Jorge Casseb
- Faculdade de Medicina, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
| | - Ava Easton
- Encephalitis Society, Malton, United Kingdom.,Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, United Kingdom
| | - Tom Solomon
- National Institute for Health Research Health Protection Unit in Emerging and Zoonotic Infections, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom.,Walton Centre National Health Service Foundation Trust, Liverpool, United Kingdom
| | - Steven S Witkin
- Faculdade de Medicina, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil.,Weill Cornell Medicine, Department of Obstetrics and Gynecology, New York, NY, United States
| | - Camila Malta Romano
- Faculdade de Medicina, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil.,Faculdade de Medicina, Hospital das Clinicas, Universidade de São Paulo, São Paulo, Brazil
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7
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Park I, Lee U. Automatic, Qualitative Scoring of the Clock Drawing Test (CDT) Based on U-Net, CNN and Mobile Sensor Data. SENSORS (BASEL, SWITZERLAND) 2021; 21:5239. [PMID: 34372476 PMCID: PMC8348723 DOI: 10.3390/s21155239] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 12/17/2022]
Abstract
The Clock Drawing Test (CDT) is a rapid, inexpensive, and popular screening tool for cognitive functions. In spite of its qualitative capabilities in diagnosis of neurological diseases, the assessment of the CDT has depended on quantitative methods as well as manual paper based methods. Furthermore, due to the impact of the advancement of mobile smart devices imbedding several sensors and deep learning algorithms, the necessity of a standardized, qualitative, and automatic scoring system for CDT has been increased. This study presents a mobile phone application, mCDT, for the CDT and suggests a novel, automatic and qualitative scoring method using mobile sensor data and deep learning algorithms: CNN, a convolutional network, U-Net, a convolutional network for biomedical image segmentation, and the MNIST (Modified National Institute of Standards and Technology) database. To obtain DeepC, a trained model for segmenting a contour image from a hand drawn clock image, U-Net was trained with 159 CDT hand-drawn images at 128 × 128 resolution, obtained via mCDT. To construct DeepH, a trained model for segmenting the hands in a clock image, U-Net was trained with the same 159 CDT 128 × 128 resolution images. For obtaining DeepN, a trained model for classifying the digit images from a hand drawn clock image, CNN was trained with the MNIST database. Using DeepC, DeepH and DeepN with the sensor data, parameters of contour (0-3 points), numbers (0-4 points), hands (0-5 points), and the center (0-1 points) were scored for a total of 13 points. From 219 subjects, performance testing was completed with images and sensor data obtained via mCDT. For an objective performance analysis, all the images were scored and crosschecked by two clinical experts in CDT scaling. Performance test analysis derived a sensitivity, specificity, accuracy and precision for the contour parameter of 89.33, 92.68, 89.95 and 98.15%, for the hands parameter of 80.21, 95.93, 89.04 and 93.90%, for the numbers parameter of 83.87, 95.31, 87.21 and 97.74%, and for the center parameter of 98.42, 86.21, 96.80 and 97.91%, respectively. From these results, the mCDT application and its scoring system provide utility in differentiating dementia disease subtypes, being valuable in clinical practice and for studies in the field.
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Affiliation(s)
| | - Unjoo Lee
- Department of Electronic Engineering, Hallym University, Chuncheon 24252, Korea;
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8
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Jansson IL, Ortiz KZ, Barreto SDS. Qualitative and quantitative aspects of the F-A-S fluency test in people with aphasia. Dement Neuropsychol 2020; 14:412-418. [PMID: 33354295 PMCID: PMC7735043 DOI: 10.1590/1980-57642020dn14-040012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Verbal fluency tests are widely used in neuropsychological assessment. The quantitative and qualitative analysis of the performance of aphasic individuals on the phonemic verbal fluency (PVF) test can contribute to a better understanding of cognitive changes in this group of patients.
