Is the Mini-Mental State Examination (MMSE useful for eligibility screening of research participants with substance use disorder?

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Aldebarán Toledo-Fernández

2016-06-01

Full Text Available Introduction: the MMSE is used for eligibility screening of potential research participants diagnosed with substance use disorder (SUD, as abilities needed to provide a valid informed consent or accurate information could be impaired in these clinical populations. Knowledge about the capacity of the MMSE to detect impairment in these abilities or at least to assess impact of SUD on its total score, however, is rather diffuse. This has important ethical and methodological implications. Objective: to analyze effects of SUD only, main substances of abuse, age of onset of substance use, recent substance use, and psychiatric comorbidity upon MMSE outcome. The overall purpose of the study was to assess the utility of the MMSE for eligibility screening of potential research participants with SUD. Method: individuals were recruited from residential facilities for substance use treatment. A demographic questionnaire, MMSE and Mini International Neuropsychiatric Interview were used. Results: A total of 601 participants were gathered for main analysis. Controlling for education, no differences in MMSE score were detected within main substances of abuse (F=1.25[4,529], p=.28, nor between SUD only versus SUD with psychiatric comorbidity (F=.58[1,597], p=.44. Effects of age of onset and recent use of specific substances upon MMSE score were also absent. Discussion and conclusions: If there is some cognitive impairment in this clinical population, it may not be pertinently assessed by the MMSE, thus casting doubt on its pertinence for eligibility screening.

Normative data for the Tygerberg Cognitive Battery and Mini-Mental Status Examination in a South African population.

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Roos, Annerine; Calata, Dorothy; Jonkers, Liesl; Maritz, Stephan J; Kidd, Martin; Daniels, Willie M U; Hugo, Frans J

2010-01-01

Normative data for the Tygerberg Cognitive Battery (TCB) and Mini-Mental Status Examination (MMSE) (in South Africa) have not been formally examined before. The TCB was developed for the bedside pen-and-paper screening of cognitive impairment in each of the 6 main cognitive domains, including attention and concentration, speech, memory, praxis, gnosis, and executive functioning. The test is also used to diagnose different neuropsychiatric conditions. The MMSE is an established screen of cognitive status, which is often used as a comparative standard for novel screening tests such as the TCB. The TCB was initially developed in English and Afrikaans, and a Xhosa version was also initiated with this study so that the 3 most common languages of the region could be accommodated. The first aim of the study was to estimate normative test performance on the TCB and MMSE among controls, and the second aim was to develop a Xhosa version of the TCB. Assessments of the TCB and MMSE were carried out in a population of healthy individuals (n = 157). In addition, healthy Xhosa-speaking participants (n = 14) were screened using a Xhosa version of the TCB. Reliability scores for all forms of the TCB were satisfactory. Age and education correlated significantly with TCB scores (r = -0.26, P < .01; r = 0.64, P < .01, respectively), whereas only education significantly correlated with MMSE scores (r = 0.32, P < .05). Normative values were calculated accordingly, that is, controlled for the effects of age and education. The TCB scores also correlated significantly with MMSE scores (r = 0.49, P < .05), demonstrating the potential of the TCB to serve as an alternate cognitive assessment tool, along with the MMSE, to focus neuropsychiatric investigations. Scores on the Xhosa version differed significantly on speech, praxis, and gnosis between the Afrikaans and English participant scores. These normative data can be used to increase precision and to provide an impartial evaluation when

Screening an elderly hearing impaired population for mild cognitive impairment using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).

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Lim, Magdalene Yeok Leng; Loo, Jenny Hooi Yin

2018-07-01

To determine if there is an association between hearing loss and poorer cognitive scores on Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) and to determine if poor hearing acuity affects scoring on the cognitive screening tests of MMSE and MoCA. One hundred fourteen elderly patients (Singapore residents) aged between 55 and 86 years were sampled. Participants completed a brief history questionnaire, pure tone audiometry, and 2 cognitive screening tests-the MMSE and MoCA. Average hearing thresholds of the better ear in the frequencies of 0.5, 1, 2, and 4 kHz were used for data analysis. Hearing loss was significantly associated with poorer cognitive scores in Poisson regression models adjusted for age. Mini-Mental State Examination scores were shown to decrease by 2.8% (P = .029), and MoCA scores by 3.5% (P = .013) for every 10 dB of hearing loss. Analysis of hearing-sensitive components of "Registration" and "Recall" in MMSE and MoCA using chi-square tests showed significantly poorer performance in the hearing loss group as compared to the normal hearing group. Phonetic analysis of target words with high error rates shows that the poor performance was likely contributed by decreased hearing acuity, on top of a possible true deficit in cognition in the hearing impaired. Hearing loss is associated with poorer cognitive scores on MMSE and MoCA, and cognitive scoring is likely confounded by poor hearing ability. This highlights an important, often overlooked aspect of sensory impairment during cognitive screening. Provisions should be made when testing for cognition in the hearing-impaired population to avoid over-referral and subsequent misdiagnoses of cognitive impairment. Copyright © 2018 John Wiley & Sons, Ltd.

Serial Mini-Mental Status Examination to Evaluate Cognitive Outcome in Patients with Traumatic Brain Injury.

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Lee, Chung Nam; Koh, Young-Cho; Moon, Chang Taek; Park, Dong Sun; Song, Sang Woo

2015-04-01

This study was aimed at finding out the changes in cognitive dysfunction in patients with traumatic brain injury (TBI) and investigating the factors limiting their cognitive improvement. Between January 2010 and March 2014, 33 patients with TBI participated in serial mini-mental status examination (MMSE). Their cognitive functions were statistically analyzed to clarify their relationship with different TBI status. Patients who developed hydrocephalus were separately analyzed in regards to their cognitive function depending on the placement of ventriculoperitoneal shunt (VPS). Bi-frontal lobe injury (β=-10.441, p<0.001), contre-coup injury (β=-6.592, p=0.007), severe parenchymal injury (β=-7.210, p=0.012), temporal lobe injury (β=-5.524, p=0.027), and dominant hemisphere injury (β=-5.388, p=0.037) significantly lowered the final MMSE scores. The risk of down-grade in the prognosis was higher in severe parenchymal injury [odds ratio (OR)=13.41, 95% confidence interval (CI)=1.31-136.78], temporal lobe injury (OR=12.3, 95% CI=2.07-73.08), dominant hemisphere injury (OR=8.19, 95% CI=1.43-46.78), and bi-frontal lobe injury (OR=7.52, 95% CI=1.31-43.11). In the 11 post-traumatic hydrocephalus patients who underwent VPS, the final MMSE scores (17.7±6.8) substantially increased from the initial MMSE scores (11.2±8.6). Presence of bi-frontal lobe injury, temporal lobe injury, dominant hemisphere injury, and contre-coup injury and severe parenchymal injury adversely influenced the final MMSE scores. They can be concluded to be poor prognostic factors in terms of cognitive function in TBI patients. Development of hydrocephalus aggravates cognitive impairment with unpredictable time of onset. Thus, close observation and routine image follow-up are mandatory for early detection and surgical intervention for hydrocephalus.

The Montreal Cognitive Assessment (MoCA) is superior to the Mini Mental State Examination (MMSE) in detection of korsakoffs syndrome

NARCIS (Netherlands)

Oudman, Erik; Postma, Albert; Van Der Stigchel, Stefan; Appelhof, Britt; Wijnia, Jan W.; Nijboer, Tanja C W

2014-01-01

The Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE) are brief screening instruments for cognitive disorders. Although these instruments have frequently been used in the detection of dementia, there is currently little knowledge on the validity to detect Korsakoffs

Blind Reduced-Rank MMSE Detector for DS-CDMA Systems

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Xiaodong Cai

2003-01-01

Full Text Available We first develop a reduced-rank minimum mean squared error (MMSE detector for direct-sequence (DS code division multiple access (CDMA by forcing the linear MMSE detector to lie in a signal subspace of a reduced dimension. While a reduced-rank MMSE detector has lower complexity, it cannot outperform the full-rank MMSE detector. We then concentrate on the blind reduced-rank MMSE detector which is obtained from an estimated covariance matrix. Our analysis and simulation results show that when the desired user′s signal is in a low-dimensional subspace, there exists an optimal subspace so that the blind reduced-rank MMSE detector lying in this subspace has the best performance. By properly choosing a subsspace, we guarantee that the optimal blind reduced-rank MMSE detector is obtained. An adaptive blind reduced-rank MMSE detector, based on a subspace tracking algorithm, is developed. The adaptive blind reduced-rank MMSE detector exhibits superior steady-state performance and fast convergence speed.

Cognitive impairment as assessed by a short form of MMSE was predictive of mortality

DEFF Research Database (Denmark)

Schultz-Larsen, Kirsten; Rahmanfard, Naghmeh; Kreiner, Svend

2008-01-01

OBJECTIVE: This study explores the association between cognitive impairment and mortality in late senescence. A specific purpose was to validate the ability of a short form of the Mini-Mental State Examination (MMSE) in predicting mortality. STUDY DESIGN AND SETTING: The cognition-mortality link,...... chronic diseases and mortality. A short, valid MMSE subscale, which was a powerful predictor of mortality especially among men, is attractive for research and clinical practice......., as assessed by the original MMSE and D-MMSE (a subscale associated to dementia) was estimated on a community sample of 1,111 older people using Cox proportional hazards models. RESULTS: Impaired cognitive function as assessed by both the original MMSE and D-MMSE predicted mortality in older men and women over...... long intervals. The association persisted after controlling for sociodemographic variables, Body Mass Index, mobility, and comorbidity and was unaffected by self-reported specific chronic diseases in both men and women. In addition, disease related risk of mortality was substantially reduced...

Reliability and validity of revised Turkish version of Mini Mental State Examination (rMMSE-T) in community-dwelling educated and uneducated elderly.

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Keskinoglu, Pembe; Ucku, Reyhan; Yener, Görsev; Yaka, Erdem; Kurt, Pinar; Tunca, Zeliha

2009-11-01

To evaluate the reliability and validity of the revised Turkish version of Mini Mental State Examination (rMMSE-T) in educated and uneducated community-dwelling elderly, to re-organize the present Turkish version of MMSE and to determine cut-off point of the revised test. This cross-sectional and analytical study involved totally 490 elderly subjects selected by cluster sampling method. Receiver operating characteristic (ROC) analysis, kappa analysis and Cronbach's alpha coefficients were used for statistical analysis. Areas under ROC curve in educated and uneducated elderly were found as 0.953 and 0.907. Cut-off point of 22/23 of rMMSE-T in educated elderly had the highest sensitivity (90.9), specificity (97.0) and positive likelihood ratio (30.3), whereas cut-off point of 18/19 of the test in uneducated elderly had the highest sensitivity (82.7), specificity (92.3) and positive likelihood ratio (10.7). The Cronbach's alpha values of the rMMSE-T for educated and uneducated elderly were higher than 0.7 (sign of good internal consistency of the test). A significant correlations between intrarater and interrater test-retest in educated elderly subjects were observed (0.966 (p = 0.000); 0.855 (p = 0.000), respectively), and also in uneducated elderly (0.988 (p = 0.000); 0.934 (p = 0.000), respectively). Kappa value of the test in educated and uneducated elderly showed a perfect agreement interraters (1.000) and a substantial agreement in intraraters (1.000, 0.784; 0.826, 0.656, respectively). rMMSE-T had a high reliability and validity. It will be more appropriate to use the revised test and the new cut-off point for the diagnosis and screening of dementia among community-dwelling Turkish elderly population. Copyright 2009 John Wiley & Sons, Ltd.

Comparison between mini mental state examination (MMSE) and Montreal cognitive assessment Indonesian version (MoCA-Ina) as an early detection of cognitive impairments in post-stroke patients

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Lestari, S.; Mistivani, I.; Rumende, C. M.; Kusumaningsih, W.

2017-08-01

Mild cognitive impairment (MCI) is defined as cognitive impairment that may never develop into dementia. Cognitive impairment is one long-term complication of a stroke. The Mini Mental State Examination (MMSE), which is commonly used as a screening tool for cognitive impairment, has a low sensitivity to detect cognitive impairment, especially MCI. Alternatively, the Montreal Cognitive Assessment Indonesian version (MoCA-Ina) has been reported to have a higher sensitivity than the MMSE. The aim of this study was to compare the proportion of MCI identified between the MMSE and MoCA-Ina in stroke patients. This was a cross-sectional study of stroke outpatients who attended the Polyclinic Neuromuscular Division, Rehabilitation Department, and Polyclinic Stroke, Neurology Department Cipto Mangunkusumo General Hospital, Jakarta. The proportion of MCI identified using the MMSE was 31.03% compared to 72.41% when using the MoCA-Ina. This difference was statistically significant (Fisher’s exact test, p = 0.033). The proportion of MCI in stroke patients was higher when using the MoCA-Ina compared to the MMSE. The MoCA-Ina should be used as an alternative in the early detection of MCI in stroke patients, especially those undergoing rehabilitation.

How to calculate an MMSE score from a MODA score (and vice versa) in patients with Alzheimer's disease.

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Cazzaniga, R; Francescani, A; Saetti, C; Spinnler, H

2003-11-01

The aim of the present study was to provide a statistically sound way of reciprocally converting scores of the mini-mental state examination (MMSE) and the Milan overall dementia assessment (MODA). A consecutive series of 182 patients with "probable" Alzheimer's disease patients was examined with both tests. MODA and MMSE scores proved to be highly correlated. A formula for converting MODA and MMSE scores was generated.

How Do Scores on the ADAS-Cog, MMSE, and CDR-SOB Correspond?

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Balsis, Steve; Benge, Jared F; Lowe, Deborah A; Geraci, Lisa; Doody, Rachelle S

2015-01-01

Clinicians and researchers who measure cognitive dysfunction often use the Alzheimer's Disease Assessment Scale--Cognitive Subscale (ADAS-Cog), the Mini-Mental State Examination (MMSE), or the Clinical Dementia Rating scale (CDR-SOB). But, the use of different measures can make it difficult to compare data across patients or studies. What is needed is a simple chart that shows how scores on these three important measures correspond to each other. Using data from 1709 participants from the Alzheimer's Disease Neuroimaging Initiative and item response theory-based statistics, we analyzed how scores on each measure, the ADAS-Cog, the MMSE, and the CDR-SOB, correspond. Results indicated multiple inflections in CDR-SOB and ADAS-Cog scores within a given MMSE score, suggesting that the CDR-SOB and ADAS-Cog are more precise in measuring the severity of cognitive dysfunction than the MMSE. This study shows how scores on these three popular measures of cognitive dysfunction correspond to each other, which is very useful information for both researchers and clinicians.

Is mini-mental score examination (MMSE scoring a new predictor of uncontrolled hypertension?

Directory of Open Access Journals (Sweden)

Khaled Sayed

2014-03-01

Conclusion: We conclude that MMSE is a simple test to run in clinic and can give an idea about the degree of structural damage caused to the brain; and hence predict whether or not the patient’s BP is well controlled. This would not replace the 24-hour ABPM but may help guide the clinicians to request this 24-hour monitoring.

Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis.

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Ciesielska, Natalia; Sokołowski, Remigiusz; Mazur, Ewelina; Podhorecka, Marta; Polak-Szabela, Anna; Kędziora-Kornatowska, Kornelia

2016-10-31

Screening tests play a crucial role in dementia diagnostics, thus they should be very sensitive for mild cognitive impairment (MCI) assessment. Nowadays, the MiniMental State Examination (MMSE) is the most commonly used scale in cognitive function evaluation, albeit it is claimed to be imprecise for MCI detection. The Montreal Cognitive Assessment (MoCA), was created as an alternative method for MMSE. Aim. MoCA vs. MMSE credibility assessment in detecting MCI, while taking into consideration the sensitivity and specificity by cut-off points. A systematic literature search was carried out by the authors using EBSCO host Web, Wiley Online Library, Springer Link, Science Direct and Medline databases. The following medical subject headings were used in the search: mild cognitive impairment, mini-mental state examination, Montreal cognitive assessment, diagnostics value. Papers which met inclusion and exclusion criteria were chosen to be included in this review. At the end, for the evaluation of MoCA 20, and MMSE 13 studies were qualified. Research credibility was established by computing weighted arithmetic mean, where weight is defined as population for which the result of sensitivity and specificity for the cut-off point was achieved. The cut-offs are shown as ROC curve and accuracy of diagnosis for MoCA and MMSE was calculated as the area under the curve (AUC). ROC curve analysis for MoCA demonstrated that MCI best detection can be achieved with a cut-off point of 24/25 (n = 9350, the sensitivity of 80.48% and specificity of 81.19%). AUC was 0.846 (95% CI 0.823-0.868). For MMSE, it turned out that more important cut-off was of 27/28 (n = 882, 66.34% sensitivity and specificity of 72.94%). AUC was 0.736 (95% CI 0.718-0.767). MoCA test better meets the criteria for screening tests for the detection of MCI among patients over 60 years of age than MMSE.

Validation and cultural adaptation of the Arabic versions of the Mini-Mental Status Examination - 2 and Mini-Cog test.

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Albanna, Mohammad; Yehya, Arij; Khairi, Abdalla; Dafeeah, Elnour; Elhadi, Abdelsalam; Rezgui, Lamia; Al Kahlout, Shahada; Yousif, Adil; Uthman, Basim; Al-Amin, Hassen

2017-01-01

The elderly population is increasing around the world, and the prevalence of dementia increases with age. Hence, it is expected that the number of people with dementia will increase significantly in the coming years. The Mini-Mental Status Examination - 2 (MMSE-2) and Mini-Cog are widely used tests to screen for dementia. These scales have good reliability and validity and are easy to administer in clinical and research settings. The purpose of this study was to validate the Arabic versions of MMSE-2 and Mini-Cog. These scales were assessed against the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision ( DSM-IV-TR ) criteria for dementia, as the gold standard. The standard versions of the MMSE-2 and Mini-Cog were translated to Arabic following the back-translation method. Then, a trained rater administered these tests to 134 Arab elderly aged >60 years. A physician, blind to the results of these two tests, assessed the participants for vascular dementia or probable Alzheimer's disease, based on the DSM-IV-TR criteria. The sample included 67.2% Qataris. The mean age was 74.86 years (standard deviation =7.71), and 61.9% did not attend school. The mean of the adjusted scores of MMSE-2 based on age and education level was 19.60 (standard deviation =6.58). According to DSM-IV-TR , 17.2% of the participants had dementia. Sensitivity and specificity of the MMSE-2 and the Mini-Cog together were 71.4% and 61.6%, respectively, which were better than those of each test alone. Together, the Arabic versions of MMSE-2 and Mini-Cog are good screening tools for cognitive impairment in Arabs.

Three sides of the same coin: measuring global cognitive impairment with the MMSE, ADAS-cog and CAMCOG.

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Wouters, Hans; van Gool, Willem A; Schmand, Ben; Zwinderman, Aeilko H; Lindeboom, Robert

2010-08-01

The total scores of the ADAS-cog, MMSE and CAMCOG, comprising various cognitive tasks, are widely used to measure a dimension of global cognitive impairment. It is unknown, however, whether this dimension is common to these instruments. This hampers comparisons when either of these instruments is used. The extent to which these instruments share a common dimension of global cognitive impairment and how their scores relate was examined. Rasch analysis of CAMCOG and MMSE data of participants from a population based study and two memory clinics pooled with ADAS-cog and MMSE data of participants from three RCTs (overall N = 1566) to estimate a common dimension of global cognitive impairment and to examine the goodness of fit of the individual items to this dimension. Using the estimated common dimension of global cognitive impairment, the total scores of the instruments could be related, e.g. a mean level of global cognitive impairment corresponded to a predicted score of 11.4 (ADAS-cog), 72.6 (CAMCOG) and 22.2 (MMSE). When revised according to The Rasch validity analyses, every individual item could be fitted to the dimension. The MMSE, ADAS-cog and CAMCOG reflect a valid common dimension of global cognitive impairment, which enables comparisons of RCTs that use the ADAS-cog and observational studies that use the CAMCOG and MMSE.

A Longitudinal Study of the Mini-Mental State Examination in Late Nonagenarians and Its Relationship with Dementia, Mortality, and Education.

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Skoog, Johan; Backman, Kristoffer; Ribbe, Mats; Falk, Hanna; Gudmundsson, Pia; Thorvaldsson, Valgeir; Borjesson-Hanson, Anne; Ostling, Svante; Johansson, Boo; Skoog, Ingmar

2017-06-01

To examine level of and change in cognitive status using the Mini-Mental State Examination (MMSE) in relation to dementia, mortality, education, and sex in late nonagenarians. Three-year longitudinal study with examinations at ages 97, 99, and 100. Trained psychiatric research nurses examined participants at their place of living. A representative population-based sample of 97-year-old Swedes (N = 591; 107 men, 484 women) living in Gothenburg, Sweden. A Swedish version of the MMSE was used to measure cognitive status. Geriatric psychiatrists diagnosed dementia according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Mixed models were fitted to the data to model the longitudinal relationship between MMSE score and explanatory variables. Individuals with dementia between age 97 and 100 had lower mean MMSE scores than those without dementia. Those who died during the 3-year follow-up had lower MMSE scores than those who survived. MMSE scores at baseline did not differ between those without dementia and those who developed dementia during the 3-year follow-up. Participants with more education had higher MMSE scores, but there was no association between education and linear change. MMSE score is associated with dementia and subsequent mortality even in very old individuals, although the preclinical phase of dementia may be short in older age. Level of education is positively associated with MMSE score but not rate of decline in individuals approaching age 100. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Validation and cultural adaptation of the Arabic versions of the Mini–Mental Status Examination – 2 and Mini-Cog test

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Albanna, Mohammad; Yehya, Arij; Khairi, Abdalla; Dafeeah, Elnour; Elhadi, Abdelsalam; Rezgui, Lamia; Al Kahlout, Shahada; Yousif, Adil; Uthman, Basim; Al-Amin, Hassen

2017-01-01

Introduction The elderly population is increasing around the world, and the prevalence of dementia increases with age. Hence, it is expected that the number of people with dementia will increase significantly in the coming years. The Mini–Mental Status Examination – 2 (MMSE-2) and Mini-Cog are widely used tests to screen for dementia. These scales have good reliability and validity and are easy to administer in clinical and research settings. Aim The purpose of this study was to validate the Arabic versions of MMSE-2 and Mini-Cog. These scales were assessed against the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for dementia, as the gold standard. Methods The standard versions of the MMSE-2 and Mini-Cog were translated to Arabic following the back-translation method. Then, a trained rater administered these tests to 134 Arab elderly aged >60 years. A physician, blind to the results of these two tests, assessed the participants for vascular dementia or probable Alzheimer’s disease, based on the DSM-IV-TR criteria. Results The sample included 67.2% Qataris. The mean age was 74.86 years (standard deviation =7.71), and 61.9% did not attend school. The mean of the adjusted scores of MMSE-2 based on age and education level was 19.60 (standard deviation =6.58). According to DSM-IV-TR, 17.2% of the participants had dementia. Sensitivity and specificity of the MMSE-2 and the Mini-Cog together were 71.4% and 61.6%, respectively, which were better than those of each test alone. Conclusion Together, the Arabic versions of MMSE-2 and Mini-Cog are good screening tools for cognitive impairment in Arabs. PMID:28352179

Examining Cognitive Status of Elderly Iranians: Farsi Version of the Modified Mini-Mental State Examination.

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Gharaeipour, Manouchehr; Andrew, Melissa K

2013-02-27

The Modified Mini-Mental State Examination (3MS) is an expanded and modified version of the Mini-Mental State Examination (MMSE). Research demonstrates that the reliability, validity, specificity, and sensitivity of the 3MS are superior to that of the MMSE in detecting cognitive impairment. The Farsi version of the 3MS (F-3MS) was examined as a screening tool for dementia among elderly Iranians. The F-3MS and the Clock Drawing Test (CDT) were administered to 58 patients with dementia and 145 control subjects with normal cognition, aged 60 to 85 years. The difference between groups on the mean total scores of the F-3MS was statistically significant (dementia = 60.65 ± 9.89, control = 80.73 ± 8.26; df = 201, t = 14.75, p validity of the F-3MS. The F-3MS can be used as a valid and reliable measure for dementia screening among elderly Iranians.

Use of days of the week in a modified mini-mental state exam (M-MMSE) for detecting geriatric cognitive impairment.

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Hamrick, Irene; Hafiz, Razia; Cummings, Doyle M

2013-01-01

The purpose of this study was to compare a modified version of the Mini-Mental State Examination (MMSE) with the standard MMSE and the Mini-Cog in patients ≥65 years old, stratified by education and literacy level. This cross-sectional exploratory study enrolled a convenience sample of 219 patients with a complaint of memory loss or a diagnosis of dementia from a geriatric outpatient clinic, nursing home, senior center, and university hospital. The MMSE was administered, and in addition to spelling and serial 7s backward, patients were asked to recite the days of the week backward with the intent to reduce educational bias. Scores on the modified MMSE were compared with scores of the MMSE and the Mini-Cog. Of the 219 patients, 157 were identified with cognitive impairment by the Mini-Cog. Using a cutoff of ≤23, the MMSE identified 118 patients and the modified MMSE identified 91 patients with cognitive impairment, and with a cutoff of ≤27 the MMSE identified 168 and the modified MMSE 149 patients. All cognitively intact subjects correctly recited the days of the week backward. Specificity of the modified MMSE was higher than the MMSE for most groups. The highest sensitivity and specificity (94% and 88%, respectively) as well as positive and negative predictive values (96% and 81%, respectively) were in patients with low levels of education for the modified MMSE using a cut off of ≤27. Using the days of the week in the MMSE among illiterate and semiliterate participants and with education less than high school, and using a cutoff of 27 of 30, correlates better with Mini-Cog for dementia screening, with fewer false positives.

The Clock Drawing Test versus Mini-mental Status Examination as a Screening Tool for Dementia: A Clinical Comparison.

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Palsetia, Delnaz; Rao, G Prasad; Tiwari, Sarvada C; Lodha, Pragya; De Sousa, Avinash

2018-01-01

There is a growing incidence of dementia patients in the community, and with this growth, there is need for rapid, valid, and easily administrable tests for the screening of dementia and mild cognitive impairment in the community. This review looks at the two most commonly used tests in dementia screening, namely, the clock drawing test (CDT) and the mini-mental status examination (MMSE). Both these tests have been used in dementia screening over the past three decades and have been the subject of scrutiny of various studies, reviews, and meta-analysis. Both these tests are analyzed on their ability to assess dementia and screen for it in the community, general practice and general hospital settings. The methods of administration and scoring of each test are discussed, and their advantages and disadvantages are explained. There is also a direct comparison made between the MMSE and CDT in dementia screening. Future research needs with these tests are also elucidated.

The Clock Drawing Test versus Mini-mental Status Examination as a Screening Tool for Dementia: A Clinical Comparison

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Palsetia, Delnaz; Rao, G. Prasad; Tiwari, Sarvada C.; Lodha, Pragya; De Sousa, Avinash

2018-01-01

There is a growing incidence of dementia patients in the community, and with this growth, there is need for rapid, valid, and easily administrable tests for the screening of dementia and mild cognitive impairment in the community. This review looks at the two most commonly used tests in dementia screening, namely, the clock drawing test (CDT) and the mini-mental status examination (MMSE). Both these tests have been used in dementia screening over the past three decades and have been the subject of scrutiny of various studies, reviews, and meta-analysis. Both these tests are analyzed on their ability to assess dementia and screen for it in the community, general practice and general hospital settings. The methods of administration and scoring of each test are discussed, and their advantages and disadvantages are explained. There is also a direct comparison made between the MMSE and CDT in dementia screening. Future research needs with these tests are also elucidated. PMID:29403122

Mini mental state examination and the Addenbrooke's cognitive examination: effect of education and norms for a multicultural population.

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Mathuranath, P S; Cherian, Joseph P; Mathew, Robert; George, Annamma; Alexander, Aley; Sarma, Sankara P

2007-01-01

To derive population norms on the Malayalam adaptation of Addenbrooke's Cognitive Examination (M-ACE) and the inclusive Malayalam mini mental state examination (M-MMSE). Education-stratified norms were obtained on randomly selected cognitively unimpaired community elders (n = 519). Valid data on norms was available on 488 subjects (age 68.5 +/- 7.1 and education 7.9 +/- 5.4). Education and age, but not gender had a significant effect on both M-ACE and M-MMSE. When compared to the effect of age, the effect of education was sevenfold more on the M-ACE and ninefold more on the M-MMSE. The mean composite score on the M-ACE (and the M-MMSE) was 42.8 +/- 9.8 (14.9 +/- 3.1) for those with 0 (n = 72), 55.9 +/- 12.5 (19.7 +/- 4.1) with 1-4 (n = 96), 62.6 +/- 11.4 (21.9 +/- 3.7) with 5-8 (n = 81), 77 +/- 10.2 (25.7 +/- 2.4) with 9-12 (n = 136) and 83.4 +/- 7.2 (26.7 +/- 1.6) with > 12 (n = 103) years of formal education. Education has the most potent effect on performance on both M-ACE and M-MMSE in the Indian cohort. Education-stratified scores on the M-ACE and the M-MMSE, will provide a more appropriate means of establishing the cognitive status of patients. It is also our feeling that these cut-off scores will be useful across India.

MMSE Estimator for Children’s Speech with Car and Weather Noise

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Sayuthi, V.

2018-04-01

Previous research mentioned that most people need and use vehicles for various purposes, in this recent time and future, as a means of traveling. Many ways can be done in a vehicle, such as for enjoying entertainment, and doing work, so vehicles not just only as a means of traveling. In this study, we will examine the children’s speech from a girl in the vehicle that affected by noise disturbances from the sound source of car noise and the weather sound noise around it, in this case, the rainy weather noise. Vehicle sounds may be from car engine or car air conditioner. The minimum mean square error (MMSE) estimator is used as an attempt to obtain or detect the children’s clear speech by representing simulation research as random process signal that factored by the autocorrelation of both the child’s voice and the disturbance noise signal. This MMSE estimator can be considered as wiener filter as the clear sound are reconstructed again. We expected that the results of this study can help as the basis for development of entertainment or communication technology for passengers of vehicles in the future, particularly using MMSE estimators.

Correlates of self-reported, autobiographical, and mini-mental status examination defined memory deficits following electroconvulsive therapy in South India.

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Rajkumar, Anto P; Petit, Cheryl P; Rachana, Arun; Deinde, Funmi; Shyamsundar, G; Thangadurai, P; Jacob, Kuruthukulangara S

2018-04-01

Cognitive deficits, self-reported or found following electroconvulsive therapy (ECT), and their correlates are diverse. Despite the characteristics of people receiving ECT in Asia differ widely from the west, pertinent research from Asia remains sparse. We investigated the correlates of self-reported, mini-mental status examination (MMSE) defined, and autobiographical memory deficits in a cohort that received ECT in a south Indian tertiary-care setting. 76 consecutive consenting people were recruited within seven days of completing their ECT course. Memory was assessed by a subjective Likert scale, MMSE, and an autobiographical memory scale (AMS). Psychopathology was assessed by brief psychiatric rating scale, and serum cortisol levels were estimated by chemi-luminescence immunoassays. Relevant sociodemographic and clinical data were collected from the participants, and their medical records. The correlates were analysed using generalised linear models after adjusting for the effects of potential confounders. Self-reported, MMSE-defined, and autobiographical memory deficits were present in 27.6% (95%CI 17.6-37.7%), 42.1% (95%CI 31.0-53.2%), and 36.8% (95%CI 26.0-47.7%) of participants, respectively. Agreement between the memory deficits was poor. Age, less education, duration of illness, hypothyroidism, and past history of another ECT course were significantly associated with MMSE-defined deficits. Age, anaemia, past ECT course, and pre-ECT blood pressure were significantly associated with autobiographical memory deficits, while residual psychopathology and cortisol levels were significantly associated with self-reported memory deficits. Self-reported, MMSE-defined, and autobiographical memory deficits are common at the completion of ECT course, and their correlates differ. All service users receiving ECT need periodic cognitive assessments evaluating multiple cognitive domains. Copyright © 2018 Elsevier B.V. All rights reserved.

Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations.

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Creavin, Sam T; Wisniewski, Susanna; Noel-Storr, Anna H; Trevelyan, Clare M; Hampton, Thomas; Rayment, Dane; Thom, Victoria M; Nash, Kirsty J E; Elhamoui, Hosam; Milligan, Rowena; Patel, Anish S; Tsivos, Demitra V; Wing, Tracey; Phillips, Emma; Kellman, Sophie M; Shackleton, Hannah L; Singleton, Georgina F; Neale, Bethany E; Watton, Martha E; Cullum, Sarah

2016-01-13

The Mini Mental State Examination (MMSE) is a cognitive test that is commonly used as part of the evaluation for possible dementia. To determine the diagnostic accuracy of the Mini-Mental State Examination (MMSE) at various cut points for dementia in people aged 65 years and over in community and primary care settings who had not undergone prior testing for dementia. We searched the specialised register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE (OvidSP), EMBASE (OvidSP), PsycINFO (OvidSP), LILACS (BIREME), ALOIS, BIOSIS previews (Thomson Reuters Web of Science), and Web of Science Core Collection, including the Science Citation Index and the Conference Proceedings Citation Index (Thomson Reuters Web of Science). We also searched specialised sources of diagnostic test accuracy studies and reviews: MEDION (Universities of Maastricht and Leuven, www.mediondatabase.nl), DARE (Database of Abstracts of Reviews of Effects, via the Cochrane Library), HTA Database (Health Technology Assessment Database, via the Cochrane Library), and ARIF (University of Birmingham, UK, www.arif.bham.ac.uk). We attempted to locate possibly relevant but unpublished data by contacting researchers in this field. We first performed the searches in November 2012 and then fully updated them in May 2014. We did not apply any language or date restrictions to the electronic searches, and we did not use any methodological filters as a method to restrict the search overall. We included studies that compared the 11-item (maximum score 30) MMSE test (at any cut point) in people who had not undergone prior testing versus a commonly accepted clinical reference standard for all-cause dementia and subtypes (Alzheimer disease dementia, Lewy body dementia, vascular dementia, frontotemporal dementia). Clinical diagnosis included all-cause (unspecified) dementia, as defined by any version of the Diagnostic and Statistical Manual of Mental Disorders (DSM); International Classification of

The Modified Telephone Interview for Cognitive Status is More Predictive of Memory Abilities Than the Mini-Mental State Examination.

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Duff, Kevin; Tometich, Danielle; Dennett, Kathryn

2015-09-01

Although not as popular as the Mini-Mental State Examination (MMSE), the modified Telephone Interview for Cognitive Status (mTICS) has some distinct advantages when screening cognitive functioning in older adults. The current study compared these 2 cognitive screening measures in their ability to predict performance on a memory composite (ie, delayed recall of verbal and visual information) in a cohort of 121 community-dwelling older adults, both at baseline and after 1 year. Both the MMSE and the mTICS significantly correlated with the memory composite at baseline (r's of .41 and .62, respectively) and at 1 year (r's of .36 and .50, respectively). At baseline, stepwise linear regression indicated that the mTICS and gender best predicted the memory composite score (R (2) = .45, P similar. Despite its lesser popularity, the mTICS may be a more attractive option when screening for cognitive abilities in this age range. © The Author(s) 2015.

Importance of the mini-mental status examination in the treatment of patients with brain metastases: a report from the radiation therapy oncology group protocol 91-04

International Nuclear Information System (INIS)

Murray, Kevin J.; Scott, Charles; Zachariah, Babu; Michalski, Jeff M.; Demas, William; Vora, Nayana L.; Whitton, Anthony; Movsas, Benjamin

2000-01-01

Purpose: Little information is available on the importance of pretreatment Mini-Mental Status Exam (MMSE) on long-term survival and neurologic function following treatment for unresectable brain metastases. This study examines the importance of the MMSE in predicting outcome in a group of patients treated with an accelerated fractionation regimen of 30 Gy in 10 daily fractions in 2 weeks. Materials and Methods: The Radiation Therapy Oncology Group (RTOG) accrued 445 patients to a Phase III comparison of accelerated hyperfractionated (AH) radiotherapy (1.6 Gy b.i.d.) to a total dose of 54.4 Gy vs. an accelerated fractionation (AF) of 30 Gy in 10 daily fractions from 1991 through 1995. All patients had histologic proof of malignancy at the primary site. Brain metastases were measurable by CT or MRI scan and all patients had a Karnofsky performance score (KPS) of at least 70 and a neurologic function classification of 1 or 2. Two hundred twenty-four patients were entered on the accelerated fractionated arm, and 182 were eligible for analysis (7 patients were judged ineligible, no MMSE information in 29, no survival data in 1, no forms submitted in 1). Results: Average age was 60 years; 58% were male and 25% had a single intracranial lesion on their pretherapy evaluation. KPS was 70 in 32%, 80 in 31%, 90 in 29%, and 100 in 14%. The average MMSE was 26.5, which is the lower quartile for normal in the U.S. population. The range of the MMSE scores was 11-30 with 30 being the maximum. A score of less than 23 indicates possible dementia, which occurred in 16% of the patients prior to treatment. The median time from diagnosis to treatment was 5 days (range, 0-158 days). The median survival was 4.2 months with a 95% confidence interval of 3.7-5.1 months. Thirty-seven percent of the patients were alive at 6 months, and 17% were alive at 1 year. The following variables were examined in a Cox proportional-hazards model to determine their prognostic value for overall survival

Sources of variation on the mini-mental state examination in a population-based sample of centenarians.

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Dai, Ting; Davey, Adam; Woodard, John L; Miller, Lloyd Stephen; Gondo, Yasuyuki; Kim, Seock-Ho; Poon, Leonard W

2013-08-01

Centenarians represent a rare but rapidly growing segment of the oldest-old. This study presents item-level data from the Mini-Mental State Examination (MMSE) in a cross-sectional, population-based sample of 244 centenarians and near-centenarians (aged 98-108, 16% men, 21% African-American, 38% community dwelling) from the Georgia Centenarian Study (2001-2008) according to age, education, sex, race, and residential status. Multiple-Indicator Multiple-Cause (MIMIC) models were used to identify systematic domain-level differences in MMSE scores according to demographic characteristics in this age group. Indirect effects of age, educational attainment, race, and residential status were found on MMSE scores. Direct effects were limited to concentration for education and race and orientation for residential status. Mean levels of cognitive functioning in centenarians were low, with mean values below most commonly-used cutoffs. Overall scores on the MMSE differed as a function of age, education, race, and residential status, with differences in scale performance limited primarily to concentration and orientation and no evidence of interactions between centenarian characteristics. Adjusting for education was not sufficient to account for differences according to race, and adjusting for residential status was not sufficient to account for differences according to age. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Predictors of performance on the MMSE and the DRS-2 among American Indian elders.

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Jervis, Lori L; Fickenscher, Alexandra; Beals, Janette; Cullum, C Munro; Novins, Douglas K; Manson, Spero M; Arciniegas, David B

2010-01-01

Little is known about factors that predict older American Indians' performance on cognitive tests. This study examined 137 American Indian elders' performance on the MMSE and the Dementia Rating Scale-Second Edition (DRS-2). Multivariate regression identified younger age, more education, not receiving Supplemental Security Income, and frequent receipt of needed health care as predictors of better performance on the MMSE. Better performance on the DRS-2 was predicted by more education, boarding school attendance, not receiving Supplemental Security Income, and frequent receipt of needed health care. This study points to the importance of economic and educational factors on cognitive test performance among American Indian elders.

Relationship between brain perfusion SPECT and MMSE score in dementia of Alzheimer's type: a statistical parametric mapping analysis

International Nuclear Information System (INIS)

Kang, Hye Jin; Kang, Eun Joo; Lee, Jae Sung

2002-01-01

The aim of this study was to identify the brain areas in which reductions of regional cerebral blood flow (rCBF) were correlated with decline of general mental function, measured by Mini-Mental State Examination (MMSE). Tc-99m HMPAO brain SPECT was performed in 9 probable AD patients at the initial and follow-up periods of 1.8 years (average) after the first study. MMSE scores were also measured in both occasions. The mean MMSE score of the initial study 16.4 (range: 5-24) and the mean MMSE score of the follow-up was 8.1 (range: 0-17). Each SPECT image was normalized to the cerebellar activity and a correlation analysis was performed between the level of rCBF in AD patients and the MMSE scores by voxel-based analysis using SPM99 software. Significant correlation was found between the blood-flow decrease in left inferior prefrontal region(BA 47) and left middle temporal region (BA 21) and the MMSE score changes. Additional areas such as anterior and posterior cingulate cortices, precuneus, and bilateral superior and middle prefrontal regions showed and similar trends. A relationship was found between reduction of regional cerebral blood flow in left prefrontal and temporal areas and decline of cognitive function in Alzheimer's diseases (AD) patients. This voxel-based analysis is useful in evaluating the progress of cognitive function in Alzheimer's disease

The Mini-Mental State Examination and Montreal Cognitive Assessment in persons with mild subacute stroke: relationship to functional outcome.

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Toglia, Joan; Fitzgerald, Kerri A; O'Dell, Michael W; Mastrogiovanni, Andrea R; Lin, C David

2011-05-01

To compare Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) global and subscores in classifying cognitive impairment in persons with mild stroke and to explore the relationship between admission and discharge functional status and improvement. Retrospective analysis of data. Acute rehabilitation unit of a large urban university-affiliated hospital. Inpatients with stroke (N=72; mean age, 70y; median time poststroke, 8.5d) and mild neurologic (median National Institutes of Health Stroke Scale score, 4) and cognitive deficits (median MMSE score, 25). Not applicable. Admission cognitive status was assessed by using the MMSE and MoCA. The motor subscale of the FIM instrument (mFIM) and motor relative functional efficiency was used to assess discharge functional status and improvement. The MoCA classified more persons as cognitively impaired than the MMSE (89% vs 63%, respectively; using a cutoff score of 27 on the MMSE and 26 on the MoCA). The MoCA also showed less of a ceiling effect than the MMSE, higher internal reliability (Cronbach α=.78 compared with α=.60), and marginally stronger associations with discharge functional status (r=.40; P<.001) than the MMSE (r=0.30; P<.05). The MoCA visuoexecutive subscore was the strongest predictor of functional status (P=.01) and improvement (P=.02) in global and subscores for both tests. The MoCA may be an important cognitive screening tool for persons with stroke and mild cognitive dysfunction on an acute rehabilitation unit. Lower visuoexecutive subscores may assist in identifying persons at risk for decreased functional gains in self-care and mobility (mFIM) during inpatient rehabilitation. The findings justify further validation studies of the MoCA in persons with subacute stroke. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Interpreting Mini-Mental State Examination Performance in Highly Proficient Bilingual Spanish-English and Asian Indian-English Speakers: Demographic Adjustments, Item Analyses, and Supplemental Measures.

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Milman, Lisa H; Faroqi-Shah, Yasmeen; Corcoran, Chris D; Damele, Deanna M

2018-04-17

Performance on the Mini-Mental State Examination (MMSE), among the most widely used global screens of adult cognitive status, is affected by demographic variables including age, education, and ethnicity. This study extends prior research by examining the specific effects of bilingualism on MMSE performance. Sixty independent community-dwelling monolingual and bilingual adults were recruited from eastern and western regions of the United States in this cross-sectional group study. Independent sample t tests were used to compare 2 bilingual groups (Spanish-English and Asian Indian-English) with matched monolingual speakers on the MMSE, demographically adjusted MMSE scores, MMSE item scores, and a nonverbal cognitive measure. Regression analyses were also performed to determine whether language proficiency predicted MMSE performance in both groups of bilingual speakers. Group differences were evident on the MMSE, on demographically adjusted MMSE scores, and on a small subset of individual MMSE items. Scores on a standardized screen of language proficiency predicted a significant proportion of the variance in the MMSE scores of both bilingual groups. Bilingual speakers demonstrated distinct performance profiles on the MMSE. Results suggest that supplementing the MMSE with a language screen, administering a nonverbal measure, and/or evaluating item-based patterns of performance may assist with test interpretation for this population.

Validation and cultural adaptation of the Arabic versions of the Mini–Mental Status Examination – 2 and Mini-Cog test

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Albanna M

2017-03-01

Full Text Available Mohammad Albanna,1,* Arij Yehya,2,* Abdalla Khairi,1 Elnour Dafeeah,1 Abdelsalam Elhadi,3 Lamia Rezgui,4 Shahada Al Kahlout,4 Adil Yousif,5 Basim Uthman,6 Hassen Al-Amin2 1Psychiatry Department, Hamad Medical Corporation, 2Psychiatry Department, Weill Cornell Medicine – Qatar, 3Primary Health Care Corporation, 4Geriatrics Department, Rumailah Hospital, Hamad Medical Corporation, 5Department of Mathematics, Statistics and Physics, College of Arts and Sciences, Qatar University, 6Neurology Department, Weill Cornell Medicine – Qatar, Doha, Qatar *These authors contributed equally to this work Introduction: The elderly population is increasing around the world, and the prevalence of dementia increases with age. Hence, it is expected that the number of people with dementia will increase significantly in the coming years. The Mini–Mental Status Examination – 2 (MMSE-2 and Mini-Cog are widely used tests to screen for dementia. These scales have good reliability and validity and are easy to administer in clinical and research settings. Aim: The purpose of this study was to validate the Arabic versions of MMSE-2 and Mini-Cog. These scales were assessed against the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR criteria for dementia, as the gold standard.Methods: The standard versions of the MMSE-2 and Mini-Cog were translated to Arabic following the back-translation method. Then, a trained rater administered these tests to 134 Arab elderly aged >60 years. A physician, blind to the results of these two tests, assessed the participants for vascular dementia or probable Alzheimer’s disease, based on the DSM-IV-TR criteria.Results: The sample included 67.2% Qataris. The mean age was 74.86 years (standard deviation =7.71, and 61.9% did not attend school. The mean of the adjusted scores of MMSE-2 based on age and education level was 19.60 (standard deviation =6.58. According to DSM-IV-TR, 17.2% of

The Veterans Affairs Saint Louis University mental status exam (SLUMS exam) and the Mini-mental status exam as predictors of mortality and institutionalization.

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Cruz-Oliver, D M; Malmstrom, T K; Allen, C M; Tumosa, N; Morley, J E

2012-07-01

To evaluate predictive validity of cognitive dysfunction of the Saint Louis University mental status (SLUMS) exam or mini-mental state exam (MMSE) for institutionalization and mortality after 7.5-years. Longitudinal study. Geriatric Research, Education and Clinical Center Veterans Affairs Hospital St. Louis, MO. Patients (N=705) were screened for cognitive dysfunction in 2003 using the SLUMS exam and MMSE, and mortality and institutionalization up to 7.5-years later were evaluated as outcome measures. The associations between outcome measures and MMSE and SLUMS exam total scores, and cognitive status were examined using Kaplan-Meier curves and Cox proportional-hazards regression. Five hundred thirty-three charts were reviewed, 176/533(33%) patients had died and 31/526 (6%) were institutionalized during 7.5-year follow-up period. All subjects were male with a mean age of 75 years and most had high school education or greater (71%). MMSE dementia, SLUMS dementia (ps<.001) and MCI (p<.05) groups had significantly lower survival rates than normal cognition group in the Kaplan-Meier curves. Scores classified as dementia on SLUMS (HR=2.4, 95% CI 1.6-3.7; p <.001) or MMSE (HR=2.3, 95% CI 1.5-3.6; p <.001) both predicted mortality and, also, institutionalization (SLUMS: HR=3.5, 95% CI 1.3-9.1; p <.01; MMSE: HR=3.8, 95% CI 1.6-9.0; p <.001) after adjustment for covariates. Unadjusted SLUMS exam MCI predicted morality (HR=1.5, 95% CI 1.1-2.2; p <.019) but not institutionalization. The SLUMS exam and MMSE both predict mortality and institutionalization for male patients screened as positive for dementia.

Converting MMSE to MoCA and MoCA 5-minute protocol in an educationally heterogeneous sample with stroke or transient ischemic attack.

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Wong, Adrian; Black, Sandra E; Yiu, Stanley Y P; Au, Lisa W C; Lau, Alexander Y L; Soo, Yannie O Y; Chan, Anne Y Y; Leung, Thomas W H; Wong, Lawrence K S; Kwok, Timothy C Y; Cheung, Theodore C K; Leung, Kam-Tat; Lam, Bonnie Y K; Kwan, Joseph S K; Mok, Vincent C T

2018-05-01

The Montreal Cognitive Assessment (MoCA) is psychometrically superior over the Mini-mental State Examination (MMSE) for cognitive screening in stroke or transient ischemic attack (TIA). It is free for clinical and research use. The objective of this study is to convert scores from the MMSE to MoCA and MoCA-5-minute protocol (MoCA-5 min) and to examine the ability of the converted scores in detecting cognitive impairment after stroke or TIA. A total of 904 patients were randomly divided into training (n = 623) and validation (n = 281) samples matched for demography and cognition. MMSE scores were converted to MoCA and MoCA-5 min using (1) equipercentile method with log-linear smoothing and (2) Poisson regression adjusting for age and education. Receiver operating characteristics curve analysis was used to examine the ability of the converted scores in differentiating patients with cognitive impairment. The mean education was 5.8 (SD = 4.6; ranged 0-20) years. The entire spectrum of MMSE scores was converted to MoCA and MoCA-5 min using equipercentile method. Relationship between MMSE and MoCA scores was confounded by age and education, and a conversion equation with adjustment for age and education was derived. In the validation sample, the converted scores differentiated cognitively impaired patients with area under receiver operating characteristics curve 0.826 to 0.859. We provided 2 methods to convert scores from the MMSE to MoCA and MoCA-5 min based on a large sample of patients with stroke or TIA having a wide range of education and cognitive levels. The converted scores differentiated patients with cognitive impairment after stroke or TIA with high accuracy. Copyright © 2018 John Wiley & Sons, Ltd.

Validation study of the Mini-Mental State Examination in a Malay-speaking elderly population in Malaysia.

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Ibrahim, Norlinah M; Shohaimi, Shamarina; Chong, Heng-Thay; Rahman, Abdul Hamid Abdul; Razali, Rosdinom; Esther, Ebernezer; Basri, Hamidon B

2009-01-01

In view of the differing sensitivity and specificity of the Mini-Mental State Examination (MMSE) in the non-English-speaking populations, we conducted the first validation study of the Malay version (M-MMSE) in Malaysia among 300 subjects (from the community and outpatient clinics). Three versions were used: M-MMSE-7 (serial 7), M-MMSE-3 (serial 3) and M-MMSE-S (spell 'dunia' backwards). Dementia was assessed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV. The optimal cutoff scores were obtained from the receiver operating characteristics curves. Seventy-three patients (24.3%) had dementia and 227 (75.7%) were controls. Three hundred patients completed the M-MMSE-7, 160 the M-MMSE-3 and 145 the M-MMSE-S. All 3 versions were valid and reliable in the diagnosis of dementia. The optimal cutoff scores varied with each version and gender. In the control group, significant gender differences were observed in the patients with the lowest educational status. Increasing educational levels significantly improved the M-MMSE performance in both genders. All 3 versions of the M-MMSE are valid and reliable as a screening tool for dementia in the Malaysian population, but at different cutoff scores. In those with the lowest educational background, gender-adjusted cutoff scores should be applied. Copyright 2009 S. Karger AG, Basel.

Mental Status and Functional Behavior In Male Geriatric Patients

OpenAIRE

Mayer, Gregory Lee

1989-01-01

It was the goal of this study to examine the ecological validity of a number of measures of mental status for geriatric individuals. Subjects were 40 alert, ambulatory male VA patients. Mental status instruments included the Mini-Mental State Examination (MMSE), the Wechsler Memory Scale (WMS) and the Vocabulary subtest of the WAIS-R. Measures of functional behavior included the Woodcock-Johnson Scales of Independent Behavior (SIB) and the Parachek Geriatric Behavior Rating Scale (PGBRS). Sig...

Putative Dementia Cases Fluctuate as a Function of Mini-Mental State Examination Cut-Off Points.

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Rosa, Ilka M; Henriques, Ana G; Wiltfang, Jens; da Cruz E Silva, Odete A B

2018-01-01

As the population ages, there is a growing need to quickly and accurately identify putative dementia cases. Many cognitive tests are available; among those commonly used are the Cognitive Dementia Rating (CDR) and the Mini-Mental Status Examination (MMSE). The aim of this work was to compare the validity and reliability of these cognitive tests in a primary care based cohort (pcb-Cohort). The MMSE and the CDR were applied to 568 volunteers in the pcb-Cohort. Distinct cut-off points for the MMSE were considered, namely MMSE 27, MMSE 24, and MMSE PT (adapted for the Portuguese population). The MMSE 27 identified the greatest number of putative dementia cases, and, as determined by the ROC curve, it was the most sensitive and specific of the MMSE cut-offs considered. Putative predictive or risk factors identified included age, literacy, depression, and diabetes mellitus (DM). DM has previously been indicated as a risk factor for dementia and Alzheimer's disease. Comparatively, the MMSE 27 cut-off has the greatest sensibility (94.9%) and specificity (66.3%) when compared to MMSE PT and MMSE 24. Upon comparing MMSE and CDR scores, the latter identified a further 146 putative dementia cases, thus permitting one to propose that in an ideal situation, both tests should be employed. This increases the likelihood of identifying putative dementia cases for subsequent follow up work, thus these cognitive tests represent important tools in patient care. Further, this is a significant study for Portuguese populations, where few of these studies have been carried out.

Conversion between Addenbrooke's Cognitive Examination III and Mini-Mental State Examination.

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Matías-Guiu, Jordi A; Pytel, Vanesa; Cortés-Martínez, Ana; Valles-Salgado, María; Rognoni, Teresa; Moreno-Ramos, Teresa; Matías-Guiu, Jorge

2017-12-10

We aim to provide a conversion between Addenbrooke's Cognitive Examination III (ACE-III) and Mini-Mental State Examination (MMSE) scores, to predict the MMSE result based on ACE-III, thus avoiding the need for both tests, and improving their comparability. Equipercentile equating method was used to elaborate a conversion table using a group of 400 participants comprising healthy controls and Alzheimer's disease (AD) patients. Then, reliability was assessed in a group of 100 healthy controls and patients with AD, 52 with primary progressive aphasia and 22 with behavioral variant frontotemporal dementia. The conversion table between ACE-III and MMSE denoted a high reliability, with intra-class correlation coefficients of 0.940, 0.922, and 0.902 in the groups of healthy controls and AD, behavioral variant frontotemporal dementia, and primary progressive aphasia, respectively. Our conversion table between ACE-III and MMSE suggests that MMSE may be estimated based on the ACE-III score, which could be useful for clinical and research purposes.

Fast Adaptive Blind MMSE Equalizer for Multichannel FIR Systems

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Abed-Meraim Karim

2006-01-01

Full Text Available We propose a new blind minimum mean square error (MMSE equalization algorithm of noisy multichannel finite impulse response (FIR systems, that relies only on second-order statistics. The proposed algorithm offers two important advantages: a low computational complexity and a relative robustness against channel order overestimation errors. Exploiting the fact that the columns of the equalizer matrix filter belong both to the signal subspace and to the kernel of truncated data covariance matrix, the proposed algorithm achieves blindly a direct estimation of the zero-delay MMSE equalizer parameters. We develop a two-step procedure to further improve the performance gain and control the equalization delay. An efficient fast adaptive implementation of our equalizer, based on the projection approximation and the shift invariance property of temporal data covariance matrix, is proposed for reducing the computational complexity from to , where is the number of emitted signals, the data vector length, and the dimension of the signal subspace. We then derive a statistical performance analysis to compare the equalization performance with that of the optimal MMSE equalizer. Finally, simulation results are provided to illustrate the effectiveness of the proposed blind equalization algorithm.

The validity of the Addenbrooke's Cognitive Examination-Revised (ACE-R) in acute stroke.

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Morris, Katie; Hacker, Vicki; Lincoln, Nadina Berrice

2012-01-01

The purpose was to examine the validity of the Addenbrooke's Cognitive Examination Revised (ACE-R) as a screening measure to detect cognitive impairment after stroke. Stroke patients in hospital were recruited and the ACE-R, which includes the Mini-Mental Status Examination (MMSE), was administered, followed by a battery of neuropsychological tests, which served as the 'gold standard' for classification of cognitive impairment. The diagnostic validity of the ACE-R was determined by ROC analysis. Of the 101 patients who completed the ACE-R, 61 also completed the neuropsychological assessment. Both the MMSE and the ACE-R were found to have inadequate diagnostic validity for the detection of overall cognitive impairment (MMSE AUC = 0.53, p > 0.05; ACE-R AUC = 0.53, p > 0.05). The ACE-R subscales predicted impairment in specific cognitive domains significantly better than chance; Visuospatial (AUC = 0.71, p cognitive functioning. The ACE-R was not a suitable measure to screen for overall cognitive impairment in acute stroke patients, but was able to detect impairment in visuospatial, attention and executive domains.

Cerebral blood flow study with 3D-SSP and neuropsychological evaluation by mini-mental state examination (MMSE) before and after clipping of unruptured cerebral aneurysm

International Nuclear Information System (INIS)

Takada, Hidekazu; Sasaki, Takehiko; Osato, Toshiaki

2006-01-01

We evaluate the influence of surgery for unruptured aneurysms on cerebral blood flow and neuropsychological estimate. We evaluated the cases of 28 consecutive patients with unruptured cerebral aneurysm treated with direct surgery accompanied by craniotomy. Before and after surgery, MRI, 123 I-IMP-SPECT with 3D-SSP analysis and MMSE were performed. There was not a significant decrease in MMSE. In 123 I-IMP-SPECT, it was recognized that the cerebral blood flow was decreased at the frontal operculum of operative site. These results indicate that careful neuropsychological evaluation is essential to make a favorable treatment plan for unruptured aneulysms. (author)

Using the Folstein Mini Mental State Exam (MMSE) to explore methodological issues in cognitive aging research.

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Monroe, Todd; Carter, Michael

2012-09-01

Cognitive scales are used frequently in geriatric research and practice. These instruments are constructed with underlying assumptions that are a part of their validation process. A common measurement scale used in older adults is the Folstein Mini Mental State Exam (MMSE). The MMSE was designed to screen for cognitive impairment and is used often in geriatric research. This paper has three aims. Aim one was to explore four potential threats to validity in the use of the MMSE: (1) administering the exam without meeting the underlying assumptions, (2) not reporting that the underlying assumptions were assessed prior to test administration, (3) use of variable and inconsistent cut-off scores for the determination of presence of cognitive impairment, and (4) failure to adjust the scores based on the demographic characteristics of the tested subject. Aim two was to conduct a literature search to determine if the assumptions of (1) education level assessment, (2) sensory assessment, and (3) language fluency were being met and clearly reported in published research using the MMSE. Aim three was to provide recommendations to minimalize threats to validity in research studies that use cognitive scales, such as the MMSE. We found inconsistencies in published work in reporting whether or not subjects meet the assumptions that underlie a reliable and valid MMSE score. These inconsistencies can pose threats to the reliability of exam results. Fourteen of the 50 studies reviewed reported inclusion of all three of these assumptions. Inconsistencies in reporting the inclusion of the underlying assumptions for a reliable score could mean that subjects were not appropriate to be tested by use of the MMSE or that an appropriate test administration of the MMSE was not clearly reported. Thus, the research literature could have threats to both validity and reliability based on misuse of or improper reported use of the MMSE. Six recommendations are provided to minimalize these threats

On Channel Estimation for OFDM/TDM Using MMSE-FDE in a Fast Fading Channel

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Gacanin Haris

2009-01-01

Full Text Available Abstract MMSE-FDE can improve the transmission performance of OFDM combined with time division multiplexing (OFDM/TDM, but knowledge of the channel state information and the noise variance is required to compute the MMSE weight. In this paper, a performance evaluation of OFDM/TDM using MMSE-FDE with pilot-assisted channel estimation over a fast fading channel is presented. To improve the tracking ability against fast fading a robust pilot-assisted channel estimation is presented that uses time-domain filtering on a slot-by-slot basis and frequency-domain interpolation. We derive the mean square error (MSE of the channel estimator and then discuss a tradeoff between improving the tracking ability against fading and the noise reduction. The achievable bit error rate (BER performance is evaluated by computer simulation and compared with conventional OFDM. It is shown that the OFDM/TDM using MMSE-FDE achieves a lower BER and a better tracking ability against fast fading in comparison with conventional OFDM.

The Telephone Interview for Cognitive Status: Creating a crosswalk with the Mini-Mental State Exam

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Fong, Tamara G.; Fearing, Michael A.; Jones, Richard N.; Shi, Peilin; Marcantonio, Edward R.; Rudolph, James L.; Yang, Frances M.; Kiely, Dan K.; Inouye, Sharon K.

2009-01-01

Background Brief cognitive screening measures are valuable tools for both research and clinical applications. The most widely used instrument, the Mini-Mental State Examination (MMSE) is limited in that it must be administered face-to-face, cannot be used in participants with visual or motor impairments, and is protected by copyright. Alternative screening instruments, such as the Telephone Interview for Cognitive Status (TICS) have been developed and may provide a valid alternative with comparable cut point scores to rate global cognitive function. Methods MMSE, TICS-30, and TICS-40 scores from 746 community dwelling elders who participated in the Aging, Demographics, and Memory Study (ADAMS) were analyzed with equipercentile equating, a statistical process of determining comparable scores based on percentile equivalents on different forms of an examination. Results Scores from the MMSE and the TICS-30 and TICS-40 corresponded well and clinically relevant cut point scores were determined; for example, an MMSE score of 23 is equivalent to 17 and 20 on the TICS-30 and TICS-40, respectively. Conclusions These findings provide scores that can be used to link TICS and MMSE scores directly. Clinically relevant and important MMSE cut points and the respective ADAMS TICS-30 and TICS-40 cut point scores have been included to identify the degree of cognitive impairment among respondents with any type of cognitive disorder. These results will help with the widespread application of the TICS in both research and clinical practice. PMID:19647495

Delayed Recall and Working Memory MMSE Domains Predict Delirium following Cardiac Surgery.

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Price, Catherine C; Garvan, Cynthia; Hizel, Loren P; Lopez, Marcos G; Billings, Frederic T

2017-01-01

Reduced preoperative cognition is a risk factor for postoperative delirium. The significance for type of preoperative cognitive deficit, however, has yet to be explored and could provide important insights into mechanisms and prediction of delirium. Our goal was to determine if certain cognitive domains from the general cognitive screener, the Mini-Mental State Exam (MMSE), predict delirium after cardiac surgery. Patients completed a preoperative MMSE prior to undergoing elective cardiac surgery. Following surgery, delirium was assessed throughout ICU stay using the Confusion Assessment Method for ICU delirium and the Richmond Agitation and Sedation Scale. Cardiac surgery patients who developed delirium (n = 137) had lower total MMSE scores than patients who did not develop delirium (n = 457). In particular, orientation to place, working memory, delayed recall, and language domain scores were lower. Of these, only the working memory and delayed recall domains predicted delirium in a regression model adjusting for history of chronic obstructive pulmonary disease, age, sex, and duration of cardiopulmonary bypass. For each word not recalled on the three-word delayed recall assessment, the odds of delirium increased by 50%. For each item missed on the working memory index, the odds of delirium increased by 36%. Of the patients who developed delirium, 47% had a primary impairment in memory, 21% in working memory, and 33% in both domains. The area under the receiver operating characteristics curve using only the working memory and delayed recall domains was 0.75, compared to 0.76 for total MMSE score. Delirium risk is greater for individuals with reduced MMSE scores on the delayed recall and working memory domains. Research should address why patients with memory and executive vulnerabilities are more prone to postoperative delirium than those with other cognitive limitations.

Does the Addenbrooke's Cognitive Examination-revised add to the Mini-Mental State Examination in established Alzheimer disease? Results from a national dementia research register.

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Law, Emma; Connelly, Peter J; Randall, Emma; McNeill, Catriona; Fox, Helen C; Parra, Mario A; Hudson, Justine; Whyte, Leigh-Ann; Johnstone, Jane; Gray, Sarah; Starr, John M

2013-04-01

To evaluate how much the Addenbrooke's Cognitive Examination-revised (ACE-R) improves the estimate of cognitive ability from the Mini-Mental State Examination (MMSE) in people with Alzheimer disease (AD). We examined itemized data in people with AD who were on the Scottish Dementia Research Interest Register drawn from eight centres across Scotland, covering 75% of the Scottish population. ACE-R items that comprise the MMSE and those that did not (non-MMSE items) were summed separately. We residualized MMSE total on non-MMSE total and vice versa to derive a measure of the variance unique to each. Five hundred and one (258 male, 243 female) participants, mean age 75.7 (range 52-94) years were on the register, of whom 329 (160 men, 169 women) had AD. Of those with AD, 309 had a mean MMSE of 20.5 and mean ACE-R of 57.5 measured with Pearson r = 0.92 between MMSE and ACE-R totals, and the regression equation ACE-R score = 3.0 × MMSE - 4.1. The unique non-MMSE items score correlated with ACE-R total r = 0.40 (16% of ACE-R variance). The ACE-R and MMSE total scores are highly correlated. In this clinical sample of people with established AD, for an MMSE score of 24, the predicted ACE-R score was 67.9 with 95% confidence intervals of 61.6-75.4. The extra non-MMSE ACE-R items improve estimates of cognitive ability by 16%. Copyright © 2012 John Wiley & Sons, Ltd.

Physical strength is associated with Mini-Mental State Examination scores in Spanish institutionalized elderly.

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Pedrero-Chamizo, Raquel; Albers, Ulrike; Tobaruela, José L; Meléndez, Agustín; Castillo, Manuel J; González-Gross, Marcela

2013-10-01

The present cross-sectional study aimed at assessing muscle strength of hands, the dominant arm and legs in Spanish institutionalized elderly people according to sex, age and cognitive status. A total of 153 elderly subjects (102 females, 51 males, mean age 83.6 ± 6.8 years) living in the region of Madrid were measured for handgrip strength (kg) with a Takei TKK 5101 digital dynamometer (range 5-100 kg, precision 0.1 kg), and arm and leg endurance strength (repetitions) according to the Rikli and Jones tests. Cognitive status was determined with the Mini-Mental State Examination (MMSE). The values for men and women were, respectively: 23.5 ± 7.3 kg and 11.6 ± 4.6 kg (right handgrip), 22.0 ± 7.8 kg and 10.7 ± 4.8 kg (left handgrip), 13 ± 5 and 10 ± 5 repetitions (arm strength), 8 ± 5 and 5 ± 4 repetitions (legs strength), and 21 ± 6 and 17 ± 7 (MMSE score). All parameters were significantly higher for men (P ≤ 0.01), but strength decline with age was less pronounced in women. In all MMSE groups, lower strength was associated with lower cognitive status. Strength values were lower in older subjects in both sexes; this difference was higher in men than in women. Higher strength values were associated with better cognitive status, which was the most influencing variable, even more than sex and age. © 2013 Japan Geriatrics Society.

Age- and Functional Status-Dependent Association Between Blood Pressure and Cognition

DEFF Research Database (Denmark)

Ogliari, Giulia; Sabayan, Behnam; Mari, Daniela

2015-01-01

OBJECTIVES: To evaluate whether the relationship between blood pressure (BP) measures and cognitive function is different according to age and functional status in older outpatients. DESIGN: Cross-sectional. SETTING: Outpatient hospital-based Milan Geriatrics 75+ Cohort Study. PARTICIPANTS......: Individuals aged 75 and older (N = 1,540). MEASUREMENTS: Blood pressure, Mini-Mental State Examination (MMSE), basic activities of daily living (ADLs), and instrumental activities of daily living (IADLs) were assessed. Associations between BP measures and MMSE score were first analyzed in the total population...... using linear regression models and were then further examined according to strata of age, ADLs, and IADLs. All analyses were adjusted for sociodemographic factors and presence of comorbidities. RESULTS: In the total population, higher systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), and mean...

The mini mental status exam as a surrogate measure of health literacy.

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Dahlke, Allison R; Curtis, Laura M; Federman, Alex D; Wolf, Michael S

2014-04-01

Studies have documented strong associations between cognitive function, health literacy skills, and health outcomes, such that outcome performance may be partially explained by cognitive ability. Common cognitive assessments such as the Mini Mental Status Exam (MMSE) therefore may be measuring the same latent construct as existing health literacy tools. We evaluated the potential of the MMSE as a surrogate measure of health literacy by comparing its convergent and predictive validity to the three most commonly used health literacy assessments and education. 827 older adults recruited from an academic general internal medicine ambulatory care clinic or one of five federally qualified health centers in Chicago, IL. Non-English speakers and those with severe cognitive impairment were excluded. Pearson correlations were completed to test the convergent validity of the MMSE with assessments of health literacy and education. Receiver Operating Characteristic (ROC) curves and the d statistic were calculated to determine the optimal cut point on the MMSE for classifying participants with limited health literacy. Multivariate logistic regression models were completed to measure the predictive validity of the new MMSE cut point. The MMSE was found to have moderate to high convergent validity with the existing health literacy measures. The ROC and d statistic analyses suggested an optimal cut point of ≤ 27 on the MMSE. The new threshold score was found to predict health outcomes at least as well as, or better than, existing health literacy measures or education alone. The MMSE has considerable face validity as a health literacy measure that could be easily administered in the healthcare setting. Further research should aim to validate this cut point and examine the constructs being measured by the MMSE and other literacy assessments.

The Agreement between the MMSE and IQCODE Tests in a Community-Based Sample of Subjects Aged 70 Years or Older Receiving In-Home Nursing: An Explorative Study

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Øyvind Kirkevold

2015-02-01

Full Text Available Aim: It was the aim of this study to compare the Mini-Mental State Examination (MMSE with the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE and to explore the characteristics of subjects with possible dementia with only one of the two tools. Methods: We used a random sample of patients aged 70+ receiving social service or in-home nursing. The patients were tested with the MMSE, and the next of kin was interviewed using the following: the IQCODE, the Cornell Scale for Depression in Dementia (CSDD, the Neuropsychiatric Inventory (NPI, instrumental activities of daily living (IADL, personal ADL (PADL and the General Medical Health Rating (GMHR. Results: Subjects with dementia defined only according to the MMSE showed a pattern of scores on IADL, PADL, CSDD, NPI-10 and GMHR similar to the no-dementia group according to both the MMSE and the IQCODE. Those with dementia defined only according to the IQCODE showed a pattern of scores similar to the possible dementia group according to both the MMSE and the IQCODE.

De item-reeks van de cognitieve screening test vergeleken met die van de mini-mental state examination

NARCIS (Netherlands)

Schmand, B.; Deelman, B. G.; Hooijer, C.; Jonker, C.; Lindeboom, J.

