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Relationship between Cognition and Activities of Daily Living in Elderly Women with Mild Cognitive Impairment in Japan  [PDF]
Miwa Yamamoto, Kyoko Izumi, Yoko Aso
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.34050
Abstract: Purpose: This study aims to examine the relationship between cognition and ADL in elderly women with MIC. Methods: Cognitive function was assessed using a 4-item instrument screening for dementia. Each item was scaled from 1 to 4. The Katz Index was used to Participants (N = 680) were asked to return the completed questionnaire in the sealed envelope provided. The study received approval from the human subject’s ethics committee at Osaka University. Results and Conclusion: Participants’ mean age was 78.2 ± 6.5 years old. The age range of participants was 65 to 97 years old. Associations were not statistically significant between cognitive function and family structure. However, associations were significant for ADL items involving excretory failure (OR = 3.5, p = 0.000 in 2004, OR = 2.9, p = 0.000 in 2005; P < 0.05) using a logistic regression analysis adjusted for age. Therefore, we recommend that nurses work to educate the public about treatment-adjusted dementia in the community, teaching family members or caretakers to observe the ADL of the elderly, being watchful for unusual excretory habits, extra clothes, or the smell of elderly persons’ dirty clothing.
Mild cognitive impairment: cognitive screening or neuropsychological assessment?
Diniz, Breno Satler;Nunes, Paula Villela;Yassuda, Monica S;Pereira, Fernanda S;Flaks, Mariana K;Viola, Luciane F;Radanovic, Marcia;Abreu, Izabella Dutra de;Borelli, Danilo T;Gattaz, Wagner F;Forlenza, Orestes Vicente;
Revista Brasileira de Psiquiatria , 2008, DOI: 10.1590/S1516-44462008000400003
Abstract: objective: to describe the neuropsychological profile of mild cognitive impairment subtypes (amnestic, non-amnestic and multiple-domain) of a clinical sample. we further address the diagnostic properties of the mini-mental state examination and the cambridge cognitive examination for the identification of the different mild cognitive impairment subtypes in clinical practice. method: cross-sectional clinical and neuropsychological evaluation of 249 elderly patients attending a memory clinic at a university hospital in sao paulo, brazil. results: the performance of patients with mild cognitive impairment was heterogeneous across the different subtests of the neuropsychological battery, with a trend towards an overall worse performance for amnestic (particularly multiple domain) mild cognitive impairment as compared to non-amnestic subtypes. screening tests for dementia (mini-mental state examination and cambridge cognitive examination) adequately discriminated cases of mild alzheimer's disease from controls, but they were not accurate to discriminate patients with mild cognitive impairment (all subtypes) from control subjects. conclusions: the discrimination of mild cognitive impairment subtypes was possible only with the aid of a comprehensive neuropsychological assessment. it is necessary to develop new strategies for mild cognitive impairment screening in clinical practice.
Mild cognitive impairment  [PDF]
Pavlovi? Dragan M.,Pavlovi? Aleksandra M.
Srpski Arhiv za Celokupno Lekarstvo , 2009, DOI: 10.2298/sarh0908434p
Abstract: Mild cognitive impairment (MCI) is a syndrome that spans the area between normal ageing and dementia. It is classified into amnestic and non-amnestic types, both with two subtypes: single domain and multiple domains. Prevalence of MCI depends on criteria and population and can vary from 0.1 to 42% persons of older age. In contrast to dementia, cognitive deterioration is less severe and activities of daily living are preserved. Most impaired higher cognitive functions in MCI are memory, executive functions, language, visuospatial functions, attention etc. Also there are depression, apathy or psychomotor agitation, and signs of psychosis. Aetiology of MCI is multiple, mostly neurodegenerative, vascular, psychiatric, internistic, neurological, traumatic and iatrogenic. Persons with amnestic MCI are at a higher risk of converting to Alzheimer's disease, while those with a single non-memory domain are at risk of developing frontotemporal dementia. Some MCI patients also progress to other dementia types, vascular among others. In contrast, some patients have a stationary course, some improve, while others even normalize. Every suspicion of MCI warrants a detailed clinical exploration to discover underlying aetiology, laboratory analyses, neuroimaging methods and some cases require a detailed neuropsychological assessment. At the present time there is no efficacious therapy for cognitive decline in MCI or the one that could postpone conversion to dementia. The treatment of curable causes, application of preventive measures and risk factor control are reasonable measures in the absence of specific therapy.
