A cross-sectional study to determine the cognitive impairment and depression among elderly in a rural area of West Bengal

Background: The increase in worldwide life expectancy among the elderly is contributing to an increase in cognitive impairment (CI). A more complicated etiology makes CI an essential clinical concern for elderly patients with depression. Ageing populations as a result of demographic change have accelerated the development of certain geriatric conditions, including CI and depression. Aims and Objectives: The objective was to identify the prevalence and contributing factors of CI and depression in the elderly rural community. Materials and Methods: A descriptive, cross-sectional, and community-based study was conducted in rural field practice area of Medical College, Kolkata, among 133 geriatric people during time period of March–June, 2022. The prevalence of CI was measured using the Mini-Mental State Examination (MMSE) scale and depression was assessed using the geriatric depression scale. Data were analyzed in SPSS software version 16. Results: Mean age of the participants was 65.68 (±6.03) years. The prevalence of CI was 86.5%, with a mean MMSE score of 19.27 ± 4.34, and the depression was 77.5% and 7.07 ± 3.39. Conclusion: Almost two-third of the geriatric population is suffering from depression and CI. To handle the issue of CI, depression, and its resulting effects, new and modified geriatric health policies are very much needed.

Revisión de las pruebas cognitivas breves para pacientes con sospecha de demencia / Review of brief cognitive tests for patients with suspected dementia

RESUMEN NTRODUCCIÓN: Para ser útiles, las pruebas cognitivas breves (PCB) deben ser rápidas, sensibles, fáciles de realizar y no necesitar de un gran entrenamiento para hacerlo. Las pruebas cognitivas breves comúnmente utilizadas incluyen el Mini Examen del Estado Mental (MMSE) y la Evaluación Cognitiva de Montreal (MoCA). OBJETIVO: Brindar una descripción de las PCB disponibles y sus propiedades psicométricas para la detección de la demencia. MÉTODOS: Revisión narrativa RESULTADOS: El MMSE le otorga un gran peso a la orientación, la memoria, la visuo-espacialidad y el lenguaje, y, en consecuencia, puede ser sensible a los déficits cognitivos encontrados en la demencia tipo Alzheimer. MoCA es una prueba breve más compleja que evalúa una gama más amplia de dominios cognitivos, especialmente funciones ejecutivas, proporcionando una mayor sensibilidad para detectar el deterioro cognitivo leve y otros tipos de demencia, no solo la demencia tipo Alzheimer. CONCLUSIONES: Las PCB son parte del arsenal necesario para ayudar a confirmar la sospecha de la demencia. La escolaridad tiene un impacto importante en el desempeño de las PCB y puede sesgar la interpretación de los resultados obtenidos.

ABSTRACT INTRODUCTION: To be useful, Brief Cognitive Tests (BCTs) must be fast, sensitive, easy to perform, and not require extensive training to do so. Commonly used brief cognitive tests include the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). OBJECTIVE: To provide a description of the available BCTs and their psychometric properties for the detection of dementia. METHODS: Narrative review RESULTS: The MMSE places great weight on orientation, memory, visuospatiality, and language, and, consequently, may be sensitive to the cognitive deficits found in Alzheimer's dementia. MoCA is a more complex brief test that assesses a broader range of cognitive domains, especially executive functions, providing greater sensitivity for detecting mild cognitive impairment and other types of dementia, not just Alzheimer's dementia. CONCLUSIONS: BCTs are part of the arsenal needed to help confirm suspected dementia. Schooling has an important impact on the performance of BCTs and can bias the interpretation of the results obtained.

Efecto del ejercicio en la memoria de adultos mayores con sobrepeso u obesidad: Revisión sistemática / Effect of exercise on the memory of overweight or obese older adults: Systematic review