1996-01-01

The items of the ¿mini-mental state examination' (MMSE) and a Dutch dementia screening instrument, the ¿cognitive screening test' (CST), as well as the ¿geriatric mental status schedule' (GMS) and the ¿Dutch adult reading test' (DART), were administered to 4051 elderly people aged 65 to 84 years.

Mini mental state examination

DEFF Research Database (Denmark)

Kørner, Ejnar Alex; Lauritzen, Lise; Wang, August

2008-01-01

INTRODUCTION: The Mini Mental State Examination (MMSE) is widely used in Denmark, but often in non-validated versions. In 2000 a cross-sectional workgroup decided on a new common version of the MMSE with a corresponding manual, which is validated for the first time in the present study. MATERIALS...... the severity of dementia disorders. Udgivelsesdato: 2008-Feb-25...

Depressive status explains a significant amount of the variance in COPD assessment test (CAT) scores.

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Miravitlles, Marc; Molina, Jesús; Quintano, José Antonio; Campuzano, Anna; Pérez, Joselín; Roncero, Carlos

2018-01-01

COPD assessment test (CAT) is a short, easy-to-complete health status tool that has been incorporated into the multidimensional assessment of COPD in order to guide therapy; therefore, it is important to understand the factors determining CAT scores. This is a post hoc analysis of a cross-sectional, observational study conducted in respiratory medicine departments and primary care centers in Spain with the aim of identifying the factors determining CAT scores, focusing particularly on the cognitive status measured by the Mini-Mental State Examination (MMSE) and levels of depression measured by the short Beck Depression Inventory (BDI). A total of 684 COPD patients were analyzed; 84.1% were men, the mean age of patients was 68.7 years, and the mean forced expiratory volume in 1 second (%) was 55.1%. Mean CAT score was 21.8. CAT scores correlated with the MMSE score (Pearson's coefficient r =-0.371) and the BDI ( r =0.620), both p CAT scores and explained 45% of the variability. However, a model including only MMSE and BDI scores explained up to 40% and BDI alone explained 38% of the CAT variance. CAT scores are associated with clinical variables of severity of COPD. However, cognitive status and, in particular, the level of depression explain a larger percentage of the variance in the CAT scores than the usual COPD clinical severity variables.

ASEP of MIMO System with MMSE-OSIC Detection over Weibull-Gamma Fading Channel Subject to AWGGN

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Keerti Tiwari

2016-01-01

Full Text Available Ordered successive interference cancellation (OSIC is adopted with minimum mean square error (MMSE detection to enhance the multiple-input multiple-output (MIMO system performance. The optimum detection technique improves the error rate performance but increases system complexity. Therefore, MMSE-OSIC detection is used which reduces error rate compared to traditional MMSE with low complexity. The system performance is analyzed in composite fading environment that includes multipath and shadowing effects known as Weibull-Gamma (WG fading. Along with the composite fading, a generalized noise that is additive white generalized Gaussian noise (AWGGN is considered to show the impact of wireless scenario. This noise model includes various forms of noise as special cases such as impulsive, Gamma, Laplacian, Gaussian, and uniform. Consequently, generalized Q-function is used to model noise. The average symbol error probability (ASEP of MIMO system is computed for 16-quadrature amplitude modulation (16-QAM using MMSE-OSIC detection in WG fading perturbed by AWGGN. Analytical expressions are given in terms of Fox-H function (FHF. These expressions demonstrate the best fit to simulation results.

Mental Status as a Predictor of Daily Function in Progressive Dementia.

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Reed, Bruce R.; And Others

1989-01-01

Compared Mini Mental Status Exam (MMSE) scores and activities of daily living (ADL) scores from 59 patients with progressive dementias. MMSE scores explained approximately one-third of variance in both instrumental and physical ADLs. Findings suggest that cognitive losses and functional impairments are 2 distinct aspects of dementia severity which…

[Discriminatory validity and association of the mini-mental test (MMSE) and the memory alteration test (M@T) with a neuropsychological battery in patients with amnestic mild cognitive impairment and Alzheimer's disease].

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Rami, L; Bosch, B; Valls-Pedret, C; Caprile, C; Sánchez-Valle Díaz, R; Molinuevo, J L

To establish the discriminatory validity of the mini-mental test (MMSE) and the memory alteration test (M@T) for the diagnosis of amnestic mild cognitive impairment (aMCI) and probable Alzheimer's disease (AD), and also to study the association between the results obtained in screening tests, a neuropsychological battery and a functional questionnaire in healthy persons and in patients with aMCI and AD. We evaluated 27 normal controls, 27 patients with aMCI and 35 patients with AD using the MMSE and a memory screening test, the M@T, a neuropsychological battery and a questionnaire on functional activities of daily living. Pearson correlation coefficients were used to evaluate the relations between the scores on the M@T and the MMSE and the neuropsychological tests. The area below the curve, the sensitivity and the specificity were calculated for the screening tests. In patients with aMCI, the scores on the M@T and the MMSE were strongly associated with the performance in the episodic memory tests in frontal tests and with the scores on the functional questionnaire, but not with tests that evaluated praxias and perceptive functions. In patients with AD, the scores on the M@T and the MMSE were associated with results in semantic memory, language, executive functions and praxias, but not with perceptive tests and functional questionnaires. In patients with aMCI and AD, the association between MMSE and M@T only correlate with some cognitive functions, without there being any association with other cognitive functions. Therefore, screening tests cannot be used as the only instrument for evaluating the cognitive status in patients with suspected dementia.

[Factors and validity analysis of Mini-Mental State Examination in Chinese elderly people].

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Gao, Ming-yue; Yang, Min; Kuang, Wei-hong; Qiu, Pei-yuan

2015-06-18

To examine factors that may have impact on the Mini-Mental State Examination (MMSE) screening validity, which could lead to further establishing the general model of the MMSE score in Chinese health elderly and to improve the screening accuracy of the existing MMSE reference. Based on the data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), the MMSE scores of 19,117 normal elderly and 137 dementia patients who met the inclusion criteria were used for the analysis. The area under the curve (AUC) and validity indexes were used to compare the screening accuracy of various criteria. Multiple linear regression was used to identify factors that had impact on the MMSE score for both the normal and dementia elderly. Descriptive analysis was performed for differences in the MMSE scores by age trends and gender between the normal and dementia elderly. The AUC of MMSE was ≥0.75(Pvalidity of MMSE in CLHLS is not affected by educational level. The analysis of factors that may impact on the MMSE screening validity are gender, age, vision and residence which with validity identification. These four factors can be used as assist tool of MMSE in the screening of dementia to improve the screening accuracy.

Vitamin C Status and Cognitive Function: A Systematic Review

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Nikolaj Travica

2017-08-01

Full Text Available Vitamin C plays a role in neuronal differentiation, maturation, myelin formation and modulation of the cholinergic, catecholinergic, and glutaminergic systems. This review evaluates the link between vitamin C status and cognitive performance, in both cognitively intact and impaired individuals. We searched the PUBMED, SCOPUS, SciSearch and the Cochrane Library from 1980 to January 2017, finding 50 studies, with randomised controlled trials (RCTs, n = 5, prospective (n = 24, cross-sectional (n = 17 and case-control (n = 4 studies. Of these, 36 studies were conducted in healthy participants and 14 on cognitively impaired individuals (including Alzheimer’s and dementia. Vitamin C status was measured using food frequency questionnaires or plasma vitamin C. Cognition was assessed using a variety of tests, mostly the Mini-Mental-State-Examination (MMSE. In summary, studies demonstrated higher mean vitamin C concentrations in the cognitively intact groups of participants compared to cognitively impaired groups. No correlation between vitamin C concentrations and MMSE cognitive function was apparent in the cognitively impaired individuals. The MMSE was not suitable to detect a variance in cognition in the healthy group. Analysis of the studies that used a variety of cognitive assessments in the cognitively intact was beyond the scope of this review; however, qualitative assessment revealed a potential association between plasma vitamin C concentrations and cognition. Due to a number of limitations in these studies, further research is needed, utilizing plasma vitamin C concentrations and sensitive cognitive assessments that are suitable for cognitively intact adults.

Conversion of the Mini-Mental State Examination to the International Classification of Functioning, Disability and Health terminology and scoring system.

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De Vriendt, P; Gorus, E; Bautmans, I; Mets, T

2012-01-01

In older patients, evaluation of the cognitive status is crucial. The Mini-Mental State Examination (MMSE) is widely used for screening of cognition, providing fairly high sensitivity, specificity and reproducibility. Recently, a consensus emerged on the necessity of an international and transparent language, as provided by the WHO's International Classification of Functioning, Disability and Health (ICF). Most assessment tools however are not in accordance with the ICF. To reformulate the MMSE according to the ICF, both for the individual items and for the scoring system. MMSE data (scores varying from 3 to 30/30) of (1) 217 cognitively healthy elderly, (2) 60 persons with mild cognitive impairment, (3) 60 patients with mild Alzheimer's disease (AD), and (4) 60 patients with moderate/severe AD were obtained from studies at a university hospital setting. Subjects were aged 65 years or more and recruited either through advertisement (group 1), from the geriatric day hospital (groups 2 and 3), or the geriatric ward (group 4). The allocation to the groups was done after multidisciplinary evaluation. The conversion of the MMSE to ICF-MMSE was done by content comparison and by subsequent translation of the scoring system using automatic algorithms. All MMSE items were converted to the corresponding ICF categories. Three ICF domains were addressed: global and specific mental functions, general tasks and demands, divided over 6 ICF categories (orientation time/place, sustaining attention, memory functions, mental functions of language, undertaking a simple task). Scores on individual items were transformed according to their relative weight on the original MMSE scale, and a total ICF-MMSE score from 0 (no problem) to 100 (complete problem) was generated. Translation was satisfying, as illustrated by a good correlation between MMSE and ICF-MMSE. The diagnostic groups were distributed over the ICF-MMSE scores as expected. For each ICF domain, ICF-MMSE subscores were higher

Differences in nutritional status between very mild Alzheimer's disease patients and healthy controls.

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Olde Rikkert, Marcel G M; Verhey, Frans R; Sijben, John W C; Bouwman, Femke H; Dautzenberg, Paul L J; Lansink, Mirian; Sipers, Walther M W; van Asselt, Dieneke Z B; van Hees, Anneke M J; Stevens, Martijn; Vellas, Bruno; Scheltens, Philip

2014-01-01

Studies on the systemic availability of nutrients and nutritional status in Alzheimer's disease (AD) are widely available, but the majority included patients in a moderate stage of AD. This study compares the nutritional status between mild AD outpatients and healthy controls. A subgroup of Dutch drug-naïve patients with mild AD (Mini-Mental State Examination (MMSE) ≥20) from the Souvenir II randomized controlled study (NTR1975) and a group of Dutch healthy controls were included. Nutritional status was assessed by measuring levels of several nutrients, conducting the Mini Nutritional Assessment (MNA®) questionnaire and through anthropometric measures. In total, data of 93 healthy cognitively intact controls (MMSE 29.0 [23.0-30.0]) and 79 very mild AD patients (MMSE = 25.0 [20.0-30.0]) were included. Plasma selenium (p < 0.001) and uridine (p = 0.046) levels were significantly lower in AD patients, with a similar trend for plasma vitamin D (p = 0.094) levels. In addition, the fatty acid profile in erythrocyte membranes was different between groups for several fatty acids. Mean MNA screening score was significantly lower in AD patients (p = 0.008), but not indicative of malnutrition risk. No significant differences were observed for other micronutrient or anthropometric parameters. In non-malnourished patients with very mild AD, lower levels of some micronutrients, a different fatty acid profile in erythrocyte membranes and a slightly but significantly lower MNA screening score were observed. This suggests that subtle differences in nutrient status are present already in a very early stage of AD and in the absence of protein/energy malnutrition.

The relation of education, occupation, and cognitive activity to cognitive status in old age: the role of physical frailty.

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Ihle, Andreas; Gouveia, Élvio R; Gouveia, Bruna R; Freitas, Duarte L; Jurema, Jefferson; Odim, Angenay P; Kliegel, Matthias

2017-09-01

It remains unclear so far whether the role of cognitive reserve may differ between physically frail compared to less frail individuals. Therefore, the present study set out to investigate the relation of key markers of cognitive reserve to cognitive status in old age and its interplay with physical frailty in a large sample of older adults. We assessed Mini-Mental State Examination (MMSE) in 701 older adults. We measured grip strength as indicator of physical frailty and interviewed individuals on their education, past occupation, and cognitive leisure activity. Greater grip strength, longer education, higher cognitive level of job, and greater engaging in cognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education, cognitive level of job, and cognitive leisure activity to MMSE scores were significantly larger in individuals with lower, compared to those with greater grip strength. Cognitive status in old age may more strongly depend on cognitive reserve accumulated during the life course in physically frail (compared to less frail) older adults. These findings may be explained by cross-domain compensation effects in vulnerable individuals.

Coding Across Multicodes and Time in CDMA Systems Employing MMSE Multiuser Detector

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Park Jeongsoon

2004-01-01

Full Text Available When combining a multicode CDMA system with convolutional coding, two methods have been considered in the literature. In one method, coding is across time in each multicode channel while in the other the coding is across both multicodes and time. In this paper, a performance/complexity analysis of decoding metrics and trellis structures for the two schemes is carried out. It is shown that the latter scheme can exploit the multicode diversity inherent in convolutionally coded direct sequence code division multiple access (DS-CDMA systems which employ minimum mean squared error (MMSE multiuser detectors. In particular, when the MMSE detector provides sufficiently different signal-to-interference ratios (SIRs for the multicode channels, coding across multicodes and time can obtain significant performance gain over coding across time, with nearly the same decoding complexity.

Cognitive cooperation groups mediated by computers and internet present significant improvement of cognitive status in older adults with memory complaints: a controlled prospective study

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Rodrigo de Rosso Krug

Full Text Available ABSTRACT Objective To estimate the effect of participating in cognitive cooperation groups, mediated by computers and the internet, on the Mini-Mental State Examination (MMSE percent variation of outpatients with memory complaints attending two memory clinics. Methods A prospective controlled intervention study carried out from 2006 to 2013 with 293 elders. The intervention group (n = 160 attended a cognitive cooperation group (20 sessions of 1.5 hours each. The control group (n = 133 received routine medical care. Outcome was the percent variation in the MMSE. Control variables included gender, age, marital status, schooling, hypertension, diabetes, dyslipidaemia, hypothyroidism, depression, vascular diseases, polymedication, use of benzodiazepines, exposure to tobacco, sedentary lifestyle, obesity and functional capacity. The final model was obtained by multivariate linear regression. Results The intervention group obtained an independent positive variation of 24.39% (CI 95% = 14.86/33.91 in the MMSE compared to the control group. Conclusion The results suggested that cognitive cooperation groups, mediated by computers and the internet, are associated with cognitive status improvement of older adults in memory clinics.

Does the combination of the MMSE and clock drawing test (mini-clock) improve the detection of mild Alzheimer's disease and mild cognitive impairment?

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Cacho, Jesús; Benito-León, Julián; García-García, Ricardo; Fernández-Calvo, Bernardino; Vicente-Villardón, José Luis; Mitchell, Alex J

2010-01-01

There is currently a need to develop tools to identify patients with mild AD and mild cognitive impairment (MCI). We determined the validity and reliability of a brief, easily administered cognitive screening battery consisting of fusion of two well-known brief tests (Mini-Mental Status Examination [MMSE] and Clock Drawing Test [CDT]) (Mini-clock) to differentiate between patients with mild AD, MCI, and healthy control subjects. 66 consecutive patients with mild AD, 21 with MCI, and 66 healthy controls seen in a memory clinic setting were compared. Receiver operating characteristic (ROC) curve analysis was used to calculate the cut-off value permitting discrimination between mild AD, MCI, and healthy control subjects. Interrater and test-retest reliability were also assessed. Mean cognitive scores for patients with AD, MCI, and control subjects on all two individual tests were significantly different (for each, p Mini-clock was higher than that obtained with MMSE or CDT in differentiating mild AD from controls (0.973 vs. 0.952 and 0.881, respectively) and MCI from controls (0.855 vs. 0.821 and 0.779, respectively). Test-retest reliability for the Mini-clock was 0.99, meanwhile interrater reliability was 0.87. The mean time to complete the test for all subjects was 8 min and 50 s. The Mini-clock is highly sensitive and specific in the detection of mild AD and reasonably accurate when attempting to separate MCI from health controls. It has a high interrater and test-retest reliability, can be quickly administered, and does not require major training.

A Practical, Hardware Friendly MMSE Detector for MIMO-OFDM-Based Systems

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Babak Daneshrad

2008-04-01

Full Text Available Design and implementation of a highly optimized MIMO (multiple-input multiple-output detector requires cooptimization of the algorithm with the underlying hardware architecture. Special attention must be paid to application requirements such as throughput, latency, and resource constraints. In this work, we focus on a highly optimized matrix inversion free 4×4 MMSE (minimum mean square error MIMO detector implementation. The work has resulted in a real-time field-programmable gate array-based implementation (FPGA- on a Xilinx Virtex-2 6000 using only 9003 logic slices, 66 multipliers, and 24 Block RAMs (less than 33% of the overall resources of this part. The design delivers over 420 Mbps sustained throughput with a small 2.77-microsecond latency. The designed 4×4 linear MMSE MIMO detector is capable of complying with the proposed IEEE 802.11n standard.

Adaptive DSP Algorithms for UMTS: Blind Adaptive MMSE and PIC Multiuser Detection

NARCIS (Netherlands)

Potman, J.

2003-01-01

A study of the application of blind adaptive Minimum Mean Square Error (MMSE) and Parallel Interference Cancellation (PIC) multiuser detection techniques to Wideband Code Division Multiple Access (WCDMA), the physical layer of Universal Mobile Telecommunication System (UMTS), has been performed as

On the impact of receiver imperfections on the MMSE-IRC receiver performance in 5G networks

DEFF Research Database (Denmark)

Tavares, Fernando Menezes Leitão; Berardinelli, Gilberto; Mahmood, Nurul Huda

2014-01-01

The usage of Minimum Mean Square Error - Interference Rejection Combining (MMSE-IRC) receivers is expected to be a significant performance booster in the ultra-dense deployment of small cells envisioned by an upcoming 5th generation (5G) Radio Access Technology (RAT). However, hardware limitation...... simulation results confirm that a realistic MMSE-IRC receiver can achieve throughput gains close to ideal, provided a reasonably high resolution Analog-to-Digital Converter (ADC) as well as a supportive radio frame format design are used....

[Adaptation and convergent validity of a telephone-based Mini-Mental State Examination].

Science.gov (United States)

Garre-Olmo, Josep; Lax-Pericall, Carme; Turro-Garriga, Oriol; Soler-Cors, Olga; Monserrat-Vila, Sílvia; Vilalta-Franch, Joan; Taylor, Joy L; López-Pousa, Secundino

2008-06-21

To adapt to Spanish and to determine the convergent validity of a Telephone Mini-Mental State Examination (t-MMSE) in order to assess the cognitive functions in Alzheimer's disease (AD) patients. Prospective and observational study of a clinical sample consisting of patients with dementia from a memory clinic. Consecutive sampling of participants was used and convergent validity of the t-MMSE and MMSE scores was determined using several statistics measures. Patients were randomly assigned depending on the administration of the in-person/telephone test (MMSE and t-MMSE) or telephone/in-person (t-MMSE and MMSE) test within a 1- to 7-day interval. The effect of the confusion variables (age, gender, years of education, dementia severity, presence or absence of hearing impairment and administration order) on the concordance between the in-person and telephone MMSE versions was analysed. After translating and retranslating the t-MMSE, of 141 participants, 77.47% subjects completed the protocol of the study. For the total score, the statistics for the convergent validity suggested a high consistency, independently of the order of test administration (intraclass correlation coefficient = 0.87, Spearman's rho = 0.77); for the all subscores, it suggested moderate and good correlations. The difference between subscores did not range more than 1 point in any case. Confusion variables did not affect the variability of the performance scores between t-MMSE and MMSE. The t-MMSE can be used as a good tool to estimate the MMSE score of patients with dementia.

Differences in pain measures by mini-mental state examination scores of residents in aged care facilities: examining the usability of the Abbey pain scale-Japanese version.

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Takai, Yukari; Yamamoto-Mitani, Noriko; Ko, Ayako; Heilemann, Marysue V

2014-03-01

The validity and reliability of the Abbey Pain Scale-Japanese version (APS-J) have been examined. However, the range of cognitive levels for which the APS-J can be accurately used in older adults has not been investigated. This study aimed to examine the differences between total/item scores of the APS-J and Mini-Mental State Examination (MMSE) scores of residents in aged care facilities who self-reported the presence or absence of pain. This descriptive study included 252 residents in aged care facilities. Self-reported pain, MMSE scores, and item/total APS-J scores for pain intensity were collected. The MMSE scores were used to create four groups on the basis of the cognitive impairment level. Self-reports of pain and the APS-J scores were compared with different MMSE score groups. The total APS-J score for pain intensity as well as scores for individual items such as "vocalization" and "facial expression" were significantly higher in those who reported pain than in those reporting no pain across all MMSE groups. The total APS-J score and item scores for "vocalization," "change in body language," and "behavioral changes" showed significant differences in the four MMSE groups. Pain intensity tended to be overestimated by the APS-J, especially among those with low MMSE scores. The APS-J can be used to assess pain intensity in residents despite their cognitive levels. However, caution is required when using it to compare scores among older adults with different cognitive capacity because of the possibility of overestimation of pain among residents with low cognitive capacity. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

MMSE-NP-RISIC-Based Channel Equalization for MIMO-SC-FDE Troposcatter Communication Systems

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Zedong Xie

2016-01-01

Full Text Available The impact of intersymbol interference (ISI on single-carrier frequency-domain equalization with multiple input multiple output (MIMO-SC-FDE troposcatter communication systems is severe. Most of the channel equalization methods fail to solve it completely. In this paper, given the disadvantages of the noise-predictive (NP MMSE-based and the residual intersymbol interference cancellation (RISIC equalization in the single input single output (SISO system, we focus on the combination of both equalization schemes mentioned above. After extending both of them into MIMO system for the first time, we introduce a novel MMSE-NP-RISIC equalization method for MIMO-SC-FDE troposcatter communication systems. Analysis and simulation results validate the performance of the proposed method in time-varying frequency-selective troposcatter channel at an acceptable computational complexity cost.

Assessment of Mental Status.

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Finney, Glen R; Minagar, Alireza; Heilman, Kenneth M

2016-02-01

Assessing the mental status of patients with a neurobehavioral disorder is a critical element in the diagnosis and treatment of these patients. This assessment should always be performed after the patient's history it taken and a general physical as well as a neurologic examination is completed. The mental status examination commences with observing the patient's appearance and level of consciousness. The examiner should also pay attention to patient's social behavior, emotional state and mood. There are 3 major means of assessing a patient's mental status. One type attempts to determine if the patient is demented and the severity of the dementia as it pertains to their ability to perform activities of daily living as well as instrumental activities. A second type of assessment utilizes what may be termed as "screening tests" or "omnibus tests". These brief tests are performed independent of the patient's history and examination. The two most frequently used screening tests are the Mini-Mental Status Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The third means of assessing a patient's mental status is by using specific neuropsychological tests that focus on specific domains of cognition, such as frontal executive functions, attention, episodic verbal and visuospatial memory, declarative knowledge such as language (speech, reading and writing) and arithmetical, as well as visuospatial and perceptual abilities. These neurobehavioral, neuropsychiatric and neuropsychological assessments of patients with a cognitive decline and behavioral abnormalities should often be accompanied by laboratory tests, and neuroimaging that can help determine the underlying pathologic process so that effective therapeutic and management approaches can be provided. Copyright © 2016 Elsevier Inc. All rights reserved.

Psychometric Properties of the Folstein Mini-Mental State Examination

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Lopez, Michael N.; Charter, Richard A.; Mostafavi, Beeta; Nibut, Lorraine P.; Smith, Whitney E.

2005-01-01

Criterion-referenced (Livingston) and norm-referenced (Gilmer-Feldt) techniques were used to measure the internal consistency reliability of Folsteins Mini-Mental State Examination (MMSE) on a large sample (N = 418) of elderly medical patients. Two administration and scoring variants of the MMSE Attention and Calculation section (Serial 7s only…

[Mini mental state examination. Validation of new Danish version].

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Kørner, Ejnar Alex; Lauritzen, Lise; Nilsson, Flemming Mørkeberg; Wang, August; Christensen, Peder; Lolk, Annette

2008-02-25

The Mini Mental State Examination (MMSE) is widely used in Denmark, but often in non-validated versions. In 2000 a cross-sectional workgroup decided on a new common version of the MMSE with a corresponding manual, which is validated for the first time in the present study. The study was performed from April 2003 until August 2005 in four psycho-geriatric departments. The participants (65+ years) were assessed on three consecutive occasions (week 0, 1 and 26) with the MMSE (nurse), and global scales as well as diagnostically with ICD-10 (psycho-geriatrician). 101 persons were included, 29 were healthy, non-demented; 82 participants were assessed at visit two, 90 at visit three, but only 88 ratings were useable. The best cut-off value for the MMSE was > or = 26. Inter-rater and test-retest (r=0.91) correlations of the MMSE were high as were the correlations to the global scales. However, there were considerable variations in mean score (+/-SD) as well as median score and range in relation to CGI and GDS values. The MMSE score is independent of sex and educational level. The MMSE also proved to be a robust scale in the present Danish version. It achieved excellent inter-rater and test-retest reliability. A cut-off value of = 26 proved better than 24 which was preferred hitherto. However, the ranges of the MMSE scores are so dispersed within the same global degree of severity that the MMSE should not generally be used to describe the severity of dementia disorders.

Do medical French students know how to properly score a mini mental state examination?

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Hernandorena, Intza; Chauvelier, Sophie; Vidal, Jean-Sébastien; Piccoli, Matthieu; Coulon, Joséphine; Hugonot-Diener, Laurence; Rigaud, Anne-Sophie; Hanon, Olivier; Duron, Emmanuelle

2017-06-01

The mini mental state examination (MMSE) is a validated tool to assess global cognitive function. Training is required before scoring. Inaccurate scoring can lead to inappropriate medical decisions. In France, MMSE is usually scored by medical students. To assess if medical French students know how to properly score a mini mental state examination. Two « physician-patient » role playings performed by 2 specialized physicians, were performed in front of University Paris V medical students. Role playing A: Scoring of a MMSE according to a script containing five tricks; Role playing B: Find the 5 errors committed in a pre-filled MMSE form, according to the second script. One hundred and five students (64.4% of women, 49.5% in fifth medical school year) anonymously participated. Eighty percent of students had already scored a MMSE and 40% had been previously trained to MMSE scoring. Forty five percent of students previously scored an MMSE, without previously being trained. In test A, 16% of students did not commit any errors, 45.7% one error and 38.1% two errors. In test B, the proportion of students who provided 0, 1, 2, 3, 4 and 5 good answers was 3.3%, 29.7%, 29.7%, 25.3%, 7.7% and 4.4% respectively. No association between medical school year, previous training to MMSE scoring and performances at both tests were found. French students do not properly score MMSE. MMSE scoring is not enough or accurately taught (by specialists). The university will provide on line the tests and a short filmed teaching course performed by neuropsychological specialists.

Mini mental state examination. Validering af en ny dansk udgave

DEFF Research Database (Denmark)

Korner, E.A.; Lauritzen, L.; Nilsson, F.M.

2008-01-01

INTRODUCTION: The Mini Mental State Examination (MMSE) is widely used in Denmark, but often in non-validated versions. In 2000 a cross-sectional workgroup decided on a new common version of the MMSE with a corresponding manual, which is validated for the first time in the present study. MATERIALS...

[Performance of an abbreviated mini mental examination to detect dementia in older people].

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Jiménez, Daniel; Lavados, Manuel; Rojas, Paula; Henríquez, Claudio; Silva, Fernando; Guillón, Marta

2017-07-01

The usefulness of the abbreviated Mini-Mental State Examination included in the Chilean Functional assessment of elderly people (MM-SE-EFAM) to detect Dementia has not been determined. To assess the performance of the MMSE-EFAM to detect dementia. We studied a non-probabilistic sample of subjects older than 65 years who had been assessed by the MMSE-EFAM in a Chilean primary care center during a period of 6 months. Patients underwent clinical evaluation by a neurologist blinded to MMSE-EFAM score, to establish the diagnosis of dementia using DSM-IV-TR criteria. Besides, the full Mini-Mental State Examination (MMSE) was applied. The clinical diagnosis of Dementia was established in 13 of the 54 peoples evaluated. MMSE-EFAM had a sensitivity of 30.8% (95% confidence intervals (CI); 9-61.4) and a specificity of 90.2% (95% CI; 76.9%-97.3%), while MMSE had a sensitivity of 84.6% (95% CI; 54.6-98.1) and a specificity of 58.5% (95% CI; 42.1-73.7). In a receiver operating characteristic (ROC) curve analysis, the areas under the curve (AUC) were 0.77 (95% CI; 0.61-0.93) and 0.82 (95% CI; 0.70-0.95) for MMSE-EFAM and MMSE, respectively. Socio-demographic variables did not influence test performance in both cases. MMSE-EFAM has a low sensitivity to detect patients with Dementia and it is not an effective screening tool. These results are in agreement with the evidence and international guidelines that do not support the use of cognitive screening tools to detect dementia in the older general population.

Oral health-related quality of life and prosthetic status of nursing home residents with or without dementia.

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Klotz, Anna-Luisa; Hassel, Alexander Jochen; Schröder, Johannes; Rammelsberg, Peter; Zenthöfer, Andreas

2017-01-01

The objective of this cross-sectional study was to evaluate the effect of prosthetic status on the oral health-related quality of life (OHRQoL) of nursing home residents with or without dementia. The study was performed in 14 nursing homes across the federal state of Baden-Württemberg, Germany. All eligible participants were included, and general and medical information and information about their dental and prosthetic statuses were collected. The Geriatric Oral Health Assessment Index (GOHAI) was administered to evaluate OHRQoL. The Mini-Mental State Examination (MMSE) served to classify participants into living or not living with dementia according to the established cutoff value for dementia (MMSE health was also similar in both groups ( P >0.05). The number of teeth (odds ratio [OR]: 2.0), the type of prosthetic status (OR: 6.5), and denture-related treatment needs (OR: 2.4) were the major factors significantly affecting OHRQoL ( P nursing home residents is substantially compromised. Several prosthetic treatment needs for residents living with or without dementia were identified. Edentulism without tooth replacement and having <5 teeth resulted in an increased risk of substantially compromised OHRQoL. Further studies should be conducted to determine whether improvements in prosthetic status can increase OHRQoL.

Examining the reliability and validity of the Hebrew version of the Mini Mental State Examination.

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Werner, P; Heinik, J; Mendel, A; Reicher, B; Bleich, A

1999-10-01

The Mini Mental State Examination is used worldwide for the screening and diagnosis of dementia. The aim of the present study was to examine the reliability and validity of the Hebrew version of the Mini Mental State Examination. The Hebrew version of the Mini Mental State Examination was administered to 36 demented and 19 non-demented elderly persons. Test-retest reliability scores were calculated as exact agreement rates, and ranged from good to excellent for all the items. Strong convergent validity, as measured by the correlation between the MMSE and the CAM-COG (r = 0.94), was found. Good predictive value was observed as over three-quarters of the participants were correctly classified as demented or non-demented. The Hebrew version of the MMSE was found to be a useful and valid instrument for the determination of dementia in the elderly population.

[Mini-Mental State Examination in geriatrics : An evaluation of diagnostic quality].

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Beyermann, S; Trippe, R H; Bähr, A A; Püllen, R

2013-12-01

Several studies have identified moderate reliability and validity for the Mini-Mental State Examination (MMSE). Some researchers showed the superiority of other dementia screening tests over the MMSE considering the test quality criteria. The aim of this study was the evaluation of MMSE, especially in the area of geriatrics. MMSE and DemTect were carried out with 154 geriatric patients: 71 persons without cognitive impairment and 83 persons without delirium showed cognitive impairments as revealed by the DemTect. In addition, we also applied the Clock-Drawing-Test (CDT), Reisberg-Scale, Geriatric Depression-Scale (GDS, 15-item version) and the Confusion-Assessment-Method (CAM). According to the multitrait-multimethod approach, MMSE's convergent and divergent validity is similar to that of the DemTect. Both tests correlate only moderately with Spearman (r = 0.609) and revealed similar results for dementia in 57.1 % of the patients. MMSE showed low reliability and moderate reliability (Cronbach's α = 0.82) when ten items with low discriminatory power were excluded from the total test score. Difficulty of all items is only moderate (p = 0.86) and only eight items of the MMSE showed good test difficulty. All in all, DemTect and MMSE are not interchangeable. The MMSE estimates the average cognitive impairment of patients as considerably less pronounced than the DemTect. MMSE is, thus, not an instrument that would be recommended for the identification of mild cognitive impairment. In this case, tests with higher reliability and validity should be used.

Why is Mini-Mental state examination performance correlated with estimated premorbid cognitive ability?

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Dykiert, D; Der, G; Starr, J M; Deary, I J

2016-09-01

Tests requiring the pronunciation of irregular words are used to estimate premorbid cognitive ability in patients with clinical diagnoses, and prior cognitive ability in normal ageing. However, scores on these word-reading tests correlate with scores on the Mini-Mental State Examination (MMSE), a widely used screening test for possible cognitive pathology. This study aimed to test whether the word-reading tests' correlations with MMSE scores in healthy older people are explained by childhood IQ or education. Wechsler Test of Adult Reading (WTAR), National Adult Reading Test (NART), MMSE scores and information about education were obtained from 1024 70-year-olds, for whom childhood intelligence test scores were available. WTAR and NART were positively correlated with the MMSE (r ≈ 0.40, p < 0.001). The shared variance of WTAR and NART with MMSE was significantly attenuated by ~70% after controlling for childhood intelligence test scores. Education explained little additional variance in the association between the reading tests and the MMSE. MMSE, which is often used to index cognitive impairment, is associated with prior cognitive ability. MMSE score is related to scores on WTAR and NART largely due to their shared association with prior ability. Obtained MMSE scores should be interpreted in the context of prior ability (or WTAR/NART score as its proxy).

Characteristic differences in the mini-mental state examination used in Asian countries

OpenAIRE

Shim, Yong S.; Yang, Dong Won; Kim, Hee-Jin; Park, Young Ho; Kim, SangYun

2017-01-01

Background The mini-mental state examination (MMSE) was adapted by individual countries according to their languages and cultures, though it has not been systematically compared. The objective of this study was to compare the linguistic and cultural variations of the MMSE used in various Asian countries. With this, we can analyze the strengths and weaknesses of the MMSE and consider using a common version in future international clinical studies in Asia. Methods We collected the MMSEs used in...

Psychometric limitations of the mini-mental state examination among nondemented older adults: an evaluation of neurocognitive and magnetic resonance imaging correlates.

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Spencer, Robert J; Wendell, Carrington R; Giggey, Paul P; Katzel, Leslie I; Lefkowitz, David M; Siegel, Eliot L; Waldstein, Shari R

2013-01-01

BACKGROUND/STUDY CONTEXT: Although many of the Mini-Mental State Examination's (MMSE) limitations are well accepted among geriatricians, neuropsychologists, and other interested clinicians and researchers, its continued use in psychometrically unsound ways suggests that additional investigation and dissemination of information are sorely needed. The authors aimed to describe the reliability and validity of the MMSE as a measure of cognitive function among healthy older adults. The authors examined MMSE performance in 124 stroke- and dementia-free, community-dwelling older adults (65% male; mean age = 66.5 years). All participants were administered an extensive neuropsychological battery composed of measures of attention, executive function, memory, and visuospatial function. A subset of 99 participants also underwent magnetic resonance imaging (MRI). MMSE test-retest reliability was examined among 65 participants who underwent repeat MMSE testing over an average interval of 83.2 days. Spearman test-retest correlation for total MMSE scores was r S = .35 (p = .004), for Serial Sevens was r S = .40 (p = .001), and for Word Recall was r S = -.01 (p = .96). Total MMSE performance correlated significantly with a minority of neuropsychological tests and MRI-derived indices of white matter disease and brain atrophy. A subset of 17% of participants demonstrated inappropriate intrusion of MMSE Pentagon Copy during another test of visuospatial recall. Overall, MMSE scores exhibited ceiling effects, poor test-retest reliability, limited sensitivity to subtle brain abnormalities, and a high rate of intrusion elsewhere in the neuropsychological battery. Individual MMSE items demonstrated poor construct validity. These qualities illustrate the serious limitations of the MMSE in detecting individual differences in cognitive function among healthy older adults.

Leucoariaosis influence on cognitive status of patients with lacunar brain infarcts

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Filipović-Danić S.

2015-01-01

Full Text Available Leukoaraiosis is a change in brain white matter with characteristic manifestation in MR and CT head scans. Common leukoaraiosis risk factors include aging and arterial hypertension. A quarter of symptomatic ischemic infarcts belongs to small blood vessel disease group and could be presented as lacunar infarcts. These two crucial pathophysiological mechanisms are in the root of cognitive dysfunction related to small blood vessel disease. 60 lacunar infarct patients were examined and parameters for groups with and with-out leukoaraiosis were determined. It was found that leukoaraiosis incidence was highest in the group of women older than 70. Neurological assessment was scored on NIH-NINDS scale, functional status was scored with Barthelo index, and cognitive status was determined using Mini Mental State Examination (MMSE and Alzheimer Disease Assessment Scale Late (ADAS-L. Correlation analysis of these parameters on significance level of *p<0.05, **p<0.01, suggests decrease in neurological status and cognitive performance.

Does farming have an effect on health status? A comparison study in west Greece.

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Demos, Konstantinos; Sazakli, Eleni; Jelastopulu, Eleni; Charokopos, Nikolaos; Ellul, John; Leotsinidis, Michalis

2013-02-26

Investigating the health status of agricultural workers is a challenging goal. Contradictory outcomes concerning farmers' health are reported in the literature. In this cross-sectional study, certain clinical and neurobehavioral health outcomes were compared between farmers and non-farmers living in the same rural area. Farmers (328) and non-farmers (347), matched per age and sex, were selected randomly in an agricultural area in West Greece. Both groups underwent haematological and biochemical examinations and were administered two neurobehavioral tests, namely the Mini-Mental State Examination (MMSE) and the Montgomery-Åsberg Depression Rating Scale (MADRS). Sociodemographic, personal medical, nutritional and lifestyle data were recorded. According to personal statements, farmers suffered from hypertension, cardiovascular, orthopaedic and ENT problems in higher frequency. Haematocrit, haemoglobin and serum cholinesterase's activity were found to be lower among farmers. Lower prevalence of hypertension and better performances on MMSE and MADRS tests were recorded in young farmers in relation to young non-farmers, while these findings were reversed in older ages. Odds Ratios were calculated through multivariate logistic regression models. Factors affecting these impairments remain to be clarified.

The Validity and Reliability of the Mini-Mental State Examination-2 for Detecting Mild Cognitive Impairment and Alzheimer's Disease in a Korean Population.

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Min Jae Baek

Full Text Available To examine the validity and reliability of the MMSE-2 for assessing patients with mild cognitive impairment (MCI and Alzheimer's disease (AD in a Korean population. Specifically, the usefulness of the MMSE-2 as a screening measure for detecting early cognitive change, which has not been detectable through the MMSE, was examined.Two-hundred and twenty-six patients with MCI, 97 patients with AD, and 91 healthy older adults were recruited. All participants consented to examination with the MMSE-2, the MMSE, and other detailed neuropsychological assessments.The MMSE-2 performed well in discriminating participants across Clinical Dementia Rating (CDR stages and CDR-Sum of Boxes (CDR-SOB, and it showed excellent internal consistency, high test-retest reliability, high interrater reliability, and good concurrent validity with the MMSE and other detailed neuropsychological assessments. The MMSE-2 was divided into two factors (tests that are sensitive to decline in cognitive functions vs. tests that are not sensitive to decline in cognitive functions in normal cognitive aging. Moreover, the MMSE-2 was divided into two factors (tests related overall cognitive functioning other than memory vs. tests related to episodic memory in patients with AD. Finally, the MMSE-2 was divided into three factors (tests related to working memory and frontal lobe functioning vs. tests related to verbal memory vs. tests related to orientation and immediate recall in patients with MCI. The sensitivity and specificity of the three versions of the MMSE-2 were relatively high in discriminating participants with normal cognitive aging from patients with MCI and AD.The MMSE-2 is a valid and reliable cognitive screening instrument for assessing cognitive impairment in a Korean population, but its ability to distinguish patients with MCI from those with normal cognitive aging may not be as highly sensitive as expected.

The Validity and Reliability of the Mini-Mental State Examination-2 for Detecting Mild Cognitive Impairment and Alzheimer's Disease in a Korean Population.

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Baek, Min Jae; Kim, Karyeong; Park, Young Ho; Kim, SangYun

To examine the validity and reliability of the MMSE-2 for assessing patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) in a Korean population. Specifically, the usefulness of the MMSE-2 as a screening measure for detecting early cognitive change, which has not been detectable through the MMSE, was examined. Two-hundred and twenty-six patients with MCI, 97 patients with AD, and 91 healthy older adults were recruited. All participants consented to examination with the MMSE-2, the MMSE, and other detailed neuropsychological assessments. The MMSE-2 performed well in discriminating participants across Clinical Dementia Rating (CDR) stages and CDR-Sum of Boxes (CDR-SOB), and it showed excellent internal consistency, high test-retest reliability, high interrater reliability, and good concurrent validity with the MMSE and other detailed neuropsychological assessments. The MMSE-2 was divided into two factors (tests that are sensitive to decline in cognitive functions vs. tests that are not sensitive to decline in cognitive functions) in normal cognitive aging. Moreover, the MMSE-2 was divided into two factors (tests related overall cognitive functioning other than memory vs. tests related to episodic memory) in patients with AD. Finally, the MMSE-2 was divided into three factors (tests related to working memory and frontal lobe functioning vs. tests related to verbal memory vs. tests related to orientation and immediate recall) in patients with MCI. The sensitivity and specificity of the three versions of the MMSE-2 were relatively high in discriminating participants with normal cognitive aging from patients with MCI and AD. The MMSE-2 is a valid and reliable cognitive screening instrument for assessing cognitive impairment in a Korean population, but its ability to distinguish patients with MCI from those with normal cognitive aging may not be as highly sensitive as expected.

The Influence of Cognitive Status on Elder Food Choice and Meal Service Satisfaction.

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Crogan, Neva L; Short, Robert; Dupler, Alice E; Heaton, Grace

2015-11-01

This article describes the testing of a new nursing home food delivery system that empowers elders to choose the foods they want to eat and gives them an active voice in menu development. Using a 2-group, repeated measures design, 61 elderly residents from 2 eastern Washington nursing homes were recruited to participate in a 6-month study. Outcome measures included food and meal service satisfaction, body weight, serum prealbumin, and food intake. Serum prealbumin levels and body weight increased post intervention for treatment group residents. Mini-Mental Status Examination (MMSE) scores were not associated with the changes in serum prealbumin, body weight, or food intake. The MMSE scores did not influence the resident's ability to actively participate in the rate the food process or choose the foods they liked and preferred to eat. Cognitive impaired older adults experienced weight gain similarly to higher functioning elderly individuals. © The Author(s) 2012.

Correlates of Level and Change in the Mini-Mental State Examination

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Soubelet, Andrea; Salthouse, Timothy A.

2011-01-01

The goal of the current project was to determine (a) the cognitive abilities assessed by the Mini Mental State Examination (MMSE; M. F. Folstein, S. E. Folstein, & P. R. McHugh, 1975), (b) whether the same abilities are associated with MMSE performance among people of different ages, and (c) whether the same abilities are involved in changes…

A meta-analysis of the accuracy of the Addenbrooke's Cognitive Examination (ACE) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) in the detection of dementia.

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Larner, Andrew J; Mitchell, Alex J

2014-04-01

The Addenbrooke's Cognitive Examination (ACE) and its Revised version (ACE-R) are relatively new screening tools for cognitive impairment that may improve upon the well-known Mini-Mental State Examination (MMSE) and other brief batteries. We systematically reviewed diagnostic accuracy studies of ACE and ACE-R. Published studies comparing ACE, ACE-R and MMSE were comprehensively sought and critically appraised. A meta-analysis of suitable studies was conducted. Of 61 possible publications identified, meta-analysis of qualifying studies encompassed 5 for ACE (1,090 participants) and 5 for ACE-R (1156 participants); of these, 9 made direct comparisons with the MMSE. Sensitivity and specificity of the ACE were 96.9% (95% CI = 92.7% to 99.4%) and 77.4% (95% CI = 58.3% to 91.8%); and for the ACE-R were 95.7% (95% CI = 92.2% to 98.2%) and 87.5% (95% CI = 63.8% to 99.4%). In a modest prevalence setting, such as primary care or general hospital settings where the prevalence of dementia may be approximately 25%, overall accuracy of the ACE (0.823) was inferior to ACE-R (0.895) and MMSE (0.882). In high prevalence settings such as memory clinics where the prevalence of dementia may be 50% or higher, overall accuracy again favored ACE-R (0.916) over ACE (0.872) and MMSE (0.895). The ACE-R has somewhat superior diagnostic accuracy to the MMSE while the ACE appears to have inferior accuracy. The ACE-R is recommended in both modest and high prevalence settings. Accuracy of newer versions of the ACE remain to be determined.

[Psychometric properties and diagnostic usefulness of the Addenbrooke's Cognitive Examination-Revised in a Chilean elderly sample].

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Muñoz-Neira, Carlos; Henríquez Ch, Fernando; Ihnen J, Josefina; Sánchez C, Mauricio; Flores M, Patricia; Slachevsky Ch, Andrea

2012-08-01

The Addenbrooke's Cognitive Examination - Revised (ACE-R) is a good alternative to the Mini Mental State Examination (MMSE) for assessing cognitive capacities in dementia. To estimate the psychometric properties and diagnostic utility of the Addenbrooke's Cognitive Examination-Revised (ACE-R) in a Chilean elderly sample. ACE-R was adapted for the Chilean population (ACE-R-Ch) and then administered to 60 dementia patients, 22 mild cognitive impairment (MCI) patients and 45 control subjects in addition to the MMSE for assessing global cognitive efficiency. Caregivers of dementia patients and collateral sources of MCI patients and elderly subjects without dementia were interviewed with measures of dementia severity, functional status in activities of daily living and cognitive changes. Convergent validity, internal consistency reliability, cutoff points, sensitivity and specificity for ACE-R-Ch were estimated. Regarding convergent validity, the ACE-R-Ch showed significant correlations (p cognitive measure (r = 0,952 with MMSE), a rating for dementia severity (Spearman rho=-0,822 with CDR), functional capacity assessments (r = -0,70 with ADLQ-Ch; r = -0,725 with PFAQ-Ch; and r = 0,650 with IADL Scale) and a measure of cognitive changes (r = -0,633 with AD8-Ch). In terms of reliability, the test had a Cronbach alpha coefficient of 0.918. The best cut-off point to distinguish cases of dementia from control subjects was a score of 76, which reached a sensitivity of 0.92 and a specificity of 0.93. The ACE-R-Ch showed acceptable psychometric properties, becoming a valid and reliable instrument to assess global cognitive efficiency or cognitive impairment. Its diagnostic utility to detect dementia patients also worked very well in a Chilean elderly sample.

Health status of UK care home residents: a cohort study.

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Gordon, Adam Lee; Franklin, Matthew; Bradshaw, Lucy; Logan, Pip; Elliott, Rachel; Gladman, John R F

2014-01-01

UK care home residents are often poorly served by existing healthcare arrangements. Published descriptions of residents' health status have been limited by lack of detail and use of data derived from surveys drawn from social, rather than health, care records. to describe in detail the health status and healthcare resource use of UK care home residents a 180-day longitudinal cohort study of 227 residents across 11 UK care homes, 5 nursing and 6 residential, selected to be representative for nursing/residential status and dementia registration. Barthel index (BI), Mini-mental state examination (MMSE), Neuropsychiatric index (NPI), Mini-nutritional index (MNA), EuroQoL-5D (EQ-5D), 12-item General Health Questionnaire (GHQ-12), diagnoses and medications were recorded at baseline and BI, NPI, GHQ-12 and EQ-5D at follow-up after 180 days. National Health Service (NHS) resource use data were collected from databases of local healthcare providers. out of a total of 323, 227 residents were recruited. The median BI was 9 (IQR: 2.5-15.5), MMSE 13 (4-22) and number of medications 8 (5.5-10.5). The mean number of diagnoses per resident was 6.2 (SD: 4). Thirty per cent were malnourished, 66% had evidence of behavioural disturbance. Residents had contact with the NHS on average once per month. residents from both residential and nursing settings are dependent, cognitively impaired, have mild frequent behavioural symptoms, multimorbidity, polypharmacy and frequently use NHS resources. Effective care for such a cohort requires broad expertise from multiple disciplines delivered in a co-ordinated and managed way.

Mini-mental state examination as a predictor of mortality among older people referred to secondary mental healthcare.

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Su, Yu-Ping; Chang, Chin-Kuo; Hayes, Richard D; Perera, Gayan; Broadbent, Matthew; To, David; Hotopf, Matthew; Stewart, Robert

2014-01-01

Lower levels of cognitive function have been found to be associated with higher mortality in older people, particularly in dementia, but the association in people with other mental disorders is still inconclusive. Data were analysed from a large mental health case register serving a geographic catchment of 1.23 million residents, and associations were investigated between cognitive function measured by the Mini-Mental State Examination (MMSE) and survival in patients aged 65 years old and over. Cox regressions were carried out, adjusting for age, gender, psychiatric diagnosis, ethnicity, marital status, and area-level socioeconomic index. A total of 6,704 subjects were involved, including 3,368 of them having a dementia diagnosis and 3,336 of them with depression or other diagnoses. Descriptive outcomes by Kaplan-Meier curves showed significant differences between those with normal and impaired cognitive function (MMSE scoremental health services regardless of a dementia diagnosis. Causal pathways between this exposure and outcome (for example, suboptimal healthcare) need further investigation.

The effect of full denture on memory and depression status in elderly

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Bahruddin Thalib

2016-06-01

Full Text Available Complaint that is most often found in elderly is declining or disappearing memory and tooth loss due to aging. Loss of teeth will cause a disturbance in the function of mastication and reportedly may also contribute to the occurrence of memory disorders and depression. The objective of this study was to analyze the influence of full denture use on memory capacity and depression level in elderly. Study conducted at Oral and Dental Hospital Faculty of Dentistry, University of Hasanuddin. This study was clinical experimental with non-randomized design with pre and post test. Sampling with purposive sampling technique, and there were 6 people who are willing to participate. Memory status measurement using Mini-Mental State Exam (MMSE and level of depression using Geriatric Depression Scale (GDS. Memory status and level of depression measurement performed before using full denture and one month after using full denture. Data were analyzed with statistical pair T-test. With a 95% confidence level, the results showed there is an increase in initial MMSE average value (25.67 to the final MMSE average value (26.83 with statistically significant effect, p 0,05. This study concluded that there was significant influence in using full denture on improved memory status of complete edentulous elderly, and despite there were decreased on level of depression, but it was not statistically significant.

SCREENING FOR POSTSTROKE COGNITIVE IMPAIRMENT VIA MINI MENTAL STATE EXAMINATION AND MONTREAL COGNITIVE ASSESSMENT SCALE

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Mirena Valkova

2012-10-01

Full Text Available Objective: The aim of our study is to examine cognitive performance after mild stroke via Mini Mental State Examination (MMSE and Montreal cognitive assessment scale (MoCA and to compare the results.Material and methods: We examined 54 patients with mild stroke (aged 52 to 72 (mean 63.17, SD 5.96; 34 males and 20 females and 54 controls, adjusted by age, sex and education level. All subjects were tested via MMSE (Bulgarian version and MoCa (Bulgarian version. Data was collected in the single step model at the 90th day after stroke incident for patients and at the day of obtaining informed consent for controls. Results: Patients have poorer performance on both MMSE and MoCa than controls. MoCa has comparatively good discriminative validity and sensitivity.Conclusions: Although MMSE is one of the classical screening tools for cognitive impairment widely used in Bulgaria, other screening tools should not be ignored. On the basis of our results, MoCa is also a good screening instrument, especially for poststroke cognitive impairment.

Incidence of Brain Atrophy and Decline in Mini-Mental State Examination Score After Whole-Brain Radiotherapy in Patients With Brain Metastases: A Prospective Study

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Shibamoto, Yuta; Baba, Fumiya; Oda, Kyota; Hayashi, Shinya; Kokubo, Masaki; Ishihara, Shun-Ichi; Itoh, Yoshiyuki; Ogino, Hiroyuki; Koizumi, Masahiko

2008-01-01

Purpose: To determine the incidence of brain atrophy and dementia after whole-brain radiotherapy (WBRT) in patients with brain metastases not undergoing surgery. Methods and Materials: Eligible patients underwent WBRT to 40 Gy in 20 fractions with or without a 10-Gy boost. Brain magnetic resonance imaging or computed tomography and Mini-Mental State Examination (MMSE) were performed before and soon after radiotherapy, every 3 months for 18 months, and every 6 months thereafter. Brain atrophy was evaluated by change in cerebrospinal fluid-cranial ratio (CCR), and the atrophy index was defined as postradiation CCR divided by preradiation CCR. Results: Of 101 patients (median age, 62 years) entering the study, 92 completed WBRT, and 45, 25, and 10 patients were assessable at 6, 12, and 18 months, respectively. Mean atrophy index was 1.24 ± 0.39 (SD) at 6 months and 1.32 ± 0.40 at 12 months, and 18% and 28% of the patients had an increase in the atrophy index by 30% or greater, respectively. No apparent decrease in mean MMSE score was observed after WBRT. Individually, MMSE scores decreased by four or more points in 11% at 6 months, 12% at 12 months, and 0% at 18 months. However, about half the decrease in MMSE scores was associated with a decrease in performance status caused by systemic disease progression. Conclusions: Brain atrophy developed in up to 30% of patients, but it was not necessarily accompanied by MMSE score decrease. Dementia after WBRT unaccompanied by tumor recurrence was infrequent

Evaluation of the Addenbrooke's Cognitive Examination's validity in a brain injury rehabilitation setting.

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Gaber, Tarek A-Z K

2008-07-01

Several reports have warned of the Mini Mental State Examination's (MMSE) inability to detect gross memory and high executive impairments. Addenbrooke's Cognitive Examination-Revised (ACE-R) has gained enormous popularity in dementia screening as it addresses the main shortcomings of MMSE. This study aimed at evaluating the use of ACE-R and to establish its sensitivity compared to MMSE in a cohort of brain injury patients. ACE-R was administered to a cohort of chronic brain injury patients. All patients had a cognitive impairment which was severe enough to prevent them working or studying. Patients with significant mental health, sensory, communication or physical impairments were excluded. Thirty-six patients were recruited, 31 males with a mean age of 37 years. For an upper cut-off value of 27/30 for MMSE and 88/100 for ACE-R, their sensitivities were 36% and 72%, respectively. For a lower cut-off value of 24/30 and 82/100 the tests sensitivities were 11% and 56%, respectively. Analysis of the ACE-R sub-tests indicated that memory and verbal fluency sub-tests showed the most dramatic impairment. MMSE is insensitive as a screening test in brain injury patients. The results show ACE-R to be a sensitive, easily administered test.

Mini-Mental State Examination in Elderly Chinese: A Population-Based Normative Study.

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Li, Hanzhi; Jia, Jianping; Yang, Zhiqiang

2016-05-07

Chinese nationwide norms of the Mini-Mental State Examination (MMSE) have not been established despite its wide use. To obtain norms for the MMSE based on age, gender, education, and rural or urban residences and to determine the optimal cut-off points of the MMSE in elderly Chinese. A cross-sectional study was conducted in Chinese community residents aged 65 years or over selected by cluster random sampling. The MMSE was administered to 9,629 subjects (7,110 cognitively normal, 2,024 with mild cognitive impairment, and 495 with dementia). The demographic influences on MMSE scores were investigated and the norms were established considering those factors. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off points. Years of education (standardized β= 0.399), rural residence (standardized β= -0.261), age (standardized β= -0.198), and being female (standardized β= -0.101) had significant effects on MMSE scores (p < 0.001). Accordingly, we presented the demographic-stratified normative data for the MMSE. The optimal cut-off points for dementia screening were 16/17 for illiterate (sensitivity 87.6% and specificity 80.8%), 19/20 for individuals with 1-6 years of education (sensitivity 93.6% and specificity 92.7%), and 23/24 for individuals with 7 or more years of education (sensitivity 94.3% and specificity 94.3%). We provide the age-, gender-, education-, and residence-specific reference norms for the MMSE derived from an investigation of a large-scale, multicenter, nationwide representative Chinese elderly population. It could be of great improvement for the use of the MMSE in dementia screening in Chinese elderly population.

Validation of the Sinhala version of the Repeatable Battery for Assessment of Neuropsychological Status (RBANS)

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Suraweera, Chathurie; Anandakumar, D; Dahanayake, D; Subendran, M; Perera, U T; Hanwella, Raveen; de Silva, Varuni

2016-12-30

Only the Mini mental state examination (MMSE) and Montreal Cognitive Assessment scale have been validated in a Sri Lankan population for the assessment of cognitive functions. Both tests are deficient in the number of domains assessed. Therefore validation of Repeatable Battery for Assessment of Neuropsychological Status is important as it assesses most of the cognitive domains. To culturally adapt RBANS and investigate the validity and reliability of culturally adapted RBANS (RBANS-S). Fifty four participants with major neurocognitive disorder and 60 normal controls aged >50 were administered with RBANS-S at the Cognitive Assessment Unit, Faculty of Medicine, Colombo and National Hospital of Sri Lanka. The participants were selected after a detailed clinical assessment according to Diagnostic and Statistical Manual – 5 criteria. Data were analysed using SPSS data package. The mean age of the sample was 69.5 years. RBANS-S total scale correlated highly with MMSE total score, (Pearson correlational coefficient = 0.793 p=0.01). Criterion validity was assessed using receiver operating curve characteristic analysis and the area under the curve was 0.937. RBANS-S showed strong concurrent validity us indicated by its significant correlations with the MMSE. All of the RBANS-S subtests demonstrated significant correlations with the MMSE subsets. The sensitivity and specificity for RBANS-S was 89% and 85% respectively at a totals score of 80.5. The RBANS-S yielded a reliability coefficient of 0.929. Culturally adapted RBANS-S is a valid and reliable instrument which can be used in assessment of cognitive functions.

Three screening methods for cognitive dysfunction using the Mini-Mental State Examination and Korean Dementia Screening Questionnaire.

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Choi, Seong Hye; Park, Moon Ho

2016-02-01

To screen for and determine cognitive dysfunction, cognitive tests and/or informant reports are commonly used. However, these cognitive tests and informant reports are not always available. The present study investigated three screening methods using the Mini-Mental State Examination (MMSE) as the cognitive test, and the Korean dementia screening questionnaire (KDSQ) as the informant report. Participants were recruited from the Korea Clinical Research Center for Dementia of South Korea, and included 2861 patients with Alzheimer's disease (dementia), 3519 patients with mild cognitive impairment and 1375 controls with no cognitive dysfunction. Three screening methods were tested: (i) MMSE alone (MMSE(cut-off) ); (ii) a conventional combination of MMSE and KDSQ (MMSE+KDSQ(cut-off) ); and (iii) a decision tree with MMSE and KDSQ (MMSE+KDSQ(decision tree) ). For discriminating any cognitive dysfunction from controls, MMSE+KDSQ(cut-off) had the highest area under the receiver operating characteristic curve (0.784). For discriminating dementia from controls, MMSE+KDSQ(cut-off) had the highest area under the receiver operating characteristic curve (0.899). For discriminating mild cognitive impairment from controls, MMSE(cut-off) had the highest area under the receiver operating characteristic curve (0.683). MMSE+KDSQ(decision tree) showed the highest sensitivity for all discriminations. For overall classification accuracy, MMSE+KDSQ(decision tree) had the highest value (70.0%). These three methods had different advantageous properties for screening and staging cognitive dysfunction. As there might be different availability across clinical settings, these three methods can be selected and used according to situational needs. © 2015 Japan Geriatrics Society.

Physical activity and cognition in the northern Manhattan study.

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Willey, Joshua Z; Park Moon, Yeseon; Ruder, Rachel; Cheung, Yuen K; Sacco, Ralph L; Elkind, Mitchell S V; Wright, Clinton B

2014-01-01

To test the hypothesis that leisure time physical activity (PA) is associated with cognitive status. We assessed cognition using the Mini-Mental Status Examination (MMSE) at enrollment and using the modified Telephone Interview for Cognitive Status (TICS-m) administered annually since 2001 in the Northern Manhattan Study. Baseline measures of leisure time PA were collected via in-person questionnaires. Total PA was categorized into 3 groups based on the metabolic equivalent (MET) score, a composite of total reported intensity and time. We used linear regression models to examine the association of PA with MMSE, and generalized estimating equations for change in TICS-m over time. There were 3,298 stroke-free participants with MMSE data (mean MMSE 26.0 ± 3.8) and 2,279 with TICS-m scores available. Compared to no PA, those with the upper quartile of MET scores had greater baseline MMSE scores (adjusted β = 0.4, p = 0.01) but no association with change in TICS-m over time. There were interactions (p education; compared to no PA, those in the upper quartile of MET scores had a greater MMSE score only among those with Medicaid/no insurance (adjusted β = 0.83, p = 0.0005) and those who did not complete high school (adjusted β = 0.68, p = 0.001). Increased levels of PA were associated with better baseline MMSE, particularly among those with socioeconomic disadvantages, but not with cognitive decline. © 2013 S. Karger AG, Basel.

B-Vitamin Intake and Biomarker Status in Relation to Cognitive Decline in Healthy Older Adults in a 4-Year Follow-Up Study

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Catherine F. Hughes

2017-01-01

Full Text Available Advancing age can be associated with an increase in cognitive dysfunction, a spectrum of disability that ranges in severity from mild cognitive impairment to dementia. Folate and the other B-vitamins involved in one-carbon metabolism are associated with cognition in ageing but the evidence is not entirely clear. The hypothesis addressed in this study was that lower dietary intake or biomarker status of folate and/or the metabolically related B-vitamins would be associated with a greater than expected rate of cognitive decline over a 4-year follow-up period in healthy older adults. Participants (aged 60–88 years; n = 155 who had been previously screened for cognitive function were reassessed four years after initial investigation using the Mini-Mental State Examination (MMSE. At the 4-year follow-up assessment when participants were aged 73.4 ± 7.1 years, mean cognitive MMSE scores had declined from 29.1 ± 1.3 at baseline to 27.5 ± 2.4 (p < 0.001, but some 27% of participants showed a greater than expected rate of cognitive decline (i.e., decrease in MMSE > 0.56 points per year. Lower vitamin B6 status, as measured using pyridoxal-5-phosphate (PLP; <43 nmol/L was associated with a 3.5 times higher risk of accelerated cognitive decline, after adjustment for age and baseline MMSE score (OR, 3.48; 95% CI, 1.58 to 7.63; p < 0.05. Correspondingly, lower dietary intake (0.9–1.4 mg/day of vitamin B6 was also associated with a greater rate of cognitive decline (OR, 4.22; 95% CI, 1.28–13.90; p < 0.05. No significant relationships of dietary intake or biomarker status with cognitive decline were observed for the other B-vitamins. In conclusion, lower dietary and biomarker status of vitamin B6 at baseline predicted a greater than expected rate of cognitive decline over a 4-year period in healthy older adults. Vitamin B6 may be an important protective factor in helping maintain cognitive health in ageing.

Extremely low frequency electromagnetic field (ELF-EMF) reduces oxidative stress and improves functional and psychological status in ischemic stroke patients.

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Cichoń, Natalia; Bijak, Michał; Miller, Elżbieta; Saluk, Joanna

2017-07-01

As a result of ischaemia/reperfusion, massive generation of reactive oxygen species occurs, followed by decreased activity of antioxidant enzymes. Extremely low frequency electromagnetic fields (ELF-EMF) can modulate oxidative stress, but there are no clinical antioxidant studies in brain stroke patients. The aim of our study was to investigate the effect of ELF-EMF on clinical and antioxidant status in post-stroke patients. Fifty-seven patients were divided into two groups: ELF-EMF and non-ELF-EMF. Both groups underwent the same 4-week rehabilitation program. Additionally, the ELF-EMF group was exposed to an ELF-EMF field of 40 Hz, 7 mT for 15 min/day for 4 weeks (5 days a week). The activity of catalase and superoxide dismutase was measured in hemolysates, and total antioxidant status (TAS) determined in plasma. Functional status was assessed before and after the series of treatments using Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Geriatric Depression Scale (GDS). Applied ELF-EMF significantly increased enzymatic antioxidant activity; however, TAS levels did not change in either group. Results show that ELF-EMF induced a significant improvement in functional (ADL) and mental (MMSE, GDS) status. Clinical parameters had positive correlation with the level of enzymatic antioxidant protection. Bioelectromagnetics. 38:386-396, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Korean Version of the Mini-Mental State Examination Using Smartphone: A Validation Study.

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Park, Hae-Yeon; Jeon, Sung-Soo; Lee, Jin-Youn; Cho, Ah-Ra; Park, Joo Hyun

2017-10-01

Stroke often leads to disability, and poststroke survivors often have limited accessibility to medical facilities. For such patients, mobile videoconferencing technology offers an opportunity to perform follow-up assessment and appropriate management of cognitive impairment. We aimed to determine the validity of the Korean version of the Mini-Mental State Examination (MMSE-K) when administered using a smartphone. Thirty patients with ischemic or hemorrhagic stroke were included in this study (20 males, 10 females; mean age, 69.8 ± 12.9 years). Both face-to-face and remote assessments of cognitive function through MMSE-K were performed for each patient at an interval of at least 3 days. Additionally, an in-person collaborator evaluated the MMSE-K score during the remote assessment. A smartphone and a tablet were used by the patient and the examiner, respectively, and remote connection was mediated using a dedicated videoconferencing application. The MMSE-K scores obtained through face-to-face, remote, and in-person assessments were compared using the Wilcoxon signed rank test and the Spearman correlation analysis. There was good agreement between face-to-face and remote assessments, as well as between remote assessment and in-person collaborator's evaluation regarding total MMSE-K score and subscores for each MMSE-K domain (orientation, memory, attention/calculation, language, and visuospatial function). Remote assessment can be a useful clinical evaluation method, and this study confirmed the validity. The smartphone represents a promising tool for the assessment of cognitive function in clinical practice, but further research into the intra- and inter-rater reliability of observations is warranted.

Diagnostic validity of age and education corrections for the Mini-Mental State Examination in older African Americans.

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Pedraza, Otto; Clark, Joy Humphreys; O'Bryant, Sid E; Smith, Glenn E; Ivnik, Robert J; Graff-Radford, Neill R; Willis, Floyd B; Petersen, Ronald C; Lucas, John A

2012-02-01

To investigate whether demographic (age and education) adjustments for the Mini-Mental State Examination (MMSE) attenuate mean score discrepancies between African-American and Caucasian adults and whether demographically adjusted MMSE scores improve the diagnostic classification accuracy of dementia in African-American adults over unadjusted MMSE scores. Cross-sectional study. Community-dwelling adults participating in the Mayo Clinic Alzheimer's Disease Patient Registry and Alzheimer's Disease Research Center. Three thousand two hundred fifty-four adults (2,819 Caucasian, 435 African American) aged 60 and older. MMSE score at study entry. African-American adults had significantly lower unadjusted MMSE scores (23.0 ± 7.4) than Caucasian adults (25.3 ± 5.4). This discrepancy persisted despite adjustment of MMSE scores for age and years of education using established regression weights or newly derived weights. Controlling for dementia severity at baseline and adjusting MMSE scores for age and quality of education attenuated this discrepancy. In African-American adults, an age- and education-adjusted MMSE cut score of 23/24 provided optimal dementia classification accuracy, but this represented only a modest improvement over an unadjusted MMSE cut score of 22/23. The posterior probability of dementia in African-American adults is presented for various unadjusted MMSE cut scores and prevalence rates of dementia. Age, dementia severity at study entry, and quality of educational experience are important explanatory factors in understanding the existing discrepancies in MMSE performance between Caucasian and African-American adults. These findings support the use of unadjusted MMSE scores when screening older African Americans for dementia, with an unadjusted MMSE cut score of 22/23 yielding optimal classification accuracy. © 2012, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

Self-administered Gerocognitive Examination (SAGE): a brief cognitive assessment Instrument for mild cognitive impairment (MCI) and early dementia.

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Scharre, Douglas W; Chang, Shu-Ing; Murden, Robert A; Lamb, James; Beversdorf, David Q; Kataki, Maria; Nagaraja, Haikady N; Bornstein, Robert A

2010-01-01

To develop a self-administered cognitive assessment instrument to facilitate the screening of mild cognitive impairment (MCI) and early dementia and determine its association with gold standard clinical assessments including neuropsychologic evaluation. Adults aged above 59 years with sufficient vision and English literacy were recruited from geriatric and memory disorder clinics, educational talks, independent living facilities, senior centers, and memory screens. After Self-administered Gerocognitive Examination (SAGE) screening, subjects were randomly selected to complete a clinical evaluation, neurologic examination, neuropsychologic battery, functional assessment, and mini-mental state examination (MMSE). Subjects were identified as dementia, MCI, or normal based on standard clinical criteria and neuropsychologic testing. Two hundred fifty-four participants took the SAGE screen and 63 subjects completed the extensive evaluation (21 normal, 21 MCI, and 21 dementia subjects). Spearman rank correlation between SAGE and neuropsychologic battery was 0.84 (0.76 for MMSE). SAGE receiver operating characteristics on the basis of clinical diagnosis showed 95% specificity (90% for MMSE) and 79% sensitivity (71% for MMSE) in detecting those with cognitive impairment from normal subjects. This study suggests that SAGE is a reliable instrument for detecting cognitive impairment and compares favorably with the MMSE. The self-administered feature may promote cognitive testing by busy clinicians prompting earlier diagnosis and treatment.

Status of the nondestructive examination equipment for the fuels and materials examination facility

International Nuclear Information System (INIS)

Frandsen, G.B.

1980-01-01

The present status of Nondestructive Examination (NDE) Equipment proposed for the Fuels and Materials Examination Facility (FMEF) now under construction at the Hanford Engineering Development Laboratory is discussed. Items discussed include the NDE cell receiving machine, the dismantling machine, the standard examination stage, profilometry, eddy current, wire wrap removal machine, surface examination, gamma scan and general NDE equipment

Impact of low mini-mental status on health outcome up to 5 years after stroke: the Erlangen Stroke Project.