Profile of Cognitive Complaints in Vascular Mild Cognitive Impairment and Mild Cognitive Impairment  [PDF]
Jenny Gu,Corinne E. Fischer,Gustavo Saposnik,Tom A. Schweizer
ISRN Neurology , 2013, DOI: 10.1155/2013/865827
Abstract: Objective. Vascular mild cognitive impairment (VaMCI) is differentiated from mild cognitive impairment (MCI) by the presence of vascular events such as stroke or small vessel disease. Typically, MCI and VaMCI patients present with subjective complaints regarding cognition; however, little is known about the specific nature of these complaints. We aimed to create a profile of subjective cognitive complaints in MCI and VaMCI patients with similar levels of objective cognitive performance. Methods. Twenty MCI and twenty VaMCI patients were recruited from a Memory Disorders Clinic in Toronto. Subjective cognitive complaints were assessed and categorized using the Neuropsychological Impairment Scale. Results. MCI and VaMCI patients achieved similar scores on measures of objective cognitive function ( ). However, the VaMCI group had more subjective complaints than the MCI group ( ), particularly in the critical items, cognitive efficiency, memory, and verbal learning domains of the Neuropsychological Impairment Scale. Conclusions. Our findings support the idea that VaMCI and MCI differ in their clinical profiles, independent of neuroimaging. VaMCI patients have significantly more subjective cognitive complaints and may be exhibiting particular deficits in memory, verbal learning, and cognitive efficiency. Our findings promote the need for further research into VaMCI-specific cognitive deficits. 1. Introduction As adults age, it is common for cognitive problems to arise. Subjective cognitive complaints (SCC) are quite prevalent among older adults, with some estimates suggesting that between 25% and 50% of all older adults have self-perceived memory impairment [1, 2]. In clinical practice, it is often difficult to assess the veracity and severity of subjective cognitive complaints, primarily because such complaints vary widely from individual to individual. As a result, clinicians and caregivers perhaps do not consider subjective complaints to have the same weight as objective findings. However, studies have shown that subjective complaints may be valid indicators of current and future cognitive impairment. A recent study by Amariglio and colleagues showed that certain subjective complaints, such as “I have trouble finding my way around familiar streets,” are correlated with impairment in delayed recall, naming, and semantic fluency [3]. A review conducted by Jonker and colleagues showed that memory complaints may be predictive of dementia or Alzheimer’s disease onset within two to four years, especially in individuals with a diagnosis of mild cognitive
Cognitive function affects trainability for physical performance in exercise intervention among older adults with mild cognitive impairment
Uemura K, Shimada H, Makizako H, Doi T, Yoshida D, Tsutsumimoto K, Anan Y, Suzuki T
Clinical Interventions in Aging , 2013, DOI: http://dx.doi.org/10.2147/CIA.S39434
Abstract: gnitive function affects trainability for physical performance in exercise intervention among older adults with mild cognitive impairment Original Research (972) Total Article Views Authors: Uemura K, Shimada H, Makizako H, Doi T, Yoshida D, Tsutsumimoto K, Anan Y, Suzuki T Published Date January 2013 Volume 2013:8 Pages 97 - 102 DOI: http://dx.doi.org/10.2147/CIA.S39434 Received: 22 October 2012 Accepted: 15 December 2012 Published: 30 January 2013 Kazuki Uemura,1,3 Hiroyuki Shimada,1 Hyuma Makizako,1,3 Takehiko Doi,1 Daisuke Yoshida,1 Kota Tsutsumimoto,1 Yuya Anan,1 Takao Suzuki2 1Section for Health Promotion, Department for Research and Development to Support Independent Life of Elderly, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 2Research Institute, National Center for Geriatrics and Gerontology, Aichi, 3Japan Society for the Promotion of Science, Tokyo, Japan Background: Although much evidence supports the hypothesis that cognitive function and physical function are interrelated, it is unclear whether cognitive decline with mild cognitive impairment influences trainability of physical performance in exercise intervention. The purpose of this study was to examine the association between cognitive function at baseline and change in physical performance after exercise intervention in older adults with mild cognitive impairment. Methods: Forty-four older adults diagnosed with mild cognitive impairment based on the Peterson criteria (mean age 74.8 years) consented to and completed a 6-month twice weekly exercise intervention. The Timed Up and Go (TUG) test was used as a measure of physical performance. The Mini-Mental State Examination (MMSE), Trail Making Test Part B, Geriatric Depression Scale, baseline muscle strength of knee extension, and attendance rate of intervention, were measured as factors for predicting trainability. Results: In the correlation analysis, the change in TUG showed modest correlations with attendance rate in the exercise program (r = -0.354, P = 0.027) and MMSE at baseline (r = -0.321, P = 0.034). A multiple regression analysis revealed that change in TUG was independently associated with attendance rate ( = -0.322, P = 0.026) and MMSE score ( = -0.295, P = 0.041), controlling for age and gender. Conclusion: General cognitive function was associated with improvements in physical performance after exercise intervention in subjects with mild cognitive impairment. Further research is needed to examine the effects of exercise programs designed to address cognitive obstacles in older adults with mild cognitive impairment.