RESUMEN La obesidad y el sobrepeso en adultos mayores se asocia con un mayor riesgo de enfermedades cognitivas, lo que contribuye a la disminución del rendimiento funcional. El objetivo de esta revisión es analizar el efecto del ejercicio en la memoria de adultos mayores con obesidad o sobrepeso. La metodología utiliza las palabras MESH: Población = envejecido, sobrepeso, obesidad; Intervención = ejercicio; Comparación = grupo control; Resultado = memoria; Diseño: ensayo clínico aleatorio. Buscando hasta diciembre de 2021 en: PUBMED, SCIELO, BVSALUD, LILACS, TRIP DATABASE Y MEDLINE. Se identifican 6.832 artículos. Se analizan cinco estudios, con 214 participantes. El índice de masa corporal medio es 28,6 ± 1,1 kg/m2 y el Mini mental medio inicial es 23,6 ± 2,1 puntos. La intervención con ejercicio es de doce a veintiséis semanas. En el modelo de efectos aleatorios el ejercicio mejora el Mini mental medio en MD = 2,6 puntos (1,7 a 3,4) p < 0,01. Heterogeneidad (87,7 %). El ejercicio mejora la función cognitiva (memoria) en adultos mayores con sobrepeso u obesidad.

ABSTRACT Obesity and overweight in older adults are associated with an increased risk of cognitive diseases, contributing to decreased functional performance. The objective of this review is to analyze the effect of exercise on memory in older adults with obesity or overweight. The methodology uses the words MESH: Population = aged, overweight, obesity; Intervention = exercise; Comparison = control groups; Result = Memory; Design: randomized controlled trial. Searching until December 2021 in PUBMED, SCIELO, BVSALUD, LILACS, TRIP DATABASE, and MEDLINE. Six thousand eight hundred thirty-two items are identified. We analyzed five studies with 214 participants. The mean body mass index is 28.6 ± 1.1 kg/m2, and the initial average Mini mental is 23.6 ± 2.1 points. The intervention with exercise is from twelve to twenty-six weeks. In the random-effects model, exercise improves the mean Mini Mental by MD = 2.6 points (1.7 to 3.4) p < 0.01. Heterogeneity (87.7 %). Exercise improves cognitive function (memory) in older adults who are overweight or obese.

Does gender influence P300 latency and mini mental state examination score in type 2 diabetes mellitus patients?

Background: P300 event-related potentials (ERPs) is an electrophysiologic marker of cognitive ability which closely reflects cognitive functions. Type 2 Diabetes mellitus (T2DM) causes many complications. Diabetes mellitus-induced damage to the central nervous system is a key focus of research. Latest magnetic resonance imaging evidence suggested that the changes in anatomy of brain is more rapidly seen in males than in females. This study was carried out to study the gender variations in P300 latency and Mini Mental State Examination (MMSE). Aim and Objective: To study the influence of gender on MMSE score as well as P300 ERP. Materials and Methods: 30 diagnosed Type 2 Diabetics aged above 40 years, with more than 2 years duration of diabetes were included in this study. MMSE questionnaire was administered to each diabetic and P300 was recorded using RMS EMG EP MARK 2 machine in all the diabetics. Results: The P300 ERP of male diabetics was prolonged significantly with mean ± standard deviation (SD) of (347.01 ± 31.55) whereas female diabetics had a mean ± SD of (318.26 ± 28.22; P = 0.014) and no significant difference was found between the mean MMSE scores of male diabetics (26.06 ± 1.38) and female diabetics (26.13 ± 1.30). Conclusion: The change in P300 ERP is swifter in males when compared with females in the middle to old age. Compared to MMSE, P300 Latency is a sensitive electrophysiological tool for diagnosing early cognitive deterioration in T2DM.

Effects of repetitive transcranial magnetic stimulation combined with oral paroxetine on cognitive status and activities of daily living in older adult patients with severe depression / 中国基层医药