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Liman, T G; Heuschmann, P U; Endres, M; Flöel, A; Schwab, S; Kolominsky-Rabas, P L

2012-06-01

Cognitive deficits are frequent stroke sequelae. Data from population-based stroke cohorts on the impact of cognitive deficits on long-term outcome are scarce. The purpose of this study was to investigate the impact of low mini-mental status on health outcome up to 5 years after first-ever stroke. Data were collected from the Erlangen Stroke Project, a population-based stroke registry covering a source population of 103,000 inhabitants. The Mini-Mental State Examination (MMSE) was used to assess global cognitive function. Health outcome included limitations in instrumental activities of daily living (IADL, Frenchay Activities Index), low independence in activities of daily living (ADL, Barthel Index), depressive symptoms (Zung Self Rating Depression Scale), and institutionalization. Using multivariate logistic regression analysis, association of an education-adjusted MMSE score ≤ 24 with these health outcomes was investigated within distinct models at 12, 36, and 60 months after stroke as well as predictors at 3 months for low IADL. A total of 705 patients with first-ever stroke were included. Institutionalization, low levels of ADL and IADL (p mini-mental status up to 3 years after stroke (OR 2.69, 95% CI 1.2-5.8) as well as older age (p mini-mental status has an independent impact on long-term health outcome after stroke. Our results emphasize the importance of cognitive status screening to identify stroke survivors at risk and manage and treat these patients more efficiently.

Montreal Cognitive Assessment and Mini-Mental State Examination are both valid cognitive tools in stroke.

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Cumming, T B; Churilov, L; Linden, T; Bernhardt, J

2013-08-01

To determine the validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) as screening tools for cognitive impairment after stroke. Cognitive assessments were administered over 2 sessions (1 week apart) at 3 months post-stroke. Scores on the MoCA and MMSE were evaluated against a diagnosis of cognitive impairment derived from a comprehensive neuropsychological battery (the criterion standard). Sixty patients participated in the study [mean age 72.1 years (SD = 13.9), mean education 10.5 years (SD = 3.9), median acute NIHSS score 5 (IQR 3-7)]. The MoCA yielded lower scores (median = 21, IQR = 17-24; mean = 20.0, SD = 5.4) than the MMSE (median = 26, IQR = 22-27; mean = 24.2, SD = 4.5). MMSE data were more skewed towards ceiling than MoCA data (skewness = -1.09 vs -0.73). Area under the receiver operator curve was higher for MoCA than for MMSE (0.87 vs 0.84), although this difference was not significant (χ(2) = 0.48, P = 0.49). At their optimal cut-offs, the MoCA had better sensitivity than the MMSE (0.92 vs 0.82) but poorer specificity (0.67 vs 0.76). The MoCA is a valid screening tool for post-stroke cognitive impairment; it is more sensitive but less specific than the MMSE. Contrary to the prevailing view, the MMSE also exhibited acceptable validity in this setting. © 2013 John Wiley & Sons A/S.

Validation of abridged mini-mental state examination scales using population-based data from Sweden and USA.

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Ericsson, Malin Christina; Gatz, Margaret; Kåreholt, Ingemar; Parker, Marti G; Fors, Stefan

2017-06-01

The objective of this study is to validate two abridged versions of the mini-mental state examination (MMSE): one intended for use in face-to-face interviews, and the other developed for telephonic interviews, using data from Sweden and the US to validate the abridged scales against dementia diagnoses as well as to compare their performance to that of the full MMSE scale. The abridged versions were based on eight domains from the original MMSE scale. The domains included in the MMSE-SF were registration, orientation, delayed recall, attention, and visual spatial ability. In the MMSE-SF-C, the visual spatial ability item was excluded, and instead, one additional orientation item was added. There were 794 participants from the Swedish HARMONY study [mean age 81.8 (4.8); the proportion of cognitively impaired was 51 %] and 576 participants from the US ADAMS study [mean age 83.2 (5.7); the proportion of cognitively impaired was 65 %] where it was possible to compare abridged MMSE scales to dementia diagnoses and to the full MMSE scale. We estimated the sensitivity and specificity levels of the abridged tests, using clinical diagnoses as reference. Analyses with both the HARMONY and the ADAMS data indicated comparable levels of sensitivity and specificity in detecting cognitive impairment for the two abridged scales relative to the full MMSE. Receiver operating characteristic curves indicated that the two abridged scales corresponded well to those of the full MMSE. The two abridged tests have adequate validity and correspond well with the full MMSE. The abridged versions could therefore be alternatives to consider in larger population studies where interview length is restricted, and the respondent burden is high.

Covert hepatic encephalopathy: does the mini-mental state examination help?

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Corrias, Michela; Turco, Matteo; Rui, Michele D; Gatta, Angelo; Angeli, Paolo; Merkel, Carlo; Amodio, Piero; Schiff, Sami; Montagnese, Sara

2014-06-01

The Mini-Mental State Examination (MMSE) has been utilized for the diagnosis of hepatic encephalopathy (HE). However, its threshold of abnormality has not been formally tested in patients with cirrhosis and its diagnostic/prognostic validity remains unknown. The aim of this study was to assess it in a large group of well-characterized outpatients with cirrhosis and no overt HE. One-hundred-and-ninety-one patients underwent clinical assessment, MMSE, electroencephalography (EEG) and paper-and-pencil psychometry (PHES); 117 were followed up for 8 ± 5 months in relation to the occurrence of HE-related hospitalizations. On the day of study, 81 patients (42%) had abnormal EEG and 67 (35%) abnormal PHES; 103 (60%) had a history of HE. Average MMSE was 26.6 ± 3.5; 22 (19%) patients had abnormal MMSE based on the standard threshold of 24. Patients with abnormal EEG/PHES/history of HE had worse MMSE performance than their counterparts with normal tests/negative history (25.7 ± 4.2 vs. 27.3 ± 2.7; P < 0.01; 25.5 ± 3.2 vs. 27.9 ± 1.8, P < 0.0001; 26.3 ± 3.7 vs. 27.4 ± 2.6, P < 0.05, respectively). Based on the above results, MMSE thresholds of 26 and 27 were tested against abnormalities in clinical/EEG/PHES indices and significant associations were observed. An MMSE threshold of 26 was also a predictor of HE-related hospitalization (Cox-Mantel: P = 0.001); patients with MMSE <26 were significantly older than those with MMSE ≥26 but comparable in terms of liver dysfunction and ammonia levels. When MMSE items were considered separately, those which correlated most significantly with standard HE indices where spatial orientation and writing. In conclusion, an MMSE <26 identifies older patients with cirrhosis who are more prone to manifest HE signs.

Improvement of Screening Accuracy of Mini-Mental State Examination for Mild Cognitive Impairment and Non-Alzheimer's Disease Dementia by Supplementation of Verbal Fluency Performance.

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Kim, Jee Wook; Lee, Dong Young; Seo, Eun Hyun; Sohn, Bo Kyung; Choe, Young Min; Kim, Shin Gyeom; Park, Shin Young; Choo, Il Han; Youn, Jong Chul; Jhoo, Jin Hyeong; Kim, Ki Woong; Woo, Jong Inn

2014-01-01

THIS STUDY AIMED TO INVESTIGATE WHETHER THE SUPPLEMENTATION OF VERBAL FLUENCY: Animal category test (VF) performance can improve the screening ability of Mini-Mental State Examination (MMSE) for mild cognitive impairment (MCI), dementia and their major subtypes. Six hundred fifty-five cognitively normal (CN), 366 MCI [282 amnestic MCI (aMCI); 84 non-amnestic MCI (naMCI)] and 494 dementia [346 Alzheimer's disease (AD); and 148 non-Alzheimer's disease dementia (NAD)] individuals living in the community were included (all aged 50 years and older) in the study. The VF-supplemented MMSE (MMSE+VF) score had a significantly better screening ability for MCI, dementia and overall cognitive impairment (MCI plus dementia) than the MMSE raw score alone. MMSE+VF showed a significantly better ability than MMSE for both MCI subtypes, i.e., aMCI and naMCI. In the case of dementia subtypes, MMSE+VF was better than the MMSE alone for NAD screening, but not for AD screening. The results support the usefulness of VF-supplementation to improve the screening performance of MMSE for MCI and NAD.

Validation Study of the Mini-Mental State Examination in Urdu Language for Pakistani Population.

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Awan, Safia; Shahbaz, Naila; Akhtar, Syed Wasim; Ahmad, Arsalan; Iqbal, Sadaf; Ahmed, Sellal; Naqvi, Haider; Wasay, Mohammad

2015-01-01

Validation study of the Mini-Mental State Examination in Urdu language for Pakistani population. This study was conducted primarily to validate and determine the optimal cutoff score in the diagnosis of dementia among Pakistani's and study the effects of gender and education on the MMSE performance in our population. Four hundred participants took part in the study. Patient with dementia recruited from five major hospitals from Pakistan. The MMSE was translated into Urdu. There were 61 men and 39 women in dementia group and 225 men and 75 women in the control group. The mean score of Urdu MMSE were lower in patients with dementia 18.5 ± 5.6 (range 0-30) as compared to the controls 26.8 ± 2.6 (range 7-30). This difference between groups was statistically significant (p<0.001). Educational based MMSE score below 15 yielded perfect sensitivity and specificity for the diagnosis of dementia. These finding confirm the influence of level of education on MMSE score and education stratified cutoff scores should be used while screening for cognitive impairment in this population.

Low Complexity Submatrix Divided MMSE Sparse-SQRD Detection for MIMO-OFDM with ESPAR Antenna Receiver

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Diego Javier Reinoso Chisaguano

2013-01-01

Full Text Available Multiple input multiple output-orthogonal frequency division multiplexing (MIMO-OFDM with an electronically steerable passive array radiator (ESPAR antenna receiver can improve the bit error rate performance and obtains additional diversity gain without increasing the number of Radio Frequency (RF front-end circuits. However, due to the large size of the channel matrix, the computational cost required for the detection process using Vertical-Bell Laboratories Layered Space-Time (V-BLAST detection is too high to be implemented. Using the minimum mean square error sparse-sorted QR decomposition (MMSE sparse-SQRD algorithm for the detection process the average computational cost can be considerably reduced but is still higher compared with a conventional MIMOOFDM system without ESPAR antenna receiver. In this paper, we propose to use a low complexity submatrix divided MMSE sparse-SQRD algorithm for the detection process of MIMOOFDM with ESPAR antenna receiver. The computational cost analysis and simulation results show that on average the proposed scheme can further reduce the computational cost and achieve a complexity comparable to the conventional MIMO-OFDM detection schemes.

Throughput of Type II HARQ-OFDM/TDM Using MMSE-FDE in a Multipath Channel

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Haris Gacanin

2009-01-01

Full Text Available In type II hybrid ARQ (HARQ schemes, the uncoded information bits are transmitted first, while the error correction parity bits are sent upon request. Consequently, frequency diversity cannot be exploited during the first transmission. In this paper, we present the use of OFDM/TDM with MMSE-FDE and type II HARQ to increase throughput of OFDM due to frequency diversity gain.

Comparison of in-person and telephone administration of the Mini-Mental State Examination in the University of Alabama at Birmingham Study of Aging.

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Kennedy, Richard E; Williams, Courtney P; Sawyer, Patricia; Allman, Richard M; Crowe, Michael

2014-10-01

To validate the Mini-Mental State Examination (MMSE) Telephone (MMSET) against the MMSE. Cross-sectional. Homes of community-dwelling older adults. African-American and non-Hispanic white adults aged 75 and older participating in the University of Alabama at Birmingham Study of Aging II, a longitudinal epidemiological study across the state of Alabama (N = 419). Cognition, measured using the MMSE, MMSET, and Six-Item Screener (SIS), and function, based on self-reported difficulty performing instrumental activities of daily living (IADLs). Correlation and agreement coefficients were used to examine concordance of the MMSE and MMSET; linear and logistic regressions were used to test associations with clinical outcomes of IADL difficulty and verified diagnoses of dementia. The MMSET showed good internal consistency (Cronbach α = 0.845), similar to the full MMSE, and strong correlation with the latter (Spearman ρ = 0.694, P < .001). The MMSET explained a similar proportion of IADL difficulty as the full MMSE (coefficient of variation = 0.201 and 0.189, respectively). The MMSET was also associated with verified dementia diagnoses (area under the receiver operating characteristic curve = 0.73), which was similar to the full MMSE. The MMSET is a brief, valid measure of cognition in older adults with psychometric properties similar to that of the full MMSE. Because it can be administered over the telephone, further use in epidemiological studies is promising. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Reliability and validity of the Repeatable Battery for the Assessment of Neuropsychological Status in community-dwelling elderly

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Cheng, Yan; Wu, Wenyuan; Wang, Jiaqi; Feng, Wei; Li, Chunbo

2011-01-01

Introduction The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a widely used screening instrument in neuropsychological assessment and is a brief, individually administered measure. The present study aims to assess the reliability and validity of the Chinese version of the RBANS in community-dwelling elderly. Material and methods All subjects come from the community-dwelling elderly in Shanghai, China. They completed a questionnaire concerning demographic information, the mini-mental state examination (MMSE) and the Chinese version of the RBANS. To test for internal consistency, Cronbach's α was calculated for all six RBANS indices. Correlations between each of the RBANS and MMSE subtests were conducted to measure the concurrent validity. A confirmatory factor analysis (CFA) was conducted to test the construct validity. Results The final sample of participants included 236 community-dwelling elderly. The mean total score on the RBANS was 86.02 (±14.19). The RBANS total score showed strong internal consistency (r = 0.806), and the coefficient α value for each of the RBANS scales ranged from 0.142 to 0.727. The total RBANS score was highly correlated with that of the MMSE (r = 0.594, pvalidity in a community-dwelling elderly sample. It may be a useful screening instrument for conducting cognitive assessments in community-dwelling elderly. PMID:22291831

Low Sensitivity of the Mini-Mental State Examination for Cognitive Assessment of Brazilian Patients With Parkinson Disease.

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Breder, Raphael; Leite, Marco Antonio Araujo; Pinto, Jony Arrais; Cavalcante, Igor Pinto; Pessoa, Bruno Lima; Neves, Marco Antônio Orsini

2017-11-01

Recent publications have highlighted the low sensitivity of the Mini-Mental State Examination (MMSE) for the cognitive assessment of patients with Parkinson disease (PD). The Montreal Cognitive Assessment (MoCA), otherwise, has shown greater sensitivity when compared to the MMSE. Based on this, we have searched for the cognitive impairment measurable by the MoCA and the functional performance on activities of daily living in a sample of Brazilian patients with PD and normal MMSE. We hypothesized that the low sensitivity of the MMSE, already shown by other authors, could be replicated in a low-income country. To describe the performance on the MoCA and the dependence on third parties for activities of daily living in a sample of Brazilian patients with PD and normal MMSE. We evaluated 43 volunteers with PD and normal MMSE considering the Brazilian cutoffs. Cognitive performance was assessed through the MoCA and functional performance through a modified version of the Disability Assessment for Dementia Scale. Despite normal score on the MMSE, considering the Brazilian cutoffs, 62.7% of the volunteers performed below the literature cutoff for the MoCA (26 points). Furthermore, 30.2% had dependence on third party for activities of daily living. By using a strict cutoff for the MMSE (26 points), 56.7% performed below the MoCA cutoff and 24.3% had dependence for activities of daily living. Our findings confirm the limitations of the MMSE for the cognitive screening of patients with PD in a low-income country.

The reliability of assigning individuals to cognitive states using the Mini Mental-State Examination: a population-based prospective cohort study

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Marioni, Riccardo E.; Chatfield, Mark; Brayne, Carol; Matthews, Fiona E.; Med Res Council

2011-01-01

Abstract Background Previous investigations of test re-test reliability of the Mini-Mental State Examination (MMSE) have used correlations and statistics such as Cronbach's α to assess consistency. In practice, the MMSE is usually used to group individuals into cognitive states. The reliability of this grouping (state based approach) has not been fully explored. Methods MMSE data were collected on a subset of 2,275 older participants (≥ 65 years) from the population-based Medical Research Cou...

Predictors of cognitive impairment assessed by Mini Mental State Examination in community-dwelling older adults: relevance of the step test.

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Muscari, Antonio; Spiller, Ilaria; Bianchi, Giampaolo; Fabbri, Elisa; Forti, Paola; Magalotti, Donatella; Pandolfi, Paolo; Zoli, Marco

2018-07-15

Several predictors of cognitive impairment assessed by Mini Mental State Examination (MMSE) have previously been identified. However, which predictors are the most relevant and what is their effect on MMSE categories remains unclear. Cross-sectional and longitudinal study using data from 1116 older adults (72.6 ± 5.6 years, 579 female), 350 of whom were followed for 7 years. At baseline, the following variables were collected: personal data, marital status, occupation, anthropometric measures, risk factors, previous cardiovascular events, self-rated health and physical activity during the last week. Furthermore, routine laboratory tests, abdominal echography and a step test (with measurement of the time needed to ascend and descend two steps 20 times) were performed. The associations of these variables with cross-sectional cognitive deficit (MMSE cognitive decline (decrease of MMSE score over 7 years of follow-up) were investigated using logistic regression models. Cross-sectional cognitive deficit was independently associated with school education ≤ 5 years, prolonged step test duration, having been blue collar or housewife (P ≤ 0.0001 for all) and, with lower significance, with advanced age, previous stroke and poor recent physical activity (P cognitive decline was mainly associated with step test duration (P = 0.0001) and diastolic blood pressure (P = 0.0002). The MMSE categories mostly associated with step test duration were orientation, attention, calculation and language, while memory appeared to be poorly or not affected. In our cohort of older adults, step test duration was the most relevant predictor of cognitive impairment. Copyright © 2018 Elsevier Inc. All rights reserved.

The Effect of Hyperhomocysteinemia on Motor Symptoms, Cognitive Status, and Vascular Risk in Patients with Parkinson’s Disease

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Bilge Kocer

2016-01-01

Full Text Available Factors related with hyperhomocysteinemia (HHcy and the impact of HHcy in Parkinson’s disease (PD are not well understood. We investigated the factors associated with increased levels of homocysteine (Hcy and the relationship between HHcy and motor symptoms, cognitive status, and vascular risk in patients with Parkinson’s disease. Among 60 patients (29 males, 48.3% with PD, the stage of the disease, the severity of clinical symptoms, and the patients’ cognitive status were measured using a modified Hoehn and Yahr Staging Scale (mHY, Unified Parkinson’s Disease Rating Scale (UPDRS II and III, and Mini-Mental State Examination (MMSE, respectively. Patients were also noted for having dyskinesia and hallucinations. Serum vitamin B12, folic acid, and plasma Hcy ​​levels were measured. Furthermore, the presence of vascular risk factors was recorded. Finally, we investigated carotid artery intima-media thickening and stenosis using colour Doppler ultrasonography as well as the presence of ischemic lesions using brain imaging techniques. Plasma Hcy ​​levels were higher with advanced age and in males. In addition, there was an inverse relationship between Hcy ​​and vitamin B12 levels. There was no correlation between HHcy and the stage of the disease, severity of motor symptoms, cognitive status as assessed by the MMSE, vascular risk factors, carotid artery atherosclerotic findings, and ischemic brain lesions. Plasma Hcy levels may rise due to several factors in PD. However, the resulting HHcy has no significant effect on the clinical picture in terms of motor features, cognitive status, and vascular diseases.

Normalized Mini-Mental State Examination for assessing cognitive change in population-based brain aging studies.

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Philipps, Viviane; Amieva, Hélène; Andrieu, Sandrine; Dufouil, Carole; Berr, Claudine; Dartigues, Jean-François; Jacqmin-Gadda, Hélène; Proust-Lima, Cécile

2014-01-01

The Mini-Mental State Examination (MMSE) is widely used in population-based longitudinal studies to quantify cognitive change. However, its poor metrological properties, mainly ceiling/floor effects and varying sensitivity to change, have largely restricted its usefulness. We propose a normalizing transformation that corrects these properties, and makes possible the use of standard statistical methods to analyze change in MMSE scores. The normalizing transformation designed to correct at best the metrological properties of MMSE was estimated and validated on two population-based studies (n = 4,889, 20-year follow-up) by cross-validation. The transformation was also validated on two external studies with heterogeneous samples mixing normal and pathological aging, and samples including only demented subjects. The normalizing transformation provided correct inference in contrast with models analyzing the change in crude MMSE that most often lead to biased estimates of risk factors and incorrect conclusions. Cognitive change can be easily and properly assessed with the normalized MMSE using standard statistical methods such as linear (mixed) models. © 2014 S. Karger AG, Basel.

The Montreal Cognitive Assessment is superior to the Mini-Mental State Examination in detecting patients at higher risk of dementia.

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Dong, YanHong; Lee, Wah Yean; Basri, Nur Adilah; Collinson, Simon Lowes; Merchant, Reshma A; Venketasubramanian, Narayanaswamy; Chen, Christopher Li-Hsian

2012-11-01

To examine the discriminant validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in detecting patients with cognitive impairment at higher risk for dementia at a memory clinic setting. Memory clinic patients were administered the MoCA, MMSE, and a comprehensive formal neuropsychological battery. Mild cognitive impairment (MCI) subtypes were dichotomized into two groups: single domain-MCI (sd-MCI) and multiple domain-MCI (md-MCI). Area under the receiver operating characteristic curve (ROC) analysis was used to compare the discriminatory ability of the MoCA and the MMSE. Two hundred thirty patients were recruited, of which 136 (59.1%) were diagnosed with dementia, 61 (26.5%) with MCI, and 33 (14.3%) with no cognitive impairment (NCI). The majority of MCI patients had md-MCI (n = 36, 59%). The MoCA had significantly larger AUCs than the MMSE in discriminating md-MCI from the lower risk group for incident dementia (NCI and sd-MCI) [MoCA 0.92 (95% CI, 0.86-0.98) vs. MMSE 0.84 (95% CI, 0.75-0.92), p = 0.02). At their optimal cut-off points, the MoCA (19/20) remained superior to the MMSE (23/24) in detecting md-MCI [sensitivity: 0.83 vs. 0.72; specificity: 0.86 vs. 0.83; PPV: 0.79 vs. 0.72; NPV: 0.89 vs. 0.83; correctly classified: 85.1% vs. 78.7%]. The MoCA is superior to the MMSE in the detection of patients with cognitive impairment at higher risk for incident dementia at a memory clinic setting.

[Use of the Mini-Mental State Examination in research on the elderly in Brazil: a systematic review].

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de Melo, Denise Mendonça; Barbosa, Altemir José Gonçalves

2015-12-01

The Mini-Mental State Examination (MMSE) is the most widely used cognitive screening test around the world. In Brazil, different MMSE versions and many cut-off points have been used. A systematic review of papers indexed in Scielo was conducted in order to analyze use of the MMSE in Brazilian empirical studies with elderly people. To search for these texts, the complete name of the instrument and its abbreviation were used. A growth trend in the scientific production during the 1998 to 2013 period was observed. Eleven versions of the MMSE were identified and the Bertolucci et al. version was the most cited. Over half of the studies used schooling as the criteria to establish cut-off points. The studies were predominantly conducted using samples recruited from large cities in the Southeastern region and in the community. Despite the growing trend of research with the elderly using the MMSE, the psychometric properties of this scale of measurement have been the subject of little investigation. Despite the widespread use of the MMSE in Brazil, there is a lack of standardization and evidence of validity for this this scale of measurement.

Beyond Screening: Can the Mini-Mental State Examination be Used as an Exclusion Tool in a Memory Clinic?

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Xu, Xin; Chong, Eddie; Hilal, Saima; Ikram, Mohammad Kamran; Venketasubramanian, Narayanaswamy; Chen, Christopher

2015-11-04

This study explores whether the Mini-Mental State Examination (MMSE) could reliably exclude definite dementia and dementia-free cases from requiring more extensive neuropsychological investigations in memory clinic settings in Singapore. Patients with memory complaints referred for possible dementia underwent the MMSE, followed by standardized neuropsychological and clinical assessments which led to a consensus diagnosis. MMSE cut-off points were derived stratified for education (less and equal/above primary level). Results show that after education stratification, using an optimal Positive Likelihood Ratio (PLR) and optimal Negative Likelihood Ratio (NLR), a higher percentage of patients were correctly identified as having dementia or dementia-free, with minimal misclassification rate. The finding suggests the MMSE can be used to exclude patients not requiring full neuropsychological assessments in a memory clinic.

Anatomic Correlation of the Mini-Mental State Examination: A Voxel-Based Morphometric Study in Older Adults.

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Dinomais, Mickael; Celle, Sebastien; Duval, Guillaume T; Roche, Frederic; Henni, Samir; Bartha, Robert; Beauchet, Olivier; Annweiler, Cedric

2016-01-01

The clinical utility of the Mini-Mental State Examination (MMSE) and its shorter version (SMMSE) is still debated. There is a need to better understand the neuroanatomical correlates of these cognitive tests. The objective of this cross-sectional study was to determine whether lower MMSE and SMMSE scores correlated with focal brain volume reduction in older adults. Participants from the GAIT study (n = 207; mean, 70.9±5.9 years; 57% female; mean MMSE 26.2±3.9; mean SMMSE 5.1±1.1) were evaluated using the MMSE and SMMSE and received a 1.5-Tesla MRI scan of the brain. Cortical gray and white matter subvolumes were automatically segmented using Statistical Parametric Mapping. Age, gender, education level, and total intracranial volume were included as potential confounders. We found correlations between the MMSE score and specific cortical regions of the limbic system including the hippocampus, amygdala, cingulate gyrus, and parahippocampal gyrus, independently of the diagnostic category (i.e., mild cognitive impairment or Alzheimer disease or controls). Regarding correlations with the SMMSE score, only one cluster in the left hippocampus was identified, which overlapped with the cluster that was positively correlated with the MMSE score. There were no correlations with the volume of white matter. In conclusion, worse MMSE and SMMSE scores were associated with gray matter atrophy mainly in the limbic system. This finding highlights that atrophy of specific brain regions are related to performance on the MMSE and the SMMSE tests, and provides new insights into the cognitive function probed by these tests.

Evaluation of a Japanese version of the Mini-Mental State Examination in elderly persons.

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Ideno, Yuki; Takayama, Mitsuyo; Hayashi, Kunihiko; Takagi, Hirofumi; Sugai, Yuichi

2012-04-01

This study aimed to examine the validity and item-response characteristics of the Mini-Mental State Examination (MMSE), which is used for assessing cognitive function, in Japanese older adults. Factor analysis and item response analysis were carried out for MMSE responses (n = 1971) from older adults living in the community (n = 1339) or in a nursing home (n = 632), including Alzheimer-type dementia (n = 330), vascular dementia (n = 36), frontotemporal dementia (n = 7), mixed Alzheimer-type and frontotemporal type dementia (n = 27), and age-related cognitive decline (n = 29). When choosing the cut-off score of 23 points for the MMSE, sensitivity and specificity for each item were calculated. A three-factor solution was found to be most appropriate by factor analysis: complex processing, simple processing and working memory. The item characteristics curves showed unidimensionality with high reproducibility. We identified a simplified scale comprising 10 items in all participants: "naming", "three-step command", "registration", "repeat a sentence", "write a complete sentence", "copies drawing of two polygons", "orientation to place", "delayed recall", "orientation to time" and "serial sevens" tasks. Sensitivity and specificity for both "year" task and "day" task were more than 90% ("year": sensitivity 92.5%, specificity 96.3%; "day": sensitivity 92.4%, specificity 91.7%). For the Alzheimer-type dementia patients, the five-factor solution was suggested by factor analysis and the MMSE also had unidimensionality in terms of level of difficulty. We found that the MMSE had multiple cognitive areas. We showed that the MMSE could be used as an essentially unidimensional measure of cognitive ability and the question about orientation to time might be useful in the simplest assessment to identify cognitive dysfunction. © 2011 Japan Geriatrics Society.

Discrimination between stages of Alzheimer's disease with subsets of Mini-Mental State Examination items. An analysis of Consortium to Establish a Registry for Alzheimer's Disease data.

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Fillenbaum, G G; Wilkinson, W E; Welsh, K A; Mohs, R C

1994-09-01

To identify minimal sets of Mini-Mental State Examination (MMSE) items that can distinguish normal control subjects from patients with mild Alzheimer's disease (AD), patients with mild from those with moderate AD, and those with moderate from those with severe AD. Two randomly selected equivalent half samples. Results of logistic regression analysis from data from the first half of the sample were confirmed by receiver operating characteristic curves on the second half. Memory disorders clinics at major medical centers in the United States affiliated with the Consortium to establish a Registry for Alzheimer's Disease (CERAD). White, normal control subjects (n = 412) and patients with AD (n = 621) who met CERAD criteria; nonwhite subjects (n = 165) and persons with missing data (n = 27) were excluded. Three four-item sets of MMSE items that discriminate, respectively, (1) normal controls from patients with mild AD, (2) patients with mild from those with moderate AD, and (3) patients with moderate from those with severe AD. The MMSE items discriminating normal controls from patients with mild AD were day, date, recall of apple, and recall of penny; those discriminating patients with mild from those with moderate AD were month, city, spelling world backward, and county, and those discriminating patients with moderate from those with severe AD were floor of building, repeating the word table, naming watch, and folding paper in half. Performance on the first two four-item sets was comparable with that of the full MMSE; the third set distinguished patients with moderate from those with severe AD better than chance. A minimum set of MMSE items can effectively discriminate normal controls from patients with mild AD and between successive levels of severity of AD. Data apply only to white patients with AD. Performance in minorities, more heterogeneous groups, or normal subjects with questionable cognitive status has not been assessed.

Montreal Cognitive Assessment Performance in Patients with Parkinson’s Disease with “Normal” Global Cognition According to Mini-Mental State Examination Score

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Nazem, Sarra; Siderowf, Andrew D.; Duda, John E.; Have, Tom Ten; Colcher, Amy; Horn, Stacy S.; Moberg, Paul J.; Wilkinson, Jayne R.; Hurtig, Howard I.; Stern, Matthew B.; Weintraub, Daniel

2009-01-01

OBJECTIVES To examine Montreal Cognitive Assessment (MoCA) performance in patients with Parkinson’s disease (PD) with “normal” global cognition according to Mini-Mental State Examination (MMSE) score. DESIGN A cross-sectional comparison of the MoCA and the MMSE. SETTING Two movement disorders centers at the University of Pennsylvania and the Philadelphia Veterans Affairs Medical Center. PARTICIPANTS A convenience sample of 131 patients with idiopathic PD who were screened for cognitive and psychiatric complications. MEASUREMENTS Subjects were administered the MoCA and MMSE, and only subjects defined as having a normal age- and education-adjusted MMSE score were included in the analyses (N = 100). As previously recommended in patients without PD, a MoCA score less than 26 was used to indicate the presence of at least mild cognitive impairment (MCI). RESULTS Mean MMSE and MoCA scores ± standard deviation were 28.8 ± 1.1 and 24.9 ± 3.1, respectively. More than half (52.0%) of subjects with normal MMSE scores had cognitive impairment according to their MoCA score. Impairments were seen in numerous cognitive domains, including memory, visuospatial and executive abilities, attention, and language. Predictors of cognitive impairment on the MoCA using univariate analyses were male sex, older age, lower educational level, and greater disease severity; older age was the only predictor in a multivariate model. CONCLUSION Approximately half of patients with PD with a normal MMSE score have cognitive impairment based on the recommended MoCA cutoff score. These results suggest that MCI is common in PD and that the MoCA is a more sensitive instrument than the MMSE for its detection. PMID:19170786

Using the Oxford Cognitive Screen to Detect Cognitive Impairment in Stroke Patients: A Comparison with the Mini-Mental State Examination.

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Mancuso, Mauro; Demeyere, Nele; Abbruzzese, Laura; Damora, Alessio; Varalta, Valentina; Pirrotta, Fabio; Antonucci, Gabriella; Matano, Alessandro; Caputo, Marina; Caruso, Maria Giovanna; Pontiggia, Giovanna Teresa; Coccia, Michela; Ciancarelli, Irene; Zoccolotti, Pierluigi

2018-01-01

The Oxford Cognitive Screen (OCS) was recently developed with the aim of describing the cognitive deficits after stroke. The scale consists of 10 tasks encompassing five cognitive domains: attention and executive function, language, memory, number processing, and praxis. OCS was devised to be inclusive and un-confounded by aphasia and neglect. As such, it may have a greater potential to be informative on stroke cognitive deficits of widely used instruments, such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment, which were originally devised for demented patients. The present study compared the OCS with the MMSE with regards to their ability to detect cognitive impairments post-stroke. We further aimed to examine performance on the OCS as a function of subtypes of cerebral infarction and clinical severity. 325 first stroke patients were consecutively enrolled in the study over a 9-month period. The OCS and MMSE, as well as the Bamford classification and NIHSS, were given according to standard procedures. About a third of patients (35.3%) had a performance lower than the cutoff (cognitive domains of the OCS. Using the MMSE as a standard of clinical practice, the comparative sensitivity of OCS was 100%. Out of the 208 patients with normal MMSE performance 180 showed impaired performance in at least one domain of the OCS. The discrepancy between OCS and MMSE was particularly strong for patients with milder strokes. As for subtypes of cerebral infarction, fewer patients demonstrated widespread impairments in the OCS in the Posterior Circulation Infarcts category than in the other categories. Overall, the results showed a much higher incidence of cognitive impairment with the OCS than with the MMSE and demonstrated no false negatives for OCS vs MMSE. It is concluded that OCS is a sensitive screen tool for cognitive deficits after stroke. In particular, the OCS detects high incidences of stroke-specific cognitive impairments, not detected

Should the mini-mental state examination be retired?

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Carnero-Pardo, C

2014-10-01

Short cognitive tests are routinely used in clinical practice to detect and screen for cognitive impairment and dementia. These cognitive tests should meet minimum criteria for both applicability and psychometric qualities. The Mini-Mental State Examination (MMSE) is the most frequently applied short cognitive test, and the article introducing it remains a milestone in the history of medicine. Its main advantages are its widespread use and the extensive empirical evidence that supports it. However, the MMSE has important shortcomings, including lack of standardisation, its lack of suitability for illiterate subjects, the considerable effect of socio-educational variables on results, and its limited effectiveness for detecting cognitive impairment. Lastly, since the test is copyright-protected, using it is necessarily either costly or fraudulent. Newer available instruments do not share these shortcomings and have demonstrated greater diagnostic accuracy for detecting cognitive impairment and dementia, as well as being more cost-effective than the MMSE CONCLUSION: It is time to acknowledge the MMSE's important role in the history of medicine and grant it a deserved and honourable retirement. Its place will be taken by more effective instruments that require less time, are user-friendly and free of charge, can be applied to all individuals, and yield more equitable outcomes. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Bridging cognitive screening tests in neurologic disorders: A crosswalk between the short Montreal Cognitive Assessment and Mini-Mental State Examination.

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Roalf, David R; Moore, Tyler M; Mechanic-Hamilton, Dawn; Wolk, David A; Arnold, Steven E; Weintraub, Daniel A; Moberg, Paul J

2017-08-01

To provide a crosswalk between the recently proposed short Montreal Cognitive Assessment (s-MoCA) and Mini-Mental State Examination (MMSE) within a clinical cohort. A total of 791 participants, with and without neurologic conditions, received both the MMSE and the MoCA at the same visit. s-MoCA scores were calculated and equipercentile equating was used to create a crosswalk between the s-MoCA and MMSE. As expected, s-MoCA scores were highly correlated (Pearson r = 0.82, P < .001) with MMSE scores. s-MoCA scores correctly classified 85% of healthy older adults and 91% of individuals with neurologic conditions that impair cognition. In addition, we provide an easy to use table that enables the conversion of s-MoCA score to MMSE score. The s-MoCA is quick to administer, provides high sensitivity and specificity for cognitive impairment, and now can be compared directly with the MMSE. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Using the Oxford Cognitive Screen to Detect Cognitive Impairment in Stroke Patients: A Comparison with the Mini-Mental State Examination

Directory of Open Access Journals (Sweden)

Mauro Mancuso

2018-02-01

Full Text Available BackgroundThe Oxford Cognitive Screen (OCS was recently developed with the aim of describing the cognitive deficits after stroke. The scale consists of 10 tasks encompassing five cognitive domains: attention and executive function, language, memory, number processing, and praxis. OCS was devised to be inclusive and un-confounded by aphasia and neglect. As such, it may have a greater potential to be informative on stroke cognitive deficits of widely used instruments, such as the Mini-Mental State Examination (MMSE or the Montreal Cognitive Assessment, which were originally devised for demented patients.ObjectiveThe present study compared the OCS with the MMSE with regards to their ability to detect cognitive impairments post-stroke. We further aimed to examine performance on the OCS as a function of subtypes of cerebral infarction and clinical severity.Methods325 first stroke patients were consecutively enrolled in the study over a 9-month period. The OCS and MMSE, as well as the Bamford classification and NIHSS, were given according to standard procedures.ResultsAbout a third of patients (35.3% had a performance lower than the cutoff (<22 on the MMSE, whereas 91.6% were impaired in at least one OCS domain, indicating higher incidences of impairment for the OCS. More than 80% of patients showed an impairment in two or more cognitive domains of the OCS. Using the MMSE as a standard of clinical practice, the comparative sensitivity of OCS was 100%. Out of the 208 patients with normal MMSE performance 180 showed impaired performance in at least one domain of the OCS. The discrepancy between OCS and MMSE was particularly strong for patients with milder strokes. As for subtypes of cerebral infarction, fewer patients demonstrated widespread impairments in the OCS in the Posterior Circulation Infarcts category than in the other categories.ConclusionOverall, the results showed a much higher incidence of cognitive impairment with the OCS than with the

Preliminary study to evaluate the validity of the mini-mental state examination in a normal population in Turkey.

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Küçükdeveci, Ayse A; Kutlay, Sehim; Elhan, Atilla H; Tennant, Alan

2005-03-01

Although the Mini-Mental State Examination (MMSE) is widely used in clinical practice, normative scores for a healthy population have not been documented in Turkey. The aim in this study was to validate the MMSE in a healthy population and to provide normal scores. Internal construct validity of the Turkish version of MMSE among a preliminary sample of 406 normal people was assessed by Rasch unidimensional measurement model. Scores of the normal sample varied according to age and education but not according to sex. The data derived from this sample showed poor fit to the Rasch model (mean item fit, -2.082, SD 3.022). Only four of 11 items met model expectations. There was also differential item functioning by education and age for most items. Thus the internal construct validity of the Turkish MMSE in a normative sample could not be demonstrated by Rasch analysis. The scale failed modern psychometric criteria for scalability. We would therefore suggest other large normative MMSE data sets to be tested in terms of internal construct validity. If these findings are replicated, the validity of MMSE norms and their consequent use in clinical practice should be reconsidered.

Iterative MMSE Detection for MIMO/BLAST DS-CDMA Systems in Frequency Selective Fading Channels - Achieving High Performance in Fully Loaded Systems

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Silva, João Carlos; Souto, Nuno; Cercas, Francisco; Dinis, Rui

A MMSE (Minimum Mean Square Error) DS-CDMA (Direct Sequence-Code Division Multiple Access) receiver coupled with a low-complexity iterative interference suppression algorithm was devised for a MIMO/BLAST (Multiple Input, Multiple Output / Bell Laboratories Layered Space Time) system in order to improve system performance, considering frequency selective fading channels. The scheme is compared against the simple MMSE receiver, for both QPSK and 16QAM modulations, under SISO (Single Input, Single Output) and MIMO systems, the latter with 2Tx by 2Rx and 4Tx by 4Rx (MIMO order 2 and 4 respectively) antennas. To assess its performance in an existing system, the uncoded UMTS HSDPA (High Speed Downlink Packet Access) standard was considered.

Validation of the Cuban Version of Addenbrooke's Cognitive Examination-Revised for Screening Mild Cognitive Impairment.

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Broche-Pérez, Yunier; López-Pujol, Héctor Alejandro

2017-01-01

The diagnostic accuracy of the Cuban version of the revised Addenbrooke's Cognitive Examination (ACE-R) in identifying mild cognitive impairment (MCI) in comparison with the Mini-Mental State Examination (MMSE) was assessed. The Cuban ACE-R was administered to a group of 129 elderly subjects (92 cognitively healthy and 37 subjects with MCI). The t tests for independent samples were used to compare scores of different psychometric scales between groups, and effect sizes (Cohen's d) were calculated. Cronbach's coefficient α was used to evaluate the reliability of psychometric scales. The validity of ACE-R to screen for MCI was assessed by receiver operating characteristic (ROC) curves. The Cuban ACE-R had reliable internal consistency (Cronbach's coefficient α = 0. 879). The optimal cut-off score for ACE-R for detecting MCI was 84/85. The sensitivity and specificity of ACE-R to screen for MCI was superior to those of MMSE. The area under the ROC curve of the Cuban ACE-R was much larger than that of MMSE (0.93 and 0.63) for detecting MCI. The Cuban ACE-R is a valid screening tool for detecting cognitive impairment. It is more sensitive and accurate in screening for MCI than MMSE. © 2018 S. Karger AG, Basel.

Adherence to the Mediterranean diet pattern, cognitive status and depressive symptoms in an elderly non-institutionalized population.

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Hernández-Galiot, Ana; Goñi, Isabel

2017-03-30

Scientific evidence indicates that adherence to the Mediterranean diet protects against the deterioration of cognitive status and depressive symptoms during aging. However, few studies have been conducted in elderly non-institutionalized subjects. This study evaluated the relation between the adherence to the Mediterranean dietary pattern and cognitive status and depressive symptoms in an elderly population over 75 years. A cross-sectional study was conducted in a Mediterranean city (Garrucha, Spain) in 79 elderly people over 75 (36 men and 41 women). Adherence to the Mediterranean dietary pattern was determined using the Mediterranean Diet Adherence Screener (MEDAS). Cognitive function was determined by the Mini Mental State Examination (MMSE), and depressive symptoms were assessed by the Geriatric Depression Scale (GDS). Most of population showed a very high adherence to the Mediterranean diet pattern and optimal cognitive and affective status. They consumed olive oil as their main source of fat, high levels of fish and fruit, low levels of foods with added sugars, and a low consumption of red meat. A significant relation between the MEDAS and MMSE scores was found. However, no relationship was observed between the MEDAS and GDS. The Mediterranean diet pattern was positively related with the cognitive function, although the infl uence of a healthy dietary pattern on the symptomatology of depression was unclear. However, an effective strategy against cognitive function and depression would be to improve physical activity rates, establish lifelong healthy eating habits, and consume a nutritionally-rich diet in order to enhance quality of life of the elderly.

The Mini-Addenbrooke's Cognitive Examination: a new assessment tool for dementia.

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Hsieh, Sharpley; McGrory, Sarah; Leslie, Felicity; Dawson, Kate; Ahmed, Samrah; Butler, Chris R; Rowe, James B; Mioshi, Eneida; Hodges, John R

2015-01-01

We developed and validated the Mini-Addenbrooke's Cognitive Examination (M-ACE) in dementia patients. Comparisons were also made with the Mini Mental State Examination (MMSE). The M-ACE was developed using Mokken scaling analysis in 117 dementia patients [behavioural variant frontotemporal dementia (bvFTD), n = 25; primary progressive aphasia (PPA), n = 49; Alzheimer's disease (AD), n = 34; corticobasal syndrome (CBS), n = 9] and validated in an independent sample of 164 dementia patients (bvFTD, n = 23; PPA, n = 82; AD, n = 38; CBS, n = 21) and 78 controls, who also completed the MMSE. The M-ACE consists of 5 items with a maximum score of 30. Two cut-offs were identified: (1) ≤25/30 has both high sensitivity and specificity, and (2) ≤21/30 is almost certainly a score to have come from a dementia patient regardless of the clinical setting. The M-ACE is more sensitive than the MMSE and is less likely to have ceiling effects. The M-ACE is a brief and sensitive cognitive screening tool for dementia. Two cut-offs (25 or 21) are recommended. © 2014 S. Karger AG, Basel.

Performance Comparison between CDTD and STTD for DS-CDMA/MMSE-FDE with Frequency-Domain ICI Cancellation

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Takeda, Kazuaki; Kojima, Yohei; Adachi, Fumiyuki

Frequency-domain equalization (FDE) based on the minimum mean square error (MMSE) criterion can provide a better bit error rate (BER) performance than rake combining. However, the residual inter-chip interference (ICI) is produced after MMSE-FDE and this degrades the BER performance. Recently, we showed that frequency-domain ICI cancellation can bring the BER performance close to the theoretical lower bound. To further improve the BER performance, transmit antenna diversity technique is effective. Cyclic delay transmit diversity (CDTD) can increase the number of equivalent paths and hence achieve a large frequency diversity gain. Space-time transmit diversity (STTD) can obtain antenna diversity gain due to the space-time coding and achieve a better BER performance than CDTD. Objective of this paper is to show that the BER performance degradation of CDTD is mainly due to the residual ICI and that the introduction of ICI cancellation gives almost the same BER performance as STTD. This study provides a very important result that CDTD has a great advantage of providing a higher throughput than STTD. This is confirmed by computer simulation. The computer simulation results show that CDTD can achieve higher throughput than STTD when ICI cancellation is introduced.

Mini-Mental State Examination score trajectories and incident disabling dementia among community-dwelling older Japanese adults.

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Taniguchi, Yu; Kitamura, Akihiko; Murayama, Hiroshi; Amano, Hidenori; Shinozaki, Tomohiro; Yokota, Isao; Seino, Satoshi; Nofuji, Yu; Nishi, Mariko; Yokoyama, Yuri; Matsuyama, Yutaka; Fujiwara, Yoshinori; Shinkai, Shoji

2017-11-01

The present prospective study used repeated measures analysis to identify potential Mini-Mental State Examination (MMSE) score trajectories and determine whether MMSE trajectory was associated with incident disabling dementia among community-dwelling older Japanese adults. A total of 1724 non-demented adults (mean age 71.4 years [SD 5.7]; 56.7% women) aged 65-90 years participated in annual geriatric health assessments during the period from June 2002 through July 2014. The total number of observations was 6755, and the average number of follow-up assessments was 3.9. A review of municipal databases in the Japanese public long-term care insurance system showed that 205 (11.9%) participants developed disabling dementia through December 2014. We identified three distinct MMSE score trajectory patterns (high, middle and low) in adults aged 65-90 years. After adjusting for important confounders, participants with middle (42.8%) and low (5.1%) MMSE trajectories had hazard ratios of 2.46 (95% confidence interval 1.64-3.68) and 10.73 (95% confidence interval 4.91-23.45), respectively, for incident disabling dementia, as compared with those in the high (52.1%) trajectory group. Approximately half of the participants were classified as having a high MMSE trajectory, whereas 43% and 5% had middle and low MMSE trajectories, respectively, in this population. Individuals with middle and low MMSE trajectories had a higher risk for incident disabling dementia, which suggests that a high-risk approach to dementia prevention should target people with mild and more rapid cognitive decline. Geriatr Gerontol Int 2017; 17: 1928-1935. © 2017 Japan Geriatrics Society.

Characteristic differences in the mini-mental state examination used in Asian countries.

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Shim, Yong S; Yang, Dong Won; Kim, Hee-Jin; Park, Young Ho; Kim, SangYun

2017-07-21

The mini-mental state examination (MMSE) was adapted by individual countries according to their languages and cultures, though it has not been systematically compared. The objective of this study was to compare the linguistic and cultural variations of the MMSE used in various Asian countries. With this, we can analyze the strengths and weaknesses of the MMSE and consider using a common version in future international clinical studies in Asia. We collected the MMSEs used in 11 Asian nations. After translating those into English, we compared them to understand the differences in the questionnaires with regard to cultural aspects. Many items may be applicable or comparable with a little modification, for Asian countries. However, attention and calculation and repetition may be incomparable. There were some differences in the contents and the ways to administer. The lack of consideration of the cultural differences and their influences on the interpretation of the same cognitive test makes cross-cultural studies difficult. Some items of MMSE tasks need readjusting for, if any, multi-national studies. This study might serve as a first step in the development of a standardized cross-cultural cognitive instrument, especially in Asia.

Lower mortality rate in people with dementia is associated with better cognitive and functional performance in an outpatient cohort

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Carolina Verdan

2014-04-01

Full Text Available We describe a three-year experience with patients with dementia. Method: clinical, cognitive and functional evaluation was performed by a multidisciplinary team for persons above 60 years. Mortality was assessed after three years. Results: Mini-Mental State Examination (MMSE (n=2,074 was 15.7 (8.4. Male patients MMSE (n=758 was 15.6 (8.3 and female's (n=1315 was 15.8 (8.3. Instrumental Activities of Daily Living Scale (n=2023 was 16.5 (7.6; females (n=1277 was 16.9 (7.2 and males (n=745 was 15.7(8.2. From these patients, 12.6% (n=209 died within three years. Baseline cognition of patients still alive was higher (p<0.001 than MMSE of those who died [MMSE=16.3 (8.1 vs. 10.6 (7.6]. Mortality rate decreased 6% (IR=0.94 for each additional point on MMSE. Higher functional status decreases the mortality rate approximately 11% (IR=0.89 independently of age, gender, and education. Conclusion: Three-year mortality rates are dependent on baseline functional and cognitive status

Transitions across cognitive states and death among older adults in relation to education: A multistate survival model using data from six longitudinal studies.

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Robitaille, Annie; van den Hout, Ardo; Machado, Robson J M; Bennett, David A; Čukić, Iva; Deary, Ian J; Hofer, Scott M; Hoogendijk, Emiel O; Huisman, Martijn; Johansson, Boo; Koval, Andriy V; van der Noordt, Maaike; Piccinin, Andrea M; Rijnhart, Judith J M; Singh-Manoux, Archana; Skoog, Johan; Skoog, Ingmar; Starr, John; Vermunt, Lisa; Clouston, Sean; Muniz Terrera, Graciela

2018-04-01

This study examines the role of educational attainment, an indicator of cognitive reserve, on transitions in later life between cognitive states (normal Mini-Mental State Examination (MMSE), mild MMSE impairment, and severe MMSE impairment) and death. Analysis of six international longitudinal studies was performed using a coordinated approach. Multistate survival models were used to estimate the transition patterns via different cognitive states. Life expectancies were estimated. Across most studies, a higher level of education was associated with a lower risk of transitioning from normal MMSE to mild MMSE impairment but was not associated with other transitions. Those with higher levels of education and socioeconomic status had longer nonimpaired life expectancies. This study highlights the importance of education in later life and that early life experiences can delay later compromised cognitive health. This study also demonstrates the feasibility and benefit in conducting coordinated analysis across multiple studies to validate findings. Copyright © 2017 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Neuropsychological profile in Chinese patients with Parkinson's disease and normal global cognition according to Mini-Mental State Examination Score.

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Qiao, Jin; Zheng, Xiyuan; Wang, Xiaoyan; Lu, Wenhui; Cao, Hongmei; Qin, Xing

2015-01-01

Cognitive impairments have been reported to be more common in non-demented patients with Parkinson's disease (PD) and education levels play an important role in intelligence. The studies on cognitive impairments in Chinese PD patients with higher education levels and normal global cognition according to Mini-Mental State Examination Score (MMSE) have not been reported. We enrolled 69 consecutive PD patients with over 6 years education levels and a MMSE score above 24 (of 30) and performed a battery of neuropsychological scales. There are extensive cognitive domain impairments in PD patients with "normal" global cognitive according to MMSE. Montreal Cognitive Assessment (MoCA) is a highly sensitive scale to screen cognitive impairments in PD. The cutoff score of 28 on the MMSE screening for cognitive impairment in Chinese PD patients with high education levels may be more appropriate.

The Qualitative Scoring MMSE Pentagon Test (QSPT: A New Method for Differentiating Dementia with Lewy Body from Alzheimer’s Disease

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Paolo Caffarra

2013-01-01

Full Text Available The differential diagnosis across different variants of degenerative diseases is sometimes controversial. This study aimed to validate a qualitative scoring method for the pentagons copy test (QSPT of Mini-Mental State Examination (MMSE based on the assessment of different parameters of the pentagons drawing, such as number of angles, distance/intersection, closure/opening, rotation, closing-in, and to verify its efficacy to differentiate dementia with Lewy Body (DLB from Alzheimer's disease (AD. We established the reliability of the qualitative scoring method through the inter-raters and intra-subjects analysis. QSPT was then applied to forty-six AD and forty-six DLB patients, using two phases statistical approach, standard and artificial neural network respectively. DLB patients had significant lower total score in the copy of pentagons and number of angles, distance/intersection, closure/opening, rotation compared to AD. However the logistic regression did not allow to establish any suitable modeling, whereas using Auto-Contractive Map (Auto-CM the DLB was more strongly associated with low scores in some qualitative parameters of pentagon copying, i.e. number of angles and opening/closure and, for the remaining subitems of the MMSE, in naming, repetition and written comprehension, and for demographic variables of gender (male and education (6–13 years. Twist system modeling showed that the QSPT had a good sensitivity (70.29% and specificity (78.67% (ROC-AUC 0.74. The proposed qualitative method of assessment of pentagons copying used in combination with non-linear analysis, showed to be consistent and effective in the differential diagnosis between Lewy Body and Alzheimer’s dementia.

Mini mental state examination in geriatric stroke patients. Validity, differences between subgroups of patients, and relationships to somatic and mental variables.

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Agrell, B; Dehlin, O

2000-12-01

To study the validity of the Mini Mental State Examination (MMSE) in geriatric stroke patients, 116 patients were tested 2-8 weeks and 6 months post-stroke. A neuropsychological test battery consisting of five tests measuring memory, calculation and spatial ability was used for validation. Motor activity, depression, aphasia and activities of daily living were assessed. Confusion in the acute stage, Barthel Index, depression scores, level of motor activity, and most of the neuropsychological tests correlated to the MMSE. Logistic regression showed 4 independent variables which could predict the MMSE scores. A factor analysis showed 3 factors which could explain 53% of the variance. The sensitivity for detecting dementia was 56%, and increased to 68% if patients with isolated spatial dysfunction were excluded. The MMSE had acceptable validity in detecting cognitive dysfunction early poststroke in this old patient population.

Reduced-Rank Chip-Level MMSE Equalization for the 3G CDMA Forward Link with Code-Multiplexed Pilot

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Goldstein J Scott

2002-01-01

Full Text Available This paper deals with synchronous direct-sequence code-division multiple access (CDMA transmission using orthogonal channel codes in frequency selective multipath, motivated by the forward link in 3G CDMA systems. The chip-level minimum mean square error (MMSE estimate of the (multiuser synchronous sum signal transmitted by the base, followed by a correlate and sum, has been shown to perform very well in saturated systems compared to a Rake receiver. In this paper, we present the reduced-rank, chip-level MMSE estimation based on the multistage nested Wiener filter (MSNWF. We show that, for the case of a known channel, only a small number of stages of the MSNWF is needed to achieve near full-rank MSE performance over a practical single-to-noise ratio (SNR range. This holds true even for an edge-of-cell scenario, where two base stations are contributing near equal-power signals, as well as for the single base station case. We then utilize the code-multiplexed pilot channel to train the MSNWF coefficients and show that adaptive MSNWF operating in a very low rank subspace performs slightly better than full-rank recursive least square (RLS and significantly better than least mean square (LMS. An important advantage of the MSNWF is that it can be implemented in a lattice structure, which involves significantly less computation than RLS. We also present structured MMSE equalizers that exploit the estimate of the multipath arrival times and the underlying channel structure to project the data vector onto a much lower dimensional subspace. Specifically, due to the sparseness of high-speed CDMA multipath channels, the channel vector lies in the subspace spanned by a small number of columns of the pulse shaping filter convolution matrix. We demonstrate that the performance of these structured low-rank equalizers is much superior to unstructured equalizers in terms of convergence speed and error rates.

Interrelationship between Mini-Mental State Examination scores and biochemical parameters in patients with mild cognitive impairment and Alzheimer's disease.

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Vasantharekha, Ramasamy; Priyanka, Hannah P; Swarnalingam, Thangavel; Srinivasan, Avathvadi Venkatesan; ThyagaRajan, Srinivasan

2017-10-01

The aim of the present study was to provide first-hand information about the prevalence of mild cognitive impairment (MCI) and Alzheimer's disease (AD) in Tamil Nadu, a southern state in India, and examine if there exists a relationship between cognitive functions and biochemical parameters in these patients. Surveys were collected from adults, older men and women (n = 3126) from different regions of Tamil Nadu, which were followed up after 12 months for 1337 participants. Mini-Mental State Examination (MMSE) scores, lipid profile, and liver function tests were carried out in the elderly, MCI and AD patients. Based on the MMSE scores, the elderly population was classified into old control (28.97 ± 1.49; n = 1868), MCI (19.58 ± 1.17; n = 734) and AD (7.18 ± 1.38; n = 304) groups. Peripheral blood samples were collected after overnight fast from both male and female volunteers (n = 40 per group) who were categorized as young adult control, old control, MCI and AD. AD patients showed lower MMSE scores compared with the young adults, old and MCI groups, and MMSE further decreased at follow-up examination a year later. In the serum of AD patients, high-density lipoprotein, alkaline phosphatase activity and bilirubin levels were lower, whereas low-density lipoprotein, total cholesterol and triglycerides levels were higher. MMSE was positively correlated with high-density lipoprotein, and negatively correlated with other lipid parameters in AD. Hypercholesterolemia is a risk factor for AD that might result in neurotoxicity and cognitive impairment. Dysfunction of lipoprotein and heme metabolism might also provide additional targets for AD diagnosis. Geriatr Gerontol Int 2017; 17: 1737-1745. © 2016 Japan Geriatrics Society.

B-Vitamin Intake and Biomarker Status in Relation to Cognitive Decline in Healthy Older Adults in a 4-Year Follow-Up Study.

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Hughes, Catherine F; Ward, Mary; Tracey, Fergal; Hoey, Leane; Molloy, Anne M; Pentieva, Kristina; McNulty, Helene

2017-01-10

Advancing age can be associated with an increase in cognitive dysfunction, a spectrum of disability that ranges in severity from mild cognitive impairment to dementia. Folate and the other B-vitamins involved in one-carbon metabolism are associated with cognition in ageing but the evidence is not entirely clear. The hypothesis addressed in this study was that lower dietary intake or biomarker status of folate and/or the metabolically related B-vitamins would be associated with a greater than expected rate of cognitive decline over a 4-year follow-up period in healthy older adults. Participants (aged 60-88 years; n = 155) who had been previously screened for cognitive function were reassessed four years after initial investigation using the Mini-Mental State Examination (MMSE). At the 4-year follow-up assessment when participants were aged 73.4 ± 7.1 years, mean cognitive MMSE scores had declined from 29.1 ± 1.3 at baseline to 27.5 ± 2.4 ( p 0.56 points per year). Lower vitamin B6 status, as measured using pyridoxal-5-phosphate (PLP; vitamin B6 was also associated with a greater rate of cognitive decline (OR, 4.22; 95% CI, 1.28-13.90; p B-vitamins. In conclusion, lower dietary and biomarker status of vitamin B6 at baseline predicted a greater than expected rate of cognitive decline over a 4-year period in healthy older adults. Vitamin B6 may be an important protective factor in helping maintain cognitive health in ageing.

Cognitive screening in substance users: Diagnostic accuracies of the Mini-Mental State Examination, Addenbrooke's Cognitive Examination-Revised, and Montreal Cognitive Assessment.

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Ridley, Nicole; Batchelor, Jennifer; Draper, Brian; Demirkol, Apo; Lintzeris, Nicholas; Withall, Adrienne

2018-03-01

Despite the considerable prevalence of cognitive impairment in substance-using populations, there has been little investigation of the utility of cognitive screening measures within this context. In the present study the accuracy of three cognitive screening measures in this population was examined-the Mini-Mental State Examination (MMSE), the Addenbrooke's Cognitive Examination-Revised (ACE-R), and the Montreal Cognitive Assessment (MoCA). A sample of 30 treatment-seeking substance users and 20 healthy individuals living in the community were administered the screening measures and a neuropsychological battery (NPB). Agreement of classification of cognitive impairment by the screening measures and NPB was examined. Results indicated that the ACE-R and MoCA had good discriminative ability in detection of cognitive impairment, with areas under the receiver-operating characteristic (ROC) curve of .85 (95% confidence interval, CI [.75. .94] and .84 (95% CI [.71, .93]) respectively. The MMSE had fair discriminative ability (.78, 95% CI [.65, .93]). The optimal cut-score for the ACE-R was 93 (impairment = score of 92 or less), at which it correctly classified 89% of individuals as cognitively impaired or intact, while the optimal cut-score for the MoCA was cognitive impairment in the context of substance use.

Validation of the Conversion between the Mini-Mental State Examination and Montreal Cognitive assessment in Korean Patients with Parkinson's Disease.

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Kim, Ryul; Kim, Han-Joon; Kim, Aryun; Jang, Mi-Hee; Kim, Hyun Jeong; Jeon, Beomseok

2018-01-01

Two conversion tables between the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) have recently been established for Parkinson's disease (PD). This study aimed to validate them in Korean patients with PD and to evaluate whether they could be influenced by educational level. A total of 391 patients with PD who undertook both the Korean MMSE and the Korean MoCA during the same session were retrospectively assessed. The mean, median, and root mean squared error (RMSE) of the difference between the true and converted MMSE scores and the intraclass correlation coefficient (ICC) were calculated according to educational level (6 or fewer years, 7-12 years, or 13 or more years). Both conversions had a median value of 0, with a small mean and RMSE of differences, and a high correlation between the true and converted MMSE scores. In the classification according to educational level, all groups had roughly similar values of the median, mean, RMSE, and ICC both within and between the conversions. Our findings suggest that both MMSE-MoCA conversion tables are useful instruments for transforming MoCA scores into converted MMSE scores in Korean patients with PD, regardless of educational level. These will greatly enhance the utility of the existing cognitive data from the Korean PD population in clinical and research settings.

Addenbrooke's Cognitive Examination validation in Parkinson's disease.

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Reyes, M A; Perez-Lloret, S; Lloret, S P; Roldan Gerschcovich, E; Gerscovich, E R; Martin, M E; Leiguarda, R; Merello, M

2009-01-01

There is a clear need for brief, sensitive and specific cognitive screening instruments in Parkinson's disease (PD). To study Addenbrooke's Cognitive Examination (ACE) validity for cognitive assessment of PD patient's using the Mattis Dementia Rating Scale (MDRS) as reference method. A specific scale for cognitive evaluation in PD, in this instance the Scales for Outcomes of Parkinson's disease-Cognition (SCOPA-COG), as well as a general use scale the Mini-mental state examination (MMSE) were also studied for further correlation. Forty-four PD patients were studied, of these 27 were males (61%), with a mean (SD) age of 69.5 (11.8) years, mean (SD) disease duration of 7.6 (6.4) years (range 1-25), mean (SD) total Unified Parkinson's Disease Rating Scale (UPDRS) score 37 (24) points, UPDRS III 16.5 (11.3) points. MDRS, ACE and SCOPA-COG scales were administered in random order. All patients remained in on-state during the study. Addenbrooke's Cognitive Examination correlated with SCOPA-COG (r = 0.93, P Addenbrooke's Cognitive Examination appears to be a valid tool for dementia evaluation in PD, with a cut-off point which should probably be set at 83 points, displaying good correlation with both the scale specifically designed for cognitive deficits in PD namely SCOPA-COG, as well as with less specific tests such as MMSE.

Estimasi Kanal Akustik Bawah Air Untuk Perairan Dangkal Menggunakan Metode Least Square (LS dan Minimum Mean Square Error (MMSE

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Mardawia M Panrereng

2015-06-01

Full Text Available Dalam beberapa tahun terakhir, sistem komunikasi akustik bawah air banyak dikembangkan oleh beberapa peneliti. Besarnya tantangan yang dihadapi membuat para peneliti semakin tertarik untuk mengembangkan penelitian dibidang ini. Kanal bawah air merupakan media komunikasi yang sulit karena adanya attenuasi, absorption, dan multipath yang disebabkan oleh gerakan gelombang air setiap saat. Untuk perairan dangkal, multipath disebabkan adanya pantulan dari permukaan dan dasar laut. Kebutuhan pengiriman data cepat dengan bandwidth terbatas menjadikan Ortogonal Frequency Division Multiplexing (OFDM sebagai solusi untuk komunikasi transmisi tinggi dengan modulasi menggunakan Binary Phase-Shift Keying (BPSK. Estimasi kanal bertujuan untuk mengetahui karakteristik respon impuls kanal propagasi dengan mengirimkan pilot simbol. Pada estimasi kanal menggunakan metode Least Square (LS nilai Mean Square Error (MSE yang diperoleh cenderung lebih besar dari metode estimasi kanal menggunakan metode Minimum Mean Square (MMSE. Hasil kinerja estimasi kanal berdasarkan perhitungan Bit Error Rate (BER untuk estimasi kanal menggunakan metode LS dan metode MMSE tidak menunjukkan perbedaan yang signifikan yaitu berselisih satu SNR untuk setiap metode estimasi kanal yang digunakan.

Validation of the Conversion between the Mini-Mental State Examination and Montreal Cognitive assessment in Korean Patients with Parkinson’s Disease

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Kim, Ryul; Kim, Han-Joon; Kim, Aryun; Jang, Mi-Hee; Kim, Hyun Jeong; Jeon, Beomseok

2018-01-01

Objective Two conversion tables between the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) have recently been established for Parkinson’s disease (PD). This study aimed to validate them in Korean patients with PD and to evaluate whether they could be influenced by educational level. Methods A total of 391 patients with PD who undertook both the Korean MMSE and the Korean MoCA during the same session were retrospectively assessed. The mean, median, and root mean squared error (RMSE) of the difference between the true and converted MMSE scores and the intraclass correlation coefficient (ICC) were calculated according to educational level (6 or fewer years, 7–12 years, or 13 or more years). Results Both conversions had a median value of 0, with a small mean and RMSE of differences, and a high correlation between the true and converted MMSE scores. In the classification according to educational level, all groups had roughly similar values of the median, mean, RMSE, and ICC both within and between the conversions. Conclusion Our findings suggest that both MMSE-MoCA conversion tables are useful instruments for transforming MoCA scores into converted MMSE scores in Korean patients with PD, regardless of educational level. These will greatly enhance the utility of the existing cognitive data from the Korean PD population in clinical and research settings. PMID:29316782

Comparison of the montreal cognitive assessment and the mini-mental state examination as screening tests in hemodialysis patients without symptoms.

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Lee, Sun Hwa; Cho, AJin; Min, Yang-Ki; Lee, Young-Ki; Jung, San

2018-11-01

Cognitive impairment in end-stage renal disease patients is associated with an increased risk of mortality. We examined the cognitive function in hemodialysis (HD) patients and compared the Korean versions of the Montreal Cognitive Assessment (K-MoCA) and of the Mini-Mental State Examination (K-MMSE) to identify the better cognitive screening instrument in these patients. Thirty patients undergoing hemodialysis and 30 matched reference group of apparently healthy control were included. All subjects underwent the K-MoCA, K-MMSE and a neuropsychological test battery to measure attention, visuospatial function, language, memory and executive function. All cognitive data were converted to z-scores with appropriate age and education level prior to group comparisons. Cognitive performance 1.0 SD below the mean was defined as modest cognitve impairment while 1.5 below the mean was defined as severe cognitive impairment. Modest cognitive impairment in memory plus other cognitive domains was detected in 27 patients (90%) while severe cognitive impairment in memory plus other cognitive domains was detected in 23 (77%) patients. Total scores in the K-MoCA were significantly lower in HD patients than in the reference group. However, no significant group difference was found in the K-MMSE. The K-MMSE ROC AUC (95% confidence interval) was 0.72 (0.59-0.85) and K-MoCA ROC AUC was 0.77 (0.65-0.89). Cognitive impairment is common but under-diagnosed in this population. The K-MoCA seems to be more sensitive than the K-MMSE in HD patients.

Total Mini-Mental State Examination score and regional cerebral blood flow using Z score imaging and automated ROI analysis software in subjects with memory impairment

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Ikeda, Eiji; Shiozaki, Kazumasa; Takahashi, Nobukazu; Togo, Takashi; Odawara, Toshinari; Oka, Takashi; Inoue, Tomio; Hirayasu, Yoshio

2008-01-01

The Mini-Mental State Examination (MMSE) is considered a useful supplementary method to diagnose dementia and evaluate the severity of cognitive disturbance. However, the region of the cerebrum that correlates with the MMSE score is not clear. Recently, a new method was developed to analyze regional cerebral blood flow (rCBF) using a Z score imaging system (eZIS). This system shows changes of rCBF when compared with a normal database. In addition, a three-dimensional stereotaxic region of interest (ROI) template (3DSRT), fully automated ROI analysis software was developed. The objective of this study was to investigate the correlation between rCBF changes and total MMSE score using these new methods. The association between total MMSE score and rCBF changes was investigated in 24 patients (mean age±standard deviation (SD) 71.5±9.2 years; 6 men and 18 women) with memory impairment using eZIS and 3DSRT. Step-wise multiple regression analysis was used for multivariate analysis, with the total MMSE score as the dependent variable and rCBF change in 24 areas as the independent variable. Total MMSE score was significantly correlated only with the reduction of left hippocampal perfusion but not with right (P<0.01). Total MMSE score is an important indicator of left hippocampal function. (author)

The reliability and validity of the mini-mental state examination in the elderly Croatian population.

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Boban, Marina; Malojčić, Branko; Mimica, Ninoslav; Vuković, Sunčica; Zrilić, Ivan; Hof, Patrick R; Simić, Goran

2012-01-01

The aim of this study was standardization and validation of the Mini-Mental State Examination (MMSE) in the general Croatian aging population. Three-hundred and forty-four participants underwent the MMSE test, 217 cognitively healthy subjects without neurological and psychiatric disorders and 127 patients with mild cognitive impairment (MCI) or dementia. The optimal cutoff point for screening of the general Croatian population (cognitively healthy vs. MCI and dementia) is 26/27; in the Croatian population aged ≥65 years, the cutoff point is 24/25, whereas for screening of highly educated persons (≥14 years of education) aged ≥65 years a higher cutoff point should be used (26/27). MMSE results when standardized and validated in a certain population might better contribute to recognition of the individuals at risk that should be directed to dementia outpatient clinics. Copyright © 2012 S. Karger AG, Basel.