Functional Hubs in Mild Cognitive Impairment  [PDF]
Adrián Navas,David Papo,Stefano Boccaletti,F. del-Pozo,Ricardo Bajo,Fernando Maestú,Pedro Gil,Irene Sendi?a-Nadal,Javier M. Buldú
Quantitative Biology , 2013,
Abstract: We investigate how hubs of functional brain networks are modified as a result of mild cognitive impairment (MCI), a condition causing a slight but noticeable decline in cognitive abilities, which sometimes precedes the onset of Alzheimer's disease. We used magnetoencephalography (MEG) to investigate the functional brain networks of a group of patients suffering from MCI and a control group of healthy subjects, during the execution of a short-term memory task. Couplings between brain sites were evaluated using synchronization likelihood, from which a network of functional interdependencies was constructed and the centrality, i.e. importance, of their nodes quantified. The results showed that, with respect to healthy controls, MCI patients were associated with decreases and increases in hub centrality respectively in occipital and central scalp regions, supporting the hypothesis that MCI modifies functional brain network topology, leading to more random structures.
Neurophysiological Biomarker of Mild Cognitive Impairment  [PDF]
Wilfried Dimpfel
Advances in Alzheimer's Disease (AAD) , 2014, DOI: 10.4236/aad.2014.32008
Abstract: Mild cognitive impairment is sometimes regarded as related to aging. However, statistically every second case turns into full dementia, which still is resistant to any treatment. It is therefore desir-able to recognize deviations from normality as early as possible. This might be feasible by using quantitative EEG analysis in the presence of mental work. The present retrospective data analysis revealed a new quantitative biomarker indicating the degree of impairment. Current source density was calculated from 16 channel EEG using CATEEM   software. Four different conditions were analyzed: relaxed state, performing a d2-concentration test, a calculation performance test and a memory test for 5 min each. Subjects older than 40 years were divided into two groups according to their DemTect score: 13 - 18 (HC; n = 44) or 8 - 12 (MCI; n = 45). Spectral power was chopped into six frequency ranges (delta, theta, alpha 1, alpha 2, beta 1 and beta 2). Average spectral power was enhanced in the MCI group in comparison to healthy subjects with respect to delta (p = 0.05) during relaxed state when all electrode positions were regarded. With respect to EEG recording during performance of three different psychometric tests it was recognized that mainly spectral changes during performance of the d2-concentration test were related to mild cognitive impairment. With regard to all electrode positions statistically significantly lower spectral power values were reached during the d2-test for delta (p = 0.001), theta (p = 0.0001) and alpha 1 waves (p = 0.08) in impaired subjects in comparison to healthy subjects. Regarding regions of interest increases of delta and theta power were seen in the fronto-temporal brain during performance of the d2-concentration test. These increases disappeared when looking at MCI data. In the centro-parietal region decreases of alpha and beta 1 power emerged, which were even larger in MCI subjects. No MCI-dependent changes were observed in the other two tests. A correlation was found between psychometric performance of the d2-test and the DemTect score (r = 0.51). MCI subjects had statistically significant worse performance in all three mental challenges in comparison to healthy volunteers. It is concluded that MCI can be characterized at an early stage by EEG recording in the relaxed state. High spectral delta and theta power in general and specifically at fronto- temporal electrode positions (especially at T3) was recognized as a biomarker for MCI. A DemTect score of 8-12 was validated as indicative for MCI.