Objective:To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with oral paroxetine in the treatment of older adult patients with severe depression and its effects on the scores of the Hamilton Rating Scale for Depression (HAMD), the Mini-Mental State Examination (MMSE), and Activities of Daily Living (ADL).Methods:A total of 192 older adult patients with severe depression who received treatment in Shaoxing 7 th People's Hospital from January 2018 to December 2019 were included in this study. They were randomly assigned to receive either oral paroxetine (control group, n = 96) or rTMS + oral paroxetine (observation group, n = 96). All patients received 1 month of treatment. Clinical efficacy was compared between the two groups. HAMD, MMSE, and ADL scores pre- and post-treatment and the incidence of adverse events during the treatment were compared between the two groups. Results:Total response rate was significantly higher in the observation group than in the control group [96.88% (93/96) vs. 89.58% (86/96), χ2 = 4.04, P < 0.05]. HAMD scores post-treatment were significantly lower in the observation group than in the control group [(6.43 ± 2.33) points vs. (11.32 ± 2.02) points, t = 15.53, P < 0.05]. MMSE and ADL scores post-treatment in the observation group were (29.13 ± 3.01) points and (71.52 ± 5.32) points, respectively, which were significantly higher than those in the control group [(24.65 ± 2.79) points, (69.65 ± 5.17) points, t = 10.69, 2.47, P < 0.05]. There was no significant difference in the incidence of adverse events between the two groups ( P > 0.05). Conclusion:The combined therapy of rTMS and oral paroxetine is highly effective on severe depression in older adult patients. It can improve cognitive function and the activities of life living.

Quality of Life of Elderly People Living in Different Types of Long-term Care Facilities

Abstract Population aging is a worldwide occurrence that has become urgent in developing countries. Quality of life can be measured to identify functional capacity and determine the degree of impact on quality of life exerted on an individual. This study aimed to measure the quality of life of elderly people who have been living in different long-term care facilities for the elderly. Therefore, this research was developed with a qualitative and descriptive approach. Data were obtained from medical records and interviews, and were analyzed in R language interpreter software on the Ubuntu Linux operating system. Seventy-nine elderly people participated in the study. Eleven lived in Home Marista, and 68 lived in Home Jesus Maria José. A socioeconomic questionnaire was used to collect data on the socioeconomic characteristics of the participants. The Mini-Mental State Exam was used to measure degree of cognition. The Short Form-36 Questionnaire was used to measure quality of life. The present study suggests that the results found can clarify the individual vulnerability of the elderly in the age group studied regardless of the type of residence. Despite the discrepancy found regarding the care provided at the long-term care facilities, the scores, obtained with the quality of life assessment, did not show significant differences.

O impacto das atividades cognitivas no desempenho no Mini-Mental de idosos octogenários de São João del Rei/MG: um estudo piloto / The impact of cognitive activities in the Mini-Mental performance of octogenarian elderly in the city of São João del Rei/MG: a pilot study

O aumento da população idosa mundial em torno de 600% nos últimos 50 anos trouxe vários desafios. O principal é a adoção de políticas que possam oferecer um envelhecimento saudável, preservando a autonomia dos sujeitos. Entre essas estratégias, a estimulação cognitiva é uma que possui baixo custo operacional e pode otimizar as funções que ainda se encontram preservadas. O objetivo desse estudo piloto retrospectivo foi avaliar o impacto protetivo das práticas de estimulação cognitiva em octogenários da cidade de São João del Rei. Para tanto foram aplicados dois instrumentos de avaliação: o Mini-Mental e um Questionário de Práticas Cognitivas. Os resultados preliminares indicam uma tendência de as práticas cognitivas impactarem positivamente no desempenho no Mini-Mental dos octogenários (p<0.01). Tais resultados têm implicações diretas, sobretudo nas estratégias de baixo custo a serem implementadas com o objetivo de se construírem reservas cognitivas na população recém adentrada na 3ª idade, visando uma maior autonomia na 4ª idade.

The increase in the world's elderly population of around 600% in the last 50 years has brought many challenges. The main one is adopting policies that can offer healthy aging, preserving the subjects' autonomy. Among these strategies, the cognitive stimulation is one that has a low operational cost and can optimize the functions which are still preserved. This retrospective pilot study aimed at evaluating the impact of cognitive stimulation practices on octogenarian elderly in the city of São João del Rei. Therefore, two evaluation instruments were applied: Mini-Mental and a Cognitive Practice Questionnaire. The preliminary results indicate a tendency that the cognitive practices impact positively on the octogenarians' cognitive performance(p<0.01). Such results have direct implications especially on the low-coststrategies to be implemented aiming at building cognitive reserves in the population of the recent 3rd age viewing a bigger autonomy in the 4th age.