Cognitive function of 320 people over 65 years from longevous areas in Guangxi Zhuang Autonomous Region:Feasibility of the mini-mental state examination

Institute of Scientific and Technical Information of China (English)

Yeguang Wu; Bin Wei; Xiaoming Zhang; Guobing Zhang; Chunlin Zhang; Zhibin Li; Chenghan Wei; Jinchao Chen; Donglan Huang; Rong Zhao; Jinrui Huang

2006-01-01

BACKGROUND: Mini-mental state examination (MMSE) of Chinese version has been widely used to survey cognitive function of elder people; especially, it shows a good reliability and validity for elder people in city.However, whether it is beneficial to measure cognitive function of elder people in countries in Guangxi Zhuang Autonomous Region should be further studied.OBJECTIVE: To investigate the feasibility, reliability and validity of the cognitive function among the elderly people aged over 65 years from Jiazhuan in Bama County of Guangxi Zhuang Autonomous Region by using the MMSE of Chinese version.DESIGN: Prevalence survey.SETTING: Department of Psychology, Nanjing Municipal Social Welfare Hospital; Department of Psychology,Yizhou Municipal Jiulong Railroad Hospital; Long Life's Institute of Bama County.PARTICIPANTS: A total of 320 old persons over 65 years old were sampled on the basis of the unit of village of Jiazhuan in Bama County of Guangxi Zhuang Autonomous Region from the 12th to 28th, March 2004. All the subjects provided the confirmed consents.METHODS: ① Mental Health Questionnaire of long life's old man was adopted including demographic data and international standardized MMSE in Chinese. The survey of MMSE was divided into two phases: In the first phase, every case was examined by MMSE. The positive result was decided by the education level. Illiterate group, who was educated less than one year, then his MMSE scores must be less than 17; primary school group, who was educated from 1 to 6 years, then his MMSE must be less than 20; middle school group, who was educated more than 7 years, then his MMSE must be less than 24. In the second phase, these cases with positive MMSE score were given the neuro-psycho and mental health examination to confirm the dementia types after diagnosis. The content of the questionnaire was revised properly without changing the meaning of the questionnaire. The interclass correlation coefficient of MMSE was 0.89. �

EXAMINING ADULT’S IDENTITY STATUSES: ADAPTIVE VS. MALADAPTIVE DIMENSION

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Maia Mestvirishvili

2014-12-01

Full Text Available To achieve the status of ego identity remains the most important challenge for the adolescence period and consequently is a challenge for developmental psychologists too. The vast majority of studies focus on understanding the dynamics of ego identity development, however, factors that cause different path of development remained unclear. This study aims at tracking the paths, which differentiate ego statuses from finding psychosocial factors contributing to ego identity achievement. For this purpose the relationships between four identity statuses - achievement, exploration, moratorium and foreclosure and number of psychosocial variables such as attachment style, self-esteem and perfectionism have been examined. 386 school teenagers aged 14-17 (M = 15.48 filled a set of questionnaires comprised of four instruments: The Ego Identity Process Questionnaire (EIPQ, The Measure of Attachment Qualities (MAQ, The Perfectionism Inventory (PI and Adult Sources of Self-Esteem Inventory (ASSEI. Discriminant analysis revealed two basic dimensions (adaptive and maladaptive, which are capable to depict the difference between ego identity statuses. The first discriminant function of ego identity status is primarily defined by conscientious perfectionism and secured attachment; whereas, the second discriminant function consists of avoidance attachment, self-evaluative perfectionism and ambivalent attachment styles.

The Mini-Cog versus the Mini-Mental State Examination and the Clock Drawing Test in daily clinical practice: screening value in a German Memory Clinic.

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Milian, Monika; Leiherr, Anna-Maria; Straten, Guido; Müller, Stephan; Leyhe, Thomas; Eschweiler, Gerhard W

2012-05-01

The aim of this study was to compare the screening value of the Mini-Cog, Clock Drawing Test (CDT), Mini-Mental State Examination (MMSE) and the algorithm MMSE and/or CDT to separate elderly people with dementia from healthy depending on test time, type and severity of dementia, and demographic variables in a German Memory Clinic. Data from a heterogeneous patient sample and healthy participants (n = 502) were retrospectively analyzed. Of the 438 patients with dementia, 49.1% of the dementia diagnoses were Alzheimer's dementia and 50.9% were non-Alzheimer's dementia. Sixty-four participants were classified as cognitively unimpaired. The CDT and an extraction of the 3-item recall of the MMSE were used to constitute the Mini-Cog algorithm. Overall, the Mini-Cog showed significantly higher discriminatory power (86.8%) than the MMSE (72.6% at a cut-off ≤ 24 and 79.2% at ≤ 25, respectively) and CDT (78.1%) (each p 0.05). The specificity of the Mini-Cog (100.0%) was similar to that of the MMSE (100.0% for both cut-offs) and CDT (96.9%) (p = 0.154). For all age and educational groups the Mini-Cog outmatched the CDT and MMSE, and was less affected by education than MMSE and less susceptible for the dementia stage than the CDT. The Mini-Cog proved to have superior discriminatory power than either CDT or MMSE and is demonstrated to be a valid "short" screening instrument taking 3 to 4 minutes to administer in the geriatric setting.

Sensitivity of the Mini-Mental State Examination, Montreal Cognitive Assessment and the Addenbrooke's Cognitive Examination III to everyday activity impairments in dementia: an exploratory study.

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Giebel, Clarissa M; Challis, David

2017-10-01

The Mini-Mental State Examination (MMSE) is one of the most frequently used cognitive measures for dementia severity and linked to deficits in everyday functioning. Recently, the Montreal Cognitive Assessment (MoCA) and the Addenbrooke's Cognitive Examination III (ACE-III) increasingly substitute for the MMSE. However, there are no specific cutoffs in the ACE-III for mild dementia. The objectives of this exploratory study were to assess the sensitivity of each scale to everyday functioning and to examine the cutoffs between mild and moderate dementia on the ACE-III. People with mild dementia completed the MMSE, MoCA and ACE-III, whilst informal carers completed the Revised Interview for Deteriorations in Daily Living Activities for Dementia to rate their relative's initiative and performance of instrumental activities of daily living and the Katz activities of daily living scale. Data were analysed using correlation analysis, raw score comparisons, Cohen's kappa and receiver operating characteristics analysis. Thirty-three dyads completed the measures. The ACE-III was the most sensitive tool for everyday functioning performance, whilst its language subscale was specifically related to initiation of activities. The most suitable cutoff on the ACE-III between mild and moderate dementia was 61. Findings suggest the ACE-III more efficiently identifies everyday functional impairments. Further research is required to confirm these exploratory analyses of the cutoff between mild and moderate dementia on the ACE-III. Both functional impairment and stage of dementia are needed in the diagnostic process and in the clinical assessment of people with dementia. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The reliability of assigning individuals to cognitive states using the Mini Mental-State Examination: a population-based prospective cohort study.

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Marioni, Riccardo E; Chatfield, Mark; Brayne, Carol; Matthews, Fiona E

2011-09-06

Previous investigations of test re-test reliability of the Mini-Mental State Examination (MMSE) have used correlations and statistics such as Cronbach's α to assess consistency. In practice, the MMSE is usually used to group individuals into cognitive states. The reliability of this grouping (state based approach) has not been fully explored. MMSE data were collected on a subset of 2,275 older participants (≥ 65 years) from the population-based Medical Research Council Cognitive Function and Ageing Study. Two measurements taken approximately two months apart were used to investigate three state-based categorisations. Descriptive statistics were used to determine how many people remained in the same cognitive group or went up or down groups. Weighted logistic regression was used to identify predictive characteristics of those who moved group. The proportion of people who remained in the same MMSE group at screen and follow-up assessment ranged from 58% to 78%. The proportion of individuals who went up one or more groups was roughly equal to the proportion that went down one or more groups; most of the change occurred when measurements were close to the cut-points. There was no consistently significant predictor for changing cognitive group. A state-based approach to analysing the reliability of the MMSE provided similar results to correlation analyses. State-based models of cognitive change or individual trajectory models using raw scores need multiple waves to help overcome natural variation in MMSE scores and to help identify true cognitive change.

Validation of the Chinese version of Addenbrooke's cognitive examination-revised for screening mild Alzheimer's disease and mild cognitive impairment.

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Fang, Rong; Wang, Gang; Huang, Yue; Zhuang, Jun-Peng; Tang, Hui-Dong; Wang, Ying; Deng, Yu-Lei; Xu, Wei; Chen, Sheng-Di; Ren, Ru-Jing

2014-01-01

As a suitable test to screen for Alzheimer's disease (AD) or mild cognitive impairment (MCI), studies to validate the Chinese version of Addenbrooke's Cognitive Examination-Revised (ACE-R) are rare. A total of 151 subjects were recruited and the neuropsychological assessments were employed. One-way analysis of variance and Bonferroni correction were used to compare scores of different psychometric scales. Intraclass correlation coefficient (ICC) and Cronbach's coefficient α were used to evaluate the reliability of psychometric scales. The validity of ACE-R to screen for mild AD and amnestic subtype of MCI (a-MCI) was assessed by receiver operating characteristic (ROC) curves. The Chinese ACE-R had good reliability (inter-rater ICC = 0.994; test-retest ICC = 0.967) as well as reliable internal consistency (Cronbach's coefficient α = 0.859). With its cutoff of 67/68, the sensitivity (0.920) and specificity (0.857) were lower than for the Mini-Mental State Examination (MMSE) cutoff (sensitivity 1.000 and specificity 0.937) to screen for mild AD. However, the sensitivity of ACE-R to screen for a-MCI was superior to the MMSE with a cutoff of 85/86. The specificity of ACE-R was lower than that of the MMSE to screen for a-MCI. The area under the ROC curve of ACE-R was much larger than that of the MMSE (0.836 and 0.751) for detecting a-MCI rather than mild AD. The Chinese ACE-R is a reliable assessment tool for cognitive impairment. It is more sensitive and accurate in screening for a-MCI rather than for AD compared to the MMSE.

Examination of the change in latent statuses in bullying behaviors across time.

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Ryoo, Ji Hoon; Wang, Cixin; Swearer, Susan M

2015-03-01

Involvement in bullying and victimization has been mostly studied using cross-sectional data from 1 time point. As such, much of our understanding of bullying and victimization has not captured the dynamic experiences of youth over time. To examine the change of latent statuses in bullying and victimization, we applied latent transition analysis examining self-reported bullying involvement from 1,180 students in 5th through 9th grades across 3 time points. We identified unobserved heterogeneous subgroups (i.e., latent statuses) and investigated how students transition between the unobserved subgroups over time. For victimization, 4 latent statuses were identified: frequent victim (11.23%), occasional traditional victim (28.86%), occasional cyber and traditional victim (10.34%), and infrequent victim (49.57%). For bullying behavior, 3 latent statuses were identified: frequent perpetrator (5.12%), occasional verbal/relational perpetrator (26.04%), and infrequent perpetrator (68.84%). The characteristics of the transitions were examined. The multiple-group effects of gender, grade, and first language learned on transitions across statuses were also investigated. The infrequent victim and infrequent perpetrator groups were the most stable, and the frequent victim and frequent perpetrator groups were the least stable. These findings suggest instability in perpetration and victimization over time, as well as significant changes, especially during school transition years. Findings suggest that school-based interventions need to address the heterogeneity in perpetrator and victim experiences in adolescence.

Comparison of the Mini-Mental State Examination and Montreal Cognitive Assessment executive subtests in detecting post-stroke cognitive impairment.

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Fu, Chen; Jin, Xianglan; Chen, Baoxin; Xue, Feiran; Niu, Huanmin; Guo, Rongjuan; Chen, Zhigang; Zheng, Hong; Wang, Le; Zhang, Yunling

2017-12-01

The Montreal Cognitive Assessment (MoCA) has been shown to be more sensitive in detecting executive dysfunction than the Mini-Mental State Examination (MMSE). However, it is still not known whether all the MoCA executive subtests contribute to the superior sensitivity. Thus, the present study aimed to determine how much executive abnormality was detected by the MMSE and MoCA executive subtests in a population-based cohort of Chinese post-stroke patients. The MMSE and MoCA were collected from post-stroke patients (within 15 days to 1 month after stroke, including ischemic stroke and hemorrhagic stroke) in 14 hospitals of northern and southern China (including 10 top-graded hospitals and 4 community hospitals) between June 2011 and September 2013. The proportions of patients with incorrect MoCA executive subtests and the proportions of patients with incorrect MMSE executive subtests were compared. A total of 1222 patients (703 men and 519 women, aged 62.06 ± 10.68 and 62.76 ± 9.86 years, respectively) were recruited. The MoCA detected more patients with executive dysfunction than the MMSE (OR 15.399, 95% CI 12.631-18.773; P < 0.001). The likelihood of incorrect MMSE executive tasks increased across decreasing scores of MoCA executive tasks (P < 0.001 for trend). Compared with the MMSE three-step command test (15.5%), the MoCA trail-making (57.8%), abstraction (48.0%) and abstraction (measurement tool; 45.7%) detected more patients with executive dysfunction (P < 0.001), whereas the MoCA digit span forwards (4.3%) and backwards (11.6%) detected fewer patients (P < 0.001 and P = 0.005, respectively). The MoCA executive tasks are more sensitive in detecting executive dysfunction compared with the MMSE executive tasks. Geriatr Gerontol Int 2017; 17: 2329-2335. © 2017 Japan Geriatrics Society.

Convergent validity of the Cognitive Performance Scale of the interRAI acute care and the mini-mental state examination.

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Wellens, Nathalie I H; Flamaing, Johan; Tournoy, Jos; Hanon, Tina; Moons, Philip; Verbeke, Geert; Boonen, Steven; Milisen, Koen

2013-07-01

The Cognitive Performance Scale (CPS) is generated from five items of the interRAI/ Minimum Data Set instruments, a comprehensive geriatric assessment method. CPS was initially designed to assess cognition in residential care, where it has shown good psychometric performance. We evaluated the performance of the interRAI Acute Care in identifying cognitive impairment among patients hospitalized on acute geriatric wards. An observational study was conducted on two geriatric wards. Trained raters independently completed the interRAI Acute Care and the Mini-Mental State Examination (MMSE) in 97 inpatients (85 ± 5 years; 67% female). The level of agreement between CPS and MMSE was explored using comparisons of means, agreement coefficients, and diagnostic accuracy. Cognitive impairment was present in 61% of the participants. Average MMSE scores were significantly different between groups with low CPS scores compared with those with high CPS scores (p <0.05). CPS explained only 48.8% of the variability in MMSE. Agreement in defining cognitively impaired subjects was moderate (percentage observed agreement, 68%; κ = 0.41). With MMSE score less than 24 as a gold standard, diagnostic accuracy of CPS was moderate (area under curve = 0.73), with low sensitivity, but excellent specificity. When lowering the MMSE cutoff to less than 18 and focusing on patients with severe cognitive impairment, CPS agreement coefficients and sensitivity increased but specificity decreased. Using education-adjusted MMSE cutoffs did not substantially affect the results. CPS can be used for coarse triage between intact and severe cognitive impairment. Although promising results have been obtained in residential and community settings, our results suggest that CPS fails to differentiate across different levels of cognitive impairment in hospitalized geriatric patients. Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Agreement and conversion formula between mini-mental state examination and montreal cognitive assessment in an outpatient sample.

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Helmi, Luqman; Meagher, David; O'Mahony, Edmond; O'Neill, Donagh; Mulligan, Owen; Murthy, Sutha; McCarthy, Geraldine; Adamis, Dimitrios

2016-09-22

To explore the agreement between the mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) within community dwelling older patients attending an old age psychiatry service and to derive and test a conversion formula between the two scales. Prospective study of consecutive patients attending outpatient services. Both tests were administered by the same researcher on the same day in random order. The total sample (n = 135) was randomly divided into two groups. One to derive a conversion rule (n = 70), and a second (n = 65) in which this rule was tested. The agreement (Pearson's r) of MMSE and MoCA was 0.86 (P < 0.001), and Lin's concordance correlation coefficient (CCC) was 0.57 (95%CI: 0.45-0.66). In the second sample MoCA scores were converted to MMSE scores according to a conversion rule from the first sample which achieved agreement with the original MMSE scores of 0.89 (Pearson's r, P < 0.001) and CCC of 0.88 (95%CI: 0.82-0.92). Although the two scales overlap considerably, the agreement is modest. The conversion rule derived herein demonstrated promising accuracy and warrants further testing in other populations.

Telemedicine and the mini-mental state examination: assessment from a distance.

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Ciemins, Elizabeth L; Holloway, Barbara; Coon, Patricia Jay; McClosky-Armstrong, Thelma; Min, Sung-Joon

2009-06-01

The objective of this study was to determine the reliability of the Mini-Mental State Examination (MMSE) administration via telehealth with a focus on the auditory and visual test components. Reliability was assessed through use of an in-person collaborator and by assessment of faxed test copies. The MMSE was administered via telehealth with the assistance of a face-to-face collaborator. Patient responses were recorded by both the remote and in-person nurse and compared item by item; total scores for each subject were also compared. Visual items were assessed through a blinded separate scoring of a faxed copy. Percent agreement per item and total score were calculated and correlations between scores were determined by Pearson correlation coefficients. Mean score differences and associated 95% confidence intervals were calculated. Eighty percent of individual items demonstrated remote to in-person agreement of >95% and all items were >85.5% in agreement. Pearson correlation coefficients demonstrated high correlations (>0.86) between 80% of the items examined. Mean differences in scored test items were not significantly different from zero. This study demonstrates the utility of using telehealth for cognitive assessment by MMSE. It supports the use of telehealth to improve healthcare access among patients for whom distance, cost, and mobility are potential barriers to attending face-to-face clinical visits. Continued validation and reliability testing is warranted to ensure that all healthcare provided via telehealth maintains an equal quality level to that of in-person care.

Validation of the German revised Addenbrooke's cognitive examination for detecting mild cognitive impairment, mild dementia in alzheimer's disease and frontotemporal lobar degeneration.

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Alexopoulos, P; Ebert, A; Richter-Schmidinger, T; Schöll, E; Natale, B; Aguilar, C A; Gourzis, P; Weih, M; Perneczky, R; Diehl-Schmid, J; Kneib, T; Förstl, H; Kurz, A; Danek, A; Kornhuber, J

2010-01-01

The diagnostic accuracy of the German version of the revised Addenbrooke's Cognitive Examination (ACE-R) in identifying mild cognitive impairment (MCI), mild dementia in Alzheimer's disease (AD) and mild dementia in frontotemporal lobar degeneration (FTLD) in comparison with the conventional Mini Mental State Examination (MMSE) was assessed. The study encompasses 76 cognitively healthy elderly individuals, 75 patients with MCI, 56 with AD and 22 with FTLD. ACE-R and MMSE were validated against an expert diagnosis based on a comprehensive diagnostic procedure. Statistical analysis was performed using the receiver operating characteristic method and regression analyses. The optimal cut-off score for the ACE-R for detecting MCI, AD, and FTLD was 86/87, 82/83 and 83/84, respectively. ACE-R was superior to MMSE only in the detection of patients with FTLD [area under the curve (AUC): 0.97 vs. 0.92], whilst the accuracy of the two instruments did not differ in identifying MCI and AD. The ratio of the scores of the memory ACE-R subtest to verbal fluency subtest contributed significantly to the discrimination between AD and FTLD (optimal cut-off score: 2.30/2.31, AUC: 0.77), whereas the MMSE and ACE-R total scores did not. The German ACE-R is superior to the most commonly employed MMSE in detecting mild dementia in FTLD and in the differential diagnosis between AD and FTLD. Thus it might serve as a valuable instrument as part of a comprehensive diagnostic workup in specialist centres/clinics contributing to the diagnosis and differential diagnosis of the cause of dementia.

Dimensions underlying the mini-mental state examination in a sample with low-education levels: the Bambuí health and aging study.

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Castro-Costa, Erico; Fuzikawa, Cintia; Ferri, Cleusa; Uchoa, Elizabeth; Firmo, Joselia; Lima-Costa, Maria Fernanda; Dewey, Michael E; Stewart, Robert

2009-10-01

To investigate the validity of previously suggested dimensions underlying the Mini-Mental State Examination (MMSE) and differences in associations of these dimensions with sociodemographic and health characteristics in an older Latin-American community sample with low levels of education. Secondary analysis of baseline data from a population-based cohort study. Bambuí, Brazil. Of 1,742 total residents aged 60 years or older, 1,558 (89.4%) participated at this study. A standard Brazilian version of the MMSE. A five-factor solution (Concentration, Language/Praxis, Orientation, Attention, and Memory) for the MMSE was generated from Principal Components Analysis, and the five-factor solutions proposed in previous studies of developed nation samples were tested in this sample by Confirmatory Factor Analysis. In the adjusted linear regression models, MMSE factors varied in their correlates: for example, female gender was associated with higher concentration, orientation, and attention but lower Language/Praxis; increased age was inversely associated only with language and attention; and activity of daily living impairment was principally associated with lower Language/Praxis. This study provides support for the cross-sectional equivalence of the MMSE, suggesting that most of the items and underlying constructs remain meaningful after alteration and translation in a low-education sample with lower overall distribution of scores.

The Addenbrooke's Cognitive Examination Revised as a potential screening test for elderly drivers.

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Ferreira, Inês S; Simões, Mário R; Marôco, João

2012-11-01

Considerable research has shown that neuropsychological tests are predictive of real-world driving ability. The Mini-Mental State Examination (MMSE) is a brief cognitive test that has been commonly used in the assessment of older drivers. However, this test has inherent problems that limit its validity to evaluate cognitive abilities related to driving and to screen for driving impairments in non-demented people. Therefore, it is useful to test new screening instruments that may predict potential unsafe drivers who require an in-depth neuropsychological assessment in a specialised centre. To date, the utility of the Addenbrooke's Cognitive Examination Revised (ACE-R) as an indicator of driving ability has not been established. In the current study, fifty older drivers (mean age=73.1 years) who were referred for a psychological assessment, the protocol of which included the ACE-R, underwent an on-road driving test. Using linear discriminant analyses, the results highlighted the higher classification accuracy of the ACE-R compared to the MMSE score, particularly for detecting unsafe drivers. Measures of visuospatial and executive functions, which are not incorporated in the MMSE score, had an incremental value in the prediction of driving ability. This emerging brief cognitive test may warrant additional study for use in the fitness to drive assessment of older adults. Copyright © 2012 Elsevier Ltd. All rights reserved.

Evaluation of chewing ability and its relationship with activities of daily living, depression, cognitive status and food intake in the community-dwelling elderly.

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Kimura, Yumi; Ogawa, Hiroshi; Yoshihara, Akihiro; Yamaga, Takayuki; Takiguchi, Tomoya; Wada, Taizo; Sakamoto, Ryota; Ishimoto, Yasuko; Fukutomi, Eriko; Chen, Wenling; Fujisawa, Michiko; Okumiya, Kiyohito; Otsuka, Kuniaki; Miyazaki, Hideo; Matsubayashi, Kozo

2013-07-01

The aim of this study was to assess chewing ability using color-changeable chewing gum and to show the association between chewing ability and geriatric functions, as well as dietary status in the community-dwelling elderly. The study population consisted of 269 community-dwelling elderly aged ≥ 75 living in Tosa, Japan. Assessment of chewing ability was carried out by a dentist using color-changeable chewing gum. Activities of daily living (ADL), depression and subjective quality of life (QOL) were assessed by questionnaire. Cognitive status was assessed by; Mini-Mental State Examination (MMSE), Hasegawa Dementia Scale-Revised (HDS-R) and Frontal Assessment Battery (FAB) during the check-up. Food diversity was assessed using the 11-item Food Diversity Score Kyoto (FDSK-11). Number of teeth was significantly related to chewing ability (Pchewing ability had significantly lower ADL scores in the items of self-maintenance (P=0.029) and intellectual activity (P=0.021). There was a significant association between low chewing ability and depression (Pchewing ability; MMSE (P=0.022), HDSR (P=0.017) and FAB (P=0.002). The participants with low chewing ability had lower food variety (Pchewing ability. Low chewing ability evaluated by color-changeable gum was associated with lower ADL, lower cognitive functioning, depression and food insufficiency in the community-dwelling elderly. More attention should be paid to assessing chewing ability of elderly persons in community settings. © 2012 Japan Geriatrics Society.

Mini-Cog and Mini-Mental State Examination: agreement in a cross-sectional study with an elderly sample.

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Costa, Diogo; Severo, Milton; Fraga, Sílvia; Barros, Henrique

2012-01-01

We aimed to compare the Mini-Mental State Examination (MMSE) with the Mini-Cog, measuring agreement in participants' classification, using a general population sample. Cross-sectional evaluation of 609 community dwellers aged ≥60 years was performed by trained interviewers. Cohen's kappa and 95% confidence intervals (CI) were calculated to assess overall agreement, and Cronbach alphas computed to assess reliability. Two-parameter Item Response Theory models (difficulty and discrimination parameters) were used to assess discrimination. Considering MMSE cut-point for scores Mini-Cog's cut-point score Mini-Cog Mini-Cog Mini-Cog's alpha was 0.2776. Co-calibration according to inherent ability is graphically presented. Agreement between scales seems fragile in our sample. The discriminative and reliability analysis suggests a better performance for subsets of the MMSE compared with the Mini-Cog. Usefulness of calibrated scores is discussed. Copyright © 2012 S. Karger AG, Basel.

The reliability of assigning individuals to cognitive states using the Mini Mental-State Examination: a population-based prospective cohort study

Directory of Open Access Journals (Sweden)

Brayne Carol

2011-09-01

Full Text Available Abstract Background Previous investigations of test re-test reliability of the Mini-Mental State Examination (MMSE have used correlations and statistics such as Cronbach's α to assess consistency. In practice, the MMSE is usually used to group individuals into cognitive states. The reliability of this grouping (state based approach has not been fully explored. Methods MMSE data were collected on a subset of 2,275 older participants (≥ 65 years from the population-based Medical Research Council Cognitive Function and Ageing Study. Two measurements taken approximately two months apart were used to investigate three state-based categorisations. Descriptive statistics were used to determine how many people remained in the same cognitive group or went up or down groups. Weighted logistic regression was used to identify predictive characteristics of those who moved group. Results The proportion of people who remained in the same MMSE group at screen and follow-up assessment ranged from 58% to 78%. The proportion of individuals who went up one or more groups was roughly equal to the proportion that went down one or more groups; most of the change occurred when measurements were close to the cut-points. There was no consistently significant predictor for changing cognitive group. Conclusion A state-based approach to analysing the reliability of the MMSE provided similar results to correlation analyses. State-based models of cognitive change or individual trajectory models using raw scores need multiple waves to help overcome natural variation in MMSE scores and to help identify true cognitive change.

Neurocognitive outcome in brain metastases patients treated with accelerated-fractionation vs. accelerated-hyperfractionated radiotherapy: an analysis from Radiation Therapy Oncology Group Study 91-04

International Nuclear Information System (INIS)

Regine, W.F.; Scott, C.; Murray, K.; Curran, W.

2001-01-01

Purpose: To evaluate neurocognitive outcome as measured by the Mini-Mental Status Examination (MMSE) among patients with unresectable brain metastases randomly assigned to accelerated fractionation (AF) vs. accelerated hyperfractionated (AH) whole-brain radiation therapy (WBRT). Methods and Materials: The Radiation Therapy Oncology Group (RTOG) accrued 445 patients with unresectable brain metastases to a Phase III comparison of AH (1.6 Gy b.i.d. to 54.4 Gy) vs. AF (3 Gy q.d. to 30 Gy). All had a KPS of ≥ 70 and a neurologic function status of 0-2. Three hundred fifty-nine patients had MMSEs performed and were eligible for this analysis. Changes in the MMSE were analyzed according to criteria previously defined in the literature. Results: The median survival was 4.5 months for both arms. The average change in MMSE at 2 and 3 months was a drop of 1.4 and 1.1, respectively, in the AF arm as compared to a drop of 0.7 and 1.3, respectively, in the AH arm (p=NS). Overall, 91 patients at 2 months and 23 patients at 3 months had both follow-up MMSE and computed tomography/magnetic resonance imaging documentation of the status of their brain metastases. When an analysis was performed taking into account control of brain metastases, a significant effect on MMSE was observed with time and associated proportional increase in uncontrolled brain metastases. At 2 months, the average change in MMSE score was a drop of 0.6 for those whose brain metastases were radiologically controlled as compared to a drop of 1.9 for those with uncontrolled brain metastases (p=0.47). At 3 months, the average change in MMSE score was a drop of 0.5 for those whose brain metastases were radiologically controlled as compared to a drop of 6.3 for those with uncontrolled brain metastases (p=0.02). Conclusion: Use of AH as compared to AF-WBRT was not associated with a significant difference in neurocognitive function as measured by MMSE in this patient population with unresectable brain metastases and

Measurement Error, Reliability, and Minimum Detectable Change in the Mini-Mental State Examination, Montreal Cognitive Assessment, and Color Trails Test among Community Living Middle-Aged and Older Adults.

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Feeney, Joanne; Savva, George M; O'Regan, Claire; King-Kallimanis, Bellinda; Cronin, Hilary; Kenny, Rose Anne

2016-05-31

Knowing the reliability of cognitive tests, particularly those commonly used in clinical practice, is important in order to interpret the clinical significance of a change in performance or a low score on a single test. To report the intra-class correlation (ICC), standard error of measurement (SEM) and minimum detectable change (MDC) for the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Color Trails Test (CTT) among community dwelling older adults. 130 participants aged 55 and older without severe cognitive impairment underwent two cognitive assessments between two and four months apart. Half the group changed rater between assessments and half changed time of day. Mean (standard deviation) MMSE was 28.1 (2.1) at baseline and 28.4 (2.1) at repeat. Mean (SD) MoCA increased from 24.8 (3.6) to 25.2 (3.6). There was a rater effect on CTT, but not on the MMSE or MoCA. The SEM of the MMSE was 1.0, leading to an MDC (based on a 95% confidence interval) of 3 points. The SEM of the MoCA was 1.5, implying an MDC95 of 4 points. MoCA (ICC = 0.81) was more reliable than MMSE (ICC = 0.75), but all tests examined showed substantial within-patient variation. An individual's score would have to change by greater than or equal to 3 points on the MMSE and 4 points on the MoCA for the rater to be confident that the change was not due to measurement error. This has important implications for epidemiologists and clinicians in dementia screening and diagnosis.

Development of a cognitive function test using virtual reality technology: examination in healthy participants.

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Sakai, Hiromi; Nagano, Akinori; Seki, Keiko; Okahashi, Sayaka; Kojima, Maki; Luo, Zhiwei

2018-07-01

We developed a virtual reality test to assess the cognitive function of Japanese people in near-daily-life environment, namely, a virtual shopping test (VST). In this test, participants were asked to execute shopping tasks using touch panel operations in a "virtual shopping mall." We examined differences in VST performances among healthy participants of different ages and correlations between VST and screening tests, such as the Mini-Mental State Examination (MMSE) and Everyday Memory Checklist (EMC). We included 285 healthy participants between 20 and 86 years of age in seven age groups. Therefore, each VST index tended to decrease with advancing age; differences among age groups were significant. Most VST indices had a significantly negative correlation with MMSE and significantly positive correlation with EMC. VST may be useful for assessing general cognitive decline; effects of age must be considered for proper interpretation of the VST scores.

Comparison of montreal cognitive assessment and mini-mental state examination in evaluating cognitive domain deficit following aneurysmal subarachnoid haemorrhage.

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George Kwok Chu Wong

Full Text Available Cognitive deficits are common after aneurysmal subarachnoid haemorrhage (aSAH, and clinical evaluation is important for their management. Our hypothesis was that the Montreal Cognitive Assessment (MoCa is superior to the Mini-Mental State Examination (MMSE in screening for cognitive domain deficit in aSAH patients.We carried out a prospective observational and diagnostic accuracy study on Hong Kong aSAH patients aged 21 to 75 years who had been admitted within 96 hours of ictus. The domain-specific neuropsychological assessment battery, the MoCA and MMSE were administered 2-4 weeks and 1 year after ictus. A cognitive domain deficit was defined as a cognitive domain z score <-1.65 (below the fifth percentile. Cognitive impairment was defined as two or more cognitive domain deficits. The study is registered at ClinicalTrials.gov of the US National Institutes of Health (NCT01038193.Both the MoCA and the MMSE were successful in differentiating between patients with and without cognitive domain deficits and cognitive impairment at both assessment periods. At 1 year post-ictus, the MoCA produced higher area under the curve scores for cognitive impairment than the MMSE (MoCA, 0.92; 95% CI, 0.83 to 0.97 versus MMSE, 0.77; 95% CI, 0.66 to 0.83, p = 0.009.Cognitive domain deficits and cognitive impairment in patients with aSAH can be screened with the MoCA in both the subacute and chronic phases.

Examining belonging at the interface of ethnicity, social status and ...

African Journals Online (AJOL)

Examining belonging at the interface of ethnicity, social status and masculinities in transnational space among foreign African male students at the University of ... finance and production as well as the on going processes of political and economic integration has led to an unprecedented increase in international migration.

Mental status testing in the elderly nursing home population.

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Nadler, J D; Relkin, N R; Cohen, M S; Hodder, R A; Reingold, J; Plum, F

1995-07-01

The clinical utility of selected brief cognitive screening instruments in detecting dementia in an elderly nursing home population was examined. One hundred twenty nursing home residents (mean age 87.9) were administered the Mini-Mental State Exam (MMSE) and the Modified Mini-Mental State Exam (3MS). The majority of the subjects (75%) were also administered the Dementia Rating Scale (DRS). Both clinically diagnosed demented (n = 57) and non-demented (n = 63) subjects participated in the study. Dementia was diagnosed in accordance with DSM-III-R criteria by physicians specializing in geriatric medicine. Using standard cutoffs for impairment, the 3MS, MMSE, and DRS achieved high sensitivity (82% to 100%) but low specificity (33% to 52%) in the detection of dementia among nursing home residents. Positive predictive values ranged from 52% to 61%, and negative predictive values from 77% to 100%. Higher age, lower education, and history of depression were significantly associated with misclassification of non-demented elderly subjects. Receiver Operating Characteristic (ROC) curve analyses revealed optimal classification of dementia with cutoff values of 74 for the 3MS, 22 for the MMSE, and 110 for the DRS. The results suggest that the 3MS, MMSE, and DRS do not differ significantly with respect to classification accuracy of dementia in a nursing home population. Elderly individuals of advanced age (i.e., the oldest-old) with lower education and a history of depression appear at particular risk for dementia misclassification with these instruments. Revised cutoff values for impairment should be employed when these instruments are applied to elderly residents of nursing homes and the oldest-old.

[Validation of the Russian version of the modified Addenbrooke's cognitive examination for Alzheimer's disease diagnosis].

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Levin, O S; Lavrov, A Yu; Lyashenko, Е А; Vasenina, E E; Trusova, N A; Datieva, V K; Makotrova, T A; Pilipenko, A Yu

2015-01-01

To evaluate the validity of the Russian version of the modified Addenbrooke's cognitive examination (ACE-m) for Alzheimer's disease (AD) diagnosis. ACE-m and MMSE, as a comparison scale, were administered to 78 patients including 49 patients with AD and 29 healthy people. ACE-m demonstrated the high validity in the diagnosis of dementia in AD. Cronbach's alpha was 0.89. ACE-m is a brief and simple in use test that measures a wide spectrum of cognitive functions, gives a general impression about cognitive deficit and diagnoses dementia in AD with the greater validity compared to MMSE. This scale is useful not only in diagnosis of AD but also in differentiation with other causes of dementia.

Tracking Cognitive Decline in Amnestic Mild Cognitive Impairment and Early-Stage Alzheimer Dementia: Mini-Mental State Examination versus Neuropsychological Battery.

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Kim, Joonho; Na, Han Kyu; Byun, Justin; Shin, Jiwon; Kim, Sungsoo; Lee, Byung Hwa; Na, Duk L

2017-01-01

Although the Mini-Mental State Examination (MMSE), Clinical Dementia Rating-Sum of Boxes (CDR-SOB), and neuropsychological batteries are widely used for evaluating cognitive function, it remains elusive which instrument best reflects the longitudinal disease progression in amnestic mild cognitive impairment (aMCI) and probable Alzheimer disease (AD). We investigated whether changes in these three instruments over time correlate with loss of cortical gray matter volume (cGMV). We retrospectively investigated 204 patients (aMCI, n = 114; AD, n = 90) who had undergone MMSE, CDR-SOB, the dementia version of the Seoul Neuropsychological Screening Battery (SNSB-D), and 3-dimensional T1-weighted magnetic resonance images at least twice. We investigated the partial correlation between annual decline in test scores and percent change of cGMV. In aMCI patients, changes in the SNSB-D total score (r = 0.340, p < 0.001) and CDR-SOB (r = 0.222, p = 0.020), but not MMSE, showed a correlation with cGMV loss, with the SNSB-D total score showing the strongest correlation. In AD patients, decline in all three test scores correlated significantly with cGMV loss, with MMSE exhibiting the strongest correlation (r = 0.464, p < 0.001). In aMCI patients, neuropsychological battery, though time-consuming, was the most adequate tool in tracking disease progression. In AD patients, however, MMSE may be the most effective longitudinal monitoring tool when considering cost-effectiveness. © 2017 S. Karger AG, Basel.

Validity of the Italian telephone version of the mini-mental state examination in the elderly healthy population.

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Vanacore, Nicola; De Carolis, Antonella; Sepe-Monti, Micaela; Bomboi, Giuseppe; Stazi, Antonia; Bianchetti, Angelo; Giubilei, Franco

2006-09-01

The biggest challenge regarding cognitive prospective evaluations in the elderly is the identification of subjects that go on to develop cognitive impairment. In this study, we compared the Italian telephone version of the MMSE (Itel-MMSE) with both the MMSE and a battery of neuropsychological tests in a group of 107 healthy elderly subjects. The aim of the study was to identify a subset of subjects who, despite having an overall score within the normal range, performed poorly in the cognitive neuropsychological evaluation. The Itel-MMSE score showed a good internal consistency as well as a significant correlation with the MMSE score, age and education. A score of < or = 21 on the Itel-MMSE was the score which reflected the highest degree of sensitivity in the neuropsychological tests. There was a statistically significant difference between subjects with an Itel-MMSE score of < or = 21 and those with a score of 22 in age, education, Attentional Matrices and Copying Drawings. Despite some potential limitations, our results strongly suggest that the Itel-MMSE may be used as a screening test to identify healthy elderly subjects whose cognitive performance is poor.

Nutritional status of care-dependent people with dementia in shared-housing arrangements--a one-year follow-up.

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Meyer, Saskia; Gräske, Johannes; Worch, Andreas; Wolf-Ostermann, Karin

2015-12-01

Malnutrition in the elderly is an important nursing challenge. Persons with dementia disease are often affected by malnutrition. During recent years, shared-housing arrangements (SHA) for older care-dependent people, frequently with dementia disease, have evolved in Germany. SHA can be an alternative to traditional residential care in nursing homes. The prevalence of malnutrition in SHA is compared to the prevalence in community dwellings and lower than the prevalence of malnutrition in nursing homes. There are no scientific data about the development of the nutritional status of older care-dependent people in SHA over one year. The aim of this study is to describe the nutritional status of care-dependent people with dementia disease living in SHA and to investigate changes over a period of one year. A longitudinal study with a one-year follow-up was performed. Standardised interviews with nurses were conducted concerning nutritional status (Mini Nutritional Assessment--MNA), cognitive capacities (Mini Mental State Examination--MMSE), activities of daily living (Extended Barthel-Index--EBI) and socio-demographic characteristics. Nutritional data were available for 45 residents at baseline and 36 residents at follow-up. At baseline, 45 residents with an average age of 78.4 years living in SHA in the state of Berlin, Germany, were included in the study. Predominantly, residents were female (73.3%) and diagnosed with dementia (88.9%), with a moderate to severe cognitive impairment (MMSE: 10.8) and low daily living abilities (EBI: 33.7). Most residents (80.6%) have a risk of malnutrition regarding the MNA. The average MNA score did decline slightly within one year (t0 = 20.8 vs. t1 = 19.7). Regular screenings for malnutrition using validated standardised assessments, which are easy to apply, should be implemented in SHA to avoid nutritional and health-related problems arising from malnutrition. Flexible structures for care, as in SHA, can facilitate coping with

Place orientation and visual construction subdomains of the Mini Mental State Examination test as predictors of rehabilitation outcome of post-acute hip-fractured patients.

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Hershkovitz, Avital; Kornyukov, Natalia; Brill, Shai

2017-11-01

The study aimed at assessing the relationship between various Mini Mental State Examination (MMSE) subdomains and rehabilitation achievements in post-acute hip-fractured patients. Six hundred and five hip-fractured patients admitted during 2010-2013 to a post-acute geriatric rehabilitation center were included in the study. Main outcome measures were the Functional Independence Measure (FIM) instrument, the motor FIM (mFIM), the Montebello Rehabilitation Factor Score (MRFS) on the mFIM and length of stay (LOS). A logistic regression analysis tested the predictive value of MMSE subdomains for achieving a satisfactory functional gain (mFIM MRFS >30%) on operated patients admitted from community. Of all the six MMSE subdomains, place orientation and visual construction demonstrated significant predictive values for rehabilitation outcome. Patients who did not err on place orientation and visual construction MMSE domains had better probabilities [(OR 1.28, 95%CI, 1.05-1.58; p = 0.017); (OR 2.15, 95%CI, 1.28-3.59; p = 0.004), respectively] of achieving better rehabilitation achievements. Similar results were obtained for cognitively impaired patient groups [(OR 1.40 95%CI, 1.11-1.77; p = 0.005); (OR 2.47, 95%CI, 1.15-5.30; p = 0.021), respectively]. For the cognitively intact patient group, the variables with significant predictive value were time orientation and visual construction MMSE subdomains [(OR 2.26, 95%CI, 1.18-4.33; p = 0.014); (OR 2.87, 95%CI, 1.16-7.09; p = 0.022), respectively]. Post-acute hip-fractured patients scoring normally on place orientation and visual construction MMSE subdomains have a better chance of achieving favorable rehabilitation outcome. Implications for Rehabilitation Post-acute hip-fractured patients have a better chance to achieve a favorable rehabilitation outcome when scoring normally on place orientation and visual construction MMSE subdomains. Patients having difficulties in orientation and visual

The association between nutritional status and frailty characteristics among geriatric outpatients.

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Kurkcu, M; Meijer, R I; Lonterman, S; Muller, M; de van der Schueren, M A E

2018-02-01

Frailty is a common clinical syndrome in older adults and is associated with an increased risk of poor health outcomes, e.g. falls, disability, hospitalization, and mortality. Nutritional status might be an important factor contributing to frailty. This study aims to describe the association between nutritional status and characteristics of frailty in patients attending a geriatric outpatient clinic. Clinical data was collected of 475 patients who visited the geriatric outpatient department of a Dutch hospital between 2005 and 2010. Frailty was determined by: incontinence, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), mobility, Geriatric Depression Scale (GDS) and Mini Mental State Exam (MMSE). Nutritional status was represented by the Mini Nutritional Assessment (MNA) and plasma concentrations of several micronutrients, whereby MNAnutritional status could prove usefulness in early clinical detection and prevention of frailty. Copyright © 2017 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

Validation of the Addenbrooke's cognitive examination for detecting early Alzheimer's disease and mild vascular dementia in a German population.

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Alexopoulos, P; Greim, B; Nadler, K; Martens, U; Krecklow, B; Domes, G; Herpertz, S; Kurz, A

2006-01-01

We assessed the diagnostic accuracy of the German version of the Addenbrooke's Cognitive Examination (ACE) in identifying early Alzheimer's disease (AD) and mild vascular dementia (VaD) in comparison with the conventional Mini-Mental State Examination (MMSE). The study refers to 50 patients with mild dementia of AD, 26 patients with mild dementia of vascular etiology and to 54 cognitively normal subjects. The ACE and MMSE were validated against an expert diagnosis based on a comprehensive diagnostic workup. Statistical analysis was performed using the receiver operator characteristics method. The optimal cut-off score for the ACE for detecting dementia in patients with early AD was 85/86, which had a sensitivity of 93% and a specificity of 86%. The optimal cut-off for the ACE for the identification of dementia in patients with mild VaD was also 85/86 and it had a sensitivity of 93% and a specificity of 100%. The kappa values imply a substantial agreement between the diagnoses made by the ACE and the MMSE. The German version of the ACE is a short and practical but accurate test battery for the identification of AD and VaD, assessing a broad range of cognitive functions and providing a wide profile of cognitive functions/dysfunctions.

The Mini-Mental State Examination as a diagnostic and screening test for delirium: systematic review and meta-analysis.

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Mitchell, Alex J; Shukla, Deepak; Ajumal, Hafsa A; Stubbs, Brendon; Tahir, Tayyeb A

2014-01-01

To analyse the evidence concerning the accuracy of the Mini-Mental State Examination (MMSE) as a diagnostic and screening test for the presence of delirium in adults. Two authors searched MEDLINE, PsychINFO and EMBASE from inception till March 2014. Articles were included that investigated the diagnostic validity of the MMSE to detect delirium against standardised criteria. A diagnostic validity meta-analysis was conducted. Thirteen studies were included representing 2017 patients in medical settings of whom 29.4% had delirium. The meta-analysis revealed the MMSE had an overall sensitivity and specificity estimate of 84.1% and 73.0%, but this was 81.1% and 82.8% in a subgroup analysis involving robust high quality studies. Sensitivity was unchanged but specificity was 68.4% (95% CI = 50.9-83.5%) in studies using a predefined cutoff of <24 to signify a case. In high-risk samples where delirium was present in 25% of patients, then the Positive predictive value and Negative predictive value would be 50.9% (48.3-66.2%) and 93.2% (90.0-96.5%). The MMSE cannot be recommended as a case-finding confirmatory test of delirium, but may be used as an initial screen to rule out high scorers who are unlikely to have delirium with approximately 93% accuracy. Copyright © 2014 Elsevier Inc. All rights reserved.

Validation of the Chinese version of Addenbrooke's Cognitive Examination III for diagnosing dementia.

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Wang, Bian-Rong; Ou, Zhou; Gu, Xiao-Hua; Wei, Cun-Sheng; Xu, Jun; Shi, Jian-Quan

2017-12-01

The aim of this study was to validate the reliability of the Chinese version of Addenbrooke's Cognitive Examination III (ACE-III) for detecting dementia. Furthermore, the present study compares the diagnostic accuracy of ACE-III with that of mini-mental state examination (MMSE). One hundred seventy-seven patients with dementia and 180 healthy controls were included in the study. The reliability of ACE-III was very good (α-coefficient = 0.888). There was a significant negative correlation between Clinical Dementia Rating Scale score and total ACE-III score. Further, there was a positive correlation between MMSE score and total ACE-III score. Age exerted a significant effect on total ACE-III score, memory score, and language score. In the present study, the cutoff score of 83 showed a sensitivity of 91.1% and a specificity of 83.1%. The present findings support that the Chinese version of ACE-III is a reliable assessment tool for dementia. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

A comparison of cognitive functions in non-hypoxemic chronic obstructive pulmonary disease (COPD patients and age-matched healthy volunteers using mini-mental state examination questionnaire and event-related potential, P300 analysis

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Prem Parkash Gupta

2013-01-01

Full Text Available Objective: To assess sub-clinical cognitive dysfunctions in stable chronic obstructive pulmonary disease (COPD patients having no hypoxemia vs. age-matched healthy volunteers using (i an electrophysiological test: Auditory event related potential, P300 test and (ii a questionnaire tool: Mini-mental state examination (MMSE questionnaire. Materials and Methods: Eighty male subjects were included: 40 stable COPD patients (smoking history >20 pack years and 40 healthy volunteers (HVs. Age, duration of illness, smoking pack years, and spirometric indices were assessed. MMSE scores were evaluated in these groups. Latency of P300 wave and amplitude of P300 wave were studied in both groups to detect P300 abnormalities in COPD group. Correlations of P300 abnormalities with patient characteristic parameters and MMSE scores were assessed. In addition, individual COPD patients having significant cognitive dysfunctions beyond cut-off value of 99 th percentile of HVs were analyzed. Results: We observed significantly prolonged P300 latency ( P 0.05 for all. Conclusions: Our study explores cognitive dysfunctions in stable COPD patients with no hypoxemia. This study highlights the relative importance of using MMSE and P300. Cognitive dysfunctions were detected both by MMSE and P300; however, MMSE abnormalities were more frequent compared to P300 abnormalities (27/40 vs. 10/40 in COPD patients.

Detection of dementia in primary care: comparison of the original and a modified Mini-Cog Assessment with the Mini-Mental State Examination.

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Kamenski, Gustav; Dorner, Thomas; Lawrence, Kitty; Psota, Georg; Rieder, Anita; Schwarz, Franz; Sepandj, Asita; Spiegel, Wolfgang; Strotzka, Stefan

2009-12-01

Background Dementia is considered widely under-detected in primary care, and general practitioners (GPs) frequently ask for easy to use tools to assist in its early detection.Aim To determine the degree of correlation between the Mini-Cog Assessment (Mini-Cog) as performed by GPs and the Mini-Mental State Examination (MMSE).Design of study This was a prospective study (2005, 2006) comparing two cognitive screening instruments.Setting Ten general practices in Austria, with patients with a hitherto undiagnosed suspicion of dementia seen consecutively.Method Sensitivity, specificity and positive and negative predictive values (PPVs and NPVs) of the Mini-Cog (applying both a colour-coded and the original rating method) were assessed for degree of correlation with the MMSE. In phase one GPs examined patients suspected of having dementia using the Mini-Cog; in phase two a neurologist retested them applying the MMSE, a clock-drawing test (CDT) and a routine clinical examination. A questionnaire on the practicability of the Mini-Cog was answered by GPs.Results Of the 107 patients who participated 86 completed the whole study protocol. The Mini-Cog, as performed by the ten GPs, displayed a sensitivity of 0.85 (95% CI: 0.71, 0.98), a specificity of 0.58 (95% CI: 0.46, 0.71), a PPV of 0.47 (95% CI: 0.33, 0.61) and an NPV of 0.90 (95% CI: 0.80, 0.99) as against the MMSE carried out by neurologists. The GPs judged the Mini-Cog useful and time saving.Conclusion The Mini-Cog has a high sensitivity and acceptable specificity in the general practice setting and has proved to be a practicable tool for the diagnosis of dementia in primary care.

Evaluation by statistical brain perfusion SPECT analysis on MRI findings, kana pick-out test and Mini-Mental State Examination results in patients with forgetfulness

International Nuclear Information System (INIS)

Nakatsuka, Hiroki; Matsubara, Ichirou; Ohtani, Haruhiko

2003-01-01

The aim of this single photon emission computed tomography (SPECT) study was to determine the abnormality of the regional cerebral blood flow (rCBF) using a three-dimensional stereotactic surface projection (3D-SSP) in 18 patients who were referred to the hospital because of forgetfulness. Two intergroup comparison by 3D-SSP analysis was conducted based on MRI, kana pick-out test and Mini-Mental State Examination (MMSE) results. Of the MRI findings, in the brain atrophy group, rCBF was decreased in the posterior cingulate gyrus, medial temporal structure and parieto-temporal association cortex; these rCBF-decreased areas are similar to the Alzheimer disease pattern. In the group where the MMSE was normal but the kana pick-out test was abnormal, rCBF was decreased in the posterior cingulate gyrus and cinguloparietal transitional area. In the group where both the MMSE and kana pick-out test were abnormal, rCBF was decreased in the parieto-temporal association cortex, temporal cortex and medial temporal structure. These results suggest that 3D-SSP analysis of the SPECT with MMSE and the kana pick-out test provides the possibility of early diagnosis of initial stage of Alzheimer's disease. (author)

Conversion Between Mini-Mental State Examination, Montreal Cognitive Assessment, and Dementia Rating Scale-2 Scores in Parkinson’s Disease

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van Steenoven, Inger; Aarsland, Dag; Hurtig, Howard; Chen-Plotkin, Alice; Duda, John E.; Rick, Jacqueline; Chahine, Lama M.; Dahodwala, Nabila; Trojanowski, John Q.; Roalf, David R.; Moberg, Paul J.; Weintraub, Daniel

2015-01-01

Cognitive impairment is one of the earliest, most common, and most disabling non-motor symptoms in Parkinson’s disease (PD). Thus, routine screening of global cognitive abilities is important for the optimal management of PD patients. Few global cognitive screening instruments have been developed for or validated in PD patients. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Dementia Rating Scale-2 (DRS-2) have been used extensively for cognitive screening in both clinical and research settings. Determining how to convert the scores between instruments would facilitate the longitudinal assessment of cognition in clinical settings and the comparison and synthesis of cognitive data in multicenter and longitudinal cohort studies. The primary aim of this study was to apply a simple and reliable algorithm for the conversion of MoCA to MMSE scores in PD patients. A secondary aim was to apply this algorithm for the conversion of DRS-2 to both MMSE and MoCA scores. The cognitive performance of a convenience sample of 360 patients with idiopathic PD was assessed by at least two of these cognitive screening instruments. We then developed conversion scores between the MMSE, MoCA, and DRS-2 using equipercentile equating and log-linear smoothing. The conversion score tables reported here enable direct and easy comparison of three routinely used cognitive screening assessments in PD patients. PMID:25381961

Malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement.

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Suzana, S; Boon, P C; Chan, P P; Normah, C D

2013-04-01

Malnutrition is a common phenomenon among the elderly and quite often related to psychosocial problems. The objective of this study was to determine malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement, i.e. FELDA Sungai Tengi, Selangor. A cross-sectional study was conducted among 160 subjects (men = 36.2%), with a mean age of 65.0 +/- 3.9 years, who were interviewed to obtain information on malnutrition risk and appetite using Mini Nutritional Assessment Short Form and Simplified Nutritional Appetite Questionnaire, respectively. Functional status was determined using Instrumental Activities of Daily Living (IADL), Elderly Mobility Scale (EMS) and handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale and De Jong Gierveld Loneliness Scale were used to identify cognitive impairment, depressive symptoms and loneliness status of subjects respectively. A total of 42.5% of subjects were at risk of malnutrition and 61.2% had poor appetite. The mean scores of IADL and EMS were lower in subjects at risk of malnutrition, compared to those who were not at high risk (p risk was predicted by poor appetite, decreased functional status (IADL) and depression. Malnutrition risk was prevalent and associated with poor appetite, functional status and psychosocial problems among the elderly subjects. The psychosocial aspect should also be incorporated in nutrition intervention programmes in order to improve mental well-being and functional independancy.

Physical, mental, and cognitive function in a convenience sample of centenarians in Australia.

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Richmond, Robyn L; Law, Jenaleen; Kay-Lambkin, Frances

2011-06-01

To examine the physical, mental, and cognitive function of centenarians. Descriptive study using a structured questionnaire and convenience sampling. Residential care facilities and private dwellings in Australia. A convenience sample of 188 centenarians. The Hospital Anxiety and Depression Scale (HADS) screened for anxiety and depression. The Katz Index of Independence in Activities of Daily Living (Katz ADL) was used to assess functional status. The Quality of Life Scale was used to assess quality of life. The Mini-Mental State Examination (MMSE) was used to screen for dementia. Structured responses were obtained for living arrangement, marital status, social relationships, and supports. Centenarians had regular contact with friends (59%), neighbors (62%), and families (72%); 54% were religious and 43.5% had received social supports. Average MMSE and Katz ADL scores were 21.5 and 3.7, respectively; 45% had scores on the MMSE indicative of dementia, 10% indicated anxiety and 14% depression on the HADS. Participants with poor ratings of health experienced higher rates of anxiety and depression than their healthier counterparts. In this convenience sample of Australian centenarians, anxiety and depression was relatively nonexistent, and most reported a high quality of life. This was despite objective deterioration in functional status, paralleling the aging process, and high dependence on others for everyday tasks. Potentially, this is suggestive of a unique ability within the sample to adapt to aging and its limitations. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

Construct validity of the mini mental state examination across time in a sample with low-education levels: 10-year follow-up of the Bambuí Cohort Study of Ageing.

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Castro-Costa, Erico; Dewey, Michael E; Uchôa, Elizabeth; Firmo, Josélia O A; Lima-Costa, Maria Fernanda; Stewart, Robert

2014-12-01

The study aims to investigate whether longitudinal data on the structure of the mini mental state examination (MMSE) collected in an older Brazilian cohort support factorial invariance over time. Analysis of 10-year data from a community-based cohort study was performed. The study took place in Bambuí, Brazil. The study sample comprised 1558 (89.4%) of all eligible 1742 elderly residents. A standard Brazilian version of the MMSE was used. A five-factor solution (developed on the baseline of the cohort) either with no constraints or with loadings constrained to equality across time provided a reasonable fit for the MMSE. A comparison between both models suggested that the model with no constraints was superior. However, the five absolute goodness-of-fit indices suggest that the fully constrained model was also adequate and did not differ substantively from the model without any restriction. The structure of the MMSE remained relatively unchanged across the 10 measurement times, thus providing evidence for the good construct validity of the scale across time. Copyright © 2014 John Wiley & Sons, Ltd.

[Screening for dementia using telephone interviews. An evaluation and reliability study of the Telephone Interview for Cognitive Status (TICS) in its modified German version].

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Matrisch, M; Trampisch, U; Klaassen-Mielke, R; Pientka, L; Trampisch, H J; Thiem, U

2012-04-01

To assess cognitive impairment or dementia in epidemiologic studies using telephone interviews for data acquisition, valid, reliable and short instruments suitable for telephone administration are required. For the Telephone Interview for Cognitive Status (TICS) in its modified German version, the only instrument used in Germany so far, more data on reliability and practicability are needed. Participants were recruited in the offices of nine primary care physicians. Data from 197 participants (115 females, mean age 78.5±4.1 years) who were tested by telephone and in the office by means of the Mini-Mental State Examination (MMSE) were used for the evaluation. For assessing reliability, a group of 91 participants (55 females, mean age 78.1±4.1 years) was contacted twice during 30 days to be tested during a telephone interview by means of the TICS in its modified German version. The intraclass correlation coefficient (ICC), a measure of reliability, was 0.67 [95% confidence interval (CI): 0.53; 0.77]. The Bland-Altman plot did not reveal any relationship between the variability of the difference between repeated measures and the total amount of the measure. For the overall TICS score, no differences were found between repeated measurements. However, the tasks recall of the word list and counting backwards showed some improvement in the repeated tests. TICS and MMSE showed only moderate correlation, with a correlation coefficient of 0.48 (95% CI: 0.36; 0.58). TICS values were dependent on age and educational level of the person tested. The TICS in its modified German version appears to be of acceptable reliability for the assessment of cognitive impairment during a telephone interview. TICS values depend on age and educational level of the person tested. TICS and MMSE correlate only moderately.

Conversion between mini-mental state examination, montreal cognitive assessment, and dementia rating scale-2 scores in Parkinson's disease.

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van Steenoven, Inger; Aarsland, Dag; Hurtig, Howard; Chen-Plotkin, Alice; Duda, John E; Rick, Jacqueline; Chahine, Lama M; Dahodwala, Nabila; Trojanowski, John Q; Roalf, David R; Moberg, Paul J; Weintraub, Daniel

2014-12-01

Cognitive impairment is one of the earliest, most common, and most disabling non-motor symptoms in Parkinson's disease (PD). Thus, routine screening of global cognitive abilities is important for the optimal management of PD patients. Few global cognitive screening instruments have been developed for or validated in PD patients. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Dementia Rating Scale-2 (DRS-2) have been used extensively for cognitive screening in both clinical and research settings. Determining how to convert the scores between instruments would facilitate the longitudinal assessment of cognition in clinical settings and the comparison and synthesis of cognitive data in multicenter and longitudinal cohort studies. The primary aim of this study was to apply a simple and reliable algorithm for the conversion of MoCA to MMSE scores in PD patients. A secondary aim was to apply this algorithm for the conversion of DRS-2 to both MMSE and MoCA scores. The cognitive performance of a convenience sample of 360 patients with idiopathic PD was assessed by at least two of these cognitive screening instruments. We then developed conversion scores between the MMSE, MoCA, and DRS-2 using equipercentile equating and log-linear smoothing. The conversion score tables reported here enable direct and easy comparison of three routinely used cognitive screening assessments in PD patients. © 2014 International Parkinson and Movement Disorder Society.

Training Nurses in Cognitive Assessment: Uses and Misuses of the Mini-Mental State Examination

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Koder, Deborah-Anne; Klahr, Amanda

2010-01-01

The Mini-Mental State Examination (MMSE) is one of the most commonly used instruments to screen for cognitive deficits within the hospital setting. However training in how to administer this widely used tool is scarce with little, if any, formal training for nursing staff. Scores are also often misused with over reliance on results and cut-offs to…

Brief screening for mild cognitive impairment in subcortical ischemic vascular disease: a comparison study of the Montreal Cognitive Assessment with the Mini-Mental State Examination.

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Xu, Qun; Cao, Wen-wei; Mi, Jian-hua; Yu, Ling; Lin, Yan; Li, Yan-sheng

2014-01-01

To assess the validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in the detection of vascular mild cognitive impairment (VaMCI) in patients with subcortical ischemic vascular disease (SIVD). Among 102 SIVD patients, both cutoff scores of the MMSE and MoCA for differentiating VaMCI from no cognitive impairment (NCI) or differentiating VaMCI from vascular dementia (VaD) were determined by the receiver operator characteristic (ROC) analysis. Optimal sensitivity with specificity of cutoff scores was obtained after the raw scores were adjusted for education. After adjusting for education, the MoCA cutoff score for differentiating VaMCI from NCI was at 24/25 and that for differentiating VaMCI from VaD was at 18/19. After applying the adjusted MoCA scores from 19 to 24 to identify VaMCI in all SIVD patients, sensitivity was at 76.7% and specificity was at 81.4% (κ = 0.579). The adjusted cutoff score of the MMSE for differentiating VaMCI from NCI was at 28/29 and that for differentiating VaMCI from VaD was at 25/26. The sensitivity and specificity of the adjusted MMSE was at 58.1 and 71.2%, respectively, when using the score from 26 to 28 to identify VaMCI in SIVD patients (κ = 0.294). The MoCA detected subcortical VaMCI better than the MMSE. © 2013 S. Karger AG, Basel.

The Mini-Cog, Clock Drawing Test, and the Mini-Mental State Examination in a German memory clinic: specificity of separation dementia from depression.

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Milian, Monika; Leiherr, Anna-Maria; Straten, Guido; Müller, Stephan; Leyhe, Thomas; Eschweiler, Gerhard W

2013-01-01

The aim of this study was to assess the specificities of the Mini-Cog, the Clock Drawing Test (CDT), and the Mini-Mental State Examination (MMSE) against depression and healthy controls in a German Memory Clinic. Furthermore, we analyzed the specificities of all three screening instruments in dependence of actual depression severity. Data from 142 depressed elderly, 438 dementia patients, and 64 healthy controls were retrospectively analyzed. The CDT and an extraction of the three-item recall of the MMSE were used to constitute the Mini-Cog algorithm. Depression severity was rated by either the Beck Depression Inventory (BDI) or the Geriatric Depression Scale (GDS) depending on the age of the patients. The Mini-Cog achieved a specificity of 79.6% against depressed elderly and 100.0% against healthy subjects (p Mini-Cog and the CDT, but also showed the lowest sensitivity for the detection of dementia. Surprisingly, the depression severity had no effect on the specificity of the Mini-Cog and the CDT, only the MMSE was susceptible for the depression severity. Although the MMSE showed higher specificities, the weighting between the sensitivities and specificities in all tests prove again the Mini-Cog as a short, valid, and sensitive screening tool.

Comparison of the Montreal Cognitive Assessment and the Mini-Mental State Examination in detecting multi-domain mild cognitive impairment in a Chinese sub-sample drawn from a population-based study.

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Dong, YanHong; Yean Lee, Wah; Hilal, Saima; Saini, Monica; Wong, Tien Yin; Chen, Christopher Li-Hsian; Venketasubramanian, Narayanaswamy; Ikram, Mohammad Kamran

2013-11-01

We examined the discriminant validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in detecting multiple-domain mild cognitive impairment (md-MCI) in a Chinese sub-sample drawn from elderly population-based study. This study included Chinese participants from the Epidemiology of Dementia in Singapore (EDIS) study aged ≥ 60 years who underwent cognitive screening with the Abbreviated Mental Test and Progressive Forgetfulness Questionnaire. Screen-positive participants subsequently underwent MoCA, MMSE, and a comprehensive formal neuropsychological battery. MCI was defined by Petersen's criteria and further classified into single-domain MCI (sd-MCI) and md-MCI. Area under the receiver operating characteristic curve (AUC) with 95% confidence intervals (CIs) was computed for the MoCA and the MMSE in detecting md-MCI. A total of 300 participants were recruited: 128 (42.7%) were diagnosed with no cognitive impairment (NCI), 47 (15.7%) with sd-MCI, and 83 (28.0%) with md-MCI. Forty-one participants were excluded, 7 (2.3%) had dementia, and 34 (11.3%) had only objective cognitive impairment without subjective complaints. Although the MoCA had a significantly larger AUC than the MMSE (0.94 (95% CI = 0.91-0.97) vs. 0.91 (95% CI = 0.86-0.95), p= 0.04), at optimal cut-off points, the MoCA (19/20) was equivalent to the MMSE (25/26) in detecting md-MCI (sensitivity: 0.80 vs. 0.87, specificity: 0.92 vs. 0.80). Both screening tests had good discriminant validity and can be used in detecting md-MCI in a sub-sample of Chinese drawn from a population-based study.

The Spanish version of the Addenbrooke's Cognitive Examination - Revised (ACE-R) in subcortical ischemic vascular dementia.

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Raimondi, Catalina; Gleichgerrcht, Ezequiel; Richly, Pablo; Torralva, Teresa; Roca, María; Camino, Julieta; Manes, Facundo

2012-11-15

Vascular dementia (VaD) is one of the most prevalent causes of dementia, and it is frequently misdiagnosed and undertreated in clinical practice. Because neuropsychological outcome depends, among other factors, on the size and location of the vascular brain injury, characterizing the cognitive profile of VaD has been especially challenging. Yet, there has been sufficient evidence to show a marked impairment of attention and executive functions, in particular in relation to Alzheimer disease. Being able to detect these deficits at bedside is crucial for everyday clinical practice, and yet, brief cognitive screening toots such as the Mini-Mental Sate Examination (MMSE) may overlook at cognitive deficits typical of patients with VaD. The Addenbrooke's Cognitive Examination Revised (ACE-R) is also a brief cognitive screening tool designed to incorporate the items of the MMSE and further extend the test to assess orientation, attention, verbal fluency, memory, language, and visuospatial abilities. In this study, we investigated the ability of the Spanish version of the ACE-R to detect the cognitive impairment showed in patients with subcortical ischemic vascular dementia, and we compared its usefulness to that of the MMSE in this population. Scores on these tests were compared to those of patients with Alzheimer disease and matched healthy controls. The 88-point cut-off proposed for the ACE-R was associated with a sensitivity of 100% and a specificity of 100% for the detection of cognitive impairment, demonstrating a stronger capacity than the MMSE (sensitivity of 42% with its 23-point cut-off score). We also found that the verbal fluency subtest of the ACE-R may be potentially useful in discriminating patients with subcortical ischemic vascular dementia from patients with AD. We discuss the utility of these findings in the context of everyday clinical practice and we propose that future studies should evaluate the potential usefulness of combining the ACE-R with a

Montreal Cognitive Assessment and Mini-Mental State Examination reliable change indices in healthy older adults.

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Kopecek, Miloslav; Bezdicek, Ondrej; Sulc, Zdenek; Lukavsky, Jiri; Stepankova, Hana

2017-08-01

Cognitive tests are used repeatedly to assess the treatment response or progression of cognitive disorders. The Montreal Cognitive Assessment (MoCA) is a valid screening test for mild cognitive impairment. The aim of our study was to establish 90% reliable change indices (RCI) for the MoCA together with the Mini-Mental State Examination (MMSE) in cognitively healthy older adults. We analyzed 197 cognitively healthy and functional independent volunteers aged 60-94 years, who met strict inclusion criteria for four consecutive years. The RCI methods by Chelune and Hsu were used. For 1, 2, and 3 years, the 90% RCI for MoCA using Chelune's formula were -4 ≤, ≥4; -4 ≤, ≥4 and -5 ≤, ≥4 points, respectively, and -3 ≤, ≥3 for the MMSE each year. Ninety percent RCI for MoCA using Hsu's formula ranged from -6 to 0, respectively, and +3 to +8 dependent on the baseline MoCA. Our study demonstrated RCI for the MoCA and MMSE in a 3-year time period that can be used for the estimation of cognitive decline or improvement in clinical settings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Cognitive Deficits in Healthy Elderly Population With "Normal" Scores on the Mini-Mental State Examination.

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Votruba, Kristen L; Persad, Carol; Giordani, Bruno

2016-05-01

This study investigated whether healthy older adults with Mini-Mental State Examination (MMSE) scores above 23 exhibit cognitive impairment on neuropsychological tests. Participants completed the MMSE and a neuropsychological battery including tests of 10 domains. Results were compared to published normative data. On neuropsychological testing, participants performed well on measures of naming and recall but showed mild to moderate impairment in working memory and processing speed and marked impairment in inhibition, sustained attention, and executive functioning. Almost everyone (91%) scored at least 1 standard deviation (SD) below the mean in at least 1 domain. The median number of domains in which individuals scored below 1 SD was 3.0 of 10.0, whereas over 21% scored below 1 SD in 5 domains or more. With the strictest of definitions for impairment, 20% of this population scored below 2.0 SDs below the norm in at least 2 domains, a necessary condition for a diagnosis of dementia. The finding that cognitive impairment, particularly in attention and executive functioning, is found in healthy older persons who perform well on the MMSE has clinical and research implications in terms of emphasizing normal variability in performance and early identification of possible impairment. © The Author(s) 2016.

Increased knowledge of thalassemia promotes early carrier status examination among medical students

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Julius Broto Dewanto

2016-04-01

A higher thalassemia knowledge score causes medical students to be willing to undergo thalassemia carrier status examination at an earlier point in timing. A well-organized educational program focusing on thalassemia and early screening in young adults may enhance the thalassemia prevention program.

Dietary glycaemic load associated with cognitive performance in elderly subjects.

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Power, Susan E; O'Connor, Eibhlís M; Ross, R Paul; Stanton, Catherine; O'Toole, Paul W; Fitzgerald, Gerald F; Jeffery, Ian B

2015-06-01

Ageing is associated with loss of cognitive function and an increased risk of dementia which is expected to place growing demands on health and long-term care providers. Among multiple causative factors, evidence suggests that cognitive impairment in older subjects may be influenced by diet. The objective of this study was to examine the association between dietary patterns, dietary glycaemic load (GL) and cognition in older Irish adults. Community-dwelling subjects (n 208; 94 males and 114 females; aged 64-93 years) were analysed. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. Cognitive capacity was tested using the Mini-Mental State Examination (MMSE). The data were clustered to derive patterns of dietary intake. Multivariable-adjusted logistic and Poisson regression models were used to examine the relationship between dietary GL and MMSE score. Elderly subjects consuming 'prudent' dietary patterns (high in fruit, vegetables, fish, low-fat dairy and salad dressings and low in red meat and white bread) had higher MMSE scores (better cognitive function) than those consuming 'Western' dietary pattern (high in red meat and white bread and low in fruit and vegetables; P nutritional status, residential property price, cardiovascular medications and energy intake. In this community-dwelling elderly Irish cohort, consumption of a high glycaemic diet is associated with poorer cognitive performance as assessed by the MMSE.