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Affiliation(s)
- Isabella Linnea Jansson
- Department of Speech-Language Pathology, Universidade Federal Fluminense - Nova Friburgo, RJ, Brazil
| | - Karin Zazo Ortiz
- Department of Speech Language and Hearing Sciences, Universidade Federal de São Paulo - São Paulo, SP, Brazil
| | - Simone Dos Santos Barreto
- Department of Specific Training in Speech-Language Pathology, Nova Friburgo Health Institute, Universidade Federal Fluminense - Nova Friburgo, RJ, Brazil
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9
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Trautwein S, Barisch-Fritz B, Scharpf A, Ringhof S, Stein T, Krell-Roesch J, Woll A. Effects of a 16-week multimodal exercise program on gait performance in individuals with dementia: a multicenter randomized controlled trial. BMC Geriatr 2020; 20:245. [PMID: 32677897 PMCID: PMC7364487 DOI: 10.1186/s12877-020-01635-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/29/2020] [Indexed: 11/10/2022] Open
Abstract
Background There is a high prevalence of gait impairments in individuals with dementia (IWD). Gait impairments are associated with increased risk of falls, disability, and economic burden for health care systems. Only few studies have investigated the effectiveness of physical activity on gait performance in IWD, reporting promising but inconsistent results. Thus, this study aimed to investigate the effectiveness of a multimodal exercise program (MEP) on gait performance in IWD. Methods In this parallel-group randomized controlled trial, we enrolled 319 IWD of mild to moderate severity, living in care facilities, aged ≥ 65 years, and being able to walk at least 10 m. The control group (n = 118) received conventional treatment, whereas the intervention group (n = 201) additionally participated in a 16-week MEP specifically tailored to IWD. We examined the effects of the MEP on spatiotemporal gait parameters and dual task costs by using the gait analysis system GAITRite. Additionally, we compared characteristics between positive, non-, and negative responders, and investigated the impact of changes in underlying motor and cognitive performance in the intervention group by conducting multiple regression analyses. Results Two-factor analyses of variance with repeated measurements did not reveal any statistically significant time*group effects on either spatiotemporal gait parameters or dual task costs. Differences in baseline gait performance, mobility, lower limb strength, and severity of cognitive impairments were observed between positive, non-, and negative responders. Positive responders were characterized by lower motor performance compared to negative and non-responders, while non-responders showed better cognitive performance than negative responders. Changes in lower limb strength and function, mobility, executive function, attention, and working memory explained up to 39.4% of the variance of changes in gait performance. Conclusions The effectiveness of a standardized MEP on gait performance in IWD was limited, probably due to insufficient intensity and amount of specific walking tasks as well as the large heterogeneity of the sample. However, additional analyses revealed prerequisites of individual characteristics and impacts of changes in underlying motor and cognitive performance. Considering such factors may improve the effectiveness of a physical activity intervention among IWD. Trial registration DRKS00010538 (German Clinical Trial Register, date of registration: 01 June 2016, retrospectively registered, https://www.drks.de/drks_web/setLocale_EN.do).
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Affiliation(s)
- Sandra Trautwein
- Karlsruhe Institute of Technology, Institute of Sports and Sports Science, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.
| | - Bettina Barisch-Fritz
- Karlsruhe Institute of Technology, Institute of Sports and Sports Science, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Andrea Scharpf
- Karlsruhe Institute of Technology, Institute of Sports and Sports Science, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Steffen Ringhof
- Karlsruhe Institute of Technology, Institute of Sports and Sports Science, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.,Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Thorsten Stein
- Karlsruhe Institute of Technology, Institute of Sports and Sports Science, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
| | - Janina Krell-Roesch
- Karlsruhe Institute of Technology, Institute of Sports and Sports Science, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany.,Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Alexander Woll
- Karlsruhe Institute of Technology, Institute of Sports and Sports Science, Engler-Bunte-Ring 15, 76131, Karlsruhe, Germany
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10
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Sumali B, Mitsukura Y, Liang KC, Yoshimura M, Kitazawa M, Takamiya A, Fujita T, Mimura M, Kishimoto T. Speech Quality Feature Analysis for Classification of Depression and Dementia Patients. SENSORS (BASEL, SWITZERLAND) 2020; 20:E3599. [PMID: 32604728 PMCID: PMC7348868 DOI: 10.3390/s20123599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 11/17/2022]
Abstract
Loss of cognitive ability is commonly associated with dementia, a broad category of progressive brain diseases. However, major depressive disorder may also cause temporary deterioration of one's cognition known as pseudodementia. Differentiating a true dementia and pseudodementia is still difficult even for an experienced clinician and extensive and careful examinations must be performed. Although mental disorders such as depression and dementia have been studied, there is still no solution for shorter and undemanding pseudodementia screening. This study inspects the distribution and statistical characteristics from both dementia patient and depression patient, and compared them. It is found that some acoustic features were shared in both dementia and depression, albeit their correlation was reversed. Statistical significance was also found when comparing the features. Additionally, the possibility of utilizing machine learning for automatic pseudodementia screening was explored. The machine learning part includes feature selection using LASSO algorithm and support vector machine (SVM) with linear kernel as the predictive model with age-matched symptomatic depression patient and dementia patient as the database. High accuracy, sensitivity, and specificity was obtained in both training session and testing session. The resulting model was also tested against other datasets that were not included and still performs considerably well. These results imply that dementia and depression might be both detected and differentiated based on acoustic features alone. Automated screening is also possible based on the high accuracy of machine learning results.