Eficacia del mini mental y PFEIFFER (SPMSQ) para detectar deterioro cognitivo en mayores de 65 años / Eficácia do mini mental e PFEIFFER (SPMSQ) para detectar deterioração cognitiva em mais de 65 anos / Efficacy of the mini mental and PFEIFFER (SPMSQ) to detect cognitive impairment in those over 65 years of age

INTRODUCCIÓN: el deterioro cognitivo (DC) es un problema cada vez más frecuente, y a menudo no es diagnosticado, porque impide una terapéutica temprana, dificultando posteriormente la calidad de vida de quien lo padece. OBJETIVO: determinar la eficacia de los cuestionarios Mini Mental y PFEIFFER (SPMSQ) para detectar la existencia de deterioro cognitivo en personas mayores de 65 años. MÉTODO: estudio analítico de corte transversal. La muestra estuvo constituida por los adultos mayores del centro geriátrico de Macas. La utilidad diagnóstica se evaluó mediante el cálculo del área bajo la curva ROC (AUC), para el cálculo de los valores de sensibilidad (S), especificidad (E) se tomaron los puntos de corte más significativos y se comparó ambos test para determinar DC. RESULTADOS: el 53% de los pacientes fueron del género masculino y la media de 82 años. El 50% presentaron síntomas de DC con al menos un cuestionario positivo; el 58% fueron positivos con Pfeiffer y el 91% con Mini mental. Finalmente, los valores de sensibilidad y especificidad del mini mental fueron de 91% y 100% respectivamente y el AUC fue de 1 mientras Pfeiffer obtuvo una S y Ede 100% y AUC de 0.9, demostrando este último ser más efectivo para el diagnóstico de DC. CONCLUSIÓN: se determinó que el test de Pfeiffer fue más efectivo que el Mini mental para el diagnóstico de DC; además, la edad y el nivel de escolaridad son factores más asociados a esta patología.

INTRODUCTION: cognitive impairment (CD) is an increasingly frequent problem, and it is often not diagnosed, because it prevents early therapy, later hindering the quality of life of those who suffer from it. OBJECTIVE: to determine the effectiveness of the Mini Mental and PFEIFFER questionnaires (SPMSQ) to detect the existence of cognitive impairment in people over 65 years of age. METHOD: analytical cross-sectional study. The sample consisted of the elderly from the Macas geriatric center. The diagnostic utility was evaluated by calculating the area under the ROC curve (AUC), for the calculation of the sensitivity (S), specificity (E) values, the most significant cut-off points were taken and both tests were compared to determine DC. RESULTS: 53% of the patients were male and the average was 82 years old. 50% presented symptoms of CD with at least one positive questionnaire; 58% were positive with Pfeiffer and 91% with Mini mental. Finally, the sensitivity and specificity values of the mini mental were 91% and 100% respectively and the AUC was 1 while Pfeiffer obtained an S and E of 100% and AUC of 0.9, proving the latter to be more effective for the diagnosis of DC. CONCLUSION: it was determined that the Pfeiffer test was more effective than the Mini mental for the diagnosis of CD; Furthermore, age and level of education are factors most associated with this pathology.

INTRODUÇÃO: o déficit cognitivo (DC) é um problema cada vez mais frequente, muitas vezes não diagnosticado, pois impede a terapia precoce, prejudicando posteriormente a qualidade de vida de quem a sofre. OBJETIVO: determinar a eficácia dos questionários Mini Mental e PFEIFFER (SPMSQ) para detectar a existência de déficit cognitivo em pessoas com mais de 65 anos. MÉTODO: estudo transversal analítico. A amostra foi composta por idosos do centro geriátrico de Macas. A utilidade diagnóstica foi avaliada pelo cálculo da área sob a curva ROC (AUC), para o cálculo dos valores de sensibilidade (S), especificidade (E), os pontos de corte mais significativos foram tomados e ambos os testes foram comparados para determinar DC. RESULTADOS: 53% dos pacientes eram do sexo masculino e a média de idade foi de 82 anos. 50% apresentaram sintomas de DC com pelo menos um questionário positivo; 58% foram positivos com Pfeiffer e 91% com Mini mental. Finalmente, os valores de sensibilidade e especificidade do mini mental foram 91% e 100% respectivamente e a AUC foi 1 enquanto Pfeiffer obteve S e E de 100% e AUC de 0,9, provando que esta última é mais eficaz para o diagnóstico de DC. CONCLUSÃO: determinouse que o teste de Pfeiffer foi mais eficaz do que o Mini mental para o diagnóstico de DC; além disso, a idade e o nível de escolaridade são os fatores mais associados a essa patologia.