Validity of the mini-mental state examination and the montreal cognitive assessment in the prediction of driving test outcome.

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Hollis, Ann M; Duncanson, Haley; Kapust, Lissa R; Xi, Patricia M; O'Connor, Margaret G

2015-05-01

To evaluate the effectiveness of two cognitive screening measures, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), in predicting driving test outcome for individuals with and without cognitive impairment. Retrospective cohort study. A clinical driving evaluation program at a teaching hospital in the United States. Adult drivers who underwent assessment with the MMSE and MoCA as part of a comprehensive driving evaluation between 2010 and 2014 (N=92). MMSE and MoCA total scores were independent variables. The outcome measure was performance on a standardized road test. A preestablished diagnosis of cognitive impairment enhanced the validity of cognitive screening measures in the identification of at-risk drivers. In individuals with cognitive impairment there was a significant relationship between MoCA score and on-road outcome. Specifically, an individual was 1.36 times as likely to fail the road test with each 1-point decrease in MoCA score. No such relationship was detected in those without a diagnosis of cognitive impairment. For individuals who have not been diagnosed with cognitive impairment, neither the MMSE nor the MoCA can be reliably used as an indicator of driving risk, but for individuals with a preestablished diagnosis of cognitive impairment, the MoCA is a useful tool in this regard. A score on the MoCA of 18 or less should raise concerns about driving safety. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Cognition and Quality of Life After Chemotherapy Plus Radiotherapy (RT) vs. RT for Pure and Mixed Anaplastic Oligodendrogliomas: Radiation Therapy Oncology Group Trial 9402

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Wang Meihua; Cairncross, Gregory; Shaw, Edward

2010-01-01

Purpose: Radiation Therapy Oncology Group 9402 compared procarbazine, lomustine, and vincristine (PCV) chemotherapy plus radiation therapy (PCV + RT) vs. RT alone for anaplastic oligodendroglioma. Here we report longitudinal changes in cognition and quality of life, effects of patient factors and treatments on cognition, quality of life and survival, and prognostic implications of cognition and quality of life. Methods and Materials: Cognition was assessed by Mini Mental Status Examination (MMSE) and quality of life by Brain-Quality of Life (B-QOL). Scores were analyzed for survivors and within 5 years of death. Shared parameter models evaluated MMSE/B-QOL with survival. Results: For survivors, MMSE and B-QOL scores were similar longitudinally and between treatments. For those who died, MMSE scores remained stable initially, whereas B-QOL slowly declined; both declined rapidly in the last year of life and similarly between arms. In the aggregate, scores decreased over time (p = 0.0413 for MMSE; p = 0.0016 for B-QOL) and were superior with age <50 years (p < 0.001 for MMSE; p = 0.0554 for B-QOL) and Karnofsky Performance Score (KPS) 80-100 (p < 0.001). Younger age and higher KPS were associated with longer survival. After adjusting for patient factors and drop-out, survival was longer after PCV + RT (HR = 0.66, 95% CI = 0.49-0.9, p = 0.0084; HR = 0.74, 95% CI = 0.54-1.01, p = 0.0592) in models with MMSE and B-QOL. In addition, there were no differences in MMSE and B-QOL scores between arms (p = 0.4752 and p = 0.2767, respectively); higher scores predicted longer survival. Conclusion: MMSE and B-QOL scores held steady in the upper range in both arms for survivors. Younger, fitter patients had better MMSE and B-QOL and longer survival.

Zinc status, psychological and nutritional assessment in old people recruited in five European countries: Zincage study.

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Marcellini, Fiorella; Giuli, Cinzia; Papa, Roberta; Gagliardi, Cristina; Dedoussis, George; Herbein, George; Fulop, Tamas; Monti, Daniela; Rink, Lothar; Jajte, Jolanta; Mocchegiani, Eugenio

2006-01-01

The paper shows the results on the relationship between zinc status, psychological dimensions (cognitive functions, mood, perceived stress) and nutritional aspects in European healthy old subjects recruited for ZINCAGE Project (supported by the European Commission in the Sixth Framework Programme). The old healthy subjects were recruited in Italy, Greece, Germany, France, Poland taking into account the different dietary habits between Northern and Southern European Countries and the pivotal role played by zinc for psychological functions. Measures of the cognitive status, mood and perceived stress level were obtained at baseline, using the "Mini Mental State Examination (MMSE)"; the "Geriatric Depression Scale (GDS - 15 items)" and the "Perceived Stress Scale (PSS)", respectively. Nutritional status was assessed using "Frequency Food Questionnaire". The sample included 853 old subjects, classified in 4 groups of age: 60-69-years-old (n = 359); 70-74-years-old (n = 225); 75-79-years-old (n = 153); 80-84-years-old (n = 116). Subjects were studied on the basis of plasma zinc, in which zinc relationship between marginal zinc deficiency and impaired psychological dimensions occurred in Greece than in other European countries due to low intake and less variety of foods rich of zinc. This phenomenon was independent by the age, suggesting that a correct zinc intake from a wide range of foods may be useful to maintain a satisfactory plasma zinc levels as well as psychological status in elderly with subsequent achievement of healthy ageing.

Mini-Mental State Examination subscores indicate visuomotor deficits in Alzheimer's disease patients: A cross-sectional study in a Dutch population.

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de Boer, Casper; Mattace-Raso, Francesco; van der Steen, Johannes; Pel, Johan J M

2014-10-01

In diagnostics of Alzheimer's disease (AD), the Mini-Mental State Examination (MMSE) questionnaire is frequently used to test cognitive decline. The final subtest of the MMSE, in which patients have to copy two interlocking pentagons, tests a variety of visuomotor functions. Recent imaging studies suggest that visuomotor function could decline in early stage AD, as a result of degeneration of the brain networks involved. The goal of the present study was to compare memory and visuomotor function in AD patients, reflected by the MMSE subscores for orientation, recall and interlocking pentagons. The MMSE subscores for orientation, recall and interlocking pentagons of 125 AD patients was extracted from their medical history. Patients were divided into three groups based on disease duration. Using related-samples Wilcoxon signed-rank tests, the performance between subtests using normalized subscores was compared within each group. In all three groups, the subscores of recall and interlocking pentagons were significantly lower than orientation. No differences were found between the subscores of recall and interlocking pentagons. The presented data suggest that memory function and visuomotor function are equally impaired in the present study population. This could indicate that visuomotor dysfunction might be a more important clinical feature of AD than is currently assumed. This knowledge can be used to develop new tests and markers for AD reflecting deficits in visuomotor functions, such as quantification of eye and hand movements. © 2013 Japan Geriatrics Society.

Variables associated with cognitive function in elderly California Seventh-day Adventists.

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Fraser, G E; Singh, P N; Bennett, H

1996-06-15

From a cohort of white, non-Hispanic California Seventh-day Adventists, 99 subjects over age 75 years in 1991 were randomly selected. Dietary habits and educational status had been measured in 1976. Subjects completed the Mini-Mental State Examination (MMSE) in 1991, and at that time, they or caregivers also gave information on current medical problems and drug therapy. Those who ate more calories in 1976 had lower MMSE scores in 1991 (p = 0.03), an association strengthened by excluding those with previous stroke or Parkinson's disease by 1991. This raises the possibility that higher consumption of calories in middle age may accelerate the decline in cognitive function seen with aging, as apparently occurs in some animals. Less-educated subjects had lower MMSE scores, especially among the very elderly. The statistical model predicts that the negative association between use of psychotropic drugs and MMSE score (p = 0.004) is particularly potent in those cognitively impaired for other reasons. If causal, this suggests that physicians should use these agents very cautiously in such subjects.

Effects of acute organophosphate ingestion on cognitive function, assessed with the mini mental state examination

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S S Jayasinghe

2012-01-01

Full Text Available Background : Chronic damage to the central nervous system resulting in cognitive impairment has been shown with repeated, low doses of organophosphorus (OP exposure over month or years. Aim: The study aimed to find out whether there is any cognitive impairment following acute OP exposure that could be detected by a simple screening instrument, the Mini Mental State Examination (MMSE, in clinical settings. Settings and Design: A cohort study. Materials and Methods: The study was conducted with matched controls. Consecutive patients admitted to the hospital with acute ingestion of OP were recruited. Cognitive function was assessed with the MMSE, digit span test, test of long-term memory function and concentration. Patients were assessed twice: at 1 and 6 weeks of exposure. Statistical Analysis: Continuous variables were analyzed with the paired and unpaired T-tests. Non-normally distributed data were analyzed with the Mann-Whitney U test and Wilcoxon Signed Rank test. Discrete variables were analyzed with the Chi-square test. Results: There were 60 patients and 61 controls. The mean age (SD of the patients and controls was 31.5 (11.6 and 31.3 (11.8 years, respectively. Forty-two patients turned up for the second assessment. Significant impairment of cognitive function was seen in the total score of MMSE (95% CI -2.5 to -0.3, orientation (95% CI -1 to -0.2 and language (95% CI -0.9 to -0.1 domains of MMSE, digit span test (95% CI 0.1-1.7 and test of long-term memory function (95% CI 0.3-2.3 in the first assessment compared with the controls. When the results of the second assessment were compared with the controls, no significant differences were seen. Conclusion: Although there was a slight transient cognitive impairment detected with the screening tests following acute OP ingestion, no long-term cognitive defects was detected.

Improving detection of dementia in Asian patients with low education: combining the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly.

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Narasimhalu, Kaavya; Lee, June; Auchus, Alexander P; Chen, Christopher P L H

2008-01-01

Previous work combining the Mini-Mental State Examination (MMSE) and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) has been conducted in western populations. We ascertained, in an Asian population, (1) the best method of combining the tests, (2) the effects of educational level, and (3) the effect of different dementia etiologies. Data from 576 patients were analyzed (407 nondemented controls, 87 Alzheimer's disease and 82 vascular dementia patients). Sensitivity, specificity and AUC values were obtained using three methods, the 'And' rule, the 'Or' rule, and the 'weighted sum' method. The 'weighted sum' rule had statistically superior AUC and specificity results, while the 'Or' rule had the best sensitivity results. The IQCODE outperformed the MMSE in all analyses. Patients with no education benefited more from combined tests. There was no difference between Alzheimer's disease and vascular dementia populations in the predictive value of any of the combined methods. We recommend that the IQCODE be used to supplement the MMSE whenever available and that the 'weighted sum' method be used to combine the MMSE and the IQCODE, particularly in populations with low education. As the study population selected may not be representative of the general population, further studies are required before generalization to nonclinical samples. (c) 2007 S. Karger AG, Basel.

Testicular biopsy in psittacine birds (Psittaciformes): comparative evaluation of testicular reproductive status by endoscopic, histologic, and cytologic examination.

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Hänse, Maria; Krautwald-Junghanns, Maria-Elisabeth; Reitemeier, Susanne; Einspanier, Almuth; Schmidt, Volker

2013-12-01

Knowledge of the reproductive cycle of male parrots is important for examining the male genital tract and for successful breeding, especially of endangered species. To evaluate different diagnostic methods and criteria concerning the classification of reproductive stages, we examined 20 testicular samples obtained at necropsy in psittacine birds of different species and testicular biopsy samples collected from 9 cockatiels (Nymphicus hollandicus) and 7 rose-ringed parakeets (Psittacula krameri) by endoscopy 4 times over a 12-month period. The testicular reproductive status was assessed histologically and then compared with the macroscopic appearance of the testicles and cytologic results. The histologic examination was nondiagnostic in 19 of 59 testicular biopsy samples. By contrast, the cytologic preparations were diagnostic in 57 of 59 biopsy samples. The results of the cytologic examination coincided with the histologic results in 34 of 38 biopsy samples and 18 of 20 necropsy samples. Macroscopic parameters displayed some differences between reproductive stages but provided an unreliable indication of the reproductive status. These results suggest that microscopic examination of a testicular biopsy sample is a reliable method for evaluating the reproductive status of male parrots and is preferable to the macroscopic evaluation of the testicle. Cytologic examination provides fast preliminary results, even when the histologic preparation is not sufficient for evaluation, but results may be erroneous. Thus, a combination of histologic and cytologic examination is recommended for evaluating testicular reproductive status.

Cognitive status, lexical learning and memory in deaf adults using sign language

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Zahra Jafari

2013-05-01

Full Text Available Background and Aim : Learning and memory are two high level cognitive performances in human that hearing loss influences them. In our study, mini-mental state examination (MMSE and Ray auditory-verbal learning test (RAVLT was conducted to study cognitive stat us and lexical learning and memory in deaf adults using sign language. Methods: This cross-sectional comparative study was conducted on 30 available congenitally deaf adults using sign language in Persian and 46 normal adults aged 19 to 27 years for both sexes, with a minimum of diploma level of education. After mini-mental state examination, Rey auditory-verbal learning test was run through computers to evaluate lexical learning and memory with visual presentation. Results: Mean scores of mini-mental state examination and Rey auditory-verbal learning test in congenitally deaf adults were significantly lower than normal individuals in all scores (p=0.018 except in the two parts of the Rey test. Significant correlation was found between results of two tests just in the normal group (p=0.043. Gender had no effect on test results. Conclusion: Cognitive status and lexical memory and learning in congenitally deaf individuals is weaker than in normal subjects. It seems that using sign language as the main way of communication in deaf people causes poor lexical memory and learning.

Vitamin B-12, apolipoprotein E genotype, and cognitive performance in community-living older adults: evidence of a gene-micronutrient interaction.

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Feng, Lei; Li, Jialiang; Yap, Keng-Bee; Kua, Ee-Heok; Ng, Tze-Pin

2009-04-01

The relation between vitamin B-12 and cognitive function in older adults is unclear. Limited evidence suggests that the relation is modulated by apolipoprotein E epsilon4. Hence, it is important to further examine this gene-nutrient interaction. The aim was to investigate the role of apolipoprotein E (APOE) epsilon4 as a genetic predisposing factor modulating the effect of vitamin B-12 on cognitive function. A battery of neuropsychological tests, including the Mini-Mental State Examination (MMSE) for global cognition, was administered at the baseline assessment to 539 Chinese adults aged > or =55 y. The MMSE was repeated at a median 18 mo (n = 376) and a median of 38 mo (n = 247) after baseline. The interaction of vitamin B-12 and APOE epsilon4 on cognitive function was examined in a linear mixed-effects model for MMSE and in a multiple linear regression model for neuropsychological test scores. APOE epsilon4 was associated with a lower MMSE score. Vitamin B-12 (natural log transformed) was positively related to MMSE score, and this association was much stronger in APOE epsilon4 carriers than in APOE epsilon4 noncarriers (P for interaction = 0.016). Significant interactions between natural log-transformed vitamin B-12 and APOE epsilon4 were also found for the Digit Span Backward Longest Sequence (P for interaction = 0.013) and Rey Auditory Verbal Learning Test immediate recall (P for interaction = 0.005). Better performance in these 2 tests was associated with vitamin B-12 in APOE epsilon4 carriers but not in APOE epsilon4 noncarriers. The association between vitamin B-12 and cognitive function was moderated by APOE epsilon4 status.

Validation of Addenbrooke's cognitive examination (ACE) in a Persian-speaking population.

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Pouretemad, Hamid Reza; Khatibi, Ali; Ganjavi, Anahita; Shams, Jamal; Zarei, Mojtaba

2009-01-01

Use of reliable screening and diagnostic tests for assessment of cognitive abilities in neurological patients is rapidly increasing in clinical practice. This is due to the increase in the prevalence of dementias and the raised awareness of cognitive impairment in neurological disorders. Two well-known bedside screening tests for dementias among the English-speaking population are the Mini Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination (ACE). However, such tests have not been developed for the Persian-speaking population, which is estimated at 120 million worldwide. In this study we developed the Persian ACE and MMSE, adopted from the English version. We also assessed the sensitivity and specificity of these tests in the identification of Alzheimer's disease (AD) and mild cognitive impairment (MCI). We found that the Persian ACE at a cutoff point of 84, has a sensitivity of 93% and a specificity of 91% in discriminating MCI from a normal population; at 78, the test has a sensitivity of 73% and a specificity of 93% in differentiating MCI from AD, and at a similar cutoff point has a sensitivity of 100% and specificity of 96% in discriminating AD from a normal population. We conclude that the Persian ACE is a valuable tool in clinical practice in the Persian-speaking population. 2009 S. Karger AG, Basel.

The Addenbrooke's Cognitive Examination for the differential diagnosis and longitudinal assessment of patients with parkinsonian disorders.

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Rittman, Timothy; Ghosh, Boyd C; McColgan, Peter; Breen, David P; Evans, Jonathan; Williams-Gray, Caroline H; Barker, Roger A; Rowe, James B

2013-05-01

Differentiating idiopathic Parkinson's disease from atypical parkinsonian syndromes is challenging, especially in the early stages. We assessed whether the Revised Addenbrooke's Cognitive Examination (ACE-R) could differentiate between parkinsonian syndromes and reflect longitudinal changes in cognition in these disorders. The ACE-R was administered at baseline and after approximately 18 months to 135 patients with parkinsonian disorders: 86 with idiopathic Parkinson's disease (PD), 30 with progressive supranuclear palsy (PSP), 19 with corticobasal degeneration (CBD). We assessed differences between groups for ACE-R, ACE-R subscores and Mini Mental State Examination (MMSE) scores at baseline (analyses of variance, receiver operating characteristics curves), and the interaction between diagnosis and change in ACE-R scores between visits (analyses of variance). The ACE-R verbal fluency subscore distinguished between PSP and PD with a high sensitivity (0.92) and specificity (0.87); total ACE-R score and the visuospatial subscore were less specific (0.87 and 0.84 respectively) and sensitive (0.70 and 0.73). Significant group level differences were found between PD and PSP for MMSE and ACE-R (total score and subscores for attention and concentration, fluency, language, and visuospatial function), and between PD and CBD for the ACE-R visuospatial subscore. Performance worsened between visits for ACE-R score in PD (p=0.001) and CBD (p=0.001); visuospatial subscore in PD (p=0.003), PSP (p=0.022) and CBD (p=0.0002); and MMSE in CBD (p=0.004). We propose the ACE-R, particularly the verbal fluency subscore, as a valuable contributor to the differential diagnosis of parkinsonian syndromes in the correct clinical context. The ACE-R may reflect disease progression in PD and CBD.

Diagnostic utility of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and its combination with the Addenbrooke's Cognitive Examination-Revised (ACE-R) in a memory clinic-based population.

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Hancock, P; Larner, A J

2009-06-01

The study aimed to assess the clinical utility of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) in patients referred to memory clinics, alone and in combination with the Addenbrooke's Cognitive Examination-Revised (ACE-R) and the Mini-mental State Examination (MMSE). This pragmatic prospective study was based on consecutive referrals attending with an informant (n = 144) to two memory clinics over a 12-month period. Patients were diagnosed using standard clinical diagnostic criteria for dementia (DSM-IV) as gold standard (dementia prevalence = 59%). The IQCODE was administered to informants, and the ACE-R and/or MMSE to most patients. The IQCODE proved acceptable to informants, and was quick and easy to use. Using traditional parameters of diagnostic utility (sensitivity, specificity, positive predictive value, likelihood ratios), the performance of the IQCODE at optimal test accuracy was highly sensitive (0.86) for the diagnosis of dementia but specificity was poor (0.39) with suboptimal positive predictive value (0.67) and small or unimportant likelihood ratios. Overall diagnostic accuracy based on area under the receiver operating characteristic (ROC) curve was 0.71. Combining the IQCODE with either ACE-R or MMSE greatly improved accuracy, specificity and positive predictive value when the tests were used in series, but not when used in parallel. In a memory clinic based population, the IQCODE proved sensitive for the diagnosis of dementia but overall diagnostic accuracy was suboptimal. Combining the IQCODE in series with the ACE-R or MMSE greatly improved diagnostic utility.

[Influence of habitual chocolate consumption over the Mini-Mental State Examination in Spanish older adults].

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Orozco Arbelaez, Edilbeto; Banegas, José Ramón; Rodríguez Artalejo, Fernando; López García, Esther

2017-07-28

There are associations described between dementia, mild cognitive impairment (MCI) and foods with a high content of polyphenols. To assess the infl uence of habitual chocolate consumption over the MMSE in Spanish older adults. Cross-sectional study, using data of the follow-up of the Seniors-Study on Nutrition and Cardiovascular Risk in Spain (ENRICA) cohort. Habitual chocolate consumption in the last year was assessed with a computerized dietary history; differences between dark chocolate and milk chocolate were recorded. Chocolate intake was classified into the following categories: no consumption, chocolate consumption of ≥ 10 g/d had a better MMSE score (adjusted beta coefficient and 95% confidence interval: 0.26 (0.02-0.50; p trend = 0.05); for dark chocolate, the results were also statistically significant (0.48 [0.18-0.78]; p trend chocolate consumption was not associated with higher likelihood of having MCI. However, dark chocolate consumption was associated with less likelihood of MCI (OR and 95%CI for MMSE ≤ 25: 0.39 [0.20-0.77]; for MMSE ≤ 24: 0.26 [0.10-0.67]; and for MMSE ≤ 23: 0.25 [0.07-0.82]). Our results suggest that habitual dark chocolate consumption might improve cognitive function among the older population.

Validity of the Clock Drawing Test in predicting reports of driving problems in the elderly

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Banou Evangelia

2004-10-01

Full Text Available Abstract Background This study examined the use of the Folstein Mini Mental Status Exam (MMSE and the Clock Drawing Test (CDT in predicting retrospective reports of driving problems among the elderly. The utility of existing scoring systems for the CDT was also examined. Methods Archival chart records of 325 patients of a geriatric outpatient clinic were reviewed, of which 162 had CDT results (including original clock drawings. T-test, correlation, and regression procedures were used to analyze the data. Results Both CDT and MMSE scores were significantly worse among non-drivers than individuals who were currently or recently driving. Among current or recent drivers, scores on both instruments correlated significantly with the total number of reported accidents or near misses, although the magnitude of the respective correlations was small. Only MMSE scores, however, significantly predicted whether or not any accidents or near misses were reported at all. Neither MMSE nor CDT scores predicted unique variance in the regressions. Conclusions The overall results suggest that both the MMSE and CDT have limited utility as potential indicators of driving problems in the elderly. The demonstrated predictive power for these instruments appears to be redundant, such that both appear to assess general cognitive function versus more specific abilities. Furthermore, the lack of robust prediction suggests that neither are sufficient to serve as stand-alone instruments on which to solely base decisions of driving capacity. Rather, individuals who evidence impairment should be provided a more thorough and comprehensive assessment than can be obtained through screening tools.

Distinct Patterns of Cognitive Aging Modified by Education Level and Gender among Adults with Limited or No Formal Education: A Normative Study of the Mini-Mental State Examination.

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Xie, Haiqun; Zhang, Chengguo; Wang, Yukai; Huang, Shuyun; Cui, Wei; Yang, Wenbin; Koski, Lisa; Xu, Xiping; Li, Youbao; Zheng, Meili; He, Mingli; Fu, Jia; Shi, Xiuli; Wang, Kai; Tang, Genfu; Wang, Binyan; Huo, Yong

2016-01-01

Dementia is increasingly prevalent due to rapid aging of the population, but under-recognized among people with low education levels. This is partly due to a lack of appropriate and precise normative data, which underestimates cognitive aging in the use of screening tools for dementia. We aimed to improve the precision of screening for cognitive impairment, by characterizing the patterns of cognitive aging and derived normative data of the Mini-Mental State Examination (MMSE) for illiterate and low-educated populations. This community-based study included data from 2,280 individuals aged 40 years or older from two rural areas. Multiple linear modeling examined the effect of aging on cognition reflected by the MMSE, stratified by education level and gender. Threshold effect of age on cognition was performed using a smoothing function. The majority of participants (60.4%) were illiterate or had attended only primary school (24.6%). The effect of aging on cognition varied by gender and education. Primary-school educated females and males remained cognitively stable up to 62 and 71 years of age, respectively, with MMSE score declining 0.4 and 0.8 points/year in females and males thereafter. Illiterates females scored 2.3 points lower than illiterate males, and scores for both declined 0.2 points/year. According to these results, normative data stratified by age, education and gender was generated. This study suggests gender and educational differences exist in cognitive aging among adults with limited or no formal education. To improve screening precision for cognitive impairment with the use of MMSE in low-educated population, age, gender, and education level should be considered.

Neurocognitive Function of Patients with Brain Metastasis Who Received Either Whole Brain Radiotherapy Plus Stereotactic Radiosurgery or Radiosurgery Alone

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Aoyama, Hidefumi; Tago, Masao; Kato, Norio; Toyoda, Tatsuya; Kenjyo, Masahiro; Hirota, Saeko; Shioura, Hiroki; Inomata, Taisuke; Kunieda, Etsuo; Hayakawa, Kazushige; Nakagawa, Keiichi; Kobashi, Gen; Shirato, Hiroki

2007-01-01

Purpose: To determine how the omission of whole brain radiotherapy (WBRT) affects the neurocognitive function of patients with one to four brain metastases who have been treated with stereotactic radiosurgery (SRS). Methods and Materials: In a prospective randomized trial between WBRT+SRS and SRS alone for patients with one to four brain metastases, we assessed the neurocognitive function using the Mini-Mental State Examination (MMSE). Of the 132 enrolled patients, MMSE scores were available for 110. Results: In the baseline MMSE analyses, statistically significant differences were observed for total tumor volume, extent of tumor edema, age, and Karnofsky performance status. Of the 92 patients who underwent the follow-up MMSE, 39 had a baseline MMSE score of ≤27 (17 in the WBRT+SRS group and 22 in the SRS-alone group). Improvements of ≥3 points in the MMSEs of 9 WBRT+SRS patients and 11 SRS-alone patients (p = 0.85) were observed. Of the 82 patients with a baseline MMSE score of ≥27 or whose baseline MMSE score was ≤26 but had improved to ≥27 after the initial brain treatment, the 12-, 24-, and 36-month actuarial free rate of the 3-point drop in the MMSE was 76.1%, 68.5%, and 14.7% in the WBRT+SRS group and 59.3%, 51.9%, and 51.9% in the SRS-alone group, respectively. The average duration until deterioration was 16.5 months in the WBRT+SRS group and 7.6 months in the SRS-alone group (p = 0.05). Conclusion: The results of the present study have revealed that, for most brain metastatic patients, control of the brain tumor is the most important factor for stabilizing neurocognitive function. However, the long-term adverse effects of WBRT on neurocognitive function might not be negligible

Risk Factors for Possible Dementia Using the Hopkins Verbal Learning Test and the Mini-Mental State Examination in Shanghai

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Xin Xu

2015-11-01

Full Text Available Using a combination of the Hopkins Verbal Learning Test (HVLT and the Mini-Mental State Examination (MMSE, we investigated the prevalence of possible dementia (DEM in community-dwelling elderly in Shanghai. Subsequently, we investigated significant risk factors for DEM and generated a DEM self-checklist for early DEM detection and case management. We found that among a total of 521 participants using a HVLT cut-off score of <19 and a MMSE cut-off score of <24, a total of 69 DEM cases were identified. Risk factors, such as advanced age (≥68 years, low education (no or primary level, self-reported history of hypertension, and self-reported subjective memory complaints (SMC were significantly predictive of DEM. The presence of ≥3 out of four of the above mentioned risk factors can effectively discriminate DEM cases from non-DEM subjects.

One-minute mental status examination for category fluency is more useful than mini-mental state examination to evaluate the reliability of insulin self-injection in elderly diabetic patients.

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Yajima, Ken; Matsushita, Takaya; Sumitomo, Hidetaka; Sakurai, Hirofumi; Katayama, Takashi; Kanno, Kazuo; Sakai, Masashi; Shigeta, Masayuki; Shirabe, Shinichiro; Nakano, Tadasumi; Nishimura, Kazuhiro; Ueki, Akio; Kitaoka, Masafumi

2014-05-04

We investigated the factors associated with the reliability of insulin self-injection in elderly diabetic patients receiving insulin therapy. We enrolled diabetic patients aged ≥65 years and receiving insulin therapy, and assessed their cognitive function by the mini-mental state examination and 1-min mental status examination for category fluency. We also observed their technique of insulin self-injection, and evaluated whether or not patients were able to inject insulin by themselves according to nine defined details in terms of insulin self-injection. The predictive factors for the reliability of insulin self-injection were determined by univariate and multivariate logistic regression analysis. There were 278 participants (135 males, 143 females) enrolled in the present study. According to multivariate logistic regression analysis, only the 1-min mental status examination score was found to be a significant independent predictor of the reliability of insulin self-injection (odds ratio 0.75; 95% confidence interval 0.62-0.90; P = 0.002). The 1-min mental status examination for category fluency can be considered more useful than mini-mental state examination to evaluate the reliability of insulin self-injection in elderly diabetic patients receiving insulin therapy.

Effects of inpatient geriatric interventions in a German geriatric hospital: Impact on ADL, mobility and cognitive status.

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Bordne, S; Schulz, R-J; Zank, S

2015-06-01

Given the demographic changes, the need for effective geriatric intervention is obvious. Geriatric care aims to maintain the highest possible level of independence and quality of life and to reduce the risk of need for care. This study investigated the benefits of geriatric care on functional performance, mobility and cognition. This study involved a retrospective analysis of clinical data from 646 patients. At hospital admission and discharge functional status was assessed using the Barthel index. Mobility was evaluated by means of the Tinetti test and cognition by the mini-mental state examination (MMSE). A follow-up was conducted on 112 patients 2-5 months after hospital discharge. Statistical analysis included t-tests including Cohen's d for effect size and multivariate regression analysis. The mean age of the study population was 81.1 ± 7.1 years including 439 women (68%) and 207 men (32%). There were significant average improvements for activities of daily living (ADL), mobility and cognition comparing discharge and admission scores. For functional and mobility status, effect sizes were medium to high. Regression analyses showed that ADL improvement was predicted by functional, mobile and cognitive status at admission. Follow-up analyses revealed a high percentage of former patients still living at home and an overall maintenance of ADL levels. Geriatric patients seem to experience long-term improvements during geriatric treatment, which appears to fulfill its aim of recovering independence. For a better understanding of relevant factors for the recreation of geriatric patients, further research is needed, e.g. with respect to the impact of the nutritional status.

PERFIL DEL MINI-MENTAL EN POLICONSUMIDORES DE 25 A 50 AÑOS DEL ÁREA METROPOLITANA DE LA CIUDAD DE BARRANQUILLA-COLOMBIA - PROFILE OF THE MINI-MENTAL POLICONSUMER FROM 25 TO 50 YEAR OF THE METROPOLITAN AREA OF THE CITY OF BARRANQUILLA-COLOMBIA

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JOHAN ACOSTA LÓPEZ

2009-06-01

Full Text Available The Mini-Mental State Examination (MMSE is a widely used screening test for assessing mental status and cognitive decline in particular. Includes assessment of temporo-spatial orientation, immediate evocation, attention, calculation, evoking lazy, language (verbal description, reading, writing. The criteria in this instrument are highly sensitive to cognitive impairment. This study seeks to establish the significant differences in mental status among consumers poly (cases and nonusers (controls through a screening test in cognitive-behavioral scales to confirm and quantify a person’s mental state MMSE. Intentionally were selected 55 adults of both sexes aged 25 to 50 years grouped in 25 cases and 30 controls that met the inclusion criteria, a structured interview, medical and neurological evaluation, neuropsychological assessment that includes various tests that assessed cognitive functions, were administrated as the main finding indicates that the MMSE total score statistically separated the consumer poly (cases and nonusers (controls, gave a poorer score in those affected. An 32%consumers poly a totalof 30 points, while 16%had a score of 29 points in the scale, followed by 44%, poly consumerswith a score of 28 points, and finally in records obtained by 8% of consumers cop was 26 points. The case group showed greater disturbances in the areas that assess memory and attention.

Cereal Intake Increases and Dairy Products Decrease Risk of Cognitive Decline among Elderly Female Japanese.

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Otsuka, R; Kato, Y; Nishita, Y; Tange, C; Nakamoto, M; Tomida, M; Imai, T; Ando, F; Shimokata, H

2014-01-01

If cognitive decline can be prevented through changes in daily diet with no medical intervention, it will be highly significant for dementia prevention. This longitudinal study examined the associations of different food intakes on cognitive decline among Japanese subjects. Prospective cohort study. The National Institute for Longevity Sciences - Longitudinal Study of Aging, a community-based study. Participants included 298 males and 272 females aged 60 to 81 years at baseline who participated in the follow-up study (third to seventh wave) at least one time. Cognitive function was assessed with the Mini-Mental State Examination (MMSE) in all study waves. Nutritional intake was assessed using a 3-day dietary record in the second wave. Cumulative data among participants with an MMSE >27 in the second wave were analyzed using a generalized estimating equation. Multivariate adjusted odds ratios (OR) and 95% confidence intervals (CI) for an MMSE score ≤27 in each study wave according to a 1 standard deviation (SD) increase of each food intake at baseline were estimated, after adjusting for age, follow-up time, MMSE score at baseline, education, body mass index, annual household income, current smoking status, energy intake, and history of diseases. In men, after adjusting for age, and follow-up period, MMSE score at baseline, the adjusted OR for a decline in MMSE score was 1.20 (95% CI, 1.02-1.42; p=0.032) with a 1-SD increase in cereal intake. After adjusting for education and other confounding variables, the OR for a decrease in MMSE score did not reach statistical significance for this variable. In women, multivariate adjusted OR for MMSE decline was 1.43 (95% CI, 1.15-1.77; p=0.001) with a 1-SD increase in cereal intake and 0.80 (95% CI, 0.65-0.98; p=0.034) with a 1-SD increase in milk and dairy product intake. This study indicates that a 1-SD (108 g/day) decrease in cereal intake and a 1-SD (128 g/day) increase in milk and dairy product intake may have an

How Can We Best Screen for Cognitive Impairment in Malaysia? A Pilot of the IDEA Cognitive Screen and Picture-Based Memory Impairment Scale and Comparison of Criterion Validity with the Mini Mental State Examination.

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Rosli, Roshaslina; Tan, Maw Pin; Gray, William K; Subramanian, Pathmawathi; Mohd Hairi, Noran Naqiah; Chin, Ai-Vyrn

2017-01-01

To pilot two new cognitive screening tools for use in an urban Malaysian population and to compare their criterion validity against a gold standard, the well-established Mini-Mental State Examination (MMSE). The IDEA cognitive screen, Picture-based Memory Impairment Scale (PMIS), and MMSE were administered to a convenience sample of elderly (≥ 65 years) from the community and outpatient clinics at an urban teaching hospital. Consensus diagnosis was performed by two geriatricians blinded to PMIS and IDEA cognitive screen scores using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) clinical criteria. The MMSE performance was used as a reference. The study enrolled 66 participants, with a median age of 78.5 years (interquartile range [IQR], 72.5-83.0) years and 11.0 median years of education (IQR, 9.0-13.0). Forty-three (65.2%) were female, and 32 (48.4%) were Chinese. The area under the receiver operating characteristic (AUROC) curve values were .962 (IDEA cognitive screen), .970 (PMIS), and .935 (MMSE). The optimal cutoff values for sensitivity and specificity were: IDEA cognitive screen: ≤ 11, 90.9% and 89.7%; PMIS: ≤ 6, 97.3% and 69.0%; and MMSE: ≤ 23, 84.6% and 76.0%. Although the sample size was small, multivariable logistic regression modelling suggested that all three screen scores did not appear to be educationally biased. The IDEA and PMIS tools are potentially valid screening tools for dementia in urban Malaysia, and perform at least as well as the MMSE. Further work on larger representative, cohorts is needed to further assess the psychometric properties. Study provides alternative screening tools for dementia for both non-specialists and specialists.

Current Status of Pathologic Examinations in Korea, 2011–2015, Based on the Health Insurance Review and Assessment Service Dataset

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Sun-ju Byeon

2017-03-01

Full Text Available Background Pathologic examinations play an important role in medical services. Until recently, the overall status of pathologic examinations in Korea has not been identified. I conducted a nationwide survey of pathologic examination status using the insurance reimbursements (IRs dataset from the Health Insurance Review and Assessment Service (HIRA. The aims of this study were to estimate current pathologic examination status in Korea and to provide information for future resource arrangement in the pathology area. Methods I asked HIRA to provide data on IR requests, including pathologic examinations from 2011 to 2015. Pathologic examination status was investigated according to the following categories: annual statistics, requesting department, type of medical institution, administrative district, and location at which pathologic examinations were performed. Results Histologic mapping, immunohistochemistry, and cervicovaginal examinations have increased in the last 5 years. Internal medicine, general surgery, obstetrics/gynecology, and urology were the most common medical departments requesting pathologic examinations. The majority of pathologic examinations were frequently performed in tertiary hospitals. About 60.3% of pathologic examinations were requested in medical institutions located in Seoul, Gyeonggi-do, and Busan. More than half of the biopsies and aspiration cytologic examinations were performed using outside services. The mean period between IR requests and 99 percentile IR request completion inspections was 6.2 months. Conclusions This survey was based on the HIRA dataset, which is one of the largest medical datasets in Korea. The trends of some pathologic examinations were reflected in the policies and needs for detailed diagnosis. The numbers and proportions of pathologic examinations were correlated with the population and medical institutions of the area, as well as patient preference. These data will be helpful for future

Evaluation and Comparison of Cognitive State and Depression in Elderly Admitted in Sanitarium with Elderly Sited in Personal Home

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Mohamad-baghere Sohrabi; Pone Zolfaghari; Farzane Mahdizade; Seyd-Mohammad Aghayan; Mojtaba Ghasemian- Aghmashhadi; Zahra Shariati; Ahmad Khosravi

2008-01-01

Introduction: In this study cognitive state and geriatric depression in elderly living in sanatorium and personal home were evaluated. Methods: The present study was conducted on 46 aged subjects living in sanitarium and 90 aged subjects staying in personal homes. Mini mental status examination (MMSE) and geriatric depression scale (GDS) questionnaires were completed according to the standard examination. Results: As for the cognitive state of the aged living in sanitarium, 13 cases (28.3%) s...

Correlation between the Quality of Attention and Cognitive Competence with Motor Action in Stroke Patients

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S. Arsic

2015-01-01

Full Text Available It is considered that cognitive function and attention could affect walking, motion control, and proper conduct during the walk. To determine whether there is a difference in the quality of attention and cognitive ability in stroke patients and patients without neurological damage of similar age and education and to determine whether the connection of attention and cognition affects motor skills, the sample consisted of 50 stroke patients tested with hemiparesis, involved in the process of rehabilitation, and 50 persons, randomly chosen, without neurological damage. The survey used the following tests: Trail Making (TMT A B test for assessing the flexibility of attention; Mini-Mental State Examination (MMSE for cognitive status; Functional Ambulation Category (FAC test to assess the functional status and parameters of walk: speed, frequency, and length of stride; STEP test for assessing the precision of movement and balance. With stroke patients, relationship between age and performance on the MMSE test was marginally significant. The ratio of performance to TMT A B test and years does not indicate statistical significance, while statistical significance between the MMSE test performance and education exists. In stroke patients, performance on MMSE test is correlated with the frequency and length of stride walk. The quality of cognitive function and attention is associated with motor skills but differs in stroke patients and people without neurological damage of similar age. The significance of this correlation can supplement research in neurorehabilitation, improve the quality of medical rehabilitation, and contribute to efficient recovery of these patients.

Correlation between the Quality of Attention and Cognitive Competence with Motor Action in Stroke Patients.

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Arsic, S; Konstantinovic, Lj; Eminovic, F; Pavlovic, D; Popovic, M B; Arsic, V

2015-01-01

It is considered that cognitive function and attention could affect walking, motion control, and proper conduct during the walk. To determine whether there is a difference in the quality of attention and cognitive ability in stroke patients and patients without neurological damage of similar age and education and to determine whether the connection of attention and cognition affects motor skills, the sample consisted of 50 stroke patients tested with hemiparesis, involved in the process of rehabilitation, and 50 persons, randomly chosen, without neurological damage. The survey used the following tests: Trail Making (TMT A B) test for assessing the flexibility of attention; Mini-Mental State Examination (MMSE) for cognitive status; Functional Ambulation Category (FAC) test to assess the functional status and parameters of walk: speed, frequency, and length of stride; STEP test for assessing the precision of movement and balance. With stroke patients, relationship between age and performance on the MMSE test was marginally significant. The ratio of performance to TMT A B test and years does not indicate statistical significance, while statistical significance between the MMSE test performance and education exists. In stroke patients, performance on MMSE test is correlated with the frequency and length of stride walk. The quality of cognitive function and attention is associated with motor skills but differs in stroke patients and people without neurological damage of similar age. The significance of this correlation can supplement research in neurorehabilitation, improve the quality of medical rehabilitation, and contribute to efficient recovery of these patients.

Psychometric properties of the Mini-Mental State Examination in patients with acquired brain injury in Turkey.

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Elhan, Atilla H; Kutlay, Sehim; Küçükdeveci, Ayse A; Cotuk, Cigdem; Oztürk, Gülsah; Tesio, Luigi; Tennant, Alan

2005-09-01

To evaluate the psychometric properties of Mini-Mental State Examination (MMSE) in patients with acquired brain injury in Turkey. A total of 207 patients with acquired brain injury were assessed. Reliability was tested by internal consistency and the person separation index; internal construct validity by Rasch analysis; external construct validity by correlation with cognitive disability; and cross-cultural validity by differential item functioning analysis compared with Italian MMSE data. Reliability was adequate with a Cronbach's alpha of 0.75 and person separation index of 0.76. After collapsing some categories, and adjustment for differential item functioning, internal construct validity was supported by fit of the data to Rasch model. Differential item functioning for culture was found in 2 items and after adjustment, data could be pooled between Turkey and Italy. External construct validity was supported by expected associations. The Turkish version of the Mini-Mental State Examination can be used as a cognitive screening tool in acquired brain injury. Cross-cultural validity between Italy and Turkey is supported, given appropriate adjustment for differential item functioning. However, shortfalls in reliability at the individual level, as well as the presence of differential item functioning suggest that a better instrument should be developed to screen for cognitive deficits following acquired brain injury.

Brief Report: The Autism Mental Status Examination--Development of a Brief Autism-Focused Exam

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Grodberg, David; Weinger, Paige M.; Kolevzon, Alexander; Soorya, Latha; Buxbaum, Joseph D.

2012-01-01

The Autism Mental Status Examination (AMSE) described here is an eight-item observational assessment that prompts the observation and recording of signs and symptoms of autism spectrum disorders (ASD). The AMSE is intended to take place seamlessly in the context of a clinical exam and produces a total score. Subjects were independently…

A Serious Game for Clinical Assessment of Cognitive Status: Validation Study.

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Tong, Tiffany; Chignell, Mark; Tierney, Mary C; Lee, Jacques

2016-05-27

We propose the use of serious games to screen for abnormal cognitive status in situations where it may be too costly or impractical to use standard cognitive assessments (eg, emergency departments). If validated, serious games in health care could enable broader availability of efficient and engaging cognitive screening. The objective of this work is to demonstrate the feasibility of a game-based cognitive assessment delivered on tablet technology to a clinical sample and to conduct preliminary validation against standard mental status tools commonly used in elderly populations. We carried out a feasibility study in a hospital emergency department to evaluate the use of a serious game by elderly adults (N=146; age: mean 80.59, SD 6.00, range 70-94 years). We correlated game performance against a number of standard assessments, including the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Confusion Assessment Method (CAM). After a series of modifications, the game could be used by a wide range of elderly patients in the emergency department demonstrating its feasibility for use with these users. Of 146 patients, 141 (96.6%) consented to participate and played our serious game. Refusals to play the game were typically due to concerns of family members rather than unwillingness of the patient to play the game. Performance on the serious game correlated significantly with the MoCA (r=-.339, P games in a clinical setting. Further research is required to demonstrate the validity and reliability of game-based assessments for clinical decision making.

A Serious Game for Clinical Assessment of Cognitive Status: Validation Study

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Chignell, Mark; Tierney, Mary C.; Lee, Jacques

2016-01-01

Background We propose the use of serious games to screen for abnormal cognitive status in situations where it may be too costly or impractical to use standard cognitive assessments (eg, emergency departments). If validated, serious games in health care could enable broader availability of efficient and engaging cognitive screening. Objective The objective of this work is to demonstrate the feasibility of a game-based cognitive assessment delivered on tablet technology to a clinical sample and to conduct preliminary validation against standard mental status tools commonly used in elderly populations. Methods We carried out a feasibility study in a hospital emergency department to evaluate the use of a serious game by elderly adults (N=146; age: mean 80.59, SD 6.00, range 70-94 years). We correlated game performance against a number of standard assessments, including the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and the Confusion Assessment Method (CAM). Results After a series of modifications, the game could be used by a wide range of elderly patients in the emergency department demonstrating its feasibility for use with these users. Of 146 patients, 141 (96.6%) consented to participate and played our serious game. Refusals to play the game were typically due to concerns of family members rather than unwillingness of the patient to play the game. Performance on the serious game correlated significantly with the MoCA (r=–.339, P games in a clinical setting. Further research is required to demonstrate the validity and reliability of game-based assessments for clinical decision making. PMID:27234145

Validation of conversion between mini-mental state examination and montreal cognitive assessment.

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Lawton, Michael; Kasten, Meike; May, Margaret T; Mollenhauer, Brit; Schaumburg, Martina; Liepelt-Scarfone, Inga; Maetzler, Walter; Vollstedt, Eva-Juliane; Hu, Michele T M; Berg, Daniela; Ben-Shlomo, Yoav

2016-04-01

Harmonizing data across cohorts is important for validating findings or combining data in meta-analyses. We replicate and validate a previous conversion of MoCA to MMSE in PD. We used five studies with 1,161 PD individuals and 2,091 observations measured with both the MoCA and MMSE. We compared a previously published conversion table using equipercentile equating with log-linear smoothing to our internally derived scores. Both conversions found good agreement within and across the studies when comparing true and converted MMSE (mean difference: 0.05; standard deviation: 1.84; median difference: 0; interquartile range: -1 to 1, using internal conversion). These results show that one can get a reliable and valid conversion between two commonly used measures of cognition in PD studies. These approaches need to be applied to other scales and domains to enable large-scale collaborative analyses across multiple PD cohorts. © 2016 The Authors. International Parkinson and Movement Disorder Society.

Changes in frontal lobe function before and after surgery in patients with unruptured intracranial aneurysm

International Nuclear Information System (INIS)

Ozaki, Saya; Kumon, Yoshiaki; Igase, Keiji; Watanabe, Hideaki; Ohnishi, Takanori

2008-01-01

We evaluated neuropsychological function in 18 patients with unruptured cerebral aneurysm who showed good postoperative outcomes. We paid particular attention to frontal lobe function. We also investigated relationships between cerebral blood flow (CBF) and frontal lobe function. Patients were examined using digit span, word fluency (WF), Stroop and trail-making tests to clarify frontal lobe function before and 1-2 months after surgery. We also used the mini-mental state examination (MMSE), Raven's colored progressive matrices (RCPM) and revised Wechsler adult intelligence scale (WAIS-R) to examine cognitive function. CBF was measured using 133 Xe-single photon emission computed tomography (SPECT) before and 1-2 months after surgery. Tests revealed that the patients' postoperative neuropsychological status was improved compared to the preoperative status for MMSE, RCPM and WAIS-R. Among the tests of frontal lobe function, WF results had deteriorated significantly after surgery. Resting CBF in the frontal lobe was significantly decreased. Regional CBF in the frontal lobe was decreased significantly in comparison with values in the parietal and temporal lobes in patients showing deterioration of WF. Deterioration of WF correlated with CBF changes in the frontal lobe. These results suggest that surgery for unruptured cerebral aneurysm exerts detrimental effects on frontal lobe function that may be related to CBF changes. (author)

Blood pressure and 10-year mortality risk in the Milan Geriatrics 75+ Cohort Study

DEFF Research Database (Denmark)

Ogliari, Giulia; Westendorp, Rudi G J; Muller, Majon

2015-01-01

BACKGROUND: optimal blood pressure targets in older adults are controversial. OBJECTIVE: to investigate whether the relation of blood pressure with mortality in older adults varies by age, functional and cognitive status. DESIGN: longitudinal geriatric outpatient cohort. SETTING: Milan Geriatrics...... 75+ Cohort Study. SUBJECTS: one thousand five hundred and eighty-seven outpatients aged 75 years and over. METHODS: the relations of systolic (SBP) and diastolic blood pressure (DBP) with mortality risk were analysed using Cox proportional hazards models. Blood pressure, Mini-Mental State Examination......: the correlations of SBP and DBP with mortality were U-shaped. Higher SBP is related to lower mortality in subjects with impaired ADL and MMSE. ADL and MMSE may identify older subjects who benefit from higher blood pressure....

Cognitive changes under memantine according to vitamin D status in Alzheimer patients: An exposed/unexposed cohort pilot study.

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Lemire, Pauline; Brangier, Antoine; Beaudenon, Melinda; Duval, Guillaume T; Annweiler, Cedric

2018-01-01

Memantine is a symptomatic treatment that partially prevents cognitive decline in Alzheimer disease (AD). The neuroprotective effects of memantine and vitamin D may potentiate each other, with benefits for cognition. The objective of this exposed/unexposed pilot study was to determine the cognitive changes among AD patients using memantine according to the presence or absence of vitamin D deficiency (VDD). Fifty-eight AD patients followed in a memory clinic during 6 months between 2009 and 2014 (mean±standard deviation, 82.9±5.0years; 56.9%female) were separated into four groups according to VDD (i.e., serum 25-hydroxyvitamin D≤25nM) at M0 and M6 (i.e., Group 1: no VDD-M0, no VDD-M6; Group 2: VDD-M0, no VDD-M6; Group 3: no VDD-M0, VDD-M6; Group 4: VDD-M0, VDD-M6). The 6-month cognitive change was examined with the Mini-Mental State Examination (MMSE) score in the 4 groups according to the use of memantine. Age, gender, body mass index, IADL score, GDS score, and use of pchychoactive drugs were measured at baseline. We found that participants using memantine had a lower MMSE score at M0 compared to those without memantine (P=0.006). After 6 months of follow-up, there was a memantine-related improvement of the MMSE score only in the participants with VDD-M6. This was significant in Group 3 with no VDD-M0 (P=0.039), but not in Group 4 who already had VDD-M0. Similarly, using memantine was associated with a 6-month improvement of MMSE only in Group 3 in whom VDD appeared during the follow-up (β=8.8, P=0.044). In conclusion, the use of memantine was associated with improved cognitive performance after 6 months of treatment in the presence of VDD at M6. Memantine may prevent the cognitive decline that accompanies the onset of VDD, which prompts to give to AD patients a regimen combining both memantine and vitamin D supplements. Copyright © 2016 Elsevier Ltd. All rights reserved.

Examining aging sexual stigma attitudes among adults by gender, age, and generational status

OpenAIRE

Syme, Maggie L.; Cohn, Tracy J.

2015-01-01

Objectives: Stigma related to later life sexuality could produce detrimental effects for older adults, through individual concerns and limited sexual health care for older adults. Identifying groups at risk for aging sexual stigma will help to focus interventions to reduce it. Accordingly, the purpose of this study was to examine cross-sectional trends in aging sexual stigma attitudes by age group, generational status, and gender.Method: An online survey was administered to a national sample ...

Equivalence of Linear MMSE Detection in DS-CDMA and MC-CDMA Systems over Time and Frequency Selective Channels

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Tamer A. Kadous

2003-01-01

Full Text Available The goal of this paper is to compare the performance of the linear minimum mean square error (MMSE detector for a class of code division multiple access (CDMA systems in time and frequency selective channels. Specifically, we consider direct sequence (DS-CDMA, multicarrier (MC-CDMA, and the MC-DS-CDMA systems. Two key tools are used in our development. First, a general time-frequency framework that includes the different CDMA systems as special cases. Second, the duality between time and frequency domains that is used to derive equivalences between the different CDMA systems operating over purely frequency selective and purely time selective channels. We then combine the insights obtained from these special cases to assess the performance of CDMA systems over time and frequency selective channels. We provide sufficient conditions for the codes employed by the CDMA systems for the equivalences to hold. Numerical results are presented to illustrate the results.

Usefulness of medial temporal lobe atrophy visual rating scale in detecting Alzheimer′s disease: Preliminary study

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Jae-Hyeok Heo

2013-01-01

Full Text Available Background: The Korean version of Mini-Mental Status Examination (K-MMSE and the Korean version of Addenbrooke Cognitive Examination (K-ACE have been validated as quick neuropsychological tests for screening dementia in various clinical settings. Medial temporal atrophy (MTA is an early pathological characteristic of Alzheimer′s disease (AD. We aimed to assess the diagnostic validity of the fusion of the neuropsychological test and visual rating scale (VRS of MTA in AD. Materials and Methods: A total of fifty subjects (25 AD, 25 controls were included. The neuropsychological tests used were the K-MMSE and the K-ACE. T1 axial imaging visual rating scale (VRS was applied for assessing the grade of MTA. We calculated the fusion score with the difference of neuropsychological test and VRS of MTA. The receiver operating characteristics (ROC curve was used to determine optimal cut-off score, sensitivity and specificity of the fusion scores in screening AD. Results: No significant differences in age, gender and education were found between AD and control group. The values of K-MMSE, K-ACE, CDR, VRS and cognitive function test minus VRS were significantly lower in the AD group than control group. The AUC (Area under the curve, sensitivity and specificity for K-MMSE minus VRS were 0.857, 84% and 80% and for K-ACE minus VRS were 0.884, 80% and 88%, respectively. Those for K-MMSE only were 0.842, 76% and 72% and for K-ACE only were 0.868, 80% and 88%, respectively. Conclusions: The fusion of the neuropsychological test and VRS suggested clinical usefulness in their easy and superiority over neuropsychological test only. However, this study failed to find any difference. This may be because of small numbers in the study or because there is no true difference.

Risk Factors for Postoperative Cognitive Dysfunctions in Elderly Patients

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N. Yu. Ibragimov

2008-01-01

Full Text Available Objective: to study the impact of a wide spectrum of factors on the development of postoperative delirium in elderly patients in relation to the changes in their cognitive functions depending on the type of anesthesia and period after surgery. Subjects and methods. The study covered 100 patients aged 65—90 years who had been electively operated on under general, regional, and combined anesthesia. Their cognitive status was elevated before and 1, 4, and 7 days after surgery, by using the Mini-Mental State Examination (MMSE schedule. The diagnosis was postoperatively established on the basis of interviews, by applying the diagnostic criteria of ICD-10 and DSM-IV (American Psychiatric Association, 1994 and verified by a psychiatrist’s consultation. Results. Seventeen patients developed delirium within the first two days following surgery. Elevated plasma sodium (p<0.000001, leukocytosis (p<0.00002, and postoperative analgesia mode (p<0.02 proved to be statistically significant risk factors for delirium. Worse results of MMSE tests at all postoperative stages than those obtained prior to surgery were significant (p<0.05. Comparing the results obtained on days 1, 4, and 7 showed a significant cognitive improvement. Analysis indicated no significant differences in MMSE changes between the groups of general, regional, and combined anesthesia at all study stages. Conclusion. In elderly patients, surgery and anesthesia lead to a considerable deterioration of cognitive functions even if the development of delirium can be avoided. There is a significant correlation of the development of delirium with leukocytosis, hypernatremia, and postoperative analgesia mode. Key words: anesthesia, postoperative delirium, cognitive status, MMSE, elderly age.

An examination of eating behaviors, physical activity, and obesity in african american adolescents: gender, socioeconomic status, and residential status differences.

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Tate, Nutrena H; Dillaway, Heather E; Yarandi, Hossein N; Jones, Lenette M; Wilson, Feleta L

2015-01-01

African American adolescents experience higher rates of obesity and have an increased risk of obesity-related diseases than do White American adolescents. Despite culturally sensitive obesity preventive interventions, obesity rates are increasing within the African American adolescent population. Current obesity interventions do not usually address the heterogeneity (e.g., socioeconomic status [SES], gender, and residential status differences) within the African American adolescent community that can affect the efficacy of these interventions. To examine the gender, SES, and residential status differences related to obesity and weight behaviors in African American adolescents. A descriptive correlational study was conducted with 15- to 17-year-old African American adolescents (n = 145) from community clinics, youth organizations, churches, and social networks in metropolitan and inner-city Detroit. Data were collected through use of survey methods and analyzed with use of descriptive statistics, independent sample t tests, and multiple regression equations. Female adolescents consumed foods higher in fat and calories (t = -2.36, p = .019) and had more body fat (t = -9.37, p = .000) than did males. Adolescents of lower SES consumed food higher in fat and calories (t = -2.23, p = .027) and had higher body mass (t = -2.57, p = .011) than did adolescents of higher SES. Inner-city African American adolescents had higher levels of physical activity (t = -2.39, p = .018) and higher body mass (t = 2.24, p = .027) than did suburban African American adolescent counterparts. Gender, SES, and residential status were statistically significant predictors of eating behaviors, physical activity, body mass index, and body fat. The initial findings from the study will assist in better understanding the obesity epidemic that affects African American adolescents in disparate proportions. Further examination of the study variables is essential to serve as a basis for

The effect of 6 weeks of Tai chi training on cognitive status, dynamic balance and quality of life in women with stroke

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Manijeh Norouzian

2017-03-01

Full Text Available Background and Objectives: Stroke can lead to permanent disabilities, including motor and cognitive impairments. The aim of this study was to determine the effect of Tai Chi training on cognitive status, dynamic balance, and quality of life in women with stroke. Methods: In this quasi-experimental study, 20 women with stroke (mean age, 65.8±3.5 years; weight, 68.4±14kg; and body mass index, 26.3±5.1kg/m2 in Qom city, were selected voluntarily and randomly divided into experimental (N=10 and control (N=10 groups. Cognitive status, dynamic balance, and quality of life were assessed by Mini-Mental State Examination (MMSE and SF-36 quality of life questionnaires and Timed Up and Go test. Tai Chi group trained for 6 weeks, three 60-minute sessions per week (a 10-minute warm-up period, a 40-minute simplified Tai Chi exercise, and a 10-minute cool-down period. Data were analyzed using dependent and independent t-tests and (p0.05. Conclusion: According to de results of the study, it can be said that Tai Chi training as a low-intensity and simple training improves dynamic balance and quality of life in women with stroke.

The Emotional Toll of Long-Term Unemployment: Examining the Interaction Effects of Gender and Marital Status

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Gokce Basbug

2017-04-01

Full Text Available Prior research shows that long-term unemployment (LTU generates a negative emotional toll but leaves unexplored how such toll varies by gender and marital status. Using a mixed-methods approach we examine how the negative emotional toll of LTU is shaped by the interaction of gender and marital status. Our qualitative findings suggest that more unemployed married men than women experience marital tensions that exacerbate the emotional toll of unemployment. Our analysis of survey data show that while marriages improve the well-being of both unemployed men and women, for married men but not women such benefits disappear once we control for household income. These findings contribute to the existing literature by deepening our understanding of how gender and marital status mediate the emotional toll of LTU.

Validation of the Danish Addenbrooke's Cognitive Examination as a screening test in a memory clinic

DEFF Research Database (Denmark)

Stokholm, Jette; Vogel, Asmus; Johannsen, Peter

2009-01-01

BACKGROUND: Addenbrooke's Cognitive Examination (ACE) is a cognitive screening test developed to detect dementia. It has been validated in several countries. Validation studies have predominantly included patients with various degrees of dementia and healthy controls. OBJECTIVE: The aim...... (MMSE >or=20), 30 non-demented patients diagnosed with depression (originally referred for evaluation of cognitive symptoms), and 63 healthy volunteers, all between 60 and 85 years of age, were included. All patients were given the ACE as a supplement to the standard diagnostic work-up. RESULTS: The cut...

Differentiation of semantic dementia and Alzheimer's disease using the Addenbrooke's Cognitive Examination (ACE).

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Davies, R Rhys; Dawson, Kate; Mioshi, Eneida; Erzinçlioğlu, Sharon; Hodges, John R

2008-04-01

The Addenbrooke's Cognitive Examination (ACE) is a simple diagnostic tool bridging the gap between the very brief Mini Mental State Exam (MMSE) and much longer test batteries used by neuropsychologists which has proven extremely popular internationally. We aimed to assess the ability of the ACE to differentiate semantic dementia (SD) from Alzheimer's disease (AD). The ACE was administered to three groups: SD patients (n = 40) and two separate groups of AD patients (n = 40 in each), matched for overall ACE or MMSE score. Significant differences were found between SD and both AD groups for the ACE sub-scores of naming, reading and orientation in time. Discriminant analysis (SD versus AD) led to the formulation of a 'semantic index' (naming plus reading minus scores for serial-7s, orientation in time and drawing). Application of the semantic index to the patient data found values of less than zero to be predictive of SD rather than AD with 88% sensitivity and 90% specificity. Validation analysis in an independent sample of 24 SD and AD patients proved even more favourable. The overall ACE score is known to be a sensitive, and specific, indicator of early neurodegenerative dementia; this study shows that the ACE can also be used to detect SD through application of the semantic index.

An Examination of the Impact of Minority Status Stress and Impostor Feelings on the Mental Health of Diverse Ethnic Minority College Students

Science.gov (United States)

Cokley, Kevin; McClain, Shannon; Enciso, Alicia; Martinez, Mercedes

2013-01-01

This study examined differences in minority status stress, impostor feelings, and mental health in a sample of 240 ethnic minority college students. African Americans reported higher minority status stress than Asian Americans and Latino/a Americans, whereas Asian Americans reported higher impostor feelings. Minority status stress and impostor…

Memory testing in dementia: how much is enough?

Science.gov (United States)

Derrer, D S; Howieson, D B; Mueller, E A; Camicioli, R M; Sexton, G; Kaye, J A

2001-01-01

Analyses of eight widely used memory measures (Word List Acquisition and Recall used in the Alzheimer's Disease Assessment Scale and the Consortium to Establish a Registry for Alzheimer's Disease neuropsychology battery, Wechsler Memory Scale-Revised [WMS-R] Logical Memory I and II, WMS-R Visual Reproduction I and II, the memory scores from the Neurobehavioral Cognitive Status Examination [NCSE], memory scores from the Mini-Mental State Examination [MMSE]), and the MMSE total score showed each to have moderate predictive power in differentiating between patients with mild dementia and healthy normal controls. When these instruments were combined in a logistic regression analysis, three of them had substantial predictive power. Together, the Word List Acquisition, WMS-R Logical Memory II, and WMS-R Visual Reproduction II were 97.26% accurate (100% sensitive and 94.59% specific) in distinguishing these two groups. The Word List Acquisition is a brief test that alone had high accuracy (92%). These memory tests are highly useful in the diagnosis of mild dementia.

Cognitive testing in non-demented Turkish immigrants

DEFF Research Database (Denmark)

Nielsen, T. Rune; Vogel, Asmus M.; Gade, Anders

2012-01-01

Nielsen, T. R. Vogel, A., Gade, A. & Waldemar, G. (2012). Cognitive testing in healthy Turkish immigrants - comparison of the RUDAS and the MMSE. Scandinavian Journal of Psychology 53, 455-460. Methods for culturally and linguistically appropriate cognitive testing of elderly minority populations...... are lacking in Europe. The aim of this study was to compare performance on the Rowland Universal Dementia Assessment Scale (RUDAS) and the Mini Mental State Examination (MMSE) in Turkish immigrants in Denmark and determine the impact of demographic and health-related variables on test performance. A sample...... of non-demented community-dwelling Turkish immigrants was recruited from the greater Copenhagen area. All participants completed a structured interview regarding demographic, physical and mental health status, as well as measures of depression and acculturation, and cognitive testing with the RUDAS...

The sensitivity and specificity of subjective memory complaints and the subjective memory rating scale, deterioration cognitive observee, mini-mental state examination, six-item screener and clock drawing test in dementia screening.

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Ramlall, S; Chipps, J; Bhigjee, A I; Pillay, B J

2013-01-01

The effectiveness of dementia screening depends on the availability of suitable screening tools with good sensitivity and specificity to confidently distinguish normal age-related cognitive decline from dementia. The aim of this study was to evaluate the discriminant validity of 7 screening measures for dementia. A sample of 140 participants aged ≥60 years living in a residential facility for the aged were assessed clinically and assigned caseness for dementia using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revised diagnostic criteria. Sensitivity and specificity of a selection of the following screening measures were tested using receiver operating characteristic (ROC) analysis for individual and combined tests: the Mini-Mental State Examination (MMSE), Six-Item Screener (SIS), Subjective Memory Complaint, Subjective Memory Complaint Clinical (SMCC), Subjective Memory Rating Scale (SMRS), Deterioration Cognitive Observee (DECO) and the Clock Drawing Test (CDT). Using ROC analyses, the SMCC, MMSE and CDT were found to be 'moderately accurate' in screening for dementia with an area under the curve (AUC) >0.70. The AUCs for the SIS (0.526), SMRS (0.661) and DECO (0.687) classified these measures as being 'less accurate'. At recommended cutoff scores, the SMCC had a sensitivity of 90.9% and specificity of 45.7%; the MMSE had a sensitivity of 63.6% and a specificity of 76.0%, and the CDT had a sensitivity of 44.4% and a specificity of 88.9%. Combining the SMCC and MMSE did not improve their predictive power except for a modest increase when using the sequential rule. The SMCC is composed of valid screening questions that have high sensitivity, are simple to administer and ideal for administration at the community or primary health care level as a first level of 'rule-out' screening. The MMSE can be included at a second stage of screening at the general hospital level and the CDT in specialist clinical settings. Sequential use of the

Validation of the modified telephone interview for cognitive status (TICS-m) in Hebrew.

Science.gov (United States)

Beeri, Michal Schnaider; Werner, Perla; Davidson, Michael; Schmidler, James; Silverman, Jeremy

2003-05-01

The validity of the Hebrew version of the Telephone Interview for Cognitive Status-Modified (TICS-m) for Mild Cognitive Impairment (MCI), for dementia, and for cognitive impairment (either MCI or dementia) was investigated. Of the 10 059 who took part of the Israel Ischemic Heart Disease Cohort, 1902 of the 2901 survivors in 1999 had TICS-m interviews. Those with a score of 27 or below and a random sample with a score of 28 or 29 were invited to have a physician's examination for the diagnosis of dementia. The analysis was performed on the 576 who agreed. Based on physician's diagnosis, 269 were diagnosed as suffering from dementia, 128 as suffering from MCI, and 179 were diagnosed with no cognitive impairment. The TICS-m Hebrew version's internal consistency was very high (Cronbach's alpha = 0.98) and showed a strong convergent validity with the MMSE (r = 0.82; p education and hearing impairment, TICS-m was a strong predictor of dementia, MCI and cognitive impairment. At a cut-off of 27/50 the Hebrew version of the TICS-m is a useful screening instrument to identify subjects suffering from mild cognitive impairment, dementia and cognitive impairment (MCI or dementia). Copyright 2003 John Wiley & Sons, Ltd.

Body Composition, Fitness Status, and Health Behaviors upon Entering College: An Examination of Female College Students from Diverse Populations

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Amanda A. Price

2016-01-01

Full Text Available Although poor health-related behaviors that impact development of chronic diseases begin much earlier than when actual disease is evident, few studies have examined health behaviors in college students, who may be at an important transitional period where early intervention could prevent development of chronic diseases. The purpose of this study was to examine health-related factors in female college students ( N = 61 by race/ethnicity and weight status. We found significant differences in health profiles between non-Hispanic White (White and African American students, including greater physical fitness and healthier diets among White students. Overweight/obese students had worse health profiles than healthy BMI students. Furthermore, weight status was significantly associated with cardiovascular fitness. This supports a focus on PA promotion for interventions in the period of emerging adulthood, alongside the other healthy behaviors, to elicit improvements in weight status and potential reduction of chronic disease risks.

Development of a screening algorithm for Alzheimer's disease using categorical verbal fluency.

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Yeon Kyung Chi

Full Text Available We developed a weighted composite score of the categorical verbal fluency test (CVFT that can more easily and widely screen Alzheimer's disease (AD than the mini-mental status examination (MMSE. We administered the CVFT using animal category and MMSE to 423 community-dwelling mild probable AD patients and their age- and gender-matched cognitively normal controls. To enhance the diagnostic accuracy for AD of the CVFT, we obtained a weighted composite score from subindex scores of the CVFT using a logistic regression model: logit (case  = 1.160+0.474× gender +0.003× age +0.226× education level - 0.089× first-half score - 0.516× switching score -0.303× clustering score +0.534× perseveration score. The area under the receiver operating curve (AUC for AD of this composite score AD was 0.903 (95% CI = 0.883 - 0.923, and was larger than that of the age-, gender- and education-adjusted total score of the CVFT (p<0.001. In 100 bootstrapped re-samples, the composite score consistently showed better diagnostic accuracy, sensitivity and specificity for AD than the total score. Although AUC for AD of the CVFT composite score was slightly smaller than that of the MMSE (0.930, p = 0.006, the CVFT composite score may be a good alternative to the MMSE for screening AD since it is much briefer, cheaper, and more easily applicable over phone or internet than the MMSE.

Post-hoc principal component analysis on a largely illiterate elderly population from North-west India to identify important elements of mini-mental state examination.

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Raina, Sunil Kumar; Chander, Vishav; Raina, Sujeet; Grover, Ashoo

2016-01-01

Mini-mental state examination (MMSE) scale measures cognition using specific elements that can be isolated, defined, and subsequently measured. This study was conducted with the aim to analyze the factorial structure of MMSE in a largely, illiterate, elderly population in India and to reduce the number of variables to a few meaningful and interpretable combinations. Principal component analysis (PCA) was performed post-hoc on the data generated by a research project conducted to estimate the prevalence of dementia in four geographically defined habitations in Himachal Pradesh state of India. Questions on orientation and registration account for high percentage of cumulative variance in comparison to other questions. The PCA conducted on the data derived from a largely, illiterate population reveals that the most important components to consider for the estimation of cognitive impairment in illiterate Indian population are temporal orientation, spatial orientation, and immediate memory.