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Affiliation(s)
- Brian Sumali
- Graduate School of Science and Technology, School of Integrated Design Engineering, Keio University, Yokohama 223-8522, Japan;
| | - Yasue Mitsukura
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, Yokohama 223-8522, Japan;
| | - Kuo-ching Liang
- Department of Psychiatry, School of Medicine, Keio University, Tokyo 160-8582, Japan; (K.-c.L.); (M.Y.); (M.K.); (A.T.); (M.M.)
| | - Michitaka Yoshimura
- Department of Psychiatry, School of Medicine, Keio University, Tokyo 160-8582, Japan; (K.-c.L.); (M.Y.); (M.K.); (A.T.); (M.M.)
| | - Momoko Kitazawa
- Department of Psychiatry, School of Medicine, Keio University, Tokyo 160-8582, Japan; (K.-c.L.); (M.Y.); (M.K.); (A.T.); (M.M.)
| | - Akihiro Takamiya
- Department of Psychiatry, School of Medicine, Keio University, Tokyo 160-8582, Japan; (K.-c.L.); (M.Y.); (M.K.); (A.T.); (M.M.)
| | - Takanori Fujita
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo 160-8582, Japan;
| | - Masaru Mimura
- Department of Psychiatry, School of Medicine, Keio University, Tokyo 160-8582, Japan; (K.-c.L.); (M.Y.); (M.K.); (A.T.); (M.M.)
| | - Taishiro Kishimoto
- Department of Psychiatry, School of Medicine, Keio University, Tokyo 160-8582, Japan; (K.-c.L.); (M.Y.); (M.K.); (A.T.); (M.M.)
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11
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Tripathi RK, Verma Y, Srivastava A, Shukla TS, Usman K, Ali W, Tiwari SC. Usefulness of clock-drawing test in Indian older adults with diabetes mellitus. Indian J Psychiatry 2020; 62:59-65. [PMID: 32001932 PMCID: PMC6964444 DOI: 10.4103/psychiatry.indianjpsychiatry_62_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 10/17/2019] [Accepted: 11/04/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Clock-drawing test (CDT) is a simple, quick, and bedside cognitive screening test which measures different cognitive domains but has some limitations. The aim of this study was to examine the usefulness of CDT for Indian older adult based on a part of an ICMR-funded research project, New Delhi, India. MATERIALS AND METHODS Sample comprised seventy participants (38 controls and 32 cases) aged 60 years and above included according to the inclusion/exclusion criteria in a consecutive series. Participants, who gave written informed consent, residing permanently in the area of Chowk, Lucknow, constituted the study sample. Semistructured sociodemographic details and medical history pro forma, socioeconomic status scale, General Health Questionnaire-12 (GHQ-12), CDT, and Hindi cognitive screening test (HCST) were administered. Biochemical investigations were carried out, and blood glucose level (fasting ≤100 mg/dl and postprandial ≤140 mg/dl) was considered for having diabetes mellitus (DM). The participants were categorized into two groups: (1) case: participants with DM only and (2) control: participants without discernible abnormality of physical illness and GHQ negative. Data were analyzed using percentages, t-test, the Chi-square test, sensitivity, and specificity. RESULTS About 71.05% participants in control and 81.25% in the case group have cognitive impairment on CDT. Significantly higher illiterates (P < 0.05) were found to be significantly more cognitively impaired on HCST. CDT has a high level of sensitivity (0.71) and low specificity (0.23) when compared with HCST. CONCLUSION CDT had screening bias to Indian older adults as a higher number of literates (almost double) and illiterates (four times) were found to be cognitively impaired compared to on HCST. Usefulness of CDT to screen Indian older adults for cognitive impairment is debatable.