A Study of Cognitive Impairment in Patients with Type 2 Diabetes Mellitus – A Prospective Observational Study

Introduction: Type 2 diabetes mellitus (DM) is the most lifestyle risk factor for cognition. Regular treatment and managementof Type 2 DM could prevent the onset and progression of cognitive impairment. Cognitive decline associated with DM mayinfluence one’s ability to perform self-care and affect glycemic control.Aim: Our prospective observational study aimed to analyze the cognitive impairment using a mini-mental status examination(MMSE) in patients with Type 2 DM.Materials and Methods: This prospective observational study was conducted to analyze the cognitive impairment using MMSEin patients with Type 2 DM. A total of 50 patients diagnosed with Type 2 diabetes were included in the study. All the demographicand laboratory investigation data so obtained was tabulated and was analyzed statistically, and results were discussed.Results: Of 50 patients, 26 patients were male and 24 patients were female. Based on the age group, 11 patients were in theage group below 40 years, 21 patients between 40 and 50 years, 16 patients between 51 and 60 years, and 2 patients >60years. Based on the duration of Type 2 diabetes, 16 patients had <5 years and MMSE score of 24.28 and 34 patients had >5years and MMSE score of 22.14. Based on cognitive impairment, 44 patients had mild cognitive impairment and 6 patientshad moderate cognitive impairment.Conclusion: From this study, we concluded that the duration of Type 2 DM and level of HbA1c affect the cognitive status ofthe individuals. A greater understanding of the mechanisms linking Type 2 DM and cognitive impairment may facilitate thedevelopment of new ways for the treatment of cognitive impairment.

Study of the prevalence of isolated vitamin B12 deficiency related dementia in patients presenting to a tertiary care hospital

Background: Objective of the study was to determine the prevalence of Isolated B12deficient dementia in patients presenting to a tertiary care hospital. The MMSE was much lower in B12 deficiency compared to irreversible causes Thus, shorter duration, severe dementia, focal neurological signs, and a vegetarian diet were significantly associated with the development of B12 deficiency.Methods: Based on exclusion and inclusion criteria 100 patients were included in this study, a detailed history of the patient were taken with respect to duration of dementia and its symptoms, type and treatment. Study in terms of the correlation of the clinical features with investigations and diet. Estimation of the prevalence of dementia with reference to B12 deficiency. Mean MMSE analysis, assessment of the improvement in MMSE after treatment with B12 injections after a6-8 wks period.Results: In this study most of our patients were in the 60-69 age groups across all causes of dementia, 22out of 26, B12 deficient patients were vegetarians. This value was in keeping with the known fact that a vegetarian diet predisposes a person to develop B12 deficiency. The association between B12 deficiency, high MCV and megaloblastic blood picture in peripheral blood smear was significant. The MMSE scores were significantly lower 13.42 in patients with B12 deficiency as compared to those with Alzheimer's 14.3 means and those with multi-infarct state 17.3 means.Conclusions: The duration of the presentation in B12 deficiency was10-12months averagely. There was a significant improvement in MMSE after treatment in pureB12 deficient patients (by 9 points) if they presented within one year of symptoms. Except for myelopathy, there was an improvement in other neurological symptoms and signs. Early diagnosis and proper treatment can make improvements in a patient's memory and quality of life.

The relevance of Mini Mental State Examination (MMSE) use on demential interdiction exams in judicial proceedings / A importância do Miniexame do Estado Mental (MEEM) nos exames de interdição demencial em processos judiciais

ABSTRACT Objective To highlight the important role of Mini Mental State Examination (MMSE) use on judicial interdiction assessments. Methods On this paper, we present a case in which we have used the Mini mental state examination (MMSE) for screening an initial dementia diagnosis, suggested by clinical and mental state examination. Results The relevance of using a screening test for demencial states on judicial interdictions assessments, as MMSE, in order to provide more objective findings to the court, has been demonstrated. Also, we review the current evidence for using MMSE on this setting and the importance of its use on demential interdiction exams in judicial proceedings. Conclusions Judicial evidence is a critical element in decision making. Judicial interdiction assessment is usually performed by expert psychiatrists. As psychiatric diagnosis relies on clinical history and mental state examination, it is composed of subjective elements, varying also according to the examiner's personal technical orientation and impressions. Neuroimaging exams are helpful on a minority of cases, in which specific findings are present. In such cases, clinical screening questionnaires play an important role - providing objective elements of neuropsychic functioning of an individual, thus limiting the subjective realm of the expert forensic report.