Post-hoc principal component analysis on a largely illiterate elderly population from North-west India to identify important elements of mini-mental state examination

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Sunil Kumar Raina

2016-01-01

Full Text Available Background: Mini-mental state examination (MMSE scale measures cognition using specific elements that can be isolated, defined, and subsequently measured. This study was conducted with the aim to analyze the factorial structure of MMSE in a largely, illiterate, elderly population in India and to reduce the number of variables to a few meaningful and interpretable combinations. Methodology: Principal component analysis (PCA was performed post-hoc on the data generated by a research project conducted to estimate the prevalence of dementia in four geographically defined habitations in Himachal Pradesh state of India. Results: Questions on orientation and registration account for high percentage of cumulative variance in comparison to other questions. Discussion: The PCA conducted on the data derived from a largely, illiterate population reveals that the most important components to consider for the estimation of cognitive impairment in illiterate Indian population are temporal orientation, spatial orientation, and immediate memory.

Adolescent Peer Victimization, Peer Status, Suicidal Ideation, and Nonsuicidal Self-Injury: Examining Concurrent and Longitudinal Associations

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Heilbron, Nicole; Prinstein, Mitchell J.

2010-01-01

This study examined concurrent and longitudinal associations among peer victimization, peer status, and self-injurious thoughts and behaviors (i.e., suicidal ideation and nonsuicidal self-injury [NSSI]) over a 2-year period. A community sample of 493 adolescents (51% girls) in Grades 6-8 participated in the study. Participants completed measures…

Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patients

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Forastiere Francesco

2008-08-01

Full Text Available Abstract Background The association between bronchial obstruction severity and mortality in Chronic Obstructive Pulmonary Disease (COPD is well established, but it is unknown whether disease-specific health status measures and multidimensional assessment (MDA have comparable prognostic value. Methods We analyzed data coming from the Salute Respiratoria nell'Anziano (Respiratory Health in the Elderly – SaRA study, enrolling elderly people attending outpatient clinics for respiratory and non-respiratory problems. From this population we selected 449 patients with bronchial obstruction (77.3% men, mean age 73.1. We classified patients' health status using tertiles of the Saint George Respiratory Questionnaire (SGRQ and a MDA including functional (the 6' walking test, WT, cognitive (Mini-Mental State Examination, MMSE and affective status (Geriatric Depression Scale, GDS. The agreement of the classification methods was calculated using the kappa statistic, and survival associated with group membership was evaluated using survival analysis. Results Pulmonary function, expressed by the FEV1, worsened with increasing SGRQ or MDA scores. Cognitive function was not associated with the SGRQ, while physical performance and mood status were impaired only in the highest tertile of SGRQ. A poor agreement was found between the two classification systems tested (k = 0.194. Compared to people in the first tertile of SGRQ score, those in the second tertile had a sex-adjusted HR of 1.22 (0.75 – 1.98 and those in the third tertile of 2.90 (1.92 – 4.40. The corresponding figures of the MDA were 1.49 (95% CI 1.02 – 2.18 and 2.01 (95% CI: 1.31 – 3.08. After adjustment for severity of obstruction, only a SGRQ in the upper tertile was associated with mortality (HR: 1.86; 95% CI: 1.14 – 3.02. Conclusion In elderly outpatients with mild-moderate COPD, a disease-specific health status index seems to be a better predictor of death compared to a MDA.

Optimal and Suboptimal Finger Selection Algorithms for MMSE Rake Receivers in Impulse Radio Ultra-Wideband Systems

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Chiang Mung

2006-01-01

Full Text Available The problem of choosing the optimal multipath components to be employed at a minimum mean square error (MMSE selective Rake receiver is considered for an impulse radio ultra-wideband system. First, the optimal finger selection problem is formulated as an integer programming problem with a nonconvex objective function. Then, the objective function is approximated by a convex function and the integer programming problem is solved by means of constraint relaxation techniques. The proposed algorithms are suboptimal due to the approximate objective function and the constraint relaxation steps. However, they perform better than the conventional finger selection algorithm, which is suboptimal since it ignores the correlation between multipath components, and they can get quite close to the optimal scheme that cannot be implemented in practice due to its complexity. In addition to the convex relaxation techniques, a genetic-algorithm- (GA- based approach is proposed, which does not need any approximations or integer relaxations. This iterative algorithm is based on the direct evaluation of the objective function, and can achieve near-optimal performance with a reasonable number of iterations. Simulation results are presented to compare the performance of the proposed finger selection algorithms with that of the conventional and the optimal schemes.

Relationship between cognitive impairment and nutritional assessment on functional status in Calabrian long-term-care.

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Malara, Alba; Sgrò, Giovanni; Caruso, Chiara; Ceravolo, Francesco; Curinga, Giuseppe; Renda, Grazia Francesca; Spadea, Fausto; Garo, Michele; Rispoli, Vincenzo

2014-01-01

The interaction between dementia and nutritional state is very complex and not yet fully understood. The aim of the present study was to assess the interaction between cognitive impairment and nutritional state in a cohort of residential elderly in relationship with functional condition of patients and their load of assistance in long-term-care facilities of the National Association of Third Age Structures (ANASTE) Calabria. One hundred seventy-four subjects (122 female and 52 male) were admitted to the long-term-care ANASTE Calabria study. All patients underwent multidimensional geriatric assessment. Nutritional state was assessed with the Mini Nutritional Assessment (MNA), whereas cognitive performance was evaluated by the Mini-Mental State Examination (MMSE). The functional state was assessed by Barthel Index (BI) and Activity Daily Living (ADL). The following nutritional biochemical parameters were also evaluated: albumin, cholesterol, iron, and hemoglobin. All patients were reassessed 180 days later. A severe cognitive impairment in MMSE performance was displayed in 49.7% patients, while 39.8% showed a moderate deficit; 6.9% had a slight deficit; and 3.4% evidenced no cognitive impairment. In MNA, 30% of patients exhibited an impairment of nutritional state; 56% were at risk of malnutrition; and 14% showed no nutritional problems. Malnutrition was present in 42% of patients with severe cognitive impairment, but only 4% of malnourished patients showed moderate cognitive deficit. The statistical analysis displayed a significant correlation between MNA and MMSE (Pnutritional state (P<0.005) as well as with the functional state (P<0.05) and mortality (P<0.01). The present study clearly shows that malnutrition may play an important role in the progression of cognitive loss.

Functional Balance and Its Determinants in Older People with Diabetes.

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Tsai, Yi-Ju; Yang, Yi-Ching; Lu, Feng-Hwa; Lee, Pei-Yun; Lee, I-Ting; Lin, Sang-I

2016-01-01

To determine functional balance abilities of older adults with diabetes, and identify determinants of these abilities. Eighty diabetic and 67 healthy non-diabetic community-dwelling older adults completed the Mini Mental Status Examination (MMSE) and questionnaires about their medical and fall histories. Participants were also assessed for vision, plantar sensitivity, muscle strength, and functional balance, including Functional Reach (FR), Five Times Sit-to-Stand (FTSTS), and 180° turn (TURN). In addition to between-group comparisons, hierarchical regression analysis was conducted to identify the independent determinants for each of the individual balance tasks for the diabetes and control group separately. The diabetes group had significantly greater body mass index, higher rate of cardiac disease, and poorer plantar sensitivity, mental status, grip and lower limb strength. The diabetes group performed significantly poorer in FTSTS and TURN (both pdeterminants for the balance tasks varied substantially between tasks and groups. For the diabetes group, they included visual and plantar sensitivity and MMSE for FR (R2 = 0.39), ankle dorsiflexion strength for FTSTS (R2 = 0.377), and plantar sensitivity, knee extension strength and MMSE for TURN (R2 = 0.391). For the control group, knee extension strength emerged as the common and only significant determinant and only explained approximately 10% of the variance for FR and TURN. Impairments in functional balance abilities were evident for older adults with diabetes. Their underpinning functional limitations were different for different tasks and were also different from those of the control group. Screening of functional balance and mental status, lower limb strength and sensory function, and interventions to address these impairments may be important to maintain function, independence and safety for older clients with diabetes.

Unconditional and Conditional Standards Using Cognitive Function Curves for the Modified Mini-Mental State Exam: Cross-Sectional and Longitudinal Analyses in Older Chinese Adults in Singapore.

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Cheung, Yin Bun; Xu, Ying; Feng, Lei; Feng, Liang; Nyunt, Ma Shwe Zin; Chong, Mei Sian; Lim, Wee Shiong; Lee, Tih Shih; Yap, Philip; Yap, Keng Bee; Ng, Tze Pin

2015-09-01

The conventional practice of assessing cognitive status and monitoring change over time in older adults using normative values of the Mini-Mental State Exam (MMSE) based on age bands is imprecise. Moreover, population-based normative data on changes in MMSE score over time are scarce and crude because they do not include age- and education-specific norms. This study aims to develop unconditional standards for assessing current cognitive status and conditional standards that take prior MMSE score into account for assessing longitudinal change, with percentile curves as smooth functions of age. Cross-sectional and longitudinal data of a modified version of the MMSE for 2,026 older Chinese adults from the Singapore Longitudinal Aging Study, aged 55-84, in Singapore were used to estimate quantile regression coefficients and create unconditional standards and conditional standards. We presented MMSE percentile curves as a smooth function of age in education strata, for unconditional and conditional standards, based on quantile regression coefficient estimates. We found the 5th and 10th percentiles were more strongly associated with age and education than were higher percentiles. Model diagnostics demonstrated the accuracy of the standards. The development and use of unconditional and conditional standards should facilitate cognitive assessment in clinical practice and deserve further studies. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Status of Breast Self-Examination Performance among Women Referring to Health Centers of Tabriz, Iran

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Farshbaf-Khalili Azizeh

2014-07-01

Full Text Available Objective: Breast cancer is the most common type of cancer and the second principal cause of deaths from cancer in women. Breast self-examination (BSE is an inexpensive screening method and is carried out by women themselves. The purpose of this study was to examine the status of breast self-examination performance among women referring to health centers of Tabriz, Iran. Materials and Methods: This study was a descriptive/ cross-sectional research carried out on 400 women aged 20-50 years. The samples were recruited randomly from among female clients of health centers in Tabriz. A questionnaire and an observational checklist were used to elicit socio-demographic information and status of BSE performance among women. Content validity was used for validation and Cronbach’s alpha was calculated (0.80 for reliability of instrument. Descriptive and inferential statistics were used to analyze data through SPSS software. Results: The findings of this research showed that only 18.8% of women performed BSE. Among them, 46.67% performed BSE monthly, and 40% at the end of menstruation. The initiation age of BSE in 77% was between 21-30 years of age. It is considerable that 54.7% of them had received no advice on BSE from physicians and midwives. The majority of women did not perform the various steps of BSE. The quality of this screening was very desirable in 2 (0.5 %, desirable in 5 (1.3%, average in 19 (4.8%, undesirable in 36 (9%, and very undesirable in 338 (84.5% women. Chi-square test showed a significant relationship between the quality of BSE performance and level of education, employment, breastfeeding quality, and family history of breast cancer (P < 0.05. Conclusion: The findings showed that the status of BSE performance was very poor. Therefore, to encourage women to use BSE correctly and regularly, education programs should be performed through various media including television, radio, and leaflets. The role of Health personnel in this

A Disease Modification Effect of APOE E4 on the Association between Urinary Albumin Excretion and Cognition in Korean Adults

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Min-Ho Shin

2014-01-01

Full Text Available Background. No previous study examined a disease modifying effect of APOE E4 status on the association between the urinary albumin-to-creatinine ratio (UACR and cognition. This study aimed to investigate whether APOE E4 modified the association in Korean adults. Methods. We performed a cross-sectional study in adults aged 45 to 74 who were living in Namwon City, Republic of Korea. Cognitive function was measured with the Korean version of modified Mini-Mental State Examination (K-mMMSE and cognitive impairment was defined as scores falling below the 25th percentile of the K-mMMSE according to age, sex, and educational attainments. Results. A total of 10,190 participants (4006 men and 6184 women were analyzed in the present study. Of these, 1698 subjects (16.7% were APOE E4 carriers. The UACR values were negatively associated with the K-mMMSE scores, even after adjusting for potential confounders including age, sex, education, and vascular risk factors. APOE E4 modified the association significantly, resulting in a steeper decline of cognitive function with the increase in UACR in E4 carriers (P for interaction = 0.021. Conclusion. Higher UACR values were significantly associated with cognitive dysfunction in the general Korean population, with cognition in APOE E4 carriers being more severely affected by increased UACR.

[Usefulness of the Addenbrooke's Cognitive Examination (Spanish version) in Peruvian patients with Alzheimer's disease and Frontotemporal Dementia].

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Custodio, Nilton; Lira, David; Montesinos, Rosa; Gleichgerrcht, Ezequiel; Manes, Facundo

2012-01-01

The development of screening tools for the assessment of cognitive status in patients with dementia must be brief yet both highly sensitive and specific in order to ensure its clinical utility. In this sense, it is important to adapt tools widely used around the world to particular populations, allowing for a more proper validity of its use in everyday clinical practice. One of the most popular general cognitive screening tools is the Addenbrooke's Cognitive Examination (ACE), which has been adapted and validated in multiple languages and populations. To assess the usefulness of the Peruvian version of the ACE in patients with dementia. Healthy controls, patients with Alzheimer disease (AD) and patients with Frontotemporal Dementia (FTD) were assessed with the Peruvian version of the ACE, the ADAScog to determine dementia severity, and a complete neuropsychological battery. The Peruvian version of the ACE showed very good internal consistency, strong concurrent validity as revealed by significant correlations between the ACE total score and both the MMSE and ADAScog. The ACE was able to differentiate healthy controls from patients with dementia with high discriminatory accuracy. Using a cut-off score of 86 (out of 100), the ACE was exhibited a sensitivity of 100% and a specificity of 100%.

Examining the Impact of Maternal Health, Race, and Socioeconomic Status on Daughter's Self-Rated Health Over Three Decades.

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Shippee, Tetyana P; Rowan, Kathleen; Sivagnanam, Kamesh; Oakes, J Michael

2015-09-01

This study examines the role of mother's health and socioeconomic status on daughter's self-rated health using data spanning three decades from the National Longitudinal Surveys of Mature Women and Young Women (N = 1,848 matched mother-daughter pairs; 1,201 White and 647 African American). Using nested growth curve models, we investigated whether mother's self-rated health affected the daughter's self-rated health and whether socioeconomic status mediated this relationship. Mother's health significantly influenced daughters' self-rated health, but the findings were mediated by mother's socioeconomic status. African American daughters reported lower self-rated health and experienced more decline over time compared with White daughters, accounting for mother's and daughter's covariates. Our findings reveal maternal health and resources as a significant predictor of daughters' self-rated health and confirm the role of socioeconomic status and racial disparities over time. © The Author(s) 2015.

Longitudinal study of self-imposed driving restrictions and deficit awareness in patients with Alzheimer disease.

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Cotrell, V; Wild, K

1999-01-01

Thirty-five patients with Alzheimer disease (AD), including 19 who were still driving, were evaluated for level of awareness and driving status. There was no significant correlation between driving status and Mini-Mental State Examination (MMSE) scores. Only the attention subscore of the awareness questionnaire yielded a statistically significant difference between drivers and nondrivers. Follow-up of the patients who were still driving was conducted 12-18 months later. All but 4 patients had stopped driving. Caregivers responded to a questionnaire assessing the patient's driving behaviors since the onset of AD. There was no correlation between MMSE and driving status. In 7 of 10 cases, caregivers or patients made the decision that the patient should stop driving. However, caregivers reported long periods between the caregiver's perception that the patient should stop driving and actual cessation (0.5-48 months). Results suggest that AD patients do restrict several areas of their driving voluntarily and that a failure to do so may be associated with an awareness deficit. In particular, a deficit of awareness for attention was significantly associated with an absence of restricted driving behaviors such as avoiding unfamiliar routes. Awareness of a deficit that is related to driving performance may be critical to restricted driving behavior, and this change in behavior may enable the patient to prolong his or her status as a driver.

Examining aging sexual stigma attitudes among adults by gender, age, and generational status.

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Syme, Maggie L; Cohn, Tracy J

2016-01-01

Stigma related to later life sexuality could produce detrimental effects for older adults, through individual concerns and limited sexual health care for older adults. Identifying groups at risk for aging sexual stigma will help to focus interventions to reduce it. Accordingly, the purpose of this study was to examine cross-sectional trends in aging sexual stigma attitudes by age group, generational status, and gender. An online survey was administered to a national sample of adults via a crowdsourcing tool, in order to examine aging sexual stigma across age groups, generational status, and gender (N = 962; 47.0% male, 52.5% female, and .5% other; mean age = 45 years). An aging sexual stigma index was formulated from the attitudinal items of the Aging Sexual Knowledge and Attitudes Scale. This sample reported moderately permissive attitudes toward aging sexuality, indicating a low level of aging sexual stigma. Though descriptive data showed trends of stigma attitudes increasing with age and later generations, there were no significant differences between age groups or generations in terms of aging sexual stigma beliefs. Men, regardless of age and/or generation, were found to espouse significantly higher stigmatic beliefs than women or those reporting 'other' gender. Aging sexual stigma beliefs may not be prevalent among the general population as cohorts become more sexually liberal over time, though men appear more susceptible to these beliefs. However, in order to more comprehensively assess aging sexual stigma, future research may benefit from measuring explicit and implicit aging sexual stigma beliefs.

Performance of Edmonton Frail Scale on frailty assessment: its association with multi-dimensional geriatric conditions assessed with specific screening tools.

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Perna, Simone; Francis, Matthew D'Arcy; Bologna, Chiara; Moncaglieri, Francesca; Riva, Antonella; Morazzoni, Paolo; Allegrini, Pietro; Isu, Antonio; Vigo, Beatrice; Guerriero, Fabio; Rondanelli, Mariangela

2017-01-04

The aim of this study was to evaluate the performance of Edmonton Frail Scale (EFS) on frailty assessment in association with multi-dimensional conditions assessed with specific screening tools and to explore the prevalence of frailty by gender. We enrolled 366 hospitalised patients (women\\men: 251\\115), mean age 81.5 years. The EFS was given to the patients to evaluate their frailty. Then we collected data concerning cognitive status through Mini-Mental State Examination (MMSE), health status (evaluated with the number of diseases), functional independence (Barthel Index and Activities Daily Living; BI, ADL, IADL), use of drugs (counting of drugs taken every day), Mini Nutritional Assessment (MNA), Geriatric Depression Scale (GDS), Skeletal Muscle Index of sarcopenia (SMI), osteoporosis and functionality (Handgrip strength). According with the EFS, the 19.7% of subjects were classified as non frail, 66.4% as apparently vulnerable and 13.9% with severe frailty. The EFS scores were associated with cognition (MMSE: β = 0.980; p nutrition (MNA: β = -0.413; p performance (Handgrip: β = -0.114, p performance tool for stratifying the state of fragility in a group of institutionalized elderly. As matter of facts the EFS has been shown to be associated with several geriatric conditions such independence, drugs assumption, mood, mental, functional and nutritional status.

Effect of Memo®, a natural formula combination, on Mini-Mental State Examination scores in patients with mild cognitive impairment

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Yakoot M

2013-07-01

Full Text Available Mostafa Yakoot,1 Amel Salem,2 Sherine Helmy3 1Green Clinic and Research Center, 2Mabarrah Clinics, 3Pharco Pharmaceutical Industries, Alexandria, Egypt Background: Mild cognitive impairment encompasses the clinical continuum between physiologic age-related cognitive changes and dementia. A variety of medications, including herbal preparations (in particular Ginkgo biloba and Panax ginseng, have been advocated as treatments for cognitive impairment in the elderly. In this study, we investigated the effect of an already marketed dietary supplement (Memo® combining 750 mg of lyophilized royal jelly with standardized extracts of G. biloba 120 mg and P. ginseng 150 mg on Mini-Mental State Examination (MMSE scores in patients with mild cognitive impairment. Methods: Sixty-six subjects presenting with forgetfulness and satisfying the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR clinical criteria for mild cognitive impairment were randomly divided into an experimental group treated with one Memo capsule before breakfast daily for 4 weeks and a control group who took placebo. The mean change in MMSE score from baseline and reported adverse effects were compared between the two groups. Results: The mean change in MMSE score in the group treated with Memo for 4 weeks was significantly greater than in the control group (+2.07 versus +0.13, respectively by the Student’s t-test (t = 6.485, P < 0.0001. This was also true after adjusting for age as a covariate and educational level as a factor nested within the treatment groups in a general linear model (analysis of covariance, F = 9.675 [corrected model], P < 0.0001. Conclusion: This combined triple formula may be beneficial in treating the cognitive decline that occurs during the aging process as well as in the early phases of pathologic cognitive impairment typical of insidious-onset vascular dementia and in the early stages of Alzheimer’s disease. Larger

The daily commute from work to home: examining employees' experiences in relation to their recovery status.

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van Hooff, Madelon L M

2015-04-01

Sufficient recovery after daily effort expenditure at work is important to protect employee health and well-being. However, the role of commuting in the daily effort-recovery process is still not very well understood. The present study aimed to advance insight in this respect by examining if relaxation, detachment, mastery and stressful delays experienced during the commute from work to home affect employees' recovery status after returning home from work and at the end of the evening. Daily job demands were expected to moderate these effects. Serenity and (low) anxiety were included as indicators of employees' recovery status. Data were collected by means of a 5-day daily diary study (three measurements daily) among 76 participants from various industries. Multilevel analyses showed that relaxation was positively and stressful delays were negatively related to employees' recovery status after returning home from work but not to indicators of recovery at the end of the evening. For detachment, similar relations were found but only on days with high job demands. Mastery was not related to employees' recovery status. These findings enhance our insight in the daily effort-recovery cycle and underline the importance of promoting detachment (on demanding workdays) and relaxation on the way home from work. Copyright © 2013 John Wiley & Sons, Ltd.

Validation of EORTC Prognostic Factors for Adults With Low-Grade Glioma: A Report Using Intergroup 86-72-51

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Daniels, Thomas B.; Brown, Paul D.; Felten, Sara J.; Wu, Wenting; Buckner, Jan C.; Arusell, Robert M.; Curran, Walter J.; Abrams, Ross A.; Schiff, David; Shaw, Edward G.

2011-01-01

Purpose: A prognostic index for survival was constructed and validated from patient data from two European Organisation for Research and Treatment of Cancer (EORTC) radiation trials for low-grade glioma (LGG). We sought to independently validate this prognostic index with a separate prospectively collected data set (Intergroup 86-72-51). Methods and Materials: Two hundred three patients were treated in a North Central Cancer Treatment Group-led trial that randomized patients with supratentorial LGG to 50.4 or 64.8 Gy. Risk factors from the EORTC prognostic index were analyzed for prognostic value: histology, tumor size, neurologic deficit, age, and tumor crossing the midline. The high-risk group was defined as patients with more than two risk factors. In addition, the Mini Mental Status Examination (MMSE) score, extent of surgical resection, and 1p19q status were also analyzed for prognostic value. Results: On univariate analysis, the following were statistically significant (p < 0.05) detrimental factors for both progression-free survival (PFS) and overall survival (OS): astrocytoma histology, tumor size, and less than total resection. A Mini Mental Status Examination score of more than 26 was a favorable prognostic factor. Multivariate analysis showed that tumor size and MMSE score were significant predictors of OS whereas tumor size, astrocytoma histology, and MMSE score were significant predictors of PFS. Analyzing by the EORTC risk groups, we found that the low-risk group had significantly better median OS (10.8 years vs. 3.9 years, p < 0.0001) and PFS (6.2 years vs. 1.9 years, p < 0.0001) than the high-risk group. The 1p19q status was available in 66 patients. Co-deletion of 1p19q was a favorable prognostic factor for OS vs. one or no deletion (median OS, 12.6 years vs. 7.2 years; p = 0.03). Conclusions: Although the low-risk group as defined by EORTC criteria had a superior PFS and OS to the high-risk group, this is primarily because of the influence of

The Utility of the Mini-Addenbrooke's Cognitive Examination as a Screen for Cognitive Impairment in Elderly Patients with Chronic Kidney Disease and Diabetes.

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Hobson, Peter; Rohoma, Kamel H; Wong, Stephen P; Kumwenda, Mick J

2016-01-01

We tested the utility of the Mini-Addenbrooke's Cognitive Examination (M-ACE) in a cohort of older adults with chronic kidney disease (CKD) and diabetes. The M-ACE was administered to 112 CKD and diabetes patients attending a nephrology clinic. Cognitive impairment was based upon patient, informant, and case review, neuropsychological assessment, and application of criteria for mild cognitive impairment (MCI) and the Diagnostic and Statistical Manual of Mental Disorders, fifth edition for dementia. The M-ACE was also compared to the Mini-Mental State Examination (MMSE). Upon assessment, 52 patients had normal cognitive function, 33 had MCI, and 27 had dementia. The area under the receiver operating curve for the M-ACE was 0.96 (95% CI 0.95-1.00). The sensitivity and specificity for a dementia diagnosis were 0.96 and 0.84 at the cut point <25 and 0.70 and 1.00 at the cut point <21. Mean M-ACE scores differed significantly between normal, demented, and MCI groups ( p < 0.001), and compared to the MMSE, the M-ACE did not suffer from ceiling effects. The M-ACE is an easily administered test with good sensitivity and specificity to capture and assist in the diagnosis of MCI or dementia in patients with CKD and diabetes.

One‐minute mental status examination for category fluency is more useful than mini‐mental state examination to evaluate the reliability of insulin self‐injection in elderly diabetic patients

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Yajima, Ken; Matsushita, Takaya; Sumitomo, Hidetaka; Sakurai, Hirofumi; Katayama, Takashi; Kanno, Kazuo; Sakai, Masashi; Shigeta, Masayuki; Shirabe, Shinichiro; Nakano, Tadasumi; Nishimura, Kazuhiro; Ueki, Akio; Kitaoka, Masafumi

2013-01-01

Abstract Aims/Introduction We investigated the factors associated with the reliability of insulin self‐injection in elderly diabetic patients receiving insulin therapy. Materials and Methods We enrolled diabetic patients aged ≥65 years and receiving insulin therapy, and assessed their cognitive function by the mini‐mental state examination and 1‐min mental status examination for category fluency. We also observed their technique of insulin self‐injection, and evaluated whether or not patients...

[Spanish validation of the MacArthur Competence Assessment Tool for Treatment interview to assess patients competence to consent treatment].

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Alvarez Marrodán, Ignacio; Baón Pérez, Beatriz; Navío Acosta, Mercedes; López-Antón, Raul; Lobo Escolar, Elena; Ventura Faci, Tirso

2014-09-09

To validate the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) Spanish version, which assesses the mental capacity of patients to consent treatment, by examining 4 areas (Understanding, Appreciation, Reasoning and Expressing a choice). 160 subjects (80 Internal Medicine inpatients, 40 Psychiatric inpatients and 40 healthy controls). MacCAT-T, Mini-Mental Status Examination (MMSE). Feasibility study, reliability and validity calculations (against to gold standard of clinical expert). Mean duration of the MacCAT-T interview was 18min. Inter-rater reliability: Intraclass correlation coefficient for Understanding=0.98, Appreciation=0.97, Reasoning=0.98, Expressing a choice=0.91. Internal consistency (Cronbach's alpha): Understanding=0.87, for Appreciation=0.76, for Reasoning=0.86. Patients considered to be incapable (gold standard) scored lower in all the MacCAT-T areas. Poor performance on the MacCAT-T was related to cognitive impairment assessed by MMSE. Spanish version of the MacCAT-T is feasible, reliable, and valid for assessing the capacity of patients to consent treatment. Copyright © 2013 Elsevier España, S.L. All rights reserved.

The use of cerebroprotein hydrolysate in dementia: A case series of 25 cases seen in a tertiary general hospital

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Mosam Phirke

2014-01-01

Full Text Available Background: Cerebroprotein hydrolysate (Cerebrolysin is a pharmacological and neurotrophic agent that has been used widely in the management of various forms of dementia. Purpose: The present paper presents a retrospective chart review of 25 patients with dementia visiting a tertiary general hospital psychiatry unit who received cerebroprotein hydrolysate as an add on treatment for dementia. Materials and Methods: Twenty-five patients were administered 20 doses of cerebroprotein hydrolysate intravenously at a dose of 60 mg in 250 ml normal saline over 1-2 h after a test dose on 20 consecutive days. The cognitive assessment was done before the first injection and after the last dose using the Adenbrook′s Cognitive Examination-Revised (ACER and the Mini Mental Status Examination (MMSE. Results: There was significant improvement in scores on the ACER and MMSE, although the final scores remained in the dementia range. None of the patients experienced any major side effects. Conclusions: Cerebroprotein thus is a useful pharmacological option in the management of dementia and warrants further study and exploration.

Rastreamento cognitivo e sintomas depressivos em idosos iniciantes em programa de exercício físico Cognitive tracking and depressive symptoms in elderly starting out on physical exercise program

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Lucélia Justino Borges

2007-01-01

Full Text Available OBJETIVO: Identificar o estado de saúde mental de idosos iniciantes em um programa de exercício físico e analisar a associação entre os indicadores sociodemográficos com a pontuação das escalas geriátricas. MÉTODOS: Participaram do estudo 121 idosos, com idade média de 68,69 ± 6,46 anos, cadastrados nos Centros de Saúde de Florianópolis/SC. Aplicou-se o Mini-Exame do Estado Mental (MEEM e a escala de depressão geriátrica (GDS. RESULTADOS: a prevalência de transtornos cognitivos foi de 9,1% e de depressão de 17,4%. Tanto a escolaridade quanto a renda apresentaram associação estatística significativas com a pontuação do MEEM (p OBJECTIVE: To identify the mental health status of elderly people starting out on an exercise program and to analyze the relationship between socio-demographic and economic indicators and scores on geriatric assessment scales. METHODS: The study enrolled 121 elderly people, with a mean age of 68.69±6.46 years, registered at Health Centers in Florianopolis. The Mini-Mental State Examination (MMSE and the Geriatric Depression Scale (GDS were applied to these subjects. RESULTS: The prevalence of cognition disorders was 9.1% and the prevalence of depression was 17.4%. Both educational level and income exhibited statistically significant associations with MMSE scores (p < 0.001 and p < 0.001, respectively. None of the variables studied (marital status, age and income were associated with GDS scores (p = 0.986, p = 0.226, p = 0.302, respectively. A significant inverse relationship was observed between MMSE and GDS scores (r = -0.201; p = 0.02. CONCLUSIONS: There were significant prevalence rates of both depression and cognitive disorders among elderly people beginning a physical exercise program. In this population, the higher the educational level and income, the better the performance on the MMSE scale. It was also detected that individuals who exhibited depressive symptoms scored lower than normal on

Health Status, Intention to Seek Health Examination, and Participation in Health Education Among Taxi Drivers in Jinan, China

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Yang, Yan; Fan, Xiao-sheng; Tian, Cui-huan; Zhang, Wei; Li, Jie; Li, Shu-qing

2014-01-01

Background: Taxi drivers are exposed to various risk factors such as work overload, stress, an irregular diet, and a sedentary lifestyle, which make these individuals vulnerable to many diseases. This study was designed to assess the health status of this occupational group. Objectives: The objective was to explore the health status, the intention to seek health examination, and participation in health education among taxi drivers in Jinan, China. Patients and Methods: The sample-size was determined scientifically. The systematic sampling procedure was used for selecting the sample. Four hundred taxi drivers were randomly selected from several taxi companies in Jinan. In total, 396 valid questionnaires (from 370 males and 26 females) were returned. Health status, intention to seek health examination, and participation in health education were assessed by a self-designed questionnaire. Other personal information including sex, age, ethnicity, marital status, years of employment as a taxi driver, education level, and habits were also collected. Results: This survey revealed that 54.8% of taxi drivers reported illness in the last two weeks and 44.7% of participants reported chronic diseases. The prevalence rates of hypertension, diabetes mellitus, gastroenteritis, arthritis, and heart disease were 18.2%, 8.8%, 26%, 18.4%, and 4.8% of questioned taxi drivers, respectively. Significant self-reported symptoms included fatigue, waist and back pain, headache, dyspepsia, and dry throat affecting 49.7%, 26.2%, 23.5%, 26%, and 27% of participants, respectively. In total, 90.1% of subjects thought that it was necessary to receive a regular health examination. Only 17.9% of subjects had been given information about health education, and significantly, more than 87% of subjects who had been given information about health education reported that the information had been helpful. Conclusions: Taxi drivers’ health was poor in our survey. Thus, using health education interventions

Movement velocity in the chair squat is associated with measures of functional capacity and cognition in elderly people at low risk of fall

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Carlos Balsalobre-Fernández

2018-04-01

Full Text Available Background The purpose of this study was to analyze the relationships between muscular performance consisting of a single repetition on the chair squat exercise (CSQ and different measures of functional capacity, balance, quality of life and cognitive status in older adults. Methods A total of 40 participants (22 women, 18 men; age = 72.2 ± 4.9 years joined the investigation. Muscular performance was assessed by measuring movement velocity in the CSQ with no external load using a validated smartphone application (PowerLift for iOS. Functional capacity, balance, quality of life and cognitive status were evaluated using the hand-grip strength (HGS test, the Berg-scale, the EuroQol 5D (EQ-5D and the Mini mental state examination questionnaire (MMSE. Finally, participants were divided into two subgroups (N = 20 according to their velocity in the CSQ exercise. Results Positive correlations were obtained between movement velocity in the CSQ and HGS (r = 0.76, p < 0.001, the Berg-scale (r = 0.65, p < 0.001, the EQ-5D (r = 0.34, p = 0.03 and the MMSE (r = 0.36, p = 0.02. Participants in the fastest subgroup showed very likely higher scores in the Berg-scale (ES = 1.15 and the HGS (ES = 1.79, as well as likely higher scores in the MMSE scale (ES = 0.69. Discussion These results could have potential clinical relevance as they support the use of a time-efficient, non-fatiguing test of muscular performance (i.e., the CSQ to evaluate functional capacity and mental cognition in older adults.

Study of Mini-Mental State Exam evolution in community-dwelling subjects aged over 60 years without dementia.

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Watfa, G; Husson, N; Buatois, S; Laurain, M C; Miget, P; Benetos, A

2011-12-01

In recent years, the Mini-Mental State Examination (MMSE) has been widely used and has been proposed for cognitive decline screening in the framework of a systematic geriatric evaluation in health centers. The aim of the present longitudinal study was to identify the potential determinants of MMSE score and its evolution over a 4-year period in a population aged over sixty years with good general health without dementia and consulting for a health check-up. Longitudinal study. The preventive medical center (CMP) in Nancy. 687 subjects over 60 years of age (mean age 65.6 ± 5.07 years) were included from the Senior health examination study. All subjects underwent 2 visits over a period of 4 years. MMSE measurement and a self-administered questionnaire of emotional and psychological state were evaluated at baseline and at the follow-up visit. The major components of total variance of baseline MMSE were represented by education level, practice of regular physical activity, nervousness and despair. Multivariate analysis identified 3 variables at baseline visit that independently predicted annual changes in MMSE: MMSE score, education level and "Difficulty in social relations" (r= -0.222, 0.154 and -0.255 respectively). Education level and several psychological factors may influence MMSE score and its evolution over time in community-dwelling subjects aged over 60 years without dementia. In these subjects, a low MMSE score does not predict cognitive decline over a period of 4 years. Therefore, the reliability of MMSE in this type of population is questionable.

Moving Elite Athletes Forward: Examining the Status of Secondary School Elite Athlete Programmes and Available Post-School Options

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Brown, Seth

2015-01-01

Purpose: The purpose of this study focused specifically on examining the status of and the promotion of two elite athlete programmes (EAPs), the students/elite athlete selection process and available post-school options. The research was guided by Michel Foucault's work in understanding the relationship between power and knowledge. Participants,…

The mini-mental Parkinson's (MMP) as a cognitive screening tool in people with Parkinson's disease.

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Caslake, Robert; Summers, Fiona; McConachie, Douglas; Ferris, Catriona; Gordon, Joanna; Harris, Clare; Caie, Linda; Counsell, Carl

2013-12-01

Cognitive decline is common in Parkinson's disease (PD) but may not be adequately identified by the mini-mental state examination (MMSE), which is better suited to Alzheimer's disease. The mini-mental Parkinson (MMP) examination is a cognitive screening tool designed in French specifically for PD. We aimed to establish the validity and reliability of the English language version of the MMP compared with the MMSE. People with various stages of PD underwent testing with the MMP and MMSE, which was then compared with a reference standard battery of neuropsychological tests to identify those with significant cognitive impairment. Forty-nine patients were recruited. Both the MMP and MMSE were significantly correlated with scores on all the neuropsychological tests in the validation battery. The median MMP score was proportionally lower (80% of maximum) than the MMSE (90% of maximum) in PD patients with cognitive impairment and those with prior neuropsychiatric complications but there was no difference between the MMP and MMSE in areas under the curves (0.84) for detecting cognitive impairment. Test-retest reliability of the MMP was good (intra-class correlation coefficient 0.793). An MMP of 28 or lower out of 32 detected cognitive impairment with 87% sensitivity and 76% specificity. The English language version of the MMP has now been validated. It detects more cognitive deficits in PD patients than the MMSE and identifies significant cognitive impairment in those with PD at least as well as the MMSE.

Relationship between prosthodontic status and nutritional intake in the elderly in Korea: National Health and Nutrition Examination Survey (NHANES IV).

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Choi, Y K; Park, D Y; Kim, Y

2014-11-01

Many health issues have been reported to be associated with poor nutritional status. We sought to examine the association between nutritional intake and oral health status in elderly people. The association between perceived disability in mastication and prosthodontic status was analysed using multiple logistic regression. Multiple linear regression was used to analyse the association between prosthodontic status and nutritional intake. The elderly subjects with partial or full dentures reported chewing difficulties 1.62-fold more frequently (95% CI: 1.06-2.49) than those with natural teeth or a fixed prosthesis after adjusting for gender, TMD (temporomandibular disorder), household income and education level. Additionally, daily nutritional intakes of energy, protein, fat, ash, calcium, phosphorus and thiamine were decreased significantly in elderly with partial or full dentures compared with those with no prosthesis or with a fixed prosthesis (P oral health status and perceived disability in mastication are associated with dietary imbalances in the elderly. We suggest that the evaluation of patients' nutritional status should be considered as a part of an overall plan for dental hygiene care. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Assessment of diffusional anisotropy of the corpus callosum in patients with multiple lacunar infarcts. Relationship between the apparent diffusion coefficient ratio and global cognitive impairment

International Nuclear Information System (INIS)

Ishihara, Makiko; Hayashi, Hiromitsu; Amano, Yasuo; Takagi, Ryo; Nakahara, Madoka; Kumazaki, Tatsuo; Cho, Keiichi; Okada, Susumu

1998-01-01

The purpose of the present study is to evaluate diffusional anisotropy of white matter in patients with multiple lacunar infarcts using diffusion-weighted echo-planar imaging (DW-EPI), and to examine the relationship between diffusional anisotropy and global cognitive ability as assessed by the mini-mental status examination (MMSE). In particular, we focused on the parameter changes for the corpus callosum as a marker for disconnection of the associative cortices. Twenty-nine patients divided into 2 cognitive level groups (low MMSE, n=16; high MMSE, n=13) and 8 normal controls were examined with a GE 1.5 T Horizon system. Three series of DW-EPI images were obtained using the following epidw g ·psd TM sequence: TR/TE=6500/120 ms, single shot, 6.5 mm slice thickness and 1.5 mm gap transaxial sections of the whole brain, with b-factors of 0 and 710 along each x- and y-axial direction. The parametric maps for apparent diffusion coefficient (ADC) in each direction, ADC(x) and ADC(y), and their rate map (ADC rate=ADC(x)/ADC(y)) were created on a pixel-by-pixel basis. ROI data were extracted from images of the corpus callosum and bilateral optic radiata. As a result, the ADC(x) was markedly larger for corpus callosum than that for optic radiata, whereas the ADC(y) showed an inverse trend, attributable to regional differences of diffusional anisotropy. In corpus callosum, however, the ADC(y) values were observed to increase with the level of disease severity, resulting in a decrease of the ADC rate. Notably, there was a significant difference between the three groups for callosal genu, with a slight positive correlation between the ADC rate and the MMSE scores. Our study suggests that a relationship exists between the reduction of diffusional anisotropy in callosal genu and the global cognitive impairment seen in patients with multiple lacunar infarcts. (K.H.)

Status report on the destructive and non-destructive examinations of U-bends removed from Trojan steam generator D

International Nuclear Information System (INIS)

Aspden, R.G.

1981-01-01

The last status report on the non-destructive examination of U-bends removed from Trojan steam generator D was dated July 7, 1980. As part of this activity, the measurement of wall thicknesses on selected U-bends was planned using an ultrasonic gage. These readings were not made because reproducible results could not be obtained using water as the coupling fluid which was necessary to avoid contamination. Three tubes from the same heat were selected for destructive examination at Westinghouse: one leaking U-bend (R1-C6) and two tubes with no indications (R1-C10 and R1-C22). Results of the examination procedure are presented. The non-destructive examination results from the July 7, 1980 report for 29 U-bends are included

Cognitive decline is associated with systemic oxidative stress: the EVA study. Etude du Vieillissement Artériel.

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Berr, C; Balansard, B; Arnaud, J; Roussel, A M; Alpérovitch, A

2000-10-01

To determine whether systemic oxidative stress status is associated with cognitive decline. A longitudinal population-based study. A cohort study of older subjects in Nantes, France. A total of 1166 high cognitive functioning subjects aged 60 to 70 in the Etude du Vieillissement Arteriel (EVA) cohort with a 4 year follow-up. Subjects completed a baseline interview and a global cognitive test (Mini-Mental Status Examination (MMSE)). Blood samples were obtained at baseline to determine plasma levels of selenium, carotenoids, thiobarbituric acid reactant substances (TBARS), an indicator of lipoperoxidation, and red blood cell vitamin E. Risk of cognitive decline, defined as a loss of 3 points in MMSE score between baseline and the 4 year follow-up, was assessed by oxidative stress level. Subjects with the highest levels of TBARS show an increased risk of cognitive decline (adjusted odds ratio (OR) = 2.25; confidence interval (CI) 95% = 1.26-4.02). This result is reinforced in the lower antioxidant status subgroup. Subjects with low levels of selenium have an increased risk of cognitive decline (OR = 1.58; CI 95% = 1.08-2.31) after adjustment for various confounding factors. These results suggest that increased levels of oxidative stress and/or antioxidant deficiencies may pose risk factors for cognitive decline. The direct implication of oxidative stress in vascular and neurodegenerative mechanisms that lead to cognitive impairment should be further explored.

A comparative study of behavioral and psychological symptoms of dementia in patients with Alzheimer's disease and vascular dementia referred to psychogeriatric services in Korea and the U.K.

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Shah, Ajit; Ellanchenny, Nalini; Suh, Guk-Hee

2005-06-01

There is a paucity of cross-cultural studies of behavioral and psychological symptoms of dementia (BPSD). BPSD were examined in consecutive series of referrals to a psychogeriatric service in Korea and the U.K. using the Behavioral Pathology in Alzheimer's Disease (BEHAVE-AD) rating scale and the Cornell Scale for Depression in Dementia (CSDD). Results were analyzed separately for Alzheimer's disease and vascular dementia. Koreans in both diagnostic groups had lower Mini-mental State Examination (MMSE) scores and higher BEHAVE-AD total and subscale scores for most subscales. In both countries, for both diagnostic groups, the total BEHAVE-AD score and several subscale scores were negatively correlated with the MMSE scores. Logistic regression analysis for Alzheimer's disease revealed that BEHAVE-AD total and most subscale scores independently predicted the country of origin in addition to the MMSE scores predicting the same. These differences in BPSD are most likely explained by the lower MMSE scores in the Korean sample. However, genuine differences in BPSD between the two countries can only be critically examined in a cross-cultural population-based epidemiological study for both diagnostic categories using validated instruments to measure BPSD and controlling for the influence of MMSE score.

Assessment of cognitive impairment in long-term oxygen therapy-dependent COPD patients.

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Karamanli, Harun; Ilik, Faik; Kayhan, Fatih; Pazarli, Ahmet Cemal

2015-01-01

A number of studies have shown that COPD, particularly in its later and more severe stages, is associated with various cognitive deficits. Thus, the primary goal of the present study was to elucidate the extent of cognitive impairment in patients with long-term oxygen therapy-dependent (LTOTD) COPD. In addition, this study aimed to determine the effectiveness of two cognitive screening tests, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), for COPD patients and the ability of oxygen therapy to mitigate COPD-related deficits in cognitive function. The present study enrolled 45 subjects: 24 nonuser and 21 regular-user LTOTD-COPD patients. All subjects had a similar grade of education, and there were no significant differences regarding age or sex. The MoCA (cutoff: therapy increased the risk of cognitive impairment (MoCA, P=0.007 and MMSE, P=0.014), and the MoCA and MMSE scores significantly correlated with the number of emergency admissions and the number of hospitalizations in the last year. In the present study, the nonuser LTOTD-COPD group exhibited a significant decrease in cognitive status compared with the regular-user LTOTD-COPD group. This suggests that the assessment of cognitive function in nonuser LTOTD-COPD patients and the use of protective strategies, such as continuous supplemental oxygen treatment, should be considered during the management of COPD in this population. In addition, the MoCA score was superior to the MMSE score for the determination of cognitive impairment in the nonuser LTOTD-COPD patients.

Prospective memory tasks: a more sensitive method for screening cognitive impairment in ALS?

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Ji Ying

2012-11-01

Full Text Available Abstract Background Cognitive change is prevalent in patients with amyotrophic lateral sclerosis (ALS, but still lack a widely accepted and sensitive screening method. In this study, we try to find a sensitive screening battery for detecting subtle cognitive deficits in patients with ALS. Methods Eighty consecutive ALS patients and 57 matched normal controls underwent the Mini-Mental Status Examination (MMSE, the verbal fluency test (VFT, the Stroop Color Word Interference Test (CWT, and the prospective memory (PM tests, including event-based (EBPM and time-based (TBPM. Results The patients did not differ from the controls in the MMSE, the VFT and the CWT. By contrast, statistically significant differences were found in the PM tests (EBPM: P=0.043; TBPM: P Conclusions Prefrontal lobar dysfunction does exist among ALS patients and may spread from the medial to the lateral region. The PM tests seem more sensitive in ALS patients with frontotemporal dysfunction than are the classical cognitive measures.

Examining the Association Between School Vending Machines and Children's Body Mass Index by Socioeconomic Status.

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O'Hara, Jeffrey K; Haynes-Maslow, Lindsey

2015-01-01

To examine the association between vending machine availability in schools and body mass index (BMI) among subgroups of children based on gender, race/ethnicity, and socioeconomic status classifications. First-difference multivariate regressions were estimated using longitudinal fifth- and eighth-grade data from the Early Childhood Longitudinal Study. The specifications were disaggregated by gender, race/ethnicity, and family socioeconomic status classifications. Vending machine availability had a positive association (P < .10) with BMI among Hispanic male children and low-income Hispanic children. Living in an urban location (P < .05) and hours watching television (P < .05) were also positively associated with BMI for these subgroups. Supplemental Nutrition Assistance Program enrollment was negatively associated with BMI for low-income Hispanic students (P < .05). These findings were not statistically significant when using Bonferroni adjusted critical values. The results suggest that the school food environment could reinforce health disparities that exist for Hispanic male children and low-income Hispanic children. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

DAMPAK DEFISIENSI IODIUM MATERNAL PADA PERSISTENSI DISFUNGSI NEUROPSIKOLOGIS ANAK USIA 12 TAHUN (EFFECT OF MATERNAL IODINE DEFICIENCY ON THE PERSISTENCE OF NEUROLOGICAL DYSFUNCTIONS IN CHILDREN AGED 12 YEARS

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Basuki Budiman

2012-06-01

Full Text Available ABSTRACT Study on the last effect of neuropsychologic dysfunction due to iodine deficiency during gestation is still scarce. This study is to confirm the persistence of neuropsychological dysfunctions at 12-year-old of children born from pregnant mothers with iodine deficiency in endemic iodine deficient area. The study is 13-year-cohort design. Iodine status (Total T4, TSH and UIE of pregnant mothers at initial study, neonatal (TSH and 12 year-old iodine status (fT4, TSH are performed. Neurological dysfunction of infants is examined every 6 weeks until the child age is 24 months. Neuropsychological dysfunction of children 12 years of age such as minimal brain dysfunction and psychological battery of Wechsler Intelligence Scale for Children (WISC are also administered. A screening to determine case and reference using is done using mini mental status examination (MMSE. Score MMSE of 28 or less are implemented as cases while others as reference. The relationship of neurological and cognitive dysfunction with both maternal iodine status and neurological dysfunction at 2 months of neonates age are elaborated. The persistency risk of neurological dysfunction at 12 years of age is 8% (95%ci: 1-15%. Maternal and neonatal iodine status (as indicated by TSH, T4 are the risk factors for the persistency at 12-years. However, delays of neurological development in two-month old infants are found as directly risk factors. Median Total IQ score for all participants are far lower than the lowest limit of normal range. A very significant difference (p=0.000 are found in Total IQ score between cases and references. Discrepancy analysis of IQV-IQP indicates brain lesions in subtle form, such as diadokhokinesis, praxis, memory, distractibility and lowered IQ score. Neuropsychological dysfunctions due maternal iodine deficiency are still persistence at 12 years. Maternal T4 during gestation is not only influences on the persistency but also impaires directly on the

An Examination of the Impact of Racial and Ethnic Identity, Impostor Feelings, and Minority Status Stress on the Mental Health of Black College Students

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McClain, Shannon; Beasley, Samuel T.; Jones, Bianca; Awosogba, Olufunke; Jackson, Stacey; Cokley, Kevin

2016-01-01

This study examined ethnic identity, racial centrality, minority status stress, and impostor feelings as predictors of mental health in a sample of 218 Black college students. Ethnic identity was found to be a significant positive predictor of mental health, whereas minority status stress and impostor feelings were significant negative predictors.…

Clinical radiological correlation in E200K familial Creutzfeldt-Jakob disease.

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Cohen, Oren S; Chapman, Joab; Korczyn, Amos D; Siaw, Oliver L; Warman-Alaluf, Naama; Nitsan, Zeev; Appel, Shmuel; Kahana, Esther; Rosenmann, Hanna; Hoffmann, Chen

2016-12-01

The use of diffusion MRI improved the accuracy of diagnosis in Creutzfeldt-Jakob disease (CJD) and expanded our knowledge of the changes occurring in the brain during the disease. The aim of this study was to test whether in patients with E200K familial CJD (fCJD) the clinical severity correlates with the disease burden as reflected by the extent of cortical involvement in DWI MRI. Consecutive fCJD patients were examined by a neurologist who performed several tests including the CJD neurological scale (CJD-NS), MiniMental status examination (MMSE), Frontal Assessment Battery (FAB), NIH Stroke Scale (NIHSS), and the expanded disability status scale (EDSS). A simultaneously acquired MRI was analyzed by measuring the extent of cortical involvement in the DWI axial sequence. Correlations were tested for using Pearson test. Fifty-two fCJD patients (35 males, mean age 59.4 ± 5.7 years) were recruited to the study. Significant negative correlation was found between the extent of cortical involvement and the cognitive performance of the patients as reflected by their MMSE and FAB scores. In addition, a significant positive correlation was found between the MRI and the clinical disease severity scales CJD-NS and EDSS. The correlation between clinical scales of severity and cognitive dysfunction and the disease burden confirms the reliability of the CJD-NS scale. Further studies are warranted to examine whether MRI may serve not only for diagnosis but also as a biomarker for follow-up of disease progression and the efficacy of potential treatments.

OPTIMAL IMPROVEMENT IN FUNCTION AFTER TOTAL HIP AND KNEE REPLACEMENT: HOW DEEP DO YOU KNOW YOUR PATIENT’S MIND?

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De Caro, M F; Vicenti, G; Abate, A; Picca, G; Leoncini, V; Lomuscio, M; Casalino, A; Solarino, G; Moretti, B

2015-01-01

Osteoarthritis (OA) of the hip and knee causes pain and loss of joint mobility, leading to limitations in physical function. When conservative treatment fails total hip and knee replacement is a cost-effective surgical option. Patients have high expectations regarding functional outcome after these procedures. If such expectations are not met, they may still be dissatisfied with the outcome of a technically successful procedure. Recently, numerous studies reported that psychological factors can influence the outcome of total knee replacement (tkr) and total hip artrhoplasty with total hip replacement (thr). We conducted a prospective study on a consecutive sample of 280 patients affected by hip or knee OA who underwent total joint replacement. At patients’ admission, Harris Hip Score (HHS) and Knee Society Score (KSS) were used to assess pain and function. Furthermore, SF-36, Mini-Mental Status Examination (MMSE), Symptom Checklist-90-R (SCL-90-R), Coping Orientation to Problems Experienced (BRIEF-COPE) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS) were administered. Patients had clinical and radio graphical follow up at 1, 3 and 6 months post-operatively. The HHS and KSS values before surgery showed a linear correlation with both SCL-90-R and MMSE. None of the investigated variables influenced post-operative HHS and KSS scores; however, the improvement of functional scores resulted conditioned by SCL-90-R values, VAS score, schooling and MMSE. Psychological factors and mental status in primary total hip and knee replacement can affect outcome and patient satisfaction. Strategies focused on identification and facing of these conditions must be considered to improve outcome of total replacement.

Narcissism and the Pursuit of Status.

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Zeigler-Hill, Virgil; Vrabel, Jennifer K; McCabe, Gillian A; Cosby, Cheryl A; Traeder, Caitlin K; Hobbs, Kelsey A; Southard, Ashton C

2018-04-10

The purpose of the present studies was to examine the connections that narcissistic admiration and narcissistic rivalry had with various aspects of status. Study 1 examined the associations that narcissism had with the motivation to seek status in a sample of 1,219 community members. Study 2 examined whether narcissism interacted with the status seeking motive to predict how individuals pursued status in a sample of 760 community members and college students. Study 3 used a daily diary approach to examine whether narcissism moderated the associations that daily perceptions of status and affiliation had with state self-esteem in 356 college students. Our results revealed that narcissistic admiration and narcissistic rivalry were somewhat similar in their desire for status but had divergent associations with other aspects of status (e.g., strategies employed to attain status, perceptions of status, reactions to perceived status). The results of the present studies suggest that narcissistic admiration is associated with an agentic orientation to the pursuit of status, whereas narcissistic rivalry is associated with an antagonistic orientation to the pursuit of status. Discussion focuses on the implications of these results for our understanding of the connections between narcissism and status. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

Long-Term Cognitive Improvement After Benfotiamine Administration in Patients with Alzheimer's Disease.

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Pan, Xiaoli; Chen, Zhichun; Fei, Guoqiang; Pan, Shumei; Bao, Weiqi; Ren, Shuhua; Guan, Yihui; Zhong, Chunjiu

2016-12-01

To date, we still lack disease-modifying therapies for Alzheimer's disease (AD). Here, we report that long-term administration of benfotiamine improved the cognitive ability of patients with AD. Five patients with mild to moderate AD received oral benfotiamine (300 mg daily) over 18 months. All patients were examined by positron emission tomography with Pittsburgh compound B (PiB-PET) and exhibited positive imaging with β-amyloid deposition, and three received PiB-PET imaging at follow-up. The five patients exhibited cognitive improvement as assayed by the Mini-Mental Status Examination (MMSE) with an average increase of 3.2 points at month 18 of benfotiamine administration. The three patients who received follow-up PiB-PET had a 36.7% increase in the average standardized uptake value ratio in the brain compared with that in the first scan. Importantly, the MMSE scores of these three had an average increase of 3 points during the same period. Benfotiamine significantly improved the cognitive abilities of mild to moderate AD patients independently of brain amyloid accumulation. Our study provides new insight to the development of disease-modifying therapy.

Examining the Psychological Effect of Rape Acknowledgment: The Interaction of Acknowledgment Status and Ambivalent Sexism.

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Wilson, Laura C; Miller, Katherine E; Leheney, Emma K; Ballman, Alesha D; Scarpa, Angela

2017-07-01

Although the majority of rape survivors do not label their experiences as rape (i.e., unacknowledged rape), the literature is mixed in terms of how this affects survivors' psychological functioning. To elucidate the discrepancies, the present study examined the interaction between rape acknowledgement and ambivalent sexism in relation to depression and posttraumatic stress disorder (PTSD) symptoms. The analyzed sample included 128 female rape survivors who were drawn from a larger college sample of 1,595 participants. The participants completed measures of sexual assault experiences, ambivalent sexism, and depression and PTSD symptoms. The results supported a significant interaction between acknowledgement status and benevolent sexism in relation to both depression and PTSD symptoms. Conversely, the present study failed to find support for an interaction between acknowledgment status and hostile sexism. The clinical implications suggest that rather than seeing acknowledging rape as essential to the recovery process, clinicians should assess for and take into account other factors that may contribute to psychological functioning. Additionally, the findings support that more complex models of trauma recovery should be investigated with the goal of working toward a more comprehensive understanding of the longitudinal process of rape acknowledgment. © 2016 Wiley Periodicals, Inc.

Comparing Mini-Mental State Examination and Attention and Digit Span in elderly exposed to polychlorinated biphenyls and polychlorinated dibenzofurans.

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Lin, Kao-Chang; Huang, Po-Chang; Yeh, Poh-Shiow; Kuo, Jinn-Rung; Ke, Der-Shin

2010-12-01

Polychlorinated biphenyls (PCB)/polychlorinated dibenzofurans (PCDF) are known to affect central nervous functioning. In recent studies, elderly patients who have been exposed to these have been noted to have psychological deficits. There is little known about which test is sensitive to neurotoxins in cognitive evaluation. The objective of the present study was to compare the significance between selective psychological tests in cognitive assessment in PCB-laden elderly. A retrospective PCB/PCDF exposed cohort was observed. Exposed elderly aged ≥ 60 years and registered in Central Health Administration were enrolled, and similar age- and sex-matched subjects served as non-exposed controls. The Mini-Mental State Examination (MMSE) and Attention and Digit Span (ADS) were tested in both groups. Student's t-test, χ(2) -test and linear regression models were used for statistical analysis.  A total of 165 exposed patients and 151 controls were analyzed. The exposed group included 49% men, a mean age of 69.3 ± 6.4 years and an education level of 4.0 ± 3.9 years. The controls included 52% men, a mean age of 69.9 ± 5.5 years and an education level of 4.5 ± 3.2 years. There was no statistical difference in MMSE before and after adjusting for the confounding variables of age, sex and education (P= 0.16 vs P= 0.12). However, ADS-forward and ADS-total scores showed a significant decline in the exposed subjects (P= 0.0001 vs P= 0.001). Using a linear regression among stratified PCB and cognitive functioning (≤30 ppb; 31-89; ≥90), a dose effect was found at the medium (31-89 ppb) and high exposure (≧90 ppb) levels. Our observations showed attention and short-term memory were impaired in PCB-laden elderly patients. Higher exposure level showed lower cognitive functioning in ADS. The MMSE was insensitive to neurotoxins. The present study shows that the selective test has a decisive role in toxic-related cognitive assessments. © 2010 The Authors. Psychogeriatrics �

Validation of a telephone screening test for Alzheimer's disease.

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Camozzato, Ana Luiza; Kochhann, Renata; Godinho, Claudia; Costa, Amanda; Chaves, Marcia L

2011-03-01

Financial constraints, mobility issues, medical conditions, crime in local areas can make cognitive assessment difficult for elders and telephone interviews can be a good alternative. This study was carried out to evaluate the reliability, validity and clinical utility of a Brazilian telephone version of the Mini Mental State Examination (Braztel-MMSE) in a community sample of healthy elderly participants and AD patients. The MMSE and the Braztel-MMSE were applied to 66 AD patients and 67 healthy elderly participants. The test-retest reliability was strong and significant (r = .92, p = .01), and the correlation between the Braztel-MMSE and the MMSE were significant (p = .01) and strong (r = .92). The general screening ability of the Braztel-MMSE was high (AUC = 0.982; CI95% = 0.964-1.001). This telephone version can therefore be used as a screening measure for dementia in older adults that need neuropsychological screening and cannot present for an evaluation.

Hypertension Among US Adults by Disability Status and Type, National Health and Nutrition Examination Survey, 2001–2010

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Stevens, Alissa; Courtney-Long, Elizabeth; Gillespie, Cathleen; Armour, Brian S.

2014-01-01

The prevalence of hypertension among people with disabilities is not well understood. We combined data from the 2001–2010 National Health and Nutrition Examination Survey to obtain estimates of hypertension prevalence by disability status and type (cognitive, hearing, vision, or mobility limitation) and assess the association between disability and hypertension. Overall, 34% of adults with disabilities had hypertension compared with 27% of adults without disabilities; adults with mobility lim...

Effectiveness and Safety of MLC601 in the Treatment of Mild to Moderate Alzheimer's Disease: A Multicenter, Randomized Controlled Trial

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Hossein Pakdaman

2015-03-01

Full Text Available Background: MLC601 is a possible modulator of amyloid precursor protein processing, and in a clinical trial study MLC601 showed some effectiveness in cognitive function in Alzheimer's disease (AD patients. We aimed to evaluate the effectiveness and safety of MLC601 in the treatment of mild to moderate AD as compared to 3 approved cholinesterase inhibitors (ChEIs including donepezil, rivastigmine and galantamine. Methods: In a multicenter, nonblinded, randomized controlled trial, 264 volunteers with AD were randomly divided into 4 groups of 66; groups 1, 2, 3 and 4 received donepezil, rivastigmine, MLC601 and galantamine, respectively. Subjects underwent a clinical diagnostic interview and a cognitive/functional battery including the Mini-Mental State Examination (MMSE and Alzheimer's Disease Assessment Scale - Cognitive subscale (ADAS-Cog. Patients were visited every 4 months, and the score of cognition was recorded by the neurologists. Results: There were no significant differences in age, sex, marital status and baseline score of cognition among the 4 groups. In total, 39 patients (14.7% left the study. Trend of cognition changes based on the modifications over the time for MMSE and ADAS-cog scores did not differ significantly among groups (p = 0.92 for MMSE and p = 0.87 for ADAS-Cog. Conclusion: MLC601 showed a promising safety profile and also efficacy compared to 3 FDA-approved ChEIs.

The psychoemotional status and cardiovascular system functional state of the first-year students under the influence of examination stress

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Liliana K. Tokaeva

2012-12-01

Full Text Available The aim of this research is to study of the influence of examination stress on psycho-emotional status and functional state of the cardiovascular system of the 1-st year students of pedagogical high school. Methods – The study involved 105 young men aged 17-18 enrolled in the specialty "Physical Education". The studies were conducted during the period in-between the exams and during the examination session. The psycho-emotional status was determined by the SAN test questionnaire and test and the CH.D. Spielberg test, adapted for Russia by Ju.L. Khanin. The state of CVS autonomic regulation was evaluated by heart rate, blood pressure, endurance ratio, Kerdo index and the adaptive capacities by P.M. Bayevsky. Results – In the absence of exposure to stress in the majority of young men the studied parameters are within normal limits, indicating sufficient adaptive capabilities. A clear correlation between the level of personal anxiety in students and the nature of their reactivity to examination stress was found: the higher the anxiety level in a student is, the more stress resistance decreases and more pronounced changes in the cardiovascular system autonomic regulation appear. The strain of adaptation mechanism was found in a stressful situation in the first-year students with a high level of personal anxiety and satisfactory adaptation – in young men with average and low personal anxiety.

Adapting the mini mental status to the context of the West-Indies.

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Godaert, Lidvine; Godard-Sebillotte, Claire; Bousquet, Lionel; Devouche, Emmanuel; Hugonot-Diener, Laurence; Nuissier, Joëlle; Triboulet, Frank; Fanon, Jean-Luc

2017-03-01

The mini mental state examination (MMSE) has become a benchmark for the screening and follow-up of cognitive impairment. The numerous translations of the MMS into other languages attest to its popularity. Clinical practice suggests that the consensual French version from the Greco (Groupe de réflexion sur les évaluations cognitives - Research working group for cognitive assessment) is not adapted to the West-Indies population because of the low socio-economic level and the widespread use of the Creole language among the elderly population. Modification of certain items by a multidisciplinary committee made it possible to adapt the instrument to the Creole culture. This procedure increases comprehension of the instrument, and should lead to improved detection of cognitive impairment in the West-Indies.

EXAMINE THE RELATIONSHIP OF SOCIO-ECONOMIC STATUS (SES) WITH LEISURE TIME SPENDING OF GIRLS EMPHASIZING SPORTING ACTIVITIES

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Bahyeh Zarei; Mozafar Yektayar

2016-01-01

The objective of this research was doing an examination about the relationship of socio-economic status (SES) with leisure time spending in the girls of Sanandaj city emphasizing sporting activities. The method of research was descriptive-correlated and has been done as field research. The population of the research consisted of all young girls of Sanandaj aged between 15-29 years old which 384 samples were selected by using multi-stage cluster sampling. The tools of research were Godrat Nama...

Prospective Evaluation of Quality of Life and Neurocognitive Effects in Patients With Multiple Brain Metastases Receiving Whole-Brain Radiotherapy With or Without Thalidomide on Radiation Therapy Oncology Group (RTOG) Trial 0118

International Nuclear Information System (INIS)

Corn, Benjamin W.; Moughan, Jennifer M.S.; Knisely, Jonathan P.S.; Fox, Sherry W.; Chakravarti, Arnab; Yung, W.K. Alfred; Curran, Walter J.; Robins, H. Ian; Brachman, David G.; Henderson, Randal H.; Mehta, Minesh P.; Movsas, Benjamin

2008-01-01

Purpose: Radiation Therapy Oncology Group (RTOG) 0118 randomized patients with multiple brain metastases to whole-brain radiotherapy (WBRT) ± thalidomide. This secondary analysis of 156 patients examined neurocognitive and quality of life (QOL) outcomes. Methods and Materials: Quality of life was determined with the Spitzer Quality of Life Index (SQLI). The Folstein Mini-Mental Status Exam (MMSE) assessed neurocognitive function. SQLI and MMSE were administered at baseline and at 2-month intervals. MMSE was scored with a threshold value associated with neurocognitive functioning (absolute cutoff level of 23) and with the use of corrections for age and educational level. Results: Baseline SQLI predicted survival. Patients with SQLI of 7-10 vs. <7 had median survival time (MST) of 4.8 vs. 3.1 months, p = 0.05. Both arms showed steady neurocognitive declines, but SQLI scores remained stable. Higher levels of neurocognitive decline were observed with age and education-level corrections. Of patients considered baseline age/educational level neurocognitive failures, 32% died of intracranial progression. Conclusions: Quality of life and neuropsychological testing can be prospectively administered on a Phase III cooperative group trial. The MMSE should be evaluated with adjustments for age and educational level. Baseline SQLI is predictive of survival. Despite neurocognitive declines, QOL remained stable during treatment and follow-up. Poor neurocognitive function may predict clinical deterioration. Lack of an untreated control arm makes it difficult to determine the contribution of the respective interventions (i.e., WBRT, thalidomide) to neurocognitive decline. The RTOG has developed a trial to study the role of preventative strategies aimed at forestalling neurocognitive decline in this population

Albumin, Hemoglobin, and the Trajectory of Cognitive Function in Community-Dwelling Older Japanese: A 13-Year Longitudinal Study.

Science.gov (United States)

Murayama, H; Shinkai, S; Nishi, M; Taniguchi, Y; Amano, H; Seino, S; Yokoyama, Y; Yoshida, H; Fujiwara, Y; Ito, H

2017-01-01

Cognitive function can substantially decline over a long period, and understanding the trajectory of cognitive function is important. However, little is known about the linkage between nutritional biomarkers and long-term cognitive change. We analyzed 13-year longitudinal data for older Japanese to examine the associations of serum albumin and hemoglobin levels with the trajectory of cognitive function. Longitudinal study. Community-based. A total of 1,744 community-dwelling adults aged 65 years or older who participated in annual health examinations in Kusatsu town, Gunma Prefecture, Japan, from 2002-2014. Cognitive function was assessed annually by the Mini-Mental State Examination (MMSE). Albumin and hemoglobin levels at baseline (the year when a respondent first participated in the health examination) were divided into quartiles. Hierarchical linear modeling was used to analyze intrapersonal and interpersonal differences in cognitive function. Participants' MMSE scores decreased at an accelerated rate over the 13-year period. Participants with the lowest baseline albumin level (below the first quartile line) showed a greater accelerated decline in MMSE scores over time, compared with those with the highest level (above the third quartile line). Moreover, MMSE scores in participants with a lower hemoglobin level and lower MMSE score at baseline tended to decline faster over time at an accelerated rate. These findings yield new insights about the complex and diverse roles of these nutritional biomarkers on the trajectory of cognitive function in old age.

The concise cognitive test for dementia screening: reliability and effects of demographic variables as compared to the mini mental state examination.

Science.gov (United States)

Srinivasan, Srikanth

2010-01-01

The Mini Mental State Examination (MMSE) is widely used for dementia screening but has several shortcomings such as prominent ceiling effects, inadequate sensitivity to mild cognitive impairment, and uneven sampling of the major cognitive domains. In this study, we pilot a new dementia screening test - the Concise Cognitive Test (CONCOG) - designed to overcome the above short comings and describe the reliability measures and age, education, and gender effects. The CONCOG has a total score of 30, and has subtests for orientation, naming, registration, free recall and recognition of four words, semantic verbal fluency and copying. Participants were screened to exclude those with any neurological or psychiatric disease, simultaneously administered the CONCOG, and a Hybrid Mini Mental State Examination (HMMSE) adapted from Folstein's MMSE and Ganguli's Hindi Mental State Examination. The study sample had 204 subjects over the age of 60 years with a mean of 73 years and education level of 8 (4.5) years. Internal consistency for the CONCOG (Cronbach's alpha) was 0.74, inter-rater reliability (Kendall's tau-b) was 0.9, and the one-month test-retest reliability (Kendall's tau-b) was 0.7. Age and education level, but not gender, significantly influenced performance on both scales. Although the influence of age on the two scales was to a similar degree, the HMMSE was more affected by education than the CONCOG. Of 204 subjects, only 12 (5.7%) subjects obtained the maximum score on the CONCOG compared with 30 (14.1%) subjects on the HMMSE. The CONCOG took less than 10 minutes to complete in this sample. Age and education stratified norms are presented for the CONCOG. The CONCOG is a reliable cognitive screening measure. It has negligible ceiling effects, is less influenced by education compared with the HMMSE, and offers subscale scores for the major cognitive domains.

A new promising screening method for cognitive functioning in elderly patients

NARCIS (Netherlands)

Kuin, Y.; Nijsten, J.M.H.; Stok-Koch, E.G.H.J.; Jansen, R.W.M.M.