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Affiliation(s)
- Rakesh Kumar Tripathi
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Yashi Verma
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anamika Srivastava
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Tanu Shree Shukla
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Kauser Usman
- Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Wahid Ali
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sarvada Chandra Tiwari
- Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India
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12
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Becattini-Oliveira AC, Câmara LCP, Dutra DDF, Sigrist ADAF, Charchat-Fichman H. Performance-based instrument to assess functional capacity in community-dwelling older adults. Dement Neuropsychol 2019; 13:386-393. [PMID: 31844491 PMCID: PMC6907697 DOI: 10.1590/1980-57642018dn13-040004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/25/2019] [Indexed: 11/21/2022] Open
Abstract
Functional capacity (FC) is a mediator between neuropsychological functions and real-world functioning, but there is a lack of evidence of its correlation in community-dwelling older adults. OBJECTIVE The study aim was to determine the FC level of community-dwelling older adults using the UCSD Performance-based Skills Assessment (UPSA) and to evaluate correlation with cognitive screening tests. METHODS Senior center participants were selected according to inclusion criteria: Portuguese fluency, age ≥60 years and self-reported independent living. The subject exclusion criteria were: dementia or other DSM-5 diagnoses, suicidal ideation or intent, non-completion of assessment battery, enrollment in another psychosocial intervention or pharmacotherapy study. FC level was determined by the UPSA, brief UPSA (UPSA-B) and Instrumental Activities of Daily Living scale (IADL's). The Mini-Mental State Examination (MMSE), Memory of Figure Test (MFT), Verbal Fluency Test (VFT) and Clock Drawing Test (CDT) were used for cognitive assessment. A total of 35 subjects that had a mean age of 72 years, were predominantly females(88.6%) and had mean education level of 11.25 years were evaluated. RESULTS Mean UPSA and UPSA-B scores were 78.5 and 70, respectively. A statistically significant correlation was observed between the UPSA and IADL, MMSE and VFT. CONCLUSION The UPSA serves as a screening assessment of FC in community-dwelling older adults, showing a positive correlation with cognitive screening tests.
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Affiliation(s)
| | | | - Douglas de Farias Dutra
- Psychology Institute, Universidade Federal do Rio de Janeiro (UFRJ),
Rio de Janeiro, RJ, Brazil
| | | | - Helenice Charchat-Fichman
- Psychology Department, Pontifícia Universidade Católica do Rio de
Janeiro (PUC-Rio), Rio de Janeiro, RJ, Brazil
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13
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Spenciere B, Mendes-Santos LC, Borges-Lima C, Charchat-Fichman H. Qualitative analysis and identification of pattern of errors in Clock Drawing Tests of community-dwelling older adults. Dement Neuropsychol 2018; 12:181-188. [PMID: 29988343 PMCID: PMC6022984 DOI: 10.1590/1980-57642018dn12-020011] [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] [Indexed: 11/22/2022] Open
Abstract
The Clock Drawing Test (CDT) is a frequently employed screening tool with different scoring systems. Quantitative and semi-quantitative scoring systems, such as Sunderland’s et al. (1989), do not discriminate different error patterns. Thus, the same score can represent a number of different neuropsychological profiles. Therefore, the use of a scoring method that emphasizes qualitative aspects to determine specific error patterns is fundamental.
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14
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de Noronha ÍFC, Barreto SDS, Ortiz KZ. The influence of education on performance of adults on the Clock Drawing Test. Dement Neuropsychol 2018; 12:61-67. [PMID: 29682235 PMCID: PMC5901251 DOI: 10.1590/1980-57642018dn12-010009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The Clock Drawing Test (CDT) is an important instrument for screening individuals suspected of having cognitive impairment.
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Affiliation(s)
| | - Simone Dos Santos Barreto
- Adjoined Professor. Department of Specific Training in Speech, Language and Hearing Sciences - Universidade Federal Fluminense, RJ, Brazil
| | - Karin Zazo Ortiz
- Associate Professor. Department of Speech, Language and Hearing Sciences - Universidade Federal de São Paulo
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15
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Tenorio M, Williams OA, Leonard M, White D, McKenna F, Dunne CP, Meagher D, Exton C. The Letter and Shape Drawing (LSD) test: An efficient and systematised approach to testing of visuospatial function. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2016:2323-2326. [PMID: 28268791 DOI: 10.1109/embc.2016.7591195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The automation and systemisation of the next generation of cognitive assessment approaches have the potential to change how clinicians assess and interact with patients. This may be especially pertinent in the case of delirium, as current methods often rely on the subjective opinion of clinicians and specialists, with potential for the condition to be overlooked or misdiagnosed. Currently, one of the most commonly used tests, is the clock-drawing test, which has relatively wide appeal as a cognitive screening instrument due to its clinical utility and psychometric properties. However, there are a number of inconsistencies associated with its use and interpretation. In this paper, we describe a new assessment methodology that we have developed, facilitated by the advances in tablet technology. In trials, our "Letter and Shape Drawing (LSD)" tool, involving both an automated scoring capability and a simpler user interaction, has demonstrated correlation with other conventional cognitive test methods although some optimisation requirements remain.