Cognitive function affects trainability for physical performance in exercise intervention among older adults with mild cognitive impairment  [cached]
Uemura K,Shimada H,Makizako H,Doi T
Clinical Interventions in Aging , 2013,
Abstract: Kazuki Uemura,1,3 Hiroyuki Shimada,1 Hyuma Makizako,1,3 Takehiko Doi,1 Daisuke Yoshida,1 Kota Tsutsumimoto,1 Yuya Anan,1 Takao Suzuki21Section for Health Promotion, Department for Research and Development to Support Independent Life of Elderly, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 2Research Institute, National Center for Geriatrics and Gerontology, Aichi, 3Japan Society for the Promotion of Science, Tokyo, JapanBackground: Although much evidence supports the hypothesis that cognitive function and physical function are interrelated, it is unclear whether cognitive decline with mild cognitive impairment influences trainability of physical performance in exercise intervention. The purpose of this study was to examine the association between cognitive function at baseline and change in physical performance after exercise intervention in older adults with mild cognitive impairment.Methods: Forty-four older adults diagnosed with mild cognitive impairment based on the Peterson criteria (mean age 74.8 years) consented to and completed a 6-month twice weekly exercise intervention. The Timed Up and Go (TUG) test was used as a measure of physical performance. The Mini-Mental State Examination (MMSE), Trail Making Test Part B, Geriatric Depression Scale, baseline muscle strength of knee extension, and attendance rate of intervention, were measured as factors for predicting trainability.Results: In the correlation analysis, the change in TUG showed modest correlations with attendance rate in the exercise program (r = -0.354, P = 0.027) and MMSE at baseline (r = -0.321, P = 0.034). A multiple regression analysis revealed that change in TUG was independently associated with attendance rate ( = -0.322, P = 0.026) and MMSE score ( = -0.295, P = 0.041), controlling for age and gender.Conclusion: General cognitive function was associated with improvements in physical performance after exercise intervention in subjects with mild cognitive impairment. Further research is needed to examine the effects of exercise programs designed to address cognitive obstacles in older adults with mild cognitive impairment.Keywords: exercise, mobility, rehabilitation, Timed Up and Go test
Validity of a novel computerized cognitive battery for mild cognitive impairment
Tzvi Dwolatzky, Victor Whitehead, Glen M Doniger, Ely S Simon, Avraham Schweiger, Dena Jaffe, Howard Chertkow
BMC Geriatrics , 2003, DOI: 10.1186/1471-2318-3-4
Abstract: A 2-center study was designed to assess discriminant validity of tests in the Mindstreams Mild Impairment Battery. Participants were 30 individuals diagnosed with MCI, 29 with mild Alzheimer's disease (AD), and 39 healthy elderly. Testing was with the Mindstreams battery and traditional neuropsychological tests. Receiver operating characteristic (ROC) analysis was used to examine the ability of Mindstreams and traditional measures to discriminate those with MCI from cognitively healthy elderly. Between-group comparisons were made (Mann-Whitney U test) between MCI and healthy elderly and between MCI and mild AD groups.Mindstreams outcome parameters across multiple cognitive domains significantly discriminated among MCI and healthy elderly with considerable effect sizes (p < 0.05). Measures of memory, executive function, visual spatial skills, and verbal fluency discriminated best, and discriminability was at least comparable to that of traditional neuropsychological tests in these domains.Mindstreams tests are effective in detecting MCI, providing a comprehensive profile of cognitive function. Further, the enhanced precision and ease of use of these computerized tests make the NeuroTrax system a valuable clinical tool in the identification of elderly at high risk for dementia.Mild cognitive impairment (MCI) is the term applied to a condition in which elderly individuals who have a subjective cognitive complaint have objective memory impairment in the absence of functional disability [1-3]. Its importance arises from the observation that it often constitutes the clinical state between normal cognition and dementia in the elderly [4]. Approximately 12–15% of MCI subjects per year convert to clinical dementia with functional disability [4,5]. For this reason, much interest has centered on the development of standardized techniques for quantification of cognitive deficits in MCI and potential therapeutic interventions for treatment of these high-risk individuals [6].Whil
Beyond mild cognitive impairment: vascular cognitive impairment, no dementia (VCIND)
Blossom CM Stephan, Fiona E Matthews, Kay-Tee Khaw, Carole Dufouil, Carol Brayne
Alzheimer's Research & Therapy , 2009, DOI: 10.1186/alzrt4
Abstract: A better understanding of dementia, including its causes, underlying pathophysiological processes and earliest possible identification, has become a major public health priority. Changes in cognition associated with age are complex, especially with regard to distinguishing usual from pathological brain ageing. Multiple and often intertwined pathological factors, including atrophy, neurodegeneration, inflammation, stroke and genetic-related factors, cause dementia [1]. Here, we explore the link between vascular disease, cognitive decline and dementia risk. Given the relatively high proportion of dementia attributable to possibly reversible midlife vascular causes [2], it has been suggested that vascular risk manipulation may result in up to a 50% reduction in the forecasted dementia prevalence rate in individuals who are 65 years old or older [3,4]. Vascular risk factors for dementia may also contribute to impairments observed in the pre-clinical stage of cognitive decline. This has raised questions regarding (a) whether vascular disease can predict cognitive change and dementia risk in otherwise non-impaired individuals and (b) the duration and possible reversal of cognitive symptoms and dementia depending on vascular disease manipulation and treatment. The aim of this review is to describe the current understanding of the division between pre-clinical cognitive impairment in the context of vascular disease versus the absence of vascular disease. The focus will be on the term 'vascular cognitive impairment, no dementia' (VCIND), an umbrella term that broadly encompasses cognitive deficits associated with vascular disease which fall short of a dementia diagnosis, in order to determine whether within the context of this condition there is a pre-clinical state linked to a high risk of dementia progression.Ageing in the developed world is associated with changes in the vascular system which result in atherogenesis, increased pulse pressure and increased risk of developi
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