1996-01-01

The Mini Mental State Examination (MMSE) is frequently used as a screening method to detect cognitive dysfunctioning. However, the MMSE has limited sensitivity to detect mild impairment. We aimed to develop a new screening method to discriminate between normal and mild cognitive functioning in older

More Delusions May Be Observed in Low-Proficient Multilingual Alzheimer’s Disease Patients

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Liu, Yi-Chien; Liu, Yen-Ying; Yip, Ping-Keung; Akanuma, Kyoko; Meguro, Kenichi

2015-01-01

Background Language impairment and behavioral symptoms are both common phenomena in dementia patients. In this study, we investigated the behavioral symptoms in dementia patients with different language backgrounds. Through this, we aimed to propose a possible connection between language and delusion. Methods We recruited 21 patients with Alzheimer’s disease (AD), according to the DSM-IV and NINCDS-ADRDA criteria, from the memory clinic of the Cardinal Tien Hospital in Taipei, Taiwan. They were classified into two groups: 11 multilinguals who could speak Japanese, Taiwanese and Mandarin Chinese, and 10 bilinguals who only spoke Taiwanese and Mandarin Chinese. There were no differences between age, education, disease duration, disease severity, environment and medical care between these two groups. Comprehensive neuropsychological examinations, including Clinical Dementia Rating (CDR), Mini-Mental Status Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), Verbal fluency, Chinese version of the Boston naming test (BNT) and the Behavioral Pathology in Alzheimer’s Disease Rating Scale (BEHAVE-AD), were administered. Results The multilingual group showed worse results on the Boston naming test. Other neuropsychological tests, including the MMSE, CASI and Verbal fluency, were not significantly different. More delusions were noted in the multilingual group. Three pairs of subjects were identified for further examination of their differences. These three cases presented the typical scenario of how language misunderstanding may cause delusions in multilingual dementia patients. Consequently, more emotion and distorted ideas may be induced in the multilinguals compared with the MMSE-matched controls. Conclusion Inappropriate mixing of language or conflict between cognition and emotion may cause more delusions in these multilingual patients. This reminds us that delusion is not a pure biological outcome of brain degeneration. Although the cognitive

More Delusions May Be Observed in Low-Proficient Multilingual Alzheimer's Disease Patients.

Science.gov (United States)

Liu, Yi-Chien; Liu, Yen-Ying; Yip, Ping-Keung; Akanuma, Kyoko; Meguro, Kenichi

2015-01-01

Language impairment and behavioral symptoms are both common phenomena in dementia patients. In this study, we investigated the behavioral symptoms in dementia patients with different language backgrounds. Through this, we aimed to propose a possible connection between language and delusion. We recruited 21 patients with Alzheimer's disease (AD), according to the DSM-IV and NINCDS-ADRDA criteria, from the memory clinic of the Cardinal Tien Hospital in Taipei, Taiwan. They were classified into two groups: 11 multilinguals who could speak Japanese, Taiwanese and Mandarin Chinese, and 10 bilinguals who only spoke Taiwanese and Mandarin Chinese. There were no differences between age, education, disease duration, disease severity, environment and medical care between these two groups. Comprehensive neuropsychological examinations, including Clinical Dementia Rating (CDR), Mini-Mental Status Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), Verbal fluency, Chinese version of the Boston naming test (BNT) and the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), were administered. The multilingual group showed worse results on the Boston naming test. Other neuropsychological tests, including the MMSE, CASI and Verbal fluency, were not significantly different. More delusions were noted in the multilingual group. Three pairs of subjects were identified for further examination of their differences. These three cases presented the typical scenario of how language misunderstanding may cause delusions in multilingual dementia patients. Consequently, more emotion and distorted ideas may be induced in the multilinguals compared with the MMSE-matched controls. Inappropriate mixing of language or conflict between cognition and emotion may cause more delusions in these multilingual patients. This reminds us that delusion is not a pure biological outcome of brain degeneration. Although the cognitive performance was not significantly different

Relationship between socioeconomic status and type 2 diabetes: results from Korea National Health and Nutrition Examination Survey (KNHANES) 2010–2012

OpenAIRE

Hwang, Jongnam; Shon, Changwoo

2014-01-01

Objective To examine the relationship between socioeconomic status (SES) and type 2 diabetes using the Korea National Health and Nutrition Examination Survey (KNHANES) 2010–2012. Design A pooled sample cross-sectional study. Setting A nationally representative population survey data. Participants A total of 14 330 individuals who participated in the KNHANES 2010–2012 were included in our analysis. Primary outcome Prevalence of type 2 diabetes. Results The relationship between SES and type 2 d...

The combined status of physical performance and depressive symptoms is strongly associated with a history of falling in community-dwelling elderly: cross-sectional findings from the Obu Study of Health Promotion for the Elderly (OSHPE).

Science.gov (United States)

Makizako, Hyuma; Shimada, Hiroyuki; Doi, Takehiko; Yoshida, Daisuke; Tsutsumimoto, Kota; Uemura, Kazuki; Anan, Yuya; Park, Hyuntae; Lee, Sangyoon; Ito, Tadashi; Suzuki, Takao

2014-01-01

The purpose of this study was to examine whether the combined factors of physical performance, depressive symptoms and cognitive status are significantly associated with a history of falling in community-dwelling elderly. We performed a cross-sectional community-based survey, the OSHPE, from August 2011 to February 2012. In total, 5104 community-dwelling older adults aged 65 years and older (mean age 72.0) participated in the OSHPE. Participants underwent a grip strength (GS) test, chair stand test (CST), Timed Up & Go (TUG) test, Geriatric Depression Scale (GDS), and Mini-Mental State Examination (MMSE). Of the 4481 participants who met our requirements, 645 (14.4%) participants reported falling at least once in the past year. In a signal detection analysis (SDA), we found that the combination of GDS (≥6 points) and TUG (≥10.6 s) had the highest fall rate (36.4%), and the combination of GDS (fall rate (11.7%). The highest fall rate group had a significantly higher odds ratio (OR) compared with the lowest fall rate group after adjusting for other potentially confounding variables [OR 3.12 (95% confidence interval (CI) 2.08-4.68) phistory of falling in community-dwelling elderly. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Prevalence and predictors of cognitive dysfunction in opioid-treated patients with cancer: a multinational study

DEFF Research Database (Denmark)

Kurita, Geana P; Sjøgren, Per; Ekholm, Ola

2011-01-01

with opioids for moderate or severe pain for at least 3 days were included. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). MMSE scores were categorized into definite cognitive dysfunction (scores ... (scores > 26). Factors potentially associated with cognitive dysfunction were assessed. Associations between MMSE and explanatory variables were analyzed by ordinal logistic regression models. Results We included 1,915 patients with cancer from 17 centers. MMSE scores less than 27 were observed in 32......-treated patients with cancer had possible or definite cognitive dysfunction. Lung cancer, daily opioid doses of 400 mg or more (oral morphine equivalents), older age, low KPS, shorter time since cancer diagnosis, and absence of BTP were predictors for cognitive dysfunction....

Cross-sectional associations of active transport, employment status and objectively measured physical activity: analyses from the National Health and Nutrition Examination Survey.

Science.gov (United States)

Yang, Lin; Hu, Liang; Hipp, J Aaron; Imm, Kellie R; Schutte, Rudolph; Stubbs, Brendon; Colditz, Graham A; Smith, Lee

2018-05-05

To investigate associations between active transport, employment status and objectively measured moderate-to-vigorous physical activity (MVPA) in a representative sample of US adults. Cross-sectional analyses of data from the National Health and Nutrition Examination Survey. A total of 5180 adults (50.2 years old, 49.0% men) were classified by levels of active transportation and employment status. Outcome measure was weekly time spent in MVPA as recorded by the Actigraph accelerometer. Associations between active transport, employment status and objectively measured MVPA were examined using multivariable linear regression models adjusted for age, body mass index, race and ethnicity, education level, marital status, smoking status, working hour duration (among the employed only) and self-reported leisure time physical activity. Patterns of active transport were similar between the employed (n=2897) and unemployed (n=2283), such that 76.0% employed and 77.5% unemployed engaged in no active transport. For employed adults, those engaging in high levels of active transport (≥90 min/week) had higher amount of MVPA than those who did not engage in active transport. This translated to 40.8 (95% CI 15.7 to 65.9) additional minutes MVPA per week in men and 57.9 (95% CI 32.1 to 83.7) additional minutes MVPA per week in women. Among the unemployed adults, higher levels of active transport were associated with more MVPA among men (44.8 min/week MVPA, 95% CI 9.2 to 80.5) only. Findings from the present study support interventions to promote active transport to increase population level physical activity. Additional strategies are likely required to promote physical activity among unemployed women. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Examination of the relation between periodontal health status and cardiovascular risk factors: serum total and high density lipoprotein cholesterol, C-reactive protein, and plasma fibrinogen.

Science.gov (United States)

Wu, T; Trevisan, M; Genco, R J; Falkner, K L; Dorn, J P; Sempos, C T

2000-02-01

Using data from the Third National Health and Nutrition Examination Survey (1988-1994), the authors examined the relation between periodontal health and cardiovascular risk factors: serum total and high density lipoprotein cholesterol, C-reactive protein, and plasma fibrinogen. A total of 10,146 participants were included in the analyses of cholesterol and C-reactive protein and 4,461 in the analyses of fibrinogen. Periodontal health indicators included the gingival bleeding index, calculus index, and periodontal disease status (defined by pocket depth and attachment loss). While cholesterol and fibrinogen were analyzed as continuous variables, C-reactive protein was dichotomized into two levels. The results show a significant relation between indicators of poor periodontal status and increased C-reactive protein and fibrinogen. The association between periodontal status and total cholesterol level is much weaker. No consistent association between periodontal status and high density lipoprotein cholesterol was detectable. Similar patterns of association were observed for participants aged 17-54 years and those 55 years and older. In conclusion, this study suggests that total cholesterol, C-reactive protein, and fibrinogen are possible intermediate factors that may link periodontal disease to elevated cardiovascular risk.

Binaural noise reduction via cue-preserving MMSE filter and adaptive-blocking-based noise PSD estimation

Science.gov (United States)

Azarpour, Masoumeh; Enzner, Gerald

2017-12-01

Binaural noise reduction, with applications for instance in hearing aids, has been a very significant challenge. This task relates to the optimal utilization of the available microphone signals for the estimation of the ambient noise characteristics and for the optimal filtering algorithm to separate the desired speech from the noise. The additional requirements of low computational complexity and low latency further complicate the design. A particular challenge results from the desired reconstruction of binaural speech input with spatial cue preservation. The latter essentially diminishes the utility of multiple-input/single-output filter-and-sum techniques such as beamforming. In this paper, we propose a comprehensive and effective signal processing configuration with which most of the aforementioned criteria can be met suitably. This relates especially to the requirement of efficient online adaptive processing for noise estimation and optimal filtering while preserving the binaural cues. Regarding noise estimation, we consider three different architectures: interaural (ITF), cross-relation (CR), and principal-component (PCA) target blocking. An objective comparison with two other noise PSD estimation algorithms demonstrates the superiority of the blocking-based noise estimators, especially the CR-based and ITF-based blocking architectures. Moreover, we present a new noise reduction filter based on minimum mean-square error (MMSE), which belongs to the class of common gain filters, hence being rigorous in terms of spatial cue preservation but also efficient and competitive for the acoustic noise reduction task. A formal real-time subjective listening test procedure is also developed in this paper. The proposed listening test enables a real-time assessment of the proposed computationally efficient noise reduction algorithms in a realistic acoustic environment, e.g., considering time-varying room impulse responses and the Lombard effect. The listening test outcome

Amyloid-beta 40 as a biomarker of cognitive impairment in acute ischemic stroke

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Aleksey A. Kulesh

2017-01-01

Full Text Available Aim: to study the role of amyloid-beta 40 (Aβ 40 in the development of cognitive impairment in acute ischemic stroke.Materials and methods. The study included 70 patients aged 33–86 years, 46 men and 24 women. In patients with acute ischemic stroke cognitive status was assessed with Mini-Mental State Examination (MMSE, Montreal Cognitive Assessment Test (MoCA, Frontal Assessment Battery (FAB, Schulte tables, Clock Drawing Test, Test for Semantic Verbal Fluency and Five Words Test. The concentration of Aβ 40 in the cerebrospinal fluid was determined. Morphometric (size of the infarct and leukoaraiosis area, volume of the brain ventricles and hippocampus and diffusion-tensor parameters of MRI (fractional anisotropy of putamen, thalamus, hippocampus, corpus callosum, limbs of the internal capsule, the cingulate, the superior longitudinal and inferior fronto-occipital tracts were studied.Results. The concentration of Aβ 40 in the cerebrospinal fluid was 436,4 (226,0–514,0 pg/ml. The protein level was associated with the result of subtests «Orientation» (MMSE and «Attention» (MoCA, as well as indirect recall with cues in MoCA. Patients with MMSE score of 24–27 points were characterized by a lower concentration of Aβ 40 as compared to patients with a score less than 24 points. Aβ 40 concentration more than 436,4 pg/mL was associated with a more severe somatic co-morbidity of stroke (hypertension, lower hemoglobin and albumin level, higher erythrocyte sedimentation rate, a smaller volume of the brain ventricles, lower fractional anisotropy of the thalamus, cingulate tracts and contralateral hippocampus. Aβ 40 concentration more than 436,4 pg/mL was also associated with a lower global cognitive status (according to the MMSE and MoCA, as well as the reduction in certain cognitive functions, namely, attention, visual-spatial functions and memory.Conclusions. The concentration of Aβ 40 in the cerebrospinal fluid is a biological marker of

Mini-Mental State Examination norms in a community-dwelling sample of elderly with low schooling in Brazil Normas do Mini-Exame do Estado Mental para uma amostra de idosos com baixa escolaridade residentes na comunidade no Brasil

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Jerson Laks

2007-02-01

Full Text Available The objective of this study was to assess Mini-Mental State Examination norms of a functionally normal sample of community-dwelling elderly. Illiterate and low-educated subjects who scored less than 5 on the Pfeffer Functional Activities Questionnaire (PFAQ [n = 397; female = 269; mean age = 72.15 (SD = 7.24 years] had the 5th, 25th, 50th, and 75th percentiles calculated according to age (65-74; 75-84 years. Overall MMSE score was 21.97 (SD = 4.48. Mean MMSE for illiterate younger individuals was 19.46 (SD = 3.47, and the quartile distribution was 14, 17, 19, and 21. MMSE of subjects with 1-8 years of schooling was 23.90 (3.87, and the distribution was 15, 22, 24, and 27. MMSE of older illiterate subjects was 18.11 (SD = 3.63, and the distribution of scores was 13, 16, 18, and 20, whereas subjects with 1-8 years of schooling scored 23.81 (SD = 4.01 and the distribution was 15, 22, 24, and 27. These MMSE normative data may help improve the detection of cognitive impairment in Brazil, mainly in the primary clinical setting.Avaliar normas do Mini-Exame do Estado Mental (MEEM de acordo com a idade e escolaridade de idosos vivendo na comunidade. Calcularam-se os quartis do MEEM para idosos com 65 a 74 e 75 a 84 anos, analfabetos e com 1-8 anos de escolaridade, com pontuação menor que cinco no Questionário de Atividades Funcional de Pfeffer (QAF [n = 397; feminino = 269; idade = 72,15 (dp = 7,24 anos].O MEEM total foi 21,97 (dp = 4,48. Nos indivíduos mais jovens, o MEEM entre analfabetos foi 19 (3,47 com quartis de 14, 17, 19, 21. O MEEM dos com 1-8 anos de escolaridade foi 23,90 (dp = 3,87, e a distribuição foi 15, 22, 24, 27. O MEEM dos analfabetos mais idosos foi 18,11 (dp = 3,63 com quartis de 13, 16, 18, 20, enquanto a pontuação dos sujeitos com 1-8 anos foi 23,81 (dp = 4,01, quartis de 15, 22, 24, 27. Os dados de normatização do MEEM podem ajudar o reconhecimento de distúrbios cognitivos no Brasil, principalmente no atendimento primário.

Validation of Addenbrooke's cognitive examination for detecting early dementia in a Japanese population.

Science.gov (United States)

Yoshida, Hidenori; Terada, Seishi; Honda, Hajime; Ata, Toshie; Takeda, Naoya; Kishimoto, Yuki; Oshima, Etsuko; Ishihara, Takeshi; Kuroda, Shigetoshi

2011-01-30

There is a clear need for brief, but sensitive and specific, cognitive screening instruments for dementia. We assessed the diagnostic accuracy of the Japanese version of Addenbrooke's Cognitive Examination (ACE) in identifying early dementia in comparison with the conventional Mini-Mental State Examination (MMSE). Standard tests for evaluating dementia screening tests were applied. A total of 201 subjects (Alzheimer's disease (AD)=65, frontotemporal dementia (FTD)=24, vascular dementia=26, dementia with Lewy bodies=11, mild cognitive impairment (MCI)=13, and controls=62) participated in this study. The reliability of the ACE was very good (alpha coefficient=0.82). In our patient series, the sensitivity for diagnosing dementia with an ACE score of ≤74 was 0.889 with a specificity of 0.987, and the sensitivity of an ACE score of ≤80 was 0.984 with a specificity of 0.867. The Japanese version of the ACE is a very accurate instrument for the detection of early dementia, and should be widely used in clinical practice. Copyright © 2009 Elsevier Ltd. All rights reserved.

Role of physical activity in reducing cognitive decline in older Mexican-American adults.

Science.gov (United States)

Ottenbacher, Allison J; Snih, Soham Al; Bindawas, Saad M; Markides, Kyriakos S; Graham, James E; Samper-Ternent, Rafael; Raji, Mukaila; Ottenbacher, Kenneth J

2014-09-01

The effect of physical activity on cognitive function in older adults from minority and disadvantaged populations is not well understood. This study examined the longitudinal association between physical activity and cognition in older Mexican Americans. The study methodology included a prospective cohort with longitudinal analysis of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly. General linear mixed models were used to assess the associations and interactions between physical activity and cognitive function over 14 years. Community-based assessments were performed in participants' homes. Physical activity was recorded for 1,669 older Mexican Americans using the Physical Activity Scale for the Elderly. Cognition was measured using the Mini-Mental State Examination (MMSE) and separated into memory and nonmemory components. A statistically significant positive association was observed between levels of physical activity and cognitive function after adjusting for age, sex, marital status, education, and comorbid health conditions. There was a statistically significant difference in MMSE scores over time between participants in the third (β = 0.11, standard error (SE) = 0.05) and fourth (β = 0.10, SE = 0.2) quartiles of physical activity and those in the first. The protective effect of physical activity on cognitive decline was evident for the memory component of the MMSE but not the nonmemory component after adjusting for covariates. Greater physical activity at baseline was associated with less cognitive decline over 14 years in older Mexican Americans. The reduction in cognitive decline appeared to be related to the memory components of cognitive function. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

Correlation of ophthalmic examination with carrier status in females potentially harboring a severe Norrie disease gene mutation.

Science.gov (United States)

Khan, Arif O; Aldahmesh, Mohammed A; Meyer, Brian

2008-04-01

To correlate ophthalmic findings with carrier status for a severe Norrie disease (ND) gene mutation (C95F). Prospective interventional case series. Six potential carriers and 1 obligate carrier from a family harboring the mutation. An ophthalmologist blind to the pedigree performed a full ophthalmic examination for the 7 asymptomatic family members. A peripheral blood sample was collected from each for ND gene sequencing. Ophthalmic examination findings (with attention to the presence or absence of retinal findings) and results of ND gene sequencing. Three carriers were identified by molecular genetics, and all 3 of them had peripheral retinal abnormality. However, 3 of the 4 genetically identified noncarriers also exhibited peripheral retinal abnormality. Two of these noncarriers with retinal findings were the offspring of a confirmed noncarrier. The genetically identified noncarrier with a normal peripheral retinal examination was the daughter of an obligate carrier. The presence of peripheral retinal changes was not useful for carrier prediction in a family harboring ND. There are likely additional loci responsible for phenotypic expression.

Comparison of the Mini Mental State Examination and depressive symptoms between high cardiovascular risk and healthy community elderly groups

Science.gov (United States)

da Costa, Amanda Lucas; Varela, Juliana Santos; Mazetti, Osmar; Restelatto, Luciane; Costa, Andry Fitterman; Godinho, Claudia; Camozzato, Ana Luiza; Picon, Paulo D.; Chaves, Márcia L.

2008-01-01

The aging of the population is a universal phenomenon with direct consequences upon the public health system. One of the main repercussions of the growth in this sector of the population is the increased prevalence of disorders such as dementia and depression which are very frequent among the elderly. The relationship between cardiovascular risk factors, dementia and depression have been addressed in many recent investigations. Objectives To evaluate the relationship of cognitive performance and depressive symptoms with cardiovascular risk in the elderly. Methods 94 high cardiovascular risk elderly patients and 160 healthy community elderly were evaluated cross-sectionally. The Mini Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS-15) were used as the main measures. The cutoff for presence of depression was 6 on the GDS. Results The high cardiovascular risk elderly group showed significantly lower scores on the MMSE (p<0.001) and was significantly associated to depression (p<0.001), independently of education. The logistic regression analysis for depression as the dependent variable, age and group (healthy community or high cardiovascular risk elderly) were kept in the final equation. Higher age (Odds Ratio=0.92; 95% CI 0.86–0.98) and high cardiovascular risk elderly (OR=2.99; 95% CI 1.36–6.59) were associated to depression. Conclusions The present findings corroborate the different cognitive performance of elderly with high cardiovascular risk factors and the association of depressive symptoms with this group. PMID:29213588

Clinical Benefits of Memantine Treatment for Alzheimer's Disease in the Okayama Memantine Study II (OMS II).

Science.gov (United States)

Matsuzono, Kosuke; Yamashita, Toru; Ohta, Yasuyuki; Hishikawa, Nozomi; Koike, Makoto; Sato, Kota; Kono, Syoichiro; Deguchi, Kentaro; Nakano, Yumiko; Abe, Koji

2015-01-01

The clinical benefits of memantine, depending on the baseline cognitive and affective conditions in real world dementia clinics, have not been completely examined. We performed the "Okayama Memantine Study II (OMS II)" to retrospectively evaluate the clinical effects of memantine monotherapy (n = 38) in Alzheimer's disease (AD) patients using seven batteries to assess dementia at the baseline, at 3, 6, and 12 months. Additionally, we divided 163 AD patients treated with memantine into two subgroups depending on the baseline cognitive score of the Mini-Mental State Examination (MMSE): the MMSE OMS II showed that memantine monotherapy improved BPSD until 12 months. The higher baseline cognitive subgroup (MMSE ≥15) and the worse baseline BPSD subgroup were expected to show better effects with memantine.

Montreal Cognitive Assessment (MoCA): validation study for frontotemporal dementia.

Science.gov (United States)

Freitas, Sandra; Simões, Mário R; Alves, Lara; Duro, Diana; Santana, Isabel

2012-09-01

The Montreal Cognitive Assessment (MoCA) is a brief instrument developed for the screening of milder forms of cognitive impairment, having surpassed the well-known limitations of the Mini-Mental State Examination (MMSE). The aim of the present study was to validate the MoCA as a cognitive screening test for behavioral-variant frontotemporal dementia (bv-FTD) by examining its psychometric properties and diagnostic accuracy. Three matched subgroups of participants were considered: bv-FTD (n = 50), Alzheimer disease (n = 50), and a control group of healthy adults (n = 50). Compared with the MMSE, the MoCA demonstrated consistently superior psychometric properties and discriminant capacity, providing comprehensive information about the patients' cognitive profiles. The diagnostic accuracy of MoCA for bv-FTD was extremely high (area under the curve AUC [MoCA] = 0.934, 95% confidence interval [CI] = 0.866-.974; AUC [MMSE] = 0.772, 95% CI = 0.677-0.850). With a cutoff below 17 points, the MoCA results for sensitivity, specificity, positive predictive value, negative predictive value, and classification accuracy were significantly superior to those of the MMSE. The MoCA is a sensitive and accurate instrument for screening the patients with bv-FTD and represents a better option than the MMSE.

Mini‑Mental State Exam versus Montreal Cognitive Assessment in ...

African Journals Online (AJOL)

Background: Mini‑mental state exam (MMSE) was used several times but no study has examined cognition on the Montreal Cognitive Assessment (MoCA) in diabetes and diabetic retinopathy (DR). In this study, we compared MMSE with MoCA in patients with DR and searched for an association between the severity of DR ...

Psychometric properties of the Flemish translation of the NEECHAM Confusion Scale

Directory of Open Access Journals (Sweden)

Abraham Ivo L

2005-03-01

Full Text Available Abstract Background Determination of a patient's cognitive status by use of a valid and reliable screening instrument is of major importance as early recognition and accurate diagnosis of delirium is necessary for effective management. This study determined the reliability, validity and diagnostic value of the Flemish translation of the NEECHAM Confusion Scale. Methods A sample of 54 elderly hip fracture patients with a mean age of 80.9 years (SD = 7.85 were included. To test the psychometric properties of the NEECHAM Confusion Scale, performance on the NEECHAM was compared to the Confusion Assessment Method (CAM and the Mini-Mental State Examination (MMSE, by using aggregated data based on 5 data collection measurement points (repeated measures. The CAM and MMSE served as gold standards. Results The alpha coefficient for the total NEECHAM score was high (0.88. Principal components analysis yielded a two-component solution accounting for 70.8% of the total variance. High correlations were found between the total NEECHAM scores and total MMSE (0.75 and total CAM severity scores (-0.73, respectively. Diagnostic values using the CAM algorithm as gold standard showed 76.9% sensitivity, 64.6% specificity, 13.5% positive and 97.5% negative predictive values, respectively. Conclusion This validation of the Flemish version of the NEECHAM Confusion Scale adds to previous evidence suggesting that this scale holds promise as a valuable screening instrument for delirium in clinical practice. Further validation studies in diverse clinical populations; however, are needed.

Prevalence of possible Alzheimer′s disease in an urban elderly population of Ludhiana: A pilot study

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Neena Bhatti

2014-01-01

Full Text Available Background : Dementias in the elderly, of which Alzheimer′s disease (AD is the most common form, may emerge as important public health problems in the elderly in low-resource developing countries whose populations are ageing rapidly. Aims: 1. To find out the prevalence of possible AD in the elderly population of an urban area of Ludhiana. 2. To identify major socio-demographic risk factors for "possible AD" in the population under study. Materials and Methods: A cross-sectional study was conducted on >60 year old residents of an urban area of Ludhiana. Data was collected from 200 consenting individuals chosen by simple random sampling, using a pre-tested questionnaire with standardized batteries, "10 Warning Signs of Alzheimer′s Disease" to screen for possible AD, Everyday Abilities Scale for India (EASI to assess physical impairment and the Hindi version of the Mini-Mental State Examination (MMSE to assess cognitive impairment. The presence of >1 warning signs was considered as "possible AD", EASI score >3 as "functional impairment" and MMSE score 80-years-old was observed to be a significant risk factor for "possible AD" [odd ratio (OR = 3.93, confidence interval (CI = 1.10-13.26. Gender, educational status, marital status, family type, employment status, and addictions were not found to be statistically significant risk factors (P > 0.05. One-third of those with "possible AD" had "probable AD". Those with "possible AD" were at high risk of having functional impairment (OR = 17.10, 95%, CI = 5.00-58.46.

A Practical Concussion Physical Examination Toolbox.

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Matuszak, Jason M; McVige, Jennifer; McPherson, Jacob; Willer, Barry; Leddy, John

With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor. The references of the pertinent articles were reviewed for other relevant sources. Clinical review. Level 3. The pertinent physical examination elements for concussion include evaluation of cranial nerves, manual muscle testing, and deep tendon reflexes; inspecting the head and neck for trauma or tenderness and cervical range of motion; Spurling maneuver; a static or dynamic balance assessment; screening ocular examination; and a mental status examination that includes orientation, immediate and delayed recall, concentration, mood, affect, insight, and judgment. Other examination elements to consider, based on signs, symptoms, or clinical suspicion, include testing of upper motor neurons, cervical strength and proprioception, coordination, pupillary reactivity, and visual acuity; examination of the jaw, temporomandibular joint, and thoracic spine; fundoscopic evaluation; orthostatic vital signs; assessment of dynamic visual acuity; and screening for depression, anxiety, substance abuse disorders, and preinjury psychiatric difficulties. Various elements of the physical examination, such as screening ocular examination, cervical musculoskeletal examination, static and/or dynamic balance assessment, and mental status examination, appear to have utility for evaluating concussion; however, data on validity are lacking.

Efficacy of acetylcholinesterase inhibitors versus nootropics in Alzheimer's disease: a retrospective, longitudinal study.

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Tsolaki, M; Pantazi, T; Kazis, A

2001-01-01

The aim of this study was to investigate the efficacy of nootropics (piracetam, aniracetam, nimodopine and dihydroergicristine) versus acetylcholinesterase inhibitors (AChE-Is) (tacrine and donepezil) in the treatment of Alzheimer's disease. This is a retrospective study of 510 patients with Alzheimer's disease. To determine clinical efficacy of treatment, we used the mean change over time in scores for the following tests: the Mini-Mental State Examination (MMSE); the Cambridge Cognitive Examination for the Elderly; and the Functional Rating Scale for Symptoms of Dementia. In all patients and in patients with severe Alzheimer's disease (baseline MMSE nootropics (-4.38 for AChE-Is group versus 1.48 for nootropics group). For patients with mild dementia (baseline MMSE score between 21 and 26), there was a significantly greater deterioration on the MMSE scale for each time-point in the nootropics group compared with the AChE-Is group. In conclusion, we did not find any strong evidence that a difference in efficacy exists between AChE-Is and nootropics in the treatment of Alzheimer's disease.

Fighting status inequalities

DEFF Research Database (Denmark)

Nielsen, Morten Ebbe Juul; Landes, Xavier

2016-01-01

Status inequalities seem to play a fairly big role in creating inequalities in health. This article assumes that there can be good reasons to fight status inequalities in order to reduce inequalities in health. It examines whether the neorepublican ideal of non-dominance does a better job as a th...

Hypertension among US adults by disability status and type, National Health and Nutrition Examination Survey, 2001-2010.

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Stevens, Alissa; Courtney-Long, Elizabeth; Gillespie, Cathleen; Armour, Brian S

2014-08-14

The prevalence of hypertension among people with disabilities is not well understood. We combined data from the 2001-2010 National Health and Nutrition Examination Survey to obtain estimates of hypertension prevalence by disability status and type (cognitive, hearing, vision, or mobility limitation) and assess the association between disability and hypertension. Overall, 34% of adults with disabilities had hypertension compared with 27% of adults without disabilities; adults with mobility limitations were more likely to have hypertension than adults without disabilities (adjusted prevalence ratio: 1.23; 95% confidence interval: 1.16-1.32). Our results suggest that adults living with disabilities are an important subpopulation to include in hypertension reporting and intervention efforts.

Problem drinking among at-risk college students: The examination of Greek involvement, freshman status, and history of mental health problems.

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Martinez, Haley S; Klanecky, Alicia K; McChargue, Dennis E

2018-02-06

Scarce research has examined the combined effect of mental health difficulties and demographic risk factors such as freshman status and Greek affiliation in understanding college problem drinking. The current study is interested in looking at the interaction among freshman status, Greek affiliation, and mental health difficulties. Undergraduate students (N = 413) from a private and public Midwestern university completed a large online survey battery between January 2009 and April 2013. Data from both schools were aggregated for the analyses. After accounting for gender, age, and school type, the three-way interaction indicated that the highest drinking levels were reported in freshman students who reported a history of mental health problems although were not involved in Greek life. Findings are discussed in the context of perceived social norms, as well as alcohol-related screenings and intervention opportunities on college campuses.

Changes in racial categorization over time and health status: an examination of multiracial young adults in the USA.

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Tabb, Karen M

2016-01-01

Multiracial (two or more races) American health related to racial stability over the life course is a pressing issue in a burgeoning multi-ethnic and multicultural global society. Most studies on multiracial health are cross-sectional and thus focus on racial categorization at a single time point, so it is difficult to establish how health indicators change for multiracials over time. Accordingly the central aim of this paper was to explore if consistency in racial categories over time is related to self-rated health for multiracial young adults in the USA. Data were drawn from the National Longitudinal Study of Adolescent Health (Add Health) survey (N = 7957). Weighted multivariate logistic regression was used to exam health status in early adulthood between individuals who switched racial categories between Waves 1 and 3 compared to those who remained in the same racial categories. There were significant differences in report of self-rated health when comparing consistent monoracial adults with multiracial adults who switch racial categories over time. Diversifying (switching from one category to many categories) multiracial respondents are less likely to report fair/poor self-rated health compared to single-race minority young adults in the fully adjusted model (OR = 0.20; 95% CI [0.06-0.60]). These results demonstrate the importance of critically examining changes in racial categories as related to health status over time. Furthermore, these results demonstrate how the switch in racial categories during adolescence can explain some variations in health status during young adulthood.

A Practical Concussion Physical Examination Toolbox

Science.gov (United States)

Matuszak, Jason M.; McVige, Jennifer; McPherson, Jacob; Willer, Barry; Leddy, John

2016-01-01

Context: With heightened awareness of concussion, there is a need to assess and manage the concussed patient in a consistent manner. Unfortunately, concussion physical examination has not been standardized or supported by evidence. Important questions remain about the physical examination. Evidence Acquisition: Review of ClinicalKey, Cochrane, MEDLINE, and PubMed prior to July 2015 was performed using search terms, including concussion, mTBI, physical examination, mental status, cranial nerves, reflexes, cervical, vestibular, and oculomotor. The references of the pertinent articles were reviewed for other relevant sources. Study Design: Clinical review. Level of Evidence: Level 3. Results: The pertinent physical examination elements for concussion include evaluation of cranial nerves, manual muscle testing, and deep tendon reflexes; inspecting the head and neck for trauma or tenderness and cervical range of motion; Spurling maneuver; a static or dynamic balance assessment; screening ocular examination; and a mental status examination that includes orientation, immediate and delayed recall, concentration, mood, affect, insight, and judgment. Other examination elements to consider, based on signs, symptoms, or clinical suspicion, include testing of upper motor neurons, cervical strength and proprioception, coordination, pupillary reactivity, and visual acuity; examination of the jaw, temporomandibular joint, and thoracic spine; fundoscopic evaluation; orthostatic vital signs; assessment of dynamic visual acuity; and screening for depression, anxiety, substance abuse disorders, and preinjury psychiatric difficulties. Conclusion: Various elements of the physical examination, such as screening ocular examination, cervical musculoskeletal examination, static and/or dynamic balance assessment, and mental status examination, appear to have utility for evaluating concussion; however, data on validity are lacking. PMID:27022058

Usefulness of ultrasound examination in the evaluation of a neonate's body fluid status.

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Kieliszczyk, Joanna; Baranowski, Wojciech; Kosiak, Wojciech

2016-06-01

Appropriate hydration is a very important prognostic factor for the patient's health. Ultrasonographic assessment of hydration status is rarely used in pediatric medicine and it is not used at all in neonates due to the fact that no reference values have been established for this age group. The aim of the paper was to establish reference values for neonates. The study included 50 neonates from two hospitals in the Lower Silesia region of Poland; 25 of them were healthy patients (full-term newborns with no perinatal complications) and 25 were sick patients (newborns with heart defects such as ostium secundum atrial septal defect, ventricular septal defect, permanent foramen ovale and patent ductus arteriosus as well as newborns with neonatal jaundice or pneumonia that occurred during the first days of life). The ultrasound scans were conducted during the first days of the children's life. For every child inferior vena cava diameter was measured in the substernal area, longitudinal plane, M-mode in two respiratory phases: inhalation and exhalation. In addition, abdominal aorta diameter was determined (substernal area, transverse plane). The study demonstrated a statistically significant difference in the calculated inferior vena cava collapsibility index between both groups. Two other indices included the ratio of the inferior vena cava diameter during the expiratory phase to the diameter of the aorta and the ratio of the inferior vena cava diameter during the inspiratory phase to the diameter of the aorta; a statistically significant difference between both groups was found only for the measurements in the inspiratory phase. Based on the study results normal ranges for hydration indices in neonates were established. The need for the measurement of the abovementioned parameters in the inspiratory phase was determined. In addition, the usefulness of the ultrasound examination for the evaluation of body fluid status in this pediatric age group, particularly in preterm

A cross-sectional study examining multiple mobility device use and fall status among middle-aged and older adults with multiple sclerosis.

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Finlayson, Marcia L; Peterson, Elizabeth W; Asano, Miho

2014-01-01

To document the prevalence of multiple mobility device use among adults with multiple sclerosis (MS) (≥ 55 years) and examine the association between falls status (faller/non-faller) and the number of mobility devices used. Cross-sectional data generated through telephone interviews with 353 participants was used for this secondary analysis. Descriptive statistics were used to address the first study purpose. Multiple device use was measured by the number of devices used, which ranged from 0 (never use a cane, walker, manual wheelchair, or power wheelchair/scooter) to 4 (use all four mobility devices at least some of the time). Logistic regression analysis was used to address the second purpose, with fall status used as the dependent variable (non-fallers [falls, this association requires further research to determine directionality.

Health Insurance Status as a Barrier to Ideal Cardiovascular Health for U.S. Adults: Data from the National Health and Nutrition Examination Survey (NHANES.

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Michael A McClurkin

Full Text Available Little is known about the association between cardiovascular (CV health and health insurance status. We hypothesized that U.S. adults without health insurance coverage would have a lower likelihood of ideal cardiovascular health.Using National Health and Nutrition Examination Survey (NHANES data from 2007-2010, we examined the relationship between health insurance status and ideal CV health in U.S. adults aged ≥19 years and <65 (N = 3304. Ideal CV health was defined by the American Heart Association (AHA as the absence of clinically manifested CV disease and the simultaneous presence of 6-7 "ideal" CV health factors and behaviors. Logistic regression modeling was used to determine the relationship between health insurance status and the odds of ideal CV health. Of the U.S. adult population, 5.4% attained ideal CV health, and 23.5% were without health insurance coverage. Those without health insurance coverage were more likely to be young (p<0.0001, male (p<0.0001, non-white (p<0.0001, with less than a high school degree (p<0.0001, have a poverty-to-income ratio less than 1 (p<0.0001 and unemployed (p<0.0001 compared to those with coverage. Lack of health insurance coverage was associated with a lower likelihood of ideal CV health; however, this relationship was attenuated by socioeconomic status.U.S. adults without health insurance coverage are less likely to have ideal CV health. Population-based strategies and interventions directed at the community-level may be one way to improve overall CV health and reach this at-risk group.

Long-term effect of galantamine on cognitive function in patients with Alzheimer’s disease versus a simulated disease trajectory: an observational study in the clinical setting

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Nakagawa R

2017-04-01

Full Text Available Ryoko Nakagawa,1 Takashi Ohnishi,1 Hisanori Kobayashi,1 Toshio Yamaoka,2 Tsutomu Yajima,3 Ai Tanimura,4 Toshiya Kato,4 Kazutake Yoshizawa1 1Evidence Generation Department, Medical Affairs Division, 2Clinical Data Management Department, R&D Division, 3Biostatistics Department, Quantitative Science Division, 4Drug Surveillance Department, R&D Division, Janssen Pharmaceutical K.K., Tokyo, Japan Background: Long-term maintenance of cognitive function is an important goal of treatment for Alzheimer’s disease (AD, but evidence about the long-term efficacy of cholinesterase inhibitors is sparse. To evaluate the long-term efficacy and safety of galantamine for AD in routine clinical practice, we conducted a 72-week post-marketing surveillance study. The effect of galantamine on cognitive function was estimated in comparison with a simulated disease trajectory. Patients and methods: Patients with mild-to-moderate AD received flexible dosing of galantamine (16–24 mg/day during this study. Cognitive function was assessed by the mini mental state examination (MMSE and the clinical status was determined by the Clinical Global Impression-Improvement (CGI-I. Changes of the MMSE score without treatment were estimated in each patient using Mendiondo’s model. Generalized linear mixed model analysis was performed to compare the simulated MMSE scores with the actual scores. Results: Of the 661 patients who were enrolled, 642 were evaluable for safety and 554 were assessed for efficacy. The discontinuation rate was 46.73%. Cognitive decline indicated by the mean change of actual MMSE scores was significantly smaller than the simulated decline. Individual analysis demonstrated that >70% of patients had better actual MMSE scores than their simulated scores. Significant improvement of CGI-I was also observed during the observation period. Adverse events occurred in 28.5% of patients and were serious in 8.41%. The reported events generally corresponded with the

Utility of TICS-M for the assessment of cognitive function in older adults.

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de Jager, Celeste A; Budge, Marc M; Clarke, Robert

2003-04-01

Routine screening of high-risk elderly people for early cognitive impairment is constrained by the limitations of currently available cognitive function tests. The Telephone Interview of Cognitive Status is a novel instrument for assessment of cognitive function that can be administered in person or by telephone. To evaluate the determinants and utility of TICS-M (13-item modified version) for assessment of cognitive function in healthy elderly people. The utility of TICS-M was compared with more widely used MMSE and CAMCOG in a cross-sectional survey of 120 older (62 to 89 years) UK adults. The TICS-M cognitive test scores (27.97, SD 4.15) were normally distributed in contrast with those for MMSE and CAMCOG that had a negatively skewed distribution. TICS-M scores were inversely correlated with age (r = -0.21) and with the NART fullscale IQ (r = -0.35), but were independent of years of education in this cohort. TICS-M was highly correlated with MMSE (r = 0.57) and with CAMCOG (r = 0.62) scores. The time required to complete the test is comparable to MMSE and substantially less than CAMCOG. The normal distribution of TICS-M test scores suggest that this test is less constrained by the ceiling effect which limits the utility of MMSE and CAMCOG test scores in detecting early cognitive impairment. TICS-M is an appropriate instrument to assess cognitive function in both research and in clinical practice. Copyright 2003 John Wiley & Sons, Ltd.

Iron status and reproduction in US women: National Health and Nutrition Examination Survey, 1999-2006.

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Elizabeth M Miller

Full Text Available Women experience significant changes in iron status throughout their reproductive lifespans. While this is evident in regions with high rates of malnutrition and infectious disease, the extent of reproductive-related changes is less well known in countries with low rates of iron deficiency anemia, such as the United States. The goal of this study is determine the relationship between women's reproductive variables (pregnancy, parity, currently breastfeeding, regular menstruation, hormonal contraceptive use, and age at menarche and iron status (hemoglobin, ferritin, transferrin receptor, and % transferrin saturation using an anthropological framework for interpreting the results. Data from women aged 18-49 were taken from the 1999-2006 US NHANES, a nationally representative cross-sectional sample of US women. Using multiple imputation and complex survey statistics, women's reproductive variables were regressed against indicators of iron status. Pregnant women had significantly poorer iron status, by most indicators, than non-pregnant women. All biomarkers demonstrated significantly lower iron levels with increasing parity. Women who were having regular periods had iron indicators that suggested decreased iron levels, while women who used hormonal contraceptives had iron indicators that suggested increased iron levels. Despite relatively good iron status and widespread availability of iron-rich foods in the US, women still exhibit patterns of iron depletion across several reproductive variables of interest. These results contribute to an ecological approach to iron status that seeks to understand variation in iron status, with the hopes that appropriate, population-specific recommendations can be developed to improve women's health.

Evaluation of socioeconomic status as a risk factor of pterygium using the Korean National Health and Nutrition Examination Survey 2010 to 2011: A STROBE-compliant article.

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Lee, Young Bok; Kim, Su Young; Park, Yong Gyu; Han, Kyung Do; Kim, Jin-Wou; Chae, Hiun Suk; Lee, Young Chun

2017-03-01

Pterygium is a common conjunctival disorder. The socioeconomic risk factors of pterygium have not been systematically evaluated in Korea. The study investigated risk factors of pterygium considering socioeconomic status.Participants were 9839 adults aged 19 to 74 years, who underwent ophthalmic slit-lamp examinations as part of the Korean National Health and Nutrition Examination Survey 2010 to 2011. Pterygium was diagnosed as a growth of fibrovascular tissue over the cornea. The socioeconomic risk factors were analyzed in association with the presence of pterygium. Multiple logistic regression analysis was used to evaluate the odds ratios for differences in socioeconomic status.The presence of pterygium was associated with diabetes mellitus, hypertension, metabolic syndrome, and sun exposure time (>5 h/d). The blood level of 25-hydroxyvitamin D was higher in the pterygium group than in the control group, but both groups were deficient in 25-hydroxyvitamin D compared with the normal reference level. Pterygium was almost 3 times as frequent among persons who worked outdoors, such as skilled agricultural, forestry, and fishery workers, than among those who worked indoors (odds ratio 3.061, 95% confidence interval 1.946-4.813). Low educational status and longer working hours were also significantly associated with pterygium.This study used a nationwide population-based survey conducted by the Korean Centers for Disease Control and Prevention to reveal that pterygium is associated with low socioeconomic status. Efforts should be made to reduce the risk of pterygium by changing modifiable risk factors, especially among people with low socioeconomic status.

Early effect of ApoE-epsilon 4 allele on cognitive results in a group of highly performing subjects: the EVA study. Etude sur le Vieillissement Artériel.

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Berr, C; Dufouil, C; Brousseau, T; Richard, F; Amouyel, P; Marceteau, E; Alpérovitch, A

1996-10-25

We examined the association between apolipoprotein E (ApoE) epsilon 4 allele and cognitive performances in a population sample of 1174 high functioning volunteers aged 59-71 years. The neuropsychological battery included the Mini Mental State Examination (MMSE) and nine tests assessing visual attention, verbal memory, visual processing, logical reasoning, psychomotor rapidity, visual memory, auditory attention and verbal fluency. The ratio of genotypes with zero, one or two epsilon 4 alleles was 70.6%, 21.4% and 1.9%, respectively. The epsilon 4 allele was significantly associated with lower scores for visual attention, psychomotor rapidity and MMSE. In the best performer subgroup (MMSE score above 25, n = 1028), all relationships persisted. Our findings demonstrate that the ApoE-epsilon 4 allele is early associated with low normal cognitive performances in areas which are not specifically affected at the subclinical onset of dementia.

Reliability and Validity of the Clinical Dementia Rating for Community-Living Elderly Subjects without an Informant.

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Nyunt, Ma Shwe Zin; Chong, Mei Sian; Lim, Wee Shiong; Lee, Tih Shih; Yap, Philip; Ng, Tze Pin

2013-01-01

The Clinical Dementia Rating (CDR) scale is widely used to assess cognitive impairment in Alzheimer's disease. It requires collateral information from a reliable informant who is not available in many instances. We adapted the original CDR scale for use with elderly subjects without an informant (CDR-NI) and evaluated its reliability and validity for assessing mild cognitive impairment (MCI) and dementia among community-dwelling elderly subjects. At two consecutive visits 1 week apart, nurses trained in CDR assessment interviewed, observed and rated cognitive and functional performance according to a protocol in 90 elderly subjects with suboptimal cognitive performance [Mini-Mental State Examination (MMSE) reliability (κ 0.77-1.00 for six domains and 0.95 for global rating) and test-retest reliability (κ 0.75-1.00 for six domains and 0.80 for global rating), good agreement (κ 0.79) with the clinical assessment status of MCI (n = 37) and dementia (n = 4) and significant differences in the mean scores for MMSE, MOCA and Instrumental Activities of Daily Living (ANOVA global p reliable assessment of MCI and dementia in community-living elderly subjects without an informant.

A placebo-controlled study of memantine (Ebixa) in dementia of Wernicke-Korsakoff syndrome.

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Rustembegović, Avdo; Kundurović, Zlata; Sapcanin, Aida; Sofic, Emin

2003-01-01

We evaluated the responses of 16 patients to preliminarily explore the spectrum of effectiveness and tolerability of the memantine, and NMDA antagonist, in the treatment of dementia in Wernicke-Korsakoff syndrome. In this study, for the first time in dementia of Wernicke-Korsakoff syndrome, the response to memantine was assessed. 16 patients with median age of 64 years and median body weight of 77 kg were treated with memantine 10 mg twice daily for up to 28 weeks. Clinical global impressions (CGI), and Mini Mental Status Examination (MMSE) were performed during the treatment period (after 2, 4, and 28 weeks). Efficacy measures also included the ADCS-Activities of Daily Living scale (ADCS-ADL). At 28 weeks, the ADCS-ADL showed significantly less deterioration in memantine treated patients compared with placebo (-2.3 compared with -4.3: p = 0.005). The results of MMSE demonstrate a significant and clinically relevant benefit for memantine relative to placebo as shown by positive outcomes in cognitive and functional assessments. Memantine (10 mg) was safe and well tolerated. The preliminarily findings of this study with 16 patients suggested that memantine is effective in the treatment of dementia in Wernicke-Korsakoff syndrome.

Time-of-flight PET image reconstruction using origin ensembles

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Wülker, Christian; Sitek, Arkadiusz; Prevrhal, Sven

2015-03-01

The origin ensemble (OE) algorithm is a novel statistical method for minimum-mean-square-error (MMSE) reconstruction of emission tomography data. This method allows one to perform reconstruction entirely in the image domain, i.e. without the use of forward and backprojection operations. We have investigated the OE algorithm in the context of list-mode (LM) time-of-flight (TOF) PET reconstruction. In this paper, we provide a general introduction to MMSE reconstruction, and a statistically rigorous derivation of the OE algorithm. We show how to efficiently incorporate TOF information into the reconstruction process, and how to correct for random coincidences and scattered events. To examine the feasibility of LM-TOF MMSE reconstruction with the OE algorithm, we applied MMSE-OE and standard maximum-likelihood expectation-maximization (ML-EM) reconstruction to LM-TOF phantom data with a count number typically registered in clinical PET examinations. We analyzed the convergence behavior of the OE algorithm, and compared reconstruction time and image quality to that of the EM algorithm. In summary, during the reconstruction process, MMSE-OE contrast recovery (CRV) remained approximately the same, while background variability (BV) gradually decreased with an increasing number of OE iterations. The final MMSE-OE images exhibited lower BV and a slightly lower CRV than the corresponding ML-EM images. The reconstruction time of the OE algorithm was approximately 1.3 times longer. At the same time, the OE algorithm can inherently provide a comprehensive statistical characterization of the acquired data. This characterization can be utilized for further data processing, e.g. in kinetic analysis and image registration, making the OE algorithm a promising approach in a variety of applications.

Total serum homocysteine levels do not identify cognitive dysfunction in multimorbid elderly patients.

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Hengstermann, S; Laemmler, G; Hanemann, A; Schweter, A; Steinhagen-Thiessen, E; Lun, A; Schulz, R-J

2009-02-01

Total blood homocysteine (Hcys) and folate levels have been investigated in association with cognitive dysfunction in healthy but not in multimorbid elderly patients. We hypothesized that total serum Hcys is an adequate marker to identify multimorbid elderly patients with cognitive dysfunction assessed by the Short Cognitive Performance Test (SKT) and Mini-Mental State Examination (MMSE). Cross-sectional study. The study center was an acute geriatric hospital. A total of 189 multimorbid elderly patients were recruited. Cognitive dysfunction was determined according to the SKT and MMSE. Biochemical parameters (Hcys, folate, vitamin B12, hemoglobin), nutritional status (BMI, Mini Nutritional Assessment, nutritional intake), and activities of daily living were assessed. According to the SKT, 25.4% of patients showed no cerebral cognitive dysfunction, 21.2% had suspected incipient cognitive dysfunction, 12.7% showed mild cognitive dysfunction, 9.0% had moderate cognitive dysfunction, and 31.7% of patients were demented. The median plasma Hcys value was elevated by approximately 20% in multimorbid elderly patients, independent of cognitive dysfunction. Serum folate and vitamin B12 concentrations were within normal ranges. We did not find significant differences in nutritional status, activities of daily living, numbers of diseases or medications, or selected biochemical parameters between the SKT groups. Elevated serum Hcys levels with normal plasma folate and vitamin B12 concentrations were observed in multimorbid elderly patients. The plasma Hcys level did not appear to be an important biological risk factor for cognitive dysfunction in multimorbid geriatric patients.

Screening for Dementia in Older Adults: Comparison of Mini-Mental State Examination, Mini-Cog, Clock Drawing Test and AD8.

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Yang, Li; Yan, Jing; Jin, Xiaoqing; Jin, Yu; Yu, Wei; Xu, Shanhu; Wu, Haibin

2016-01-01

This study was conducted to estimate screening performance of dementia screening tools including Mini-Mental State Examination (MMSE), Mini-Cog, Clock Drawing Test (CDT) and Ascertain Dementia 8 questionnaire (AD8) for older adults. 2015 participants aged 65 years or more in eastern China were enrolled. 4 screening tests were administered and scored by specifically trained psychiatrists. We used data from two-by-two tables to calculate the sensitivity, specificity, and positive and negative predictive values (PPV/NPV). Our study showed that dementia was highly prevalent among elderly in Zhejiang province. The Mini-Cog, with excellent screening characteristics and spending less time, could be considered to be used as a screening tool among communities to help to diagnose dementia early.

Cognitive Dysfunction and Malnutrition Are Independent Predictor of Dysphagia in Patients with Acute Exacerbation of Congestive Heart Failure.

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Yokota, Junichi; Ogawa, Yoshiko; Yamanaka, Shinsuke; Takahashi, Yoshimi; Fujita, Hiroshi; Yamaguchi, Nobuhiro; Onoue, Noriko; Ishizuka, Takeshi; Shinozaki, Tsuyoshi; Kohzuki, Masahiro

2016-01-01

Early detection and intervention for dysphagia is important in patients with congestive heart failure (CHF). However, previous studies have focused on how many patients with dysphagia develop CHF. Studies focusing on the comorbidity of dysphagia in patients with CHF are rare. Additionally, risk factors for dysphagia in patients with CHF are unclear. Thus, the aim of this study was to clarify risk factors for dysphagia in patients with acute exacerbation of CHF. A total of 105 patients, who were admitted with acute exacerbation of CHF, were enrolled. Clinical interviews, blood chemistry analysis, electrocardiography, echocardiography, Mini-Mental State Examination (MMSE), exercise tolerance tests, phonatory function tests, and evaluation of activities of daily living (ADL) and nutrition were conducted on admission. After attending physicians permitted the drinking of water, swallowing screening tests were performed. Patients were divided into a dysphagia group (DG) or a non-dysphagia group (non-DG) based on Functional Oral Intake Scale level. Among the 105 patients, 38 had dysphagia. A greater number of patients had history of aspiration pneumonia and dementia, and there was a higher age, N-terminal pro-B-type natriuretic peptide level in the DG compared with the non-DG. MMSE scores, exercise tolerance, phonatory function, status of ADL, nutrition, albumin, and transthyretin were lower in the DG compared with the non-DG. In multivariate analysis, after adjusting for age and sex, MMSE, BI score, and transthyretin was independently associated with dysphagia. Comorbidity of dysphagia was 36.1% in patients with acute exacerbation of CHF, and cognitive dysfunction and malnutrition may be an independent predictor of dysphagia.

Reduced benefit from mnemonic strategies in early-stage Alzheimer's disease: a brief testing-the-limits paradigm for clinical practice.

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Uttner, Ingo; Schurig, Niklas; von Arnim, Christine A F; Lange-Asschenfeldt, Christian; Tumani, Hayrettin; Riepe, Matthias W

2010-10-01

Discriminating incipient Alzheimer's disease (AD) from major depression (MD) and age related memory decline is a challenge in clinical practice. Since AD is characterized by an early loss of neuronal and functional plasticity, a dynamic test strategy, such as the testing-the-limits (TtL) approach, that measures learning capacity can be a helpful diagnostic tool. To evaluate this, a short recognition paradigm consisting of a pre-test (baseline) and two post-test conditions with an interposed encoding instruction was developed and administered to individuals with incipient AD (n = 19; Mini Mental Status Examination (MMSE) 26.5), patients with depressive disorders (n = 11; MMSE 30), and healthy controls (n = 11; MMSE 30). In addition, participants completed a set of traditional neuropsychological tests that focused on the subjects' cognitive baseline performance. Intergroup comparisons (Kruskal-Wallis, U test) revealed significantly higher post-test failure rates in AD patients. Pre-test performance of MD and AD patients did not differ. Intra-group comparisons (Friedman, Wilcoxon test) showed that all three subject samples benefit from intervention in post-test 1. In contrast to MD and healthy individuals, who revealed significantly lower failure rates in post-test 2 compared to the pre-test, AD patients did not improve. Out of the 15 traditional test scores obtained, only two discriminated simultaneously between AD and each of the other groups. Our data confirm the finding of an impaired cognitive plasticity already present in very early stages of AD and illustrate the efficiency of a dynamic test approach in identifying incipient dementia.

"THE RELATION OF HYPERHOMOCYSTEINEMIA TO COGNITIVE FUNCTION AND BRAIN ATROPHY IN PATIENTS WITH MULTIPLE SCLEROSIS "

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M. Ghaffarpour

2007-06-01

Full Text Available Cognitive impairment may be a common even at the onset of multiple sclerosis (MS. In this case-control study, we tried to find out the probable relationship between homocysteine levels and cerebral atrophy or cognitive impairment in patients with multiple sclerosis. One hundred fifty six patients who had MS according to McDonald diagnostic criteria were included in this study. Patients’ age, gender, and educational level, MS duration and clinical type, disability, cognitive function state based on minimental state examination (MMSE, presence of hyperhomocysteinemia, and brain atrophy were evaluated. There was no statistically significant relationship between hyperhomocysteinemia and cognitive status. Total homocysteine levels had a significant correlation with MMSE score only in those patients with elementary level of education. Also total homocysteine levels and overall cerebral atrophy did not indicate significant relationship according to those independent variables mentioned above except in the patients with EDSS less than 6. When intercaudate ratio > 0.10 was applied as a criterion for cerebral atrophy, we found that hyperhomocysteinemia related significantly to intercaudate ratio > 0.10 in females, aged between 21 and 30 years, MS duration ≤ 5 years, primary progressive MS and relapsing-remitting MS clinical types, EDSS ≤ 3 and elementary level of education. We suggest applying MMSE only for the first step of cognitive function survey. In the next steps, much more exact test must be used (e.g. MSNQ. Also we can not suggest measuring plasma homocysteine level as criterion for monitoring the cognitive function in patients with MS.

Examining the Association Between Different Aspects of Socioeconomic Status, Race, and Disability in Hawaii.

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Seto, Jason; Davis, James; Taira, Deborah Ann

2018-02-20

Socioeconomic status and race/ethnicity are known to be associated with health disparities. This study used data (2010-2014) from the American Community Survey. Respondents over age 30 from Hawaii were included (n = 44,921). Outcome variables were self-reported disability in vision, hearing, ambulatory function, self-care, independent living, or cognitive function. Four measures of socioeconomic status were personal income, average income for the area, income inequality for area, and education. This study used multivariable logistic regression to predict disability by race/ethnicity and socioeconomic status, controlling for age and gender. All four measures of socioeconomic status were significant predictors of at least one type of disability after adjustment for age, gender, and other measures of socioeconomic status. Higher education was significantly related to having every type of disability. Similarly, people with high personal income were less likely to have each type of disability than those with middle income, and those with low income were more likely to have all disabilities except hearing. Income inequality was significantly associated with half the disabilities. Low area income was significantly associated with increased vision-related disability, while high income was associated with less likelihood of hearing-related disability. Native Hawaiians were significantly more likely to report having a disability than Filipinos and Chinese for all six types of disability, Japanese for four, and whites for two, after adjustment. These results suggest that in order to reduce health disparities for Native Hawaiians, as well as other ethnic groups, a range of socioeconomic factors need to be addressed.

The Saint Louis University Mental Status Examination Is Better than the Mini-Mental State Examination to Determine the Cognitive Impairment in Turkish Elderly People.

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Kaya, Derya; Isik, Ahmet Turan; Usarel, Cansu; Soysal, Pinar; Ellidokuz, Hulya; Grossberg, George T

2016-04-01

Presence of detailed screening instruments to detect cognitive impairment in the older adults' culture and language is very essential. The Saint Louis University Mental Status Examination (SLUMS) is one of cognitive screening scales used. The aim of the study was to establish the validity and reliability of the Turkish version of SLUMS (SLUMS-T). Two hundred seventy-four participants aged 60 years and older admitted to our geriatric clinic were screened for cognitive impairment using SLUMS-T and Mini-Mental State Examination. Internal consistency was analyzed with Cronbach α test. Area under curves of receiver operating characteristic analyses were used to test the predictive accuracy of the SLUMS-T for detecting amnestic mild cognitive impairment (aMCI) and Alzheimer disease (AD) to set an appropriate cut-off point. The SLUMS-T scores were positively correlated with the Mini-Mental State Examination scores of the patients with aMCI and patients with AD and controls (r = 0.687, P < .001; r = 0.880, P < .001; respectively). Internal consistency of the SLUMS-T was Cronbach α = 0.85. It was found that SLUMS-T with a cut-off point of 23 had a sensitivity of 66.6% and a specificity of 72.3% for the diagnosis of aMCI, and with a cut-off point of 20 had a sensitivity of 83.8% and a specificity of 87.3% for the diagnosis of AD. SLUMS-T was demonstrated to have sufficient validity and reliability to evaluate cognitive impairment including MCI among Turkish elderly people. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.

Individual and Area Level Socioeconomic Status and Its Association with Cognitive Function and Cognitive Impairment (Low MMSE) among Community-Dwelling Elderly in Singapore.

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Wee, Liang En; Yeo, Wei Xin; Yang, Gui Rong; Hannan, Nazirul; Lim, Kenny; Chua, Christopher; Tan, Mae Yue; Fong, Nikki; Yeap, Amelia; Chen, Lionel; Koh, Gerald Choon-Huat; Shen, Han Ming

2012-01-01

Neighborhood socioeconomic status (SES) can affect cognitive function. We assessed cognitive function and cognitive impairment among community-dwelling elderly in a multi-ethnic urban low-SES Asian neighborhood and compared them with a higher-SES neighborhood. The study population involved all residents aged ≥60 years in two housing estates comprising owner-occupied housing (higher SES) and rental flats (low SES) in Singapore in 2012. Cognitive impairment was defined as cognitive function, while multilevel logistic regression determined predictors of cognitive impairment. Participation was 61.4% (558/909). Cognitive impairment was found in 26.2% (104/397) of residents in the low-SES community and in 16.1% (26/161) of residents in the higher-SES community. After adjusting for other sociodemographic variables, living in a low-SES community was independently associated with poorer cognitive function (β = -1.41, SD = 0.58, p cognitive impairment (adjusted odds ratio 5.13, 95% CI 1.98-13.34). Among cognitively impaired elderly in the low-SES community, 96.2% (100/104) were newly detected. Living in a low-SES community is independently associated with cognitive impairment in an urban Asian society.

Applicability of the Telephone Interview for Cognitive Status (Modified) in a community sample with low education level: association with an extensive neuropsychological battery.

Science.gov (United States)

Castanho, Teresa Costa; Portugal-Nunes, Carlos; Moreira, Pedro Silva; Amorim, Liliana; Palha, Joana Almeida; Sousa, Nuno; Correia Santos, Nadine

2016-02-01

To explore the applicability of a Portuguese (PT) version of the Telephone Interview for Cognitive Status (TICS), with a delayed recall item [modified (M)], here termed TICSM-PT, against an extensive (in-person) battery of neuropsychological instruments, in a sample of older individuals with low educational level and without clinically manifest/diagnosed cognitive impairment. Following translation/back-translation and pilot testing in 33 community dwellers, 142 community dwellers aged 52 to 84 years (mean = 67.45, SD = 7.91) were selected from local health care centres for the study (convenience sampling; stratified age and gender). Cronbach's alpha was used to assess internal consistency, and convergent validity was evaluated through the correlation between TICSM-PT and the Mini Mental State Examination (MMSE), as well as with a comprehensive battery of cognitive instruments. Divergent/discriminant validity was assessed through a battery of psychological instruments. The receiver operating curve was determined for TICSM-PT to classify participants with and without possible indication of cognitive impairment. TICSM-PT showed a satisfactory internal consistency (Cronbach's alpha = 0.705), convergent validity and discriminant validity. TICSM-PT presented a positive association with the global cognitive measures Mini Mental State Examination and the Montreal Cognitive Assessment, and also with most neuropsychological parameters. Receiver operating curve curves presented a sensitivity of 90.6% and specificity of 73.7%. The area under the curve statistic yielded a threshold score equal or below 13.5 for cognitive impairment. TICSM-PT is a practical tool for rapid cognitive assessment among older individuals with low educational background. Copyright © 2015 John Wiley & Sons, Ltd.

Associations between Food Security Status and Dietary Inflammatory Potential within Lower-Income Adults from the United States National Health and Nutrition Examination Survey, Cycles 2007 to 2014.

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Bergmans, Rachel S; Palta, Mari; Robert, Stephanie A; Berger, Lawrence M; Ehrenthal, Deborah B; Malecki, Kristen M

2018-06-01

Evidence suggests both that chronic inflammation mediates the association of food insecurity with adverse health outcomes and that diet may be a significant source of inflammation among food insecure individuals. To examine whether food security status is associated with dietary inflammatory potential. Cross-sectional data came from the National Health and Nutrition Examination Survey (NHANES), cycles 2007 to 2014 (n=10,630). The analysis sample is representative of noninstitutionalized US adults with an income-to-poverty ratio ≤3.00. Dietary Inflammatory Index (DII) score, calculated using the average of two 24-hour dietary recalls, was the main outcome measure. Type III F tests or χ 2 tests compared population characteristics by food security status, defined using the US Food Security Survey Module. Multivariable linear regression was used to estimate the association between food security status and the DII score and moderation by demographic factors. Survey weighting procedures accounted for the effects of stratification and clustering used in the NHANES study design. When accounting for socioeconomic status, demographic factors, and health status, DII score was higher at greater levels of food insecurity (P=0.0033). Those with very low food security had a 0.31 (95% CI=0.12 to 0.49) higher DII score than those with high food security. Age moderated the association between food security status and DII score (interaction P=0.0103), where the magnitude of the association between DII score and severity of food insecurity was higher for those >65 years than for younger age groups. Food security status may be associated with dietary inflammatory potential, which is hypothesized to play a role in multiple chronic health conditions. Further research is needed to determine the causal nature of this relationship and evaluate how best to implement programs designed to address health disparities within food insecure populations. Copyright © 2018 Academy of Nutrition and

Oral hygiene status, gingival status, periodontal status, and treatment needs among pregnant and nonpregnant women: A comparative study

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Meena Kashetty

2018-01-01

Full Text Available Objectives: The gingival and periodontal changes during pregnancy are well known. Gingivitis is the most prevalent oral manifestations associated with pregnancy. The hormonal and vascular changes that accompany pregnancy are known to exaggerate the inflammatory response to the local irritants. Hence, a study was designed to assess oral hygiene status, gingival status, periodontal status, and treatment needs (TNs among pregnant and nonpregnant women. Materials and Methods: A cross-sectional study was conducted among 120 pregnant and 120 nonpregnant women of 18–44 years age attending the Outpatient Department of Gynaecology and Obstetrics in Government Hospital of Belgaum city, Karnataka, India. The study consisted of an interview and oral examination. Type 3 examination was followed. Simplified Oral Hygiene Index (OHI-S, Gingival Index, and Community Periodontal Index and TNs Index were used to assess “oral hygiene status,” “gingival status,” and “periodontal status and TNs,” respectively. Results: The pregnant women showed poor oral hygiene with the mean OHI-S score as 2.68. Gingivitis was prevalent in almost all the pregnant and nonpregnant women. However, it was found more severe in pregnant women with mean gingival score as 1.25. A definite increase in gingivitis was found from Trimester II to Trimester III. The mean number of sextants showing healthy gingiva was significantly (P < 0.01 lower among pregnant women. Conclusions: Pregnant women showed poor oral hygiene, more gingival inflammation, and more periodontal disease as compared to nonpregnant women. The severity of gingivitis increased in Trimester III. Proper oral hygiene practice can prevent these diseases and further complications.

The current status of the Korean student health examination

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Hye-Jung Shin

2013-08-01

Full Text Available Recent trends place an emphasis on school health care, the ultimate goal of which is to protect,maintain, and promote students’ health. School health care is a program that integrates health careservices, health education, health counseling, and local social health services. The student healthexamination (SHE system is a part of school health care and schools and communities must beavailable to provide professional health services. Pediatricians also have important roles as experts inboth school health care and the SHE system. In this article, the history of school health care, its legalbasis, and the current status of the SHE system in Korea are reviewed. Furthermore, sample surveysfrom the past few years are reviewed. Through this holistic approach, future directions are proposed forthe improvement of SHE and school health care.

Hypertension Among US Adults by Disability Status and Type, National Health and Nutrition Examination Survey, 2001–2010

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Courtney-Long, Elizabeth; Gillespie, Cathleen; Armour, Brian S.

2014-01-01

The prevalence of hypertension among people with disabilities is not well understood. We combined data from the 2001–2010 National Health and Nutrition Examination Survey to obtain estimates of hypertension prevalence by disability status and type (cognitive, hearing, vision, or mobility limitation) and assess the association between disability and hypertension. Overall, 34% of adults with disabilities had hypertension compared with 27% of adults without disabilities; adults with mobility limitations were more likely to have hypertension than adults without disabilities (adjusted prevalence ratio: 1.23; 95% confidence interval: 1.16–1.32). Our results suggest that adults living with disabilities are an important subpopulation to include in hypertension reporting and intervention efforts. PMID:25121351

Reliability and Validity of a Novel Internet-Based Battery to Assess Mood and Cognitive Function in the Elderly.

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Myers, Candice A; Keller, Jeffrey N; Allen, H Raymond; Brouillette, Robert M; Foil, Heather; Davis, Allison B; Greenway, Frank L; Johnson, William D; Martin, Corby K

2016-10-18

Dementia is a chronic condition in the elderly and depression is often a concurrent symptom. As populations continue to age, accessible and useful tools to screen for cognitive function and its associated symptoms in elderly populations are needed. The aim of this study was to test the reliability and validity of a new internet-based assessment battery for screening mood and cognitive function in an elderly population. Specifically, the Helping Hand Technology (HHT) assessments for depression (HHT-D) and global cognitive function (HHT-G) were evaluated in a sample of 57 elderly participants (22 male, 35 female) aged 59-85 years. The study sample was categorized into three groups: 1) dementia (n = 8; Mini-Mental State Exam (MMSE) score 10-24), 2) mild cognitive impairment (n = 24; MMSE score 25-28), and 3) control (n = 25; MMSE score 29-30). Test-retest reliability (Pearson correlation coefficient, r) and internal consistency reliability (Cronbach's alpha, α) of the HHT-D and HHT-G were assessed. Validity of the HHT-D and HHT-G was tested via comparison (Pearson r) to commonly used pencil-and-paper based assessments: HHT-D versus the Geriatric Depression Scale (GDS) and HHT-G versus the MMSE. Good test-retest (r = 0.80; p validity of the HHT-D was obtained (r = 0.60 between the HHT-D and GDS; p Validity of the HHT-G was supported (r = 0.71 between the HHT-G and MMSE; p valid computerized assessments to screen for depression and cognitive status, respectively, in an elderly sample.