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16
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Lima CMB, Alves HVD, Mograbi DC, Pereira FF, Fernandez JL, Charchat-Fichman H. Performance on cognitive tests, instrumental activities of daily living and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro, Brazil. Dement Neuropsychol 2017; 11:54-61. [PMID: 29213494 PMCID: PMC5619215 DOI: 10.1590/1980-57642016dn11-010009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To describe the performance on basic cognitive tasks, instrumental activities
of daily living, and depressive symptoms of a community-based sample of
elderly adults in Rio de Janeiro (Brazil) who participated in multiple
physical, social, and cognitive activities at government-run community
centers. Methods A total of 264 educated older adults (> 60 years of age of both genders)
were evaluated by the Brief Cognitive Screening Battery (BCSB), Lawton's and
Pfeffer's activities of daily living indexes, and the Geriatric Depressive
Scale (GDS). Results The mean age of the sample was 75.7 years. The participants had a mean of 9.3
years of formal education. With the exception of the Clock Drawing Test
(CDT), mean scores on the cognitive tests were consistent with the values in
the literature. Only 6.4% of the sample had some kind of dependence for
activities of daily living. The results of the Geriatric Depression Scale
(GDS-15) indicated mild symptoms of depression in 16.8% of the sample Conclusion This study provided important demographic, cognitive, and functional
characteristics of a specific community-based sample of elderly adults in
Rio de Janeiro, Brazil.
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Affiliation(s)
| | - Heloisa Veiga Dias Alves
- Pontificia Universidade Catolica do Rio de Janeiro - Psicologia, Rio de Janeiro RJ - Brazil.,Bolsista do CNPq
| | - Daniel Correa Mograbi
- Pontificia Universidade Catolica do Rio de Janeiro - Psicologia, Rio de Janeiro RJ - Brazil
| | - Flávia Furtado Pereira
- Secretaria Especial de Envelhecimento e Qualidade de Vida - SESQV, Rio de Janeiro RJ - Brazil
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Camargo CHF, Tolentino EDS, Bronzini A, Ladeira MDA, Lima R, Schultz-Pereira GL, Young-Blood MR. Comparison of the use of screening tools for evaluating cognitive impairment in patients with Parkinson's disease. Dement Neuropsychol 2016; 10:344-350. [PMID: 29213480 PMCID: PMC5619276 DOI: 10.1590/s1980-5764-2016dn1004015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background Screening tests have been used for cognitive deficits in Parkinson's disease (PD). Objective This study compared the Montreal Cognitive Assessment (MoCA) test, the Mini-Mental State Examination (MMSE) and the clock drawing test for this purpose. Methods A total of 50 patients with PD were selected, 41 (82%) were diagnosed with dementia by the criteria of the Movement Disorder Society. The test Scales for Outcomes in Parkinson's Disease-Cognition (SCOPA-Cog) was used as the gold standard in comparison with the screening tests. Results The MoCA test (AUC=0.906) had a sensitivity of 87.80% and specificity of 88.89%. When the MMSE was associated with the clock drawing test (AUC=0.936), it had a specificity of 66.67% and sensitivity of up to 97.56%. Conclusion The study suggests that the MoCA test can be a good screening test in PD. However, MMSE associated with the clock drawing test may be more effective than the MoCA test.
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Affiliation(s)
| | - Eduardo de Souza Tolentino
- Medicine Student. Neurology service, Hospital Universitário, Universidade Estadual de Ponta Grossa, PR, Brasil
| | - Augusto Bronzini
- Medicine Student. Neurology service, Hospital Universitário, Universidade Estadual de Ponta Grossa, PR, Brasil
| | - Marcelo de Araújo Ladeira
- Medicine Student. Neurology service, Hospital Universitário, Universidade Estadual de Ponta Grossa, PR, Brasil
| | - Ronilson Lima
- Medicine Student. Neurology service, Hospital Universitário, Universidade Estadual de Ponta Grossa, PR, Brasil
| | | | - Marcelo Rezende Young-Blood
- MD, MSc. Neurologist of Neurology Service, Hospital Universitário, Universidade Estadual de Ponta Grossa, PR, Brasil
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