RESUMO Objetivo Destacar a importância do uso do Miniexame do Estado Mental (MEEM) nas perícias de interdição judicial por demência. Métodos Neste artigo, apresentamos um caso no qual aplicamos o MEEM para rastreamento de demência inicial, cujo diagnóstico foi sugerido por meio de história clínica e exame do estado mental. Resultados Foi demonstrada a importância de usar um teste de rastreamento para demência, no caso o MEEM, nas perícias de interdição por esse diagnóstico, a fim de fornecer elementos mais objetivos ao juízo. Ainda, fornecemos uma revisão das evidências atuais para a aplicação do MEEM nesse contexto, bem como a importância do uso dele nas perícias de interdição por demência. Conclusões A prova pericial é um elemento crítico para a tomada de decisão judicial. A perícia de interdição judicial por demência é usualmente realizada por especialistas em psiquiatria. Como o diagnóstico psiquiátrico baseia-se na história clínica e no exame do estado mental, é composto de elementos subjetivos, variando de acordo com a técnica e impressão individual do examinador. Exames de neuroimagem são úteis em uma minoria de casos, nos quais achados específicos estão presentes. Assim, questionários clínicos para rastreamento de doenças mostram-se importantes, pois fornecem elementos objetivos do funcionamento neuropsíquico do indivíduo, diminuindo o papel da subjetividade no laudo pericial.

Correlation among Three Cognitive Tools in Memory Assessment / 中国康复理论与实践

Objective:To explore the correlation and characteristics of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Rivermead Behavioural Memory Test-III (RBMT-III) in evaluating memory ability of patients with brain injuries. Methods:From March, 2016 to February, 2018, 62 patients with brain injuries were evaluated with the Chinese version of MMSE, MoCA and RBMT-III. The correlation among them was analyzed. Results:There was positive correlation among the total scores of MMSE, MoCA and RBMT-III (r = 0.682 to 0.786, P < 0.001), as well as the retrospective memory (r = 0.525 to 0.610, P < 0.001) and long-term memory (r = 0.553 to 0.692, P < 0.001). There was positive correlation between RBMT-III and MMSE in short-term memory (r = 0.337, P = 0.007). The prospective memory of RBMT-III positively correlated with retrospective memory of MMSE and MoCA (r = 0.639, r = 0.585, P < 0.001), and the short-term memory of RBMT-III with long-term memory of MMSE and MoCA (r = 0.454, r = 0.534, P < 0.001). Conclusion:MMSE, MoCA and RBMT-III are consistent in evaluating retrospective memory and long-term memory for patients with brain injuries. RBMT-III and MMSE are consistent in evaluating short-term memory for patients with brain injuries. The memory scores of MMSE and MoCA are helpful to judge the event-based prospective memory in patients with brain injuries, while the scores of long-term memory are helpful to judge short-term memory.

Association between serum non-high-density lipoprotein cholesterol and cognitive dysfunction after acute ischemic stroke: a cross-sectional study

This study aimed to explore the association between serum non-high-density lipoprotein cholesterol (non-HDL-C) and cognitive dysfunction risk in patients with acute ischemic stroke (AIS). This cross-sectional study enrolled 583 AIS patients. Biochemical markers and lipid profile were collected after admission. AIS patients were classified into high group (non-HDL-C ≥3.4 mM) and normal group (non-HDL-C <3.4 mM). Mini-Mental State Examination scale (MMSE), Montreal Cognitive Assessment scale (MoCA), Activities of Daily Living (ADL) scale, Neuropsychiatric Inventory (NPI), and Hamilton Depression scale 21 version (HAMD-21) were applied on the third day after admission. Compared with the control group, patients of the high group had higher body mass index and higher frequency of intracranial artery stenosis, and exhibited higher levels of non-HDL-C, total cholesterol, triglycerides, low-density lipoprotein cholesterol, homocysteine, fasting blood glucose, and glycosylated hemoglobin (HbA1c), and lower levels of high-density lipoprotein cholesterol (all P<0.05). Compared with the control group, patients of the high group had significantly lower MMSE and MoCA scores (MMSE: 26.01±4.17 vs 23.12±4.73, P<0.001; MoCA: 22.28±5.28 vs 20.25±5.87, P<0.001) and higher scores on the NPI and HAMD-21 (both P<0.001). MMSE (r=-0.306, P<0.001) and MoCA scores (r=-0.251, P<0.001) were negatively associated with non-HDL-C level. Multivariate regression analysis revealed that non-HDL-C level (OR=1.361, 95%CI: 1.059-1.729, P=0.016) was independently associated with the presence of cognitive dysfunction after adjusting for confounding factors. High serum non-HDL-C level might significantly increase the risk of cognitive dysfunction after AIS.

Prevalence of Risk Factors for Dementia in Elderly Population in a Tribal Area of Central India – A Community-Based Cross-Sectional Study

Background: Approximately 50 million people worldwide are suffering from dementia, it is the 7th leading cause of death among the elderly. In India, more than 4 million people have some form of dementia 3. According to the World Health Organization, India’s population of those aged over 65, which was 40 million in 1997, is set to increase to 108 million by 2025 and 240 million by 2050.Aim and Objective: The aim of the study was to study the prevalence of risk factors of dementia among the elderly population residing in a tribal area of Central India.Materials and Methods: A door to door cross-sectional study was conducted in the rural/tribal area with a pre-designed case record form that investigated the prevalence of risk factors along with measurement of anthropometry and mini-mental state examination was used to categorize subjects according to their mental status.Results: This study reports high prevalence of risk factors such as hypertension (31.8%), tobacco chewing (25.43%), high waist-hip ratio (24.57%), smoking habit (15.03%), head injury (11%), overweight (9.54%), alcohol intake (9.25%), 71–80 age (9.25%), diabetics (9%), stroke (4.62%), family history of dementia (2.6%), obesity (2.31%), coronary artery disease (CAD) (1.73%), and depression (1.45%).Conclusions: This study highlights a significant burden of undiagnosed cases of hypertension, diabetes, depression, and CAD all of which are important risk factors for dementia in the community, most of them are poorly controlled. There is a need to identify the large pool of undiagnosed cases of the mentioned morbidities by screening and offer early treatment to avoid complications.

acupuncture method for mild cognitive impairment: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical efficacy of acupuncture method for mild cognitive impairment in the elderly.@*METHODS@#A total of 96 patients were randomly divided into an observation group, a control group and a waiting group, 32 cases in each group. The patients in the observation group were treated with acupuncture at Baihui (GV 20), Shenting (GV 24), Yintang (GV 29) and Sishencong (EX-HN 1), etc, while the patients in the control group were treated with nonpenetrating sham acupuncture at the same acupoints as the observation group. The treatment was given once every other day, three times a week for 8 weeks. The patients in the waiting group only received health guidance for 8 weeks. Montreal cognitive assessment scale (MoCA) and mini-mental state examination (MMSE) were used before and after 8-week treatment in all three groups. The observation group and the control group were followed up for 2 months and evaluated with MoCA and MMSE.@*RESULTS@#The MoCA scores in the observation group after treatment and during follow-up were higher than before treatment (0.05). The MoCA scores in the control group after treatment and during follow-up were higher than before treatment (0.05). The difference before and after treatment in the observation group was higher than the control group and waiting group (0.05). The MMSE scores after treatment and during follow-up were higher than before treatment in the control group (0.05). The difference before and after treatment the observation group and control group was not significant (>0.05), and those in the two groups were higher than the waiting group (<0.01). The difference between follow-up and before treatment in the observation group was higher than the control group (<0.01), and the difference between follow-up and after treatment was lower than the control group (<0.01).@*CONCLUSION@# acupuncture method could improve cognitive impairment in elderly patients with mild cognitive impairment.