Usefulness of ultrasound examination in the evaluation of a neonate’s body fluid status

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Joanna Kieliszczyk

2016-06-01

Full Text Available Appropriate hydration is a very important prognostic factor for the patient’s health. Ultrasonographic assessment of hydration status is rarely used in pediatric medicine and it is not used at all in neonates due to the fact that no reference values have been established for this age group. The aim of the paper was to establish reference values for neonates. Material and methods: The study included 50 neonates from two hospitals in the Lower Silesia region of Poland; 25 of them were healthy patients (full-term newborns with no perinatal complications and 25 were sick patients (newborns with heart defects such as ostium secundum atrial septal defect, ventricular septal defect, permanent foramen ovale and patent ductus arteriosus as well as newborns with neonatal jaundice or pneumonia that occurred during the first days of life. The ultrasound scans were conducted during the first days of the children’s life. For every child inferior vena cava diameter was measured in the substernal area, longitudinal plane, M-mode in two respiratory phases: inhalation and exhalation. In addition, abdominal aorta diameter was determined (substernal area, transverse plane. Results: The study demonstrated a statistically significant difference in the calculated inferior vena cava collapsibility index between both groups. Two other indices included the ratio of the inferior vena cava diameter during the expiratory phase to the diameter of the aorta and the ratio of the inferior vena cava diameter during the inspiratory phase to the diameter of the aorta; a statistically significant difference between both groups was found only for the measurements in the inspiratory phase. Conclusions: Based on the study results normal ranges for hydration indices in neonates were established. The need for the measurement of the abovementioned parameters in the inspiratory phase was determined. In addition, the usefulness of the ultrasound examination for the evaluation of body

Examining differences in physical activity levels by employment status and/or job activity level: Gender-specific comparisons between the United States and Sweden.

Science.gov (United States)

Kwak, Lydia; Berrigan, David; Van Domelen, Dane; Sjöström, Michael; Hagströmer, Maria

2016-06-01

The aim of the study was to examine the relationship between employment status and job activity level with physical activity (PA) and sedentary time, stratified by gender and country. Cross-sectional study design. Data from working age adults (18-65 years) from two cross-sectional studies, the Swedish 2001-2002 and 2007-2008 Attitude Behavior and Change Study (ABC; n=1165) and the 2003-2006 US National Health and Nutrition Examination Survey (NHANES; n=4201), were stratified by employment status (employed and not employed) and job activity level (active, sedentary and mixed). PA in counts×min(-1) and time spent in sedentary, low and moderate or higher intensity were measured with accelerometers. Analyses were conducted in 2012-2013. In NHANES, the employed had significantly higher counts×min(-1) and spent more time in moderate or higher intensity PA than those not employed. In ABC, no significant differences were observed between employed and unemployed. Adults with active versus sedentary occupations had higher counts×min(-1) and less sedentary time in both the USA and Sweden and in both men and women. For example, counts×min(-1) were 20-40% greater in active versus sedentary jobs. Employment status is related to PA and sedentary time among men and women in the USA but not in Sweden. Among the employed, occupational PA is associated with total PA and sedentary time for both genders and in both countries. Comparisons of PA levels based on objective measurements can refine understanding of country differences in activity. Copyright © 2015 Sports Medicine Australia. All rights reserved.

Utility and limitations of Addenbrooke's Cognitive Examination-Revised for detecting mild cognitive impairment in Parkinson's disease.

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Komadina, Natalie C; Terpening, Zoe; Huang, Yue; Halliday, Glenda M; Naismith, Sharon L; Lewis, Simon J G

2011-01-01

To evaluate the utility of the Addenbrooke's Cognitive Examination-Revised (ACE-R) as a screening tool for mild cognitive impairment in Parkinson's disease (PD-MCI). PD patients underwent comprehensive neuropsychological and neurological evaluations and ACE-R assessment. The ACE-R was superior to the Mini-Mental State Exam (MMSE) in detecting PD-MCI, with a cutoff score of ≤93 offering a sensitivity of 61% and a specificity of 64%. The utility of the ACE-R in detecting PD-MCI is largely influenced by the fluency sub-domain score, and has optimal discriminability when utilized in patients with lower levels of education (≤12 years of formal schooling). The ACE-R must be used cautiously as a screening tool for PD-MCI, with results being most influenced by its fluency sub-domain score and patient education levels. Copyright © 2011 S. Karger AG, Basel.

Comparing Diagnostic Accuracy of Cognitive Screening Instruments: A Weighted Comparison Approach

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A.J. Larner

2013-03-01

Full Text Available Background/Aims: There are many cognitive screening instruments available to clinicians when assessing patients' cognitive function, but the best way to compare the diagnostic utility of these tests is uncertain. One method is to undertake a weighted comparison which takes into account the difference in sensitivity and specificity of two tests, the relative clinical misclassification costs of true- and false-positive diagnosis, and also disease prevalence. Methods: Data were examined from four pragmatic diagnostic accuracy studies from one clinic which compared the Mini-Mental State Examination (MMSE with the Addenbrooke's Cognitive Examination-Revised (ACE-R, the Montreal Cognitive Assessment (MoCA, the Test Your Memory (TYM test, and the Mini-Mental Parkinson (MMP, respectively. Results: Weighted comparison calculations suggested a net benefit for ACE-R, MoCA, and MMP compared to MMSE, but a net loss for TYM test compared to MMSE. Conclusion: Routine incorporation of weighted comparison or other similar net benefit measures into diagnostic accuracy studies merits consideration to better inform clinicians of the relative value of cognitive screening instruments.

8 CFR 1245.5 - Medical examination.

Science.gov (United States)

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Medical examination. 1245.5 Section 1245.5... examination. Pursuant to section 232(b) of the Act, an applicant for adjustment of status shall be required to have a medical examination by a designated civil surgeon, whose report setting forth the findings of...

8 CFR 245.5 - Medical examination.

Science.gov (United States)

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Medical examination. 245.5 Section 245.5... THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 245.5 Medical examination. Pursuant to section 232(b) of the Act, an applicant for adjustment of status shall be required to have a medical examination by...

Socioeconomic status and risk of rheumatoid arthritis

DEFF Research Database (Denmark)

Pedersen, Line Merete Blak; Jacobsen, Søren; Klarlund, Mette

2006-01-01

To examine whether markers of socioeconomic status (SES) are associated with risk of rheumatoid arthritis (RA), and if so, whether selected lifestyle-related factors could explain this association.......To examine whether markers of socioeconomic status (SES) are associated with risk of rheumatoid arthritis (RA), and if so, whether selected lifestyle-related factors could explain this association....

Effect Size (Cohen's d of Cognitive Screening Instruments Examined in Pragmatic Diagnostic Accuracy Studies

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Andrew J. Larner

2014-07-01

Full Text Available Background/Aims: Many cognitive screening instruments (CSI are available to clinicians to assess cognitive function. The optimal method comparing the diagnostic utility of such tests is uncertain. The effect size (Cohen's d, calculated as the difference of the means of two groups divided by the weighted pooled standard deviations of these groups, may permit such comparisons. Methods: Datasets from five pragmatic diagnostic accuracy studies, which examined the Mini-Mental State Examination (MMSE, the Mini-Mental Parkinson (MMP, the Six-Item Cognitive Impairment Test (6CIT, the Montreal Cognitive Assessment (MoCA, the Test Your Memory test (TYM, and the Addenbrooke's Cognitive Examination-Revised (ACE-R, were analysed to calculate the effect size (Cohen's d for the diagnosis of dementia versus no dementia and for the diagnosis of mild cognitive impairment versus no dementia (subjective memory impairment. Results: The effect sizes for dementia versus no dementia diagnosis were large for all six CSI examined (range 1.59-1.87. For the diagnosis of mild cognitive impairment versus no dementia, the effect sizes ranged from medium to large (range 0.48-1.45, with MoCA having the largest effect size. Conclusion: The calculation of the effect size (Cohen's d in diagnostic accuracy studies is straightforward. The routine incorporation of effect size calculations into diagnostic accuracy studies merits consideration in order to facilitate the comparison of the relative value of CSI.

Three-dimensional stereotactic surface projections of rCBF analysis on the forgetfulness of patients using Mini-Mental State Examination results

International Nuclear Information System (INIS)

Nakatsuka, Hiroki; Matsubara, Ichirou; Ohtani, Haruhiko

2003-01-01

The aim of this single photon emission computed tomography (SPECT) study was to determine the abnormality of the regional cerebral blood flow (rCBF), using a three-dimensional stereotactic surface projection (3D-SSP), in 18 patients referred to the hospital due to forgetfulness. An intergroup comparison, by 3D-SSP analysis, was conducted based on Mini-Mental State Examination (MMSE) results of the total score, time orientation, place orientation, recall, serial sevens and figure copy. In each abnormal group, rCBF was partially decreased in the temporo-parietal cortex, medial temporal structure and posterior cingulate gyrus; these areas with decreased rCBF are similar to the pattern found in Alzheimer's disease. In the abnormal group, at the time of orientation and figure copy, rCBF was decreased in the right parieto-occipital area. (author)

Examining short-term nutritional status among BaAka foragers in transitional economies.

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Remis, Melissa J; Jost Robinson, Carolyn A

2014-07-01

Foragers in transitioning economies are at an increased risk of negative health outcomes as they undergo changes in subsistence patterns and diet. Here, we provide anthropometric data and examine the nutrition and health of adult BaAka foragers in relationship to declining wildlife and economic change in the Dzanga Sangha Protected Areas (APDS), Central African Republic. From June to August 2012, we collected biological data and dietary recall surveys from individuals in Mossapoula (MS) and Yandoumbé (YDBE) villages using standard anthropometric techniques and a single capillary blood finger prick. In our analysis, we identified variation in anthropometric measurements and hemoglobin levels by village (MS = 66, YDBE = 75) and gender (64 men, 77 women). Immigration, increased gun hunting and wildlife trades have reduced forager reliance on forest resources. These changes are evidenced in the marginal health of contemporary BaAka foragers of APDS. Although anthropometric measures of nutritional status do not significantly differ between communities, hemoglobin data highlight inequities in access to forest products between villages with different proximity to community hunting zones. Further, poor dietary diversity and low frequency of purchased foods in the diet indicate that the transition to a market economy has not been fully realized and diets are impoverished. Economic changes appear to have had the most impact at MS village, where forest use is most restricted and consumption of meat and forest products was reduced. This work highlights the nutritional and health needs of foragers in rapidly transitioning economies; especially those impacted by conservation management and zoning policies. © 2014 Wiley Periodicals, Inc.

Adolescents' selective visual attention for high-status peers: The role of perceiver status and gender

NARCIS (Netherlands)

Lansu, T.A.M.; Cillessen, A.H.N.; Karremans, J.C.T.M.

2014-01-01

Previous research has shown that adolescents' attention for a peer is determined by the peer's status. This study examined how it is also determined by the status of the perceiving adolescent, and the gender of both parties involved (perceiver and perceived). Participants were 122 early adolescents

Variation in Subjective Aging by Sexual Minority Status.

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Barrett, Anne; Barbee, Harry

2017-06-01

The past few decades have seen increased scholarly attention to gay and lesbian individuals' aging experiences; however, few studies examine differences in subjective aging by sexual minority status. We identify four perspectives on the association between sexual minority status and subjective aging-double jeopardy, crisis competence, gender interactive, and limited salience perspectives. We examine each perspective's predictions using data from the first wave of Midlife in the United States (1995-1996; MIDUS). Ordinary least square regression models reveal strongest support for the limited salience perspective, suggesting that sexual minority status has weaker effects on subjective aging than do other social factors, such as age, health, and gender. However, some results provide support for the gender interactive perspective, positing that the effect of sexual minority status on subjective aging varies by gender. Our study provides an organizational framework of theoretical perspectives that can guide further examinations of variation in aging experiences by sexual minority status.

Examining Cyberbullying Tendency and Multidimensional Perceived Social Support Status of Teacher Candidates

Science.gov (United States)

Levent, Faruk; Taçgin, Zeynep

2017-01-01

The teachers have a substantial role for students through consciously the Internet usage and struggle with cyberbullying. The purpose of this study is to investigate cyberbullying tendency and multidimensional perceived social support status of the teacher candidates. The participants of this research have become 412 teacher candidates as…

Does Status Inconsistency Matter for Marital Quality?

Science.gov (United States)

Gong, Min

2007-01-01

This study tests status inconsistency theory by examining the associations between wives' and husbands' relative statuses--that is, earnings, work-time, occupational, and educational inconsistencies--and marital quality and global happiness. The author asks three questions: (a) Is status inconsistency associated with marital quality and overall…

Examination of the pest status of corn-infesting Ulidiidae (Diptera).

Science.gov (United States)

Goyal, Gaurav; Nuessly, Gregg S; Seal, Dakshina R; Steck, Gary J; Capinera, John L; Meagher, Robert L

2012-10-01

Larvae of 11 species of picture-winged flies (Diptera: Ulididae) are known to feed on corn plants (Zea mays L.) in the western hemisphere. Larvae emerge from eggs deposited in leaf axils and corn silk to feed mostly within ears, but the primary versus secondary nature (i.e., pest status) of their infestation is not known for all of these species. Choice and no-choice tests by using a split-plot design were conducted in greenhouse and field trials to determine the pest status on sweet corn of three of these species found in Florida: Chaetopsis massyla (Walker), Euxesta eluta Loew, and E. stigmatias Loew. The main treatments (uninfested ears and ears experimentally infested with either Spodoptera frugiperda [Lepidoptera: Noctuidae] or E. eluta larvae) were applied at first silk. The subtreatments (C. massyla, E. eluta, or E. stigmatias adults caged on ears) were applied 7 d later and maintained for 10 d. All three fly species were reared from uninfested and experimentally infested ears in both choice and no-choice tests in greenhouse and field trials confirming both primary and secondary modes of ear infestation. More flies of all three species emerged from ears that were preinfested with S. frugiperda compared with uninfested ears suggesting either preference for or greater survival within ears previously infested by S. frugiperda. Fewer E. eluta and E. stigmatias emerged from ears preinfested with E. eluta in no-choice field tests, suggesting that previous infestation by this fly may negatively affect oviposition or that older fly larvae affect survival of neonate larvae. All three species studied here should be considered primary pests that can render unprotected sweet corn ears unmarketable.

Status inconsistency in groups : How discrepancies between instrumental and expressive status result in symptoms of stress

NARCIS (Netherlands)

van de Brake, Hendrik; Grow, André; Dijkstra, Jan Kornelis

This study examines whether a mismatch between the positions that individuals hold in different status hierarchies results in symptoms of stress. Prior research has focused on inconsistencies between socioeconomic status dimensions (e.g., education and income) and did not find a significant relation

The level of cognitive function and recognition of emotions in older adults.

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Virtanen, Marianna; Singh-Manoux, Archana; Batty, G David; Ebmeier, Klaus P; Jokela, Markus; Harmer, Catherine J; Kivimäki, Mika

2017-01-01

The association between cognitive decline and the ability to recognise emotions in interpersonal communication is not well understood. We aimed to investigate the association between cognitive function and the ability to recognise emotions in other people's facial expressions across the full continuum of cognitive capacity. Cross-sectional analysis of 4039 participants (3016 men, 1023 women aged 59 to 82 years) in the Whitehall II study. Cognitive function was assessed using a 30-item Mini-Mental State Examination (MMSE), further classified into 8 groups: 30, 29, 28, 27, 26, 25, 24, and <24 (possible dementia) MMSE points. The Facial Expression Recognition Task (FERT) was used to examine recognition of anger, fear, disgust, sadness, and happiness. The multivariable adjusted difference in the percentage of accurate recognition between the highest and lowest MMSE group was 14.9 (95%CI, 11.1-18.7) for anger, 15.5 (11.9-19.2) for fear, 18.5 (15.2-21.8) for disgust, 11.6 (7.3-16.0) for sadness, and 6.3 (3.1-9.4) for happiness. However, recognition of several emotions was reduced already after 1 to 2-point reduction in MMSE and with further points down in MMSE, the recognition worsened at an accelerated rate. The ability to recognize emotion in facial expressions is affected at an early stage of cognitive impairment and might decline at an accelerated rate with the deterioration of cognitive function. Accurate recognition of happiness seems to be less affected by a severe decline in cognitive performance than recognition of negatively valued emotions.

Detecting dementia in patients with normal neuropsychological screening by Short Smell Test and Palmo-Mental Reflex Test: an observational study.

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Streit, Sven; Limacher, Andreas; Zeller, Andreas; Bürge, Markus

2015-07-25

General practitioners (GPs) are in best position to suspect dementia. Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT) are widely used. Additional neurological tests may increase the accuracy of diagnosis. We aimed to evaluate diagnostic ability to detect dementia with a Short Smell Test (SST) and Palmo-Mental Reflex (PMR) in patients whose MMSE and CDT are normal, but who show signs of cognitive dysfunction. This was a 3.5-year cross-sectional observational study in the Memory Clinic of the University Department of Geriatrics in Bern, Switzerland. Participating patients with normal MMSE (>26 points) and CDT (>5 points) were referred by GPs because they suspected dementia. All were examined according to a standardized protocol. Diagnosis of dementia was based on DSM-IV TR criteria. We used SST and PMR to determine if they accurately detected dementia. In our cohort, 154 patients suspected of dementia had normal MMSE and CDT test results. Of these, 17 (11%) were demented. If SST or PMR were abnormal, sensitivity was 71% (95% CI 44-90%), and specificity 64% (95% CI 55-72%) for detecting dementia. If both tests were abnormal, sensitivity was 24% (95% CI 7-50%), but specificity increased to 93% (95% CI 88-97%). Patients suspected of dementia, but with normal MMSE and CDT results, may benefit if SST and PMR are added as diagnostic tools. If both SST and PMR are abnormal, this is a red flag to investigate these patients further, even though their negative neuropsychological screening results.

The level of cognitive function and recognition of emotions in older adults.

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Marianna Virtanen

Full Text Available The association between cognitive decline and the ability to recognise emotions in interpersonal communication is not well understood. We aimed to investigate the association between cognitive function and the ability to recognise emotions in other people's facial expressions across the full continuum of cognitive capacity.Cross-sectional analysis of 4039 participants (3016 men, 1023 women aged 59 to 82 years in the Whitehall II study. Cognitive function was assessed using a 30-item Mini-Mental State Examination (MMSE, further classified into 8 groups: 30, 29, 28, 27, 26, 25, 24, and <24 (possible dementia MMSE points. The Facial Expression Recognition Task (FERT was used to examine recognition of anger, fear, disgust, sadness, and happiness.The multivariable adjusted difference in the percentage of accurate recognition between the highest and lowest MMSE group was 14.9 (95%CI, 11.1-18.7 for anger, 15.5 (11.9-19.2 for fear, 18.5 (15.2-21.8 for disgust, 11.6 (7.3-16.0 for sadness, and 6.3 (3.1-9.4 for happiness. However, recognition of several emotions was reduced already after 1 to 2-point reduction in MMSE and with further points down in MMSE, the recognition worsened at an accelerated rate.The ability to recognize emotion in facial expressions is affected at an early stage of cognitive impairment and might decline at an accelerated rate with the deterioration of cognitive function. Accurate recognition of happiness seems to be less affected by a severe decline in cognitive performance than recognition of negatively valued emotions.

Sensitivity and specificity of Addenbrooke's Cognitive Examination, Mattis Dementia Rating Scale, Frontal Assessment Battery and Mini Mental State Examination for diagnosing dementia in Parkinson's disease.

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Kaszás, B; Kovács, N; Balás, I; Kállai, J; Aschermann, Z; Kerekes, Z; Komoly, S; Nagy, F; Janszky, J; Lucza, T; Karádi, K

2012-06-01

Among the non-motor features of Parkinson's disease (PD), cognitive impairment is one of the most troublesome problems. Highly sensitive and specific screening instruments for detecting dementia in PD (PDD) are required in the clinical practice. In our study we evaluated the sensitivity and specificity of different neuropsychological tests (Addenbrooke's Cognitive Examination, ACE; Frontal Assessment Battery, FAB and Mattis Dementia Rating Scale, MDRS) in 73 Parkinson's disease patients without depression. By receiver operating characteristic curve analysis, these screening instruments were tested against the recently established clinical diagnostic criteria of PDD. Best cut-off score for ACE to identify PDD was 80 points (sensitivity = 74.0%, specificity = 78.1%). For FAB the most optimal cut-off value was 12 points (sensitivity = 66.3%, specificity = 72.2%); whereas for MDRS it was 125 points (sensitivity = 89.8%, specificity = 98.3%). Among the examined test batteries, MDRS had the best clinicometric profile for detecting PDD. Although the types of applied screening instruments might differ from movement disorder clinic to clinic within a country, determination of the most specific and sensitive test for the given population remains to be an important task. Our results demonstrated that the specificity and sensitivity of MDRS was better than those of ACE, FAB and MMSE in Hungary. However, further studies with larger sample size and more uniform criteria for participation are required to determine the most suitable screening instrument for cognitive impairment. Copyright © 2012 Elsevier Ltd. All rights reserved.

Examining the Professional Status of Full-Time Sociology Faculty in Community Colleges

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Kapitulik, Brian P.; Rowell, Katherine R.; Smith, Michelle A.; Amaya, Nicole V.

2016-01-01

In this article, we utilize national survey data to assess the professional status of full-time sociology faculty in community colleges. Traditionally, sociologists have argued that for a particular type of work to be conceptualized as a profession, it must meet certain criteria, such as: esoteric knowledge and skills, high levels of workplace…

Amyloid and APOE ε4 interact to influence short-term decline in preclinical Alzheimer disease.

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Mormino, Elizabeth C; Betensky, Rebecca A; Hedden, Trey; Schultz, Aaron P; Ward, Andrew; Huijbers, Willem; Rentz, Dorene M; Johnson, Keith A; Sperling, Reisa A

2014-05-20

To examine whether β-amyloid (Aβ) and APOE ε4 status independently contribute or interact to influence longitudinal cognitive decline in clinically normal older individuals (CN). Data from 490 CNs were aggregated across 3 observational cohort studies (Harvard Aging Brain Study, Alzheimer's Disease Neuroimaging Initiative, and Australian Imaging Biomarkers and Lifestyle Study of Ageing; median age = 75.0 years, 255 female), and the contributions of APOE ε4 and Aβ on longitudinal change over a median of 1.49 years were examined. Cognitive decline was assessed with the Mini-Mental State Examination (MMSE) and Logical Memory (immediate and delayed recall scores). High Aβ participants were more likely to be APOE ε4+ than low Aβ participants. CNs who were both high Aβ and APOE ε4+ showed greater decline in Logical Memory immediate recall (p Alzheimer disease risk factors on cognitive decline in aging. © 2014 American Academy of Neurology.

“End-Stage” Neurofibrillary Tangle Pathology in Preclinical Alzheimer's Disease: Fact or Fiction?

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Abner, Erin L.; Kryscio, Richard J.; Schmitt, Frederick A.; SantaCruz, Karen S.; Jicha, Gregory A.; Lin, Yushun; Neltner, Janna M.; Smith, Charles D.; Van Eldik, Linda J.; Nelson, Peter T.

2011-01-01

Among individuals who were cognitively intact before death, autopsies may reveal some Alzheimer's disease-type pathology. The presence of end-stage pathology in cognitively intact persons would support the hypothesis that pathological markers are epiphenomena. We assessed advanced neurofibrillary (Braak stages V and VI) pathology focusing on nondemented individuals. Data from the National Alzheimer's Coordinating Center database (n = 4,690 included initially) and from the Nun Study (n = 526 included initially) were analyzed, with antemortem information about global cognition and careful postmortem studies available from each case. Global cognition (final Mini-Mental State Examination scores [MMSE] and clinical ‘dementia’ status) was correlated with neuropathology, including the severity of neurofibrillary pathology (Braak stages and neurofibrillary tangle counts in cerebral neocortex). Analyses support three major findings: 1. Braak stage V cases and Braak VI cases are significantly different from each other in terms of associated antemortem cognition; 2. There is an appreciable range of pathology within the category of Braak stage VI based on tangle counts such that brains with the most neurofibrillary tangles in neocortex always had profound antemortem cognitive impairment; and 3. There was no nondemented case with final MMSE score of 30 within a year of life and Braak stage VI pathology. It may be inappropriate to combine Braak stages V and VI cases, particularly in patients with early cognitive dysfunction, since the two pathological stages appear to differ dramatically in terms of both pathological severity and antemortem cognitive status. There is no documented example of truly end-stage neurofibrillary pathology coexisting with intact cognition. PMID:21471646

The validity and reliability of the Turkish version of Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) in patients with mild and moderate Alzheimer's disease and normal subjects.

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Mavioglu, H; Gedizlioglu, M; Akyel, S; Aslaner, T; Eser, E

2006-03-01

The cognitive subscale of the Alzheimer's Disease Assesment Scale (ADAS-Cog) is the most widely used test in clinical trials dealing with Alzheimer's disease (AD). The aim of this study was to investigate the validity and reliability of the Turkish version of ADAS-Cog. Twenty-nine patients with AD, fulfilling NINCDS-ADRDA criteria of probable AD, who were in stage 3-5 according to the Global Deterioration Scale (GDS), and 27 non-demented control subjects with similar age, gender and educational status were recruited for the study. The Turkish version of ADAS-Cog, Standardized Mini Mental Status Examination (MMSE) and Short Orientation-Memory-Concentration Test (SOMCT) were applied to both of the groups. Inter-rater reliability, internal consistency, test-retest reliability; face validity, differential validity and convergent validity were statistically analyzed. Both MMSE and ADAS-Cog have significantly differentiated patients with AD and control subjects (p ADAS-Cog scores in AD group (r: -0.739). ADAS-Cog was also highly significantly correlated with GDS (r: 0.720) and SOMCT (r: 0.738). For the group with AD, control and whole cohort coefficients of internal consistency, Cronbach's alpha: 0.800, 0.515, 0.873 were found respectively. Inter-rater reliability for total ADAS-Cog score was found as ICC: 0.99 and 0.98 and test-retest reliability was found as ICC: 0.91 and 0.95 for demented and nondemented subjects, respectively. The Turkish version of ADAS-Cog has been found to be highly reliable and valid in differentiating patients with mild and moderate AD from nondemented subjects.

Effect of virtual reality on cognitive dysfunction in patients with brain tumor.

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Yang, Seoyon; Chun, Min Ho; Son, Yu Ri

2014-12-01

To investigate whether virtual reality (VR) training will help the recovery of cognitive function in brain tumor patients. Thirty-eight brain tumor patients (19 men and 19 women) with cognitive impairment recruited for this study were assigned to either VR group (n=19, IREX system) or control group (n=19). Both VR training (30 minutes a day for 3 times a week) and computer-based cognitive rehabilitation program (30 minutes a day for 2 times) for 4 weeks were given to the VR group. The control group was given only the computer-based cognitive rehabilitation program (30 minutes a day for 5 days a week) for 4 weeks. Computerized neuropsychological tests (CNTs), Korean version of Mini-Mental Status Examination (K-MMSE), and Korean version of Modified Barthel Index (K-MBI) were used to evaluate cognitive function and functional status. The VR group showed improvements in the K-MMSE, visual and auditory continuous performance tests (CPTs), forward and backward digit span tests (DSTs), forward and backward visual span test (VSTs), visual and verbal learning tests, Trail Making Test type A (TMT-A), and K-MBI. The VR group showed significantly (p<0.05) better improvements than the control group in visual and auditory CPTs, backward DST and VST, and TMT-A after treatment. VR training can have beneficial effects on cognitive improvement when it is combined with computer-assisted cognitive rehabilitation. Further randomized controlled studies with large samples according to brain tumor type and location are needed to investigate how VR training improves cognitive impairment.

[Reliability and validity of the Severe Impairment Battery, short form (SIB-s), in patients with dementia in Spain].

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Cruz-Orduña, Isabel; Agüera-Ortiz, Luis F; Montorio-Cerrato, Ignacio; León-Salas, Beatriz; Valle de Juan, M Cristina; Martínez-Martín, Pablo

2015-01-01

People with progressive dementia evolve into a state where traditional neuropsychological tests are not effective. Severe Impairment Battery (SIB) and short form (SIB-s) were developed for evaluating the cognitive status in patients with severe dementia. To evaluate the psychometric attributes of the SIB-s in patients with severe dementia. 127 institutionalized patients (female: 86.6%; mean age: 82.6 ± 7.5 years-old) with dementia were assessed with the SIB-s, the Global Deterioration Scale (GDS), Mini-Mental State Examination (MMSE), Severe Mini-Mental State Examination (sMMSE), Barthel Index and FAST. SIB-s acceptability, reliability, validity and precision were analyzed. The mean total score for scale was 19.1 ± 15.34 (range: 0-48). Floor effect was 18.1%, only marginally higher than the desirable 15%. Factor analysis identified a single factor explaining 68% of the total variance of the scale. Cronbach's alpha coefficient was 0.96 and the item-total corrected correlation ranged from 0.27 to 0.83. The item homogeneity value was 0.43. Test-retest and inter-rater reliability for the total score was satisfactory (ICC: 0.96 and 0.95, respectively). The SIB-s showed moderate correlation with functional dependency scales (Barthel Index: 0.48, FAST: -0.74). Standard error of measurement was 3.07 for the total score. The SIB-s is a reliable and valid instrument for evaluating patients with severe dementia in the Spanish population of relatively brief instruments.

The Effects of Integrative Reminiscence Therapy on Signs and Symptoms of Depression in the Elderly

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Asghar Mohammadzadeh

2011-04-01

Full Text Available Objectives: The Main aim of this study was to determine the effects of integrative reminiscence therapy on signs and symptoms of depression in the institutionalized elderly. Methods & Materials: This study was an experimental study with pre-test and post-test along with control group. The statistical society in this study consisted of all elderly adults residing in centers of Isfahan. Sample selection style was simple random sampling. The Geriatric Depression Scale (GDS and Mini Mental Status Examination (MMSE were primarily administered and the scores of higher than ten in GDS (severe and moderate depression and higher than twenty one in MMSE were identified and a number of 36 subjects were randomly selected and were randomly divided into two groups, 18 participants to experiment group and 18 participants to the control group. Results: The analysis of the results was performed using independent t-test and chisquare. Mean of the difference of pretest and posttest results was acquired in experimental group (M=2.5385, SD=0.87706and control group (M=1, SD=0.93541. Conclusion: The results of this study suggest that integrative reminiscence therapy can significantly result in reducing depression signs and symptoms in older adults. This intervention can serve as a supplementary treatment along with pharmaceutical treatment.

Predictors of placebo group decline in the Alzheimer's disease Assessment Scale-cognitive subscale (ADAS-Cog) in 24 week clinical trials of Alzheimer's disease.

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Irizarry, Michael C; Webb, David J; Bains, Chanchal; Barrett, Steven J; Lai, Robert Y; Laroche, Janette P; Hosford, David; Maher-Edwards, Gareth; Weil, John G

2008-07-01

One limitation of several recent 24 week Alzheimer's disease (AD) clinical trials was the lack of cognitive decline detected by the AD Assessment Scale-cognitive subscale (ADAS-cog) in the placebo groups, possibly obscuring true medication effects. Data from 733 individuals in the placebo arms of six AD clinical trials performed 1996-1997 were pooled to examine the relationship of clinical, demographic, and genetic characteristics with the 24 week change in ADAS-cog. Baseline cognitive and functional status and the screening-to-baseline change in ADAS-cog were the strongest independent predictors of the 24 week change in ADAS-cog. The ADAS-cog did not detect progression in patients with mild dementia (screening Mini-Mental State Exam, MMSE, >or=20). The change in ADAS-cog from screening to baseline was inversely correlated with the 24 week change score; it was more difficult to detect cognitive decline at 24 weeks if individuals markedly worsened from screening to baseline. The effects of baseline MMSE and screening-to-baseline change in ADAS-cog generalized to the placebo group (N=106) of another AD study performed in 2004-2005. Overcoming lack of placebo decline in AD clinical trials will require scales more sensitive to cognitive decline in mild AD and strategies to reduce within-person variability in outcome measures.

Dietary Patterns Derived by Cluster Analysis are Associated with Cognitive Function among Korean Older Adults.

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Kim, Jihye; Yu, Areum; Choi, Bo Youl; Nam, Jung Hyun; Kim, Mi Kyung; Oh, Dong Hoon; Yang, Yoon Jung

2015-05-29

The objective of this study was to investigate major dietary patterns among older Korean adults through cluster analysis and to determine an association between dietary patterns and cognitive function. This is a cross-sectional study. The data from the Korean Multi-Rural Communities Cohort Study was used. Participants included 765 participants aged 60 years and over. A quantitative food frequency questionnaire with 106 items was used to investigate dietary intake. The Korean version of the MMSE-KC (Mini-Mental Status Examination-Korean version) was used to assess cognitive function. Two major dietary patterns were identified using K-means cluster analysis. The "MFDF" dietary pattern indicated high consumption of Multigrain rice, Fish, Dairy products, Fruits and fruit juices, while the "WNC" dietary pattern referred to higher intakes of White rice, Noodles, and Coffee. Means of the total MMSE-KC and orientation score of the participants in the MFDF dietary pattern were higher than those of the WNC dietary pattern. Compared with the WNC dietary pattern, the MFDF dietary pattern showed a lower risk of cognitive impairment after adjusting for covariates (OR 0.64, 95% CI 0.44-0.94). The MFDF dietary pattern, with high consumption of multigrain rice, fish, dairy products, and fruits may be related to better cognition among Korean older adults.

Comparison of histologic margin status in low-grade cutaneous and subcutaneous canine mast cell tumours examined by radial and tangential sections.

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Dores, C B; Milovancev, M; Russell, D S

2018-03-01

Radial sections are widely used to estimate adequacy of excision in canine cutaneous mast cell tumours (MCTs); however, this sectioning technique estimates only a small fraction of total margin circumference. This study aimed to compare histologic margin status in grade II/low grade MCTs sectioned using both radial and tangential sectioning techniques. A total of 43 circumferential margins were evaluated from 21 different tumours. Margins were first sectioned radially, followed by tangential sections. Tissues were examined by routine histopathology. Tangential margin status differed in 10 of 43 (23.3%) margins compared with their initial status on radial section. Of 39 margins, 9 (23.1%) categorized as histologic tumour-free margin (HTFM) >0 mm were positive on tangential sectioning. Tangential sections detected a significantly higher proportion of positive margins relative to radial sections (exact 2-tailed P-value = .0215). The HTFM was significantly longer in negative tangential margins than positive tangential margins (mean 10.1 vs 3.2 mm; P = .0008). A receiver operating characteristic curve comparing HTFM and tangentially negative margins found an area under the curve of 0.83 (95% confidence interval: 0.71-0.96). Although correct classification peaked at the sixth cut-point of HTFM ≥1 mm, radial sections still incorrectly classified 50% of margins as lacking tumour cells. Radial sections had 100% specificity for predicting negative tangential margins at a cut-point of 10.9 mm. These data indicate that for low grade MCTs, HTFMs >0 mm should not be considered completely excised, particularly when HTFM is <10.9 mm. This will inform future studies that use HTFM and overall excisional status as dependent variables in multivariable prognostic models. © 2017 John Wiley & Sons Ltd.

Cognitive and functional status of elderly people of a long stay institution of the municipality Divinópolis, Minas Gerais State, Brazil = Estado cognitivo e funcional de idosos de uma instituição de longa permanência do município de Divinópolis, Estado de Minas Gerais, Brasil

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Juliana Valério Gontijo

2012-10-01

Full Text Available This study aimed to evaluate and characterize the functional capacity and cognitive status of elderly people living in a long-stay institution of the municipality of Divinópolis, Minas Gerais State. The population consisted of 67 elderly people aged between 62 and 102 years, 76% female and 24% male. Data were gathered using the Barthel index of the Mini-Mental State Examination (MMSE and a form for the social characterization. A significant correlation was observed between the Barthel index and the MMSE, i.e. between functional capacity and cognitive status. Also a significant correlation was detected between education and mental state and between age and mental and functional state. The sex of the participants had no influence on the results. A percentage of 55% had no cognitive impairment, 39% were considered independent and 37% semi-dependent, and only 24% were totally dependent to perform activities of daily living. Therefore, it is emphasized the importance of thinking about the reasons that take to the institutionalization of elderly people.O presente estudo teve por objetivo avaliar e caracterizar a capacidade funcional e o estado cognitivo de idosos residentes de uma instituição de longa permanência do município de Divinópolis, MG. A população avaliada constou de 67 idosos com idade entre 62 e 102 anos, sendo 76% do sexo feminino e 24% do sexo masculino. Os dados foram obtidos utilizando do Índice de Barthel, do Miniexame do Estado Mental e também de um formulário para caracterização social dos idosos. Houve correlação significativa entre o Índice de Barthel e o MEEM, ou seja, entre capacidade funcional e estado cognitivo. Observou-se uma relação significativa entre escolaridade e estado mental e entre idade e estado mental e funcional. O sexo dos pesquisados não influenciou nos resultados dos testes. Uma porcentagem de 55% dos pesquisados não apresentaram déficit cognitivo, sendo que 39% foram considerados

Health status of Russian minorities in former Soviet Republics.

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Groenewold, W G F; van Ginneken, J K

2011-08-01

To examine if, and to what extent, disparities in health status exist between ethnic Russians and the native majority populations of four former Soviet Republics; and to determine to what extent indicators of socio-economic status and lifestyle behaviours explain variations in health status. Data from the World Health Organization's World Health Surveys of former Soviet Republics that include information on ethnicity (i.e. Estonia, Latvia, Ukraine, Kazakhstan and Russia) were used. Russia was included as the benchmark population as it is the country of origin of ethnic Russians. Data were collected from respondents aged ≥25 years in 2001-2003. Principal component analysis was used to derive the Health Status Index and Household Wealth Index. Multiple classification analysis was applied to examine the effects of the determinants on health status, including ethnic group membership. In Estonia and Kazakhstan, ethnic Russians have, on average, a lower health status than members of the majority population, while their health status is higher in Ukraine. Higher levels of material wealth, educational attainment and physical activity were associated with a higher health status. The association of these variables with health status was often stronger than the association between ethnic group membership and health status. Differences in health status between Russian ethnic minorities and the majority populations were found in Estonia and Kazakhstan, but were non-existent in Latvia and were the opposite of what was expected in Ukraine. Use of the Health Status Index in combination with multiple classification analysis proved to be a useful approach to examine health status differentials, and to identify and profile vulnerable groups in a society. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Socioeconomic status and sex ratios at birth in Sweden: No evidence for a Trivers-Willard effect for a wide range of status indicators.

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Kolk, Martin; Schnettler, Sebastian

2016-01-01

This study examines if there exists a positive association between socioeconomic status and the proportion of male births in humans, as proposed by Trivers and Willard in 1973, using individual-level data drawn from the complete population of Sweden. We examine more than 3,000,000 births between 1960 and 2007 using administrative register data with comprehensive information on various dimensions of socioeconomic status. We use six different operationalizations of socioeconomic status, including earnings, post-transfer income (including government allowances), wealth, parental wealth, educational level, and occupational class. We apply regression models that compare both changes in status for the same woman over time and differences in status across different women. We also measure socioeconomic status both at the year of child birth and the year of conception. Our results show the absence of any relationship between socioeconomic status and sex ratios, using a large number of different operationalizations of status. We conclude that no substantive relationship between socioeconomic status and sex ratios exists for the population and period of our study. © 2015 Wiley Periodicals, Inc.

Status hierarchy, attractiveness hierarchy and sex ratio : Three contextual factors explaining the status-aggression link among adolescents

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Zwaan, Michiel; Dijkstra, Jan; Veenstra, René

The moderating effects of three specific conditions (status hierarchy, attractiveness hierarchy and sex ratio) on the link between status (popularity) and physical and relational aggression were examined in a large sample of adolescent boys (N = 1,665) and girls (N = 1,637) (M age = 13.60). In line

The relationship between cognitive and physical function among residents of a Czech senior home

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Annelies Matthé

2015-12-01

Full Text Available Background: The decline in cognition and physical fitness is common in advanced age. Objective: The relationship between cognition and aerobic capacity was compared to the relationship between cognition and balance. Methods: Twenty one females and six male residents of a Czech senior center participated in the study (mean age: 77.5 ± 7.0; range: 62-86 years. The Mini Mental State Examination (MMSE was used for assessing cognition, the Berg Balance Scale (BBS for assessing balance, and the 6-Minute Walk Test (6MWT assessed physical fitness. Based on the MMSE scores, two groups of cognitive functioning were formed - high and low. Results: Participants in the "high MMSE" group reached a significantly higher score on the 6MWT (p = .01 than the "low MMSE" group. Group differences on the BBS were marginally significant (p = .07, d = 0.6. Conclusions: Based on this sample, the level of physical fitness can be explained by cognitive functioning, while that of balance should be further studied in its relationship to cognitive functioning.

Examining the impact of migrant status on ethnic differences in mental health service use preceding a first diagnosis of schizophrenia.

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Anderson, Kelly K; McKenzie, Kwame J; Kurdyak, Paul

2017-08-01

Some ethnic groups have more negative contacts with health services for first-episode psychosis, likely arising from a complex interaction between ethnicity, socio-economic factors, and immigration status. Using population-based health administrative data, we sought to examine the effects of ethnic group and migrant status on patterns of health service use preceding a first diagnosis of schizophrenia or schizoaffective disorder among people aged 14-35 over a 10-year period. We compared access to care and intensity of service use for first-generation ethnic minority groups to the general population of Ontario. To control for migrant status, we restricted the sample to first-generation migrants and compared service use indicators for ethnic minority groups to the European migrant group. Our cohort included 18,080 people with a first diagnosis of schizophrenia or schizoaffective disorder, of whom 14.4% (n = 2607) were the first-generation migrants. Our findings suggest that the magnitude of ethnic differences in health service use is reduced and no longer statistically significant when the sample is restricted to first-generation migrants. Of exception, nearly, all migrant groups have lower intensity of primary care use, and Caribbean migrants are consistently less likely to use psychiatric services. We observed fewer ethnic differences in health service use preceding the first diagnosis of psychosis when patterns are compared among first-generation migrants, rather than to the general population, suggesting that the choice of reference group influences ethnic patterning of health service use. We need a comprehensive understanding of the mechanisms behind observed differences for minority groups to adequately address disparities in access to care.

Going outdoors and cognitive function among community-dwelling older adults: Moderating role of physical function.

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Harada, Kazuhiro; Lee, Sangyoon; Park, Hyuntae; Shimada, Hiroyuki; Makizako, Hyuma; Doi, Takehiko; Yoshida, Daisuke; Tsutsumimoto, Kota; Anan, Yuya; Uemura, Kazuki; Suzuki, Takao

2016-01-01

Identifying the risk factors of cognitive impairment is essential for implementing effective prevention strategies for dementia. Previous studies have shown that the frequency of going outdoors is inversely associated with cognitive decline. Little research has examined whether the relationship between going outdoors and cognitive decline varies with physical functioning in older adults. The aim of the present study was to examine the relationship between going outdoors and cognitive function in older adults with and without physical function limitations. The present study analyzed the data of 4450 individuals (aged 65 years or older) who participated in the Obu Study of Health Promotion for the Elderly. The measures were the Mini-Mental State Examination (MMSE), going outdoors (at least once a week or not), self-reported physical function limitations (with or without), and demographic and health-related factors as potential confounders. Analysis of covariance and post-hoc comparisons showed that although going outdoors at least once a week was associated with higher MMSE scores among older adults with limited physical function, it was not significantly associated with the MMSE scores among older adults without limited physical function. Similarly, logistic regression analyses, stratified by physical function, showed a significant association between going outdoors and MMSE (older adults with limited physical function. The results show that going outdoors less than once a week is associated with decreased cognitive function among older adults with limited physical function, but it is not associated with cognitive function among older adults without limited physical function. © 2015 Japan Geriatrics Society.

Exploring the Role of Cognitive Factors in a New Instrument for Elders' Financial Capacity Assessment.

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Giannouli, Vaitsa; Stamovlasis, Dimitrios; Tsolaki, Magda

2018-01-01

The influence of cognitive factors on financial capacity across the dementia spectrum of cognitive aging, Alzheimer's disease (AD), and mild cognitive impairment (MCI) has been little investigated, while it has not been investigated at all in other types of dementia as well as in extended samples of elders in Greece. The aim of this study is to investigate financial capacity, to develop a tool, test its psychometric properties, validate, and then test the tool in groups of healthy controls compared to elders with dementia, while examining other facets of their cognitive performance. 719 elders from Greece including healthy participants and patients with different types of dementia were examined with Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS) and a battery of neuropsychological tests concerning various cognitive functions. Significantly different profiles in the scores and subscores of LCPLTAS for all the groups of dementia patients were found, with a general incapacity finding for all the dementia groups including the MCI patients. Logistic regression showed that Mini-Mental State Examination (MMSE), Geriatric Depression Scale, and Trail Making Part B predicted competence on LCPLTAS for the dementia patients. Persons with MCI and dementia had lower financial knowledge scores than those without cognitive impairment, with MMSE scores below 27 suggestive as an indication of financial incapacity. The LCPLTAS provides information for a strong positive correlation with MMSE, while the use both of MMSE and LCPLTAS as adequate measures of financial (in)capacity is discussed for the Greek legal procedures regarding elder guardianship cases.

Status Hierarchy, Attractiveness Hierarchy and Sex Ratio: Three Contextual Factors Explaining the Status-Aggression Link among Adolescents

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Zwaan, Michiel; Dijkstra, Jan Kornelis; Veenstra, Rene

2013-01-01

The moderating effects of three specific conditions (status hierarchy, attractiveness hierarchy and sex ratio) on the link between status (popularity) and physical and relational aggression were examined in a large sample of adolescent boys ("N" = 1,665) and girls ("N" = 1,637) ("M" age = 13.60). In line with the…

Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians.

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Radford, Kylie; Mack, Holly A; Draper, Brian; Chalkley, Simon; Delbaere, Kim; Daylight, Gail; Cumming, Robert G; Bennett, Hayley; Broe, Gerald A

2015-01-01

Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking. In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus. All tests were culturally acceptable with good psychometric properties. Receiver operating characteristic curve analyses revealed that the MMSE and mKICA were the most accurate. The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population. © 2015 S. Karger AG, Basel.

Microbleeds do not affect rate of cognitive decline in Alzheimer disease.

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van der Vlies, Annelies E; Goos, Jeroen D C; Barkhof, Frederik; Scheltens, Philip; van der Flier, Wiesje M

2012-08-21

To investigate the relationship between brain microbleeds (MBs) and the rate of cognitive decline in Alzheimer disease (AD). In this cohort study, we studied 221 patients with AD with available baseline MRI scans (1.0 or 1.5 T) and at least 2 Mini-Mental State Examinations (MMSE) scores obtained more than 1 year apart from our memory clinic. Mean ± SD follow-up time was 3 ± 1 years, and patients had a median of 4 MMSE scores (range 2-17). We used linear mixed models with sex and age as covariates to investigate whether MBs influenced the rate of cognitive decline. Mean age was 68 ± 9 years, 109 (49%) patients were female, and the baseline MMSE score was 22 ± 4. There were 39 patients (18%) with MBs (median 2, range 1-27) and 182 without. Linear mixed models showed that overall patients declined 2 MMSE points per year. We found no association of the presence of MBs with baseline MMSE or change in MMSE. Adjustment for atrophy, white matter hyperintensities, lacunes, and vascular risk factors did not change the results nor did stratification for MB location, APOE ε4 carriership, or age at onset (≤65 years vs >65 years). Repeating the analyses with number of MBs as predictor rendered similar results. MBs did not influence the rate of cognitive decline in patients with AD. The formerly reported increased risk of mortality in patients with MBs seems not to be attributable to a steeper rate of decline per se but might be due to vascular events, including (hemorrhagic) stroke.

Rapid Screening for Cognitive Impairment in Parkinson’s Disease: A Pilot Study

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YanHong Dong

2015-01-01

Full Text Available Aim. This study sought to establish the discriminant validity of a rapid cognitive screen, that is, the National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN 5-minute protocol, and compare its discriminant validity to the Montreal Cognitive Assessment (MoCA and Mini Mental State Examination (MMSE in detecting cognitive impairment (CI in PD patients. Methods. One hundred and one PD patients were recruited from a movement disorders clinic in Singapore and they received the NINDS-CSN 5-minute protocol, MoCA, and MMSE. No cognitive impairment (NCI was defined as Clinical Dementia Rating (CDR = 0 and CI was defined as CDR ≥ 0.5. Results. Area under the receiver operating characteristic curve of NINDS-CSN 5-minute protocol was statistically equivalent to MoCA and larger than MMSE (0.86 versus 0.90, P=0.07; 0.86 versus 0.76, P=0.03. The sensitivity of NINDS-CSN 5-minute protocol (<9 was statistically equivalent to MoCA (<22 (0.77 versus 0.85, P=0.13 and superior to MMSE (<24 (0.77 versus 0.52, P<0.01 in detecting CI, while the specificity of NINDS-CSN 5-minute protocol (<9 was statistically equivalent to MoCA (<22 and MMSE (<24 (0.78 versus 0.88, P=0.34. Conclusion. The NINDS-CSN 5-minute protocol is time expeditious while remaining statistically equivalent to MoCA and superior to MMSE and therefore is suitable for rapid cognitive screening of CI in PD patients.

Videoconference-based mini mental state examination: a validation study.

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Timpano, Francesca; Pirrotta, Fabio; Bonanno, Lilla; Marino, Silvia; Marra, Angela; Bramanti, Placido; Lanzafame, Pietro

2013-12-01

Neuropsychological testing is a prime criterion of good practice to document cognitive deficits in a rapidly aging population. Telecommunication technologies may overcome limitations related to test administration. We compared performance of the Italian videoconference-based version of the Mini Mental State Examination (VMMSE) with performance of the standard MMSE administered face-to-face (F2F), to validate the Italian version of the 28-item VMMSE. To validate the Italian version of the VMMSE, we compared its performance with standard F2F. The sample (n=342) was administered three VMMSEs within 6 weeks after F2F testing. We identified the optimal cutoff through the receiver operating characteristic curve, as well as the VMMSE consistency through inter- and intrarater reliability (Inter/RR and Intra/RR) analysis. We found high levels of sensitivity and specificity for the optimal VMMSE cutoff identification and an accuracy of 0.96 (95% confidence interval 0.94-0.98). Intra/RR and inter/RR were highly significant. This study demonstrates that VMMSE is a valid instrument in clinical and research screening and monitoring of subjects affected by cognitive disorders. This study shows a significant correlation between videoconference assessment and the F2F one, providing an important impetus to expand studies and the knowledge about the usefulness of tele-assistance services. Our findings have important implications for both longitudinal assistance and clinical care of demented patients.

Race, Socioeconomic Status, and Health during Childhood: A Longitudinal Examination of Racial/Ethnic Differences in Parental Socioeconomic Timing and Child Obesity Risk.

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Jones, Antwan

2018-04-11

Prior research suggests that socioeconomic standing during the early years of life, particularly in utero, is associated with child health. However, it is unclear whether socioeconomic benefits are only maximized at very young ages. Moreover, given the link between socioeconomic status (SES) and race, research is inconclusive whether any SES benefits during those younger ages would uniformly benefit all racial and ethnic groups. Using 1986-2014 data from the National Longitudinal Study of Youth (NLSY79), this study examines the impact of socioeconomic timing on child weight outcomes by race. Specifically, this research investigates whether specific points exist where socioeconomic investment would have higher returns on child health. Findings suggest that both the timing and the type of socioeconomic exposure is important to understanding child weight status. SES, particularly mother's employment and father's education, is important in determining child health, and each measure is linked to weight gain differently for White, Black, and Hispanic children at specific ages. Policies such as granting more educational access for men and work-family balance for women are discussed.

Race, Socioeconomic Status, and Health during Childhood: A Longitudinal Examination of Racial/Ethnic Differences in Parental Socioeconomic Timing and Child Obesity Risk

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Antwan Jones

2018-04-01

Full Text Available Prior research suggests that socioeconomic standing during the early years of life, particularly in utero, is associated with child health. However, it is unclear whether socioeconomic benefits are only maximized at very young ages. Moreover, given the link between socioeconomic status (SES and race, research is inconclusive whether any SES benefits during those younger ages would uniformly benefit all racial and ethnic groups. Using 1986–2014 data from the National Longitudinal Study of Youth (NLSY79, this study examines the impact of socioeconomic timing on child weight outcomes by race. Specifically, this research investigates whether specific points exist where socioeconomic investment would have higher returns on child health. Findings suggest that both the timing and the type of socioeconomic exposure is important to understanding child weight status. SES, particularly mother’s employment and father’s education, is important in determining child health, and each measure is linked to weight gain differently for White, Black, and Hispanic children at specific ages. Policies such as granting more educational access for men and work-family balance for women are discussed.

Association between mental health status and bone mineral density: Analysis of the 2008-2010 Korea national health and nutrition examination survey.

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Changtae Hahn

Full Text Available The current study aimed to investigate the association between mental health status and bone mineral density (BMD using data from the Korean National Health and Nutrition Examination Survey (KNHANES 2008-2010. We enrolled 15,876 South Korean participants (4,010 postmenopausal females, 4,836 premenopausal females, and 7,016 males, all aged 20 years or older. BMD was measured using dual-energy radiography absorptiometry at the femoral neck (NK, lumbar spine (LSP, and total femur (TFM. Mental health status data were obtained from a self-report questionnaire that assessed psychological stress, depressed mood, and suicidal ideation. Psychological stress was negatively correlated with BMD in the LSP, NK, and TFM for the male group. Depressed mood was associated with lower BMD in the LSP, NK and TFM for the premenopausal female group, and in the LSP for the male group. Suicidal ideation was associated with lower BMD in the NK and TFM for the male group. Mental health problems were associated with lower BMD, especially in premenopausal females and males. Future investigations should focus on the shared pathophysiology between mental health problems and BMD, and the interrelationship between increased BMD and recovery from mental health problems.

[Clinical stages of patients with Alzheimer disease treated in specialist clinics in Spain. The EACE study].

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Alom Poveda, J; Baquero, M; González-Adalid Guerreiro, M

2013-10-01

The diagnostic paradigm of Alzheimer disease (AD) is changing; there is a trend toward diagnosing the disease in its early stages, even before the complete syndrome of dementia is apparent. The clinical stage at which AD is usually diagnosed in our area is unknown. Therefore, the purpose of this study is to describe the clinical stages of AD patients at time of diagnosis. Multicentre, observational and cross-sectional study. Patients with probable AD according to NINCDS-ARDRA criteria, attended in specialist clinics in Spain, were included in the study. We recorded the symptom onset to evaluation and symptom onset to diagnosis intervals and clinical status of AD (based on MMSE, NPI questionnaire, and CDR scale). Participants in this study included 437 specialists representing all of Spain's autonomous communities and a total of 1,707 patients, of whom 1,694 were included in the analysis. Mean MMSE score was 17.6±4.8 (95% CI:17.4-17.9). Moderate cognitive impairment (MMSE between 10 and 20) was detected in 64% of the patients, and severe cognitive impairment (MMSEde Neurología. Published by Elsevier Espana. All rights reserved.

Primary status, complementary status, and organizational survival in the U.S. venture capital industry.

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Bothner, Matthew S; Kim, Young-Kyu; Lee, Wonjae

2015-07-01

We introduce a distinction between two kinds of status and examine their effects on the exit rates of organizations investing in the U.S. venture capital industry. Extending past work on status-based competition, we start with a simple baseline: we describe primary status as a network-related signal of an organization's quality in a leadership role, that is, as a function of the degree to which an organization leads others that are themselves well regarded as lead organizations in the context of investment syndicates. Combining Harary's (1959) image of the elite consultant with Goffman's (1956) concept of "capacity-esteem," we then discuss complementary status as an affiliation-based signal of an organization's quality in a supporting role. We measure complementary status as a function of the extent to which an organization is invited into syndicates by well-regarded lead organizations-that is, by those possessing high levels of primary status. Findings show that, conditioning on primary status, complementary status reduces the rate at which venture capital organizations exit the industry. Consistent with the premise that these kinds of status correspond to different roles and market identities, we also find that complementary status attenuates (and ultimately reverses) the otherwise favorable effect of primary status on an organization's life chances. Theoretically and methodologically oriented scope conditions, as well as implications for future research, are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

Does cognitive/physical screening in an outpatient setting predict institutionalization after hip fracture?

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Hongisto, Markus T; Nuotio, Maria; Luukkaala, Tiina; Väistö, Olli; Pihlajamäki, Harri K

2016-10-22

Institutionalization after hip fracture is a socio-economical burden. We examined the predictive value of Instrumental Activities of Daily Living (IADL) and Mini Mental State Examination (MMSE) for institutionalization after hip fracture to identify patients at risk for institutionalization. Fragility hip fracture patients ≥65 years of age (n = 584) were comprehensively examined at a geriatric outpatient clinic 4 to 6 months after surgery and followed 1 year postoperatively. A telephone interview with a structured inquiry was performed at 1, 4, and 12 months after hip fracture. Age-adjusted univariate logistic regression analysis revealed that IADL and MMSE scores measured at the outpatient clinic were significantly associated with living arrangements 1 year after hip fracture. Multivariate logistic regression analysis established that institutionalization 1 year after hip fracture was significantly predicted by institutionalization at 4 months (odds ratio [OR] 16.26, 95 % confidence interval [CI] 7.37-35.86), IADL <5 (OR 12.96, 95 % CI 1.62-103.9), and MMSE <20 (OR 4.19, 95 % CI 1.82-9.66). A cut-off value of 5 was established for IADL with 100 % (95 % CI 96 %-100 %) sensitivity and 38 % (95 % CI 33 %-43 %) specificity and for MMSE, a cut-off value of 20 had 83 % (95 % CI 74 %-91 %) sensitivity and 65 % (95 % CI 60 %-70 %) specificity for institutionalization. During the time period from 4 to 12 months, 66 (11 %) patients changed living arrangements, and 36 (55 %) of these patients required more supportive accommodations. IADL and MMSE scores obtained 4 to 6 months after hospital discharge may be applicable for predicting institutionalization among fragility hip fracture patients ≥65 years of age at 1 year after hip fracture. An IADL score of ≥5 predicted the ability to remain in the community. Changes in living arrangements also often occur after 4 months.

Association between dietary intake of vitamin A, C, and E as antioxidants and cognitive function in the elderly at a nursing home

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Jowy Tani

2007-12-01

Full Text Available As oxidative stress is considered one of the major mechanisms underlying degenerative changes, antioxidants from dietary sources, such as vitamin A, C, and E, may have protective effects against oxidative stress and thus be able to prevent or delay cognitive impairment in the elderly. This cross sectional study was designed to determine the association between dietary intake of vitamin A, C, and E and the presence of cognitive impairment in the elderly, along with other factors. Subjects included 36 residents from a nursing home in Jakarta, Indonesia. The data obtained including daily nutrition intake values one week prior to sampling converted from semi- quantitative food frequency questionnaire (SFFQ results, Mini Mental State Examination (MMSE scores, and anthropometrical measurement results. This study showed that while sex, age, education, nutritional status, and macronutrients intake were not significantly associated with presence of cognitive impairment, significant positive correlation existed between education and MMSE score (p=0.036, r=0.351. Higher vitamin A and vitamin C intake were shown to be significantly associated with lower incidence of cognitive impairment (p=0.022 and p=0.045, respectively. Moreover, vitamin C was shown to have significant positive correlation with MMSE score (p=0.031, r=0.359. However, the association between vitamin E and the presence of impairment was not significant (p=0.129. Higher intake of vitamin A and C may delay or prevent cognitive impairment in the elderly. Higher intake of vitamin C may contribute to better cognitive functioning. The findings may be explained by the two antioxidant vitamins’ protective effects against neurode generative processes cause by oxidative stress. (Med J Indones 2007; 16:261-6Keywords: antioxidant, vitamin A, vitamin C, vitamin E, cognitive impairment, the elderly

Glucose impairment and ghrelin gene variants are associated to cognitive dysfunction.

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Mora, M; Mansego, M L; Serra-Prat, M; Palomera, E; Boquet, X; Chaves, J F; Puig-Domingo, M

2014-04-01

Cognitive state and brain volume have been related to body mass index, abdominal fat, waist-hip ratio, components of metabolic syndrome (MS) and ghrelin. Genetic variations within the ghrelin gene have been recently associated to MS. The aim of our study was to investigate cognitive state by Mini-Mental State Examination (MMSE) in relation to MS components (ATP-III criteria) and ghrelin gene polymorphisms in dwelling individuals aged ≥70. 280 subjects (137 men/143 women, age 77.03 ± 5.92) from the Mataró Ageing Study were included. Individuals were phenotypically characterized by anthropometric variables, lipids, glucose, blood pressure and MMSE. SNPs -501AC (rs26802), -994CT (rs26312), -604GA (rs27647), M72L (rs696217) and L90G (rs4684677) of the ghrelin gene were studied. Genotypes were determined by polymerase chain reaction and SNapshot minisequencing. 22.1 % had MMSE Ghrelin SNPs were associated to MMSE: M72L C/A genotype showed lower score than C/C (p = 0.032, after adjusting for confounders 0.049); L90G A/T genotype showed lower score than A/A (p = 0.054, after adjusting 0.005). MMSE Ghrelin gene variant influence cognitive function in old dwelling individuals participating in the Mataró Ageing Study.

Dietary Approaches to Stop Hypertension Diet, Weight Status, and Blood Pressure among Children and Adolescents: National Health and Nutrition Examination Surveys 2003-2012.

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Cohen, Juliana F W; Lehnerd, Megan E; Houser, Robert F; Rimm, Eric B

2017-09-01

The Dietary Approaches to Stop Hypertension (DASH) diet is associated with lower blood pressure and reduced risk of cardiovascular disease among adults, but little is known about accordance with this dietary pattern or health benefits among children and adolescents. The objectives were to evaluate accordance with the DASH diet, differences over time, and the association with health attributes among a nationally representative sample of US children and adolescents. Cross-sectional data from the 2003-2012 National Health and Nutrition Examination Surveys (NHANES) were analyzed. Data from 9,793 individuals aged 8 to 18 years were examined. DASH accordance was estimated based on nine nutrient targets: total fat, saturated fat, protein, cholesterol, fiber, calcium, magnesium, potassium, and sodium; possible score range is 0 to 9. Accordance with the DASH diet across time was examined comparing the 2011-2012 to 2003-2004 NHANES surveys. The association between DASH score and weight status was examined using multinomial logistic regression, and the associations with waist circumference, systolic blood pressure, and diastolic blood pressure were examined using multivariable linear regression. Accordance with the DASH diet was low across the age groups, with a range of mean DASH scores from 1.48 to 2.14. There were no significant changes across time. DASH score was inversely associated with systolic blood pressure (mm Hg) among 14- to 18-year-olds (β=-.46; 95% CI -.83 to -.09) among the larger sample of participants who completed at least one dietary recall, but no significant differences were seen in other age categories. In the subsample of participants with both dietary recalls, a significant inverse association was seen between DASH score and systolic blood pressure for 11- to 13-year-olds (β=-.57; 95% CI -1.02 to -.12). There were no significant associations between this dietary pattern and weight status, waist circumference, or diastolic blood pressure. Few US

Clinical significance of corpus callosum atrophy in a mixed elderly population

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Ryberg, C; Rostrup, E; Stegmann, M B

2007-01-01

) score, history of depression, geriatric depression scale (GDS) score, subjective gait difficulty, history of falls, walking speed, and total score on the short physical performance battery (SPPB) were analyzed. Significant correlations between CC atrophy and MMSE, SPPB, and walking speed were identified...... subjects with ARWMC from the Leukoaraiosis And DISability (LADIS) study, the CC was segmented on the normalised mid-sagittal magnetic resonance imaging (MRI) slice and subdivided into five regions. Correlations between the CC areas and subjective memory complaints, mini mental state examination (MMSE...

Comparison of oral health status and daily nutrient intake between elders who live alone and elders who live with family: Based on the Korean National Health and Nutrition Examination Survey (KNHANES VI) (2013-2015).

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Kim, Eun-Jeong; Jin, Bo-Hyoung

2018-06-01

To compare the nutritional factors and oral status of elders living alone and elders living with their families in Korea. Numerous studies have found that the presence of fewer remaining teeth is associated with decreased nutrient intake; however, there is no study comparing the nutritional status and oral status of elders living alone with that of elders living with family based on a nationally representative sample. A sample of 2904 individuals who participated in the sixth Korean National Health and Nutrition Examination Survey was reviewed (65-84 years of age). Living status was defined according to the participants' self-reported questionnaire, and a nutrient intake questionnaire was designed as an open questionnaire and used during the face-to-face interviews. The number of existing teeth was used to determine oral status. A complex-sample general linear analysis and multivariate logistic regression analysis were used to evaluate the association between the number of teeth and nutrient intake among elders living with family and elders living alone after adjusting for confounders. Elders living alone were significantly older and tended to have the following characteristics: women, lower household income, lower educational level, poor perceived health status, non-smokers, non-drinkers and lack of physical activity. Elders living alone had a poorer perceived oral health status, had not received an oral examination in the past year, had chewing problems and had fewer existing teeth (P oral health and nutrient intake status. Participants who had many existing teeth had higher nutrient intake than the participants who had fewer existing teeth. For healthy lives at old age, family support or additional social support for elders living alone should be considered. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

Cognitive functions in the acute period of polytrauma and correction of their disorders with thiocetam

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Krishtafor A.A.

2017-10-01

Full Text Available Aim of the work – to evaluate the effectiveness of thiocetam as a medicine that prevents cognitive impairments in patients with polytrauma, as well as to compare the scales of cognitive function assessment - MoCA and MMSE. We examined 50 victims with polytrauma without severe intracranial lesions, randomly divided into a control group (26 patients and a main (24 patients group. Patients of the control group received conventional intensive therapy for traumatic illness, patients of the main group in addition to this therapy received thiocetam. The somatic status was assessed according to the generally accepted clinical and laboratory indicators. The level of cognitive functions before the injury was assessed by the CFQ questionnaire for 2-3 days after the injury; The MoCA and MMSE scales were used on the 2nd day, when patients were transferred from the intensive care unit and before the discharge. The severity of injury was assessed by the ISS scale. The severity of the response to traumatic stress was assessed by the IES-R scale. In both groups, the baseline level of cognitive function was within the age range. On the second day after the trauma, significant inhibition of cognitive functions in both groups was noted, but in the main group this decrease was un­reliably less. At subsequent stages a gradual increase in both groups was noted, however, in the main group recovery of cognitive functions occurred more rapidly. After 3 months, decrease in cognitive functions preserved at a level when patients were discharged from the hospital. In the main group there were significantly fewer pa­tients whose posttraumatic stress after 3 months increased from minimal to low. When using the MoCA scale, there was a more pronounced decrease in cognitive functions than with the MMSE scale, but it in the less degree consider pecu­liarities of thinking. Thiocetam prevents the decrease of cognitive functions in patients with polytrauma and, due to that, also

Efficacy of Early Rehabilitation After Surgical Repair of Acute Aneurysmal Subarachnoid Hemorrhage: Outcomes After Verticalization on Days 2-5 Versus Day 12 Post-Bleeding.

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Milovanovic, Andjela; Grujicic, Danica; Bogosavljevic, Vojislav; Jokovic, Milos; Mujovic, Natasa; Markovic, Ivana Petronic

2017-01-01

To develop a specific rehabilitation protocol for patients who have undergone surgical repair of acute aneurysmal subarachnoid hemorrhage (aSAH), and to determine the time at which verticalization should be initiated after aSAH. Sixty-five patients who underwent acute-term surgery for aSAH and early rehabilitation were evaluated in groups: Group 1 (n=34) started verticalization on days 2-5 post-bleeding whereas Group 2 (n=31) started verticalization approximately day 12 post-bleeding. All patients were monitored for early complications, vasospasm and ischemia. Assessments of motor status, depression and anxiety (using Zung scales), and cognitive status (using the Mini-Mental State Examination (MMSE)) were conducted at discharge and at 1 and 3 months post-surgery. At discharge, Group 1 had a significantly higher proportion of patients with ischemia than Group 2 (p=0.004). Group 1 had a higher proportion of patients with hemiparesis than Group 2 three months post-surgery (p=0.015). Group 1 patients scored significantly higher on the Zung depression scale than Group 2 patients at 1 month (p=0.005) and 3 months post-surgery (p=0.001; the same applies to the Zung anxiety scale (p=0.006 and p=0.000, respectively). Group 2 patients scored significantly higher on the MMSE than those in Group 1 at discharge (p=0.040) and 1 month post-surgery (p=0.025). Early verticalization had no effect with respect to preventing early postoperative complications in this patient group. Once a patient has undergone acute surgical repair of aSAH, it is safe and preferred that rehabilitation be initiated immediately postsurgery. However, verticalization should not start prior to day 12 post-bleeding.

Research on the nutrition and cognition of high-risk stroke groups in community and the relevant factors.

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Zhao, N-N; Zeng, K-X; Wang, Y-L; Sheng, P-J; Tang, C-Z; Xiao, P; Liu, X-W

2017-12-01

To investigate the prevalence rate of nutritional risk in high-risk stroke groups in community, analyze its influencing factors, and analyze and compare the relationship between nutritional risk or malnutrition assessed by different nutritional evaluation methods and cognitive function, so as to provide the basis and guidance for clinical nutritional assessment and support. A cross-sectional survey was performed for 1196 cases in high-risk stroke groups in community from December 2015 to January 2017. At the same time, the nutritional status of patients was evaluated using the mini nutritional assessment (MNA) and MNA-short form (MNA-SF), and the cognitive status of patients was evaluated using the mini-mental state examination (MMSE). Moreover, the relevant influencing factors of nutritional risk and MMSE score were analyzed and compared. High-risk stroke groups in community suffered from a high risk of malnutrition. MNA-SF had a higher specificity and lower false positive rate than MNA. Nutritional risk occurred more easily in high-risk stroke groups in community with a history of diabetes mellitus, less physical exercise or light manual labor, daily use of multiple drugs, and higher age. Those with a higher nutritional risk were more prone to cognitive impairment. High-risk stroke groups in community, complicated with hyperhomocysteinemia, daily use of three or more kinds of prescription drugs, and a previous history of stroke, were accompanied by cognitive impairment easily. MNA-SF can be used for the nutritional screening of high-risk stroke groups in community. For the high-risk stroke groups in community, the rational nutritional diet should be publicized, blood sugar should be controlled in a scientific manner and physical exercise should be moderately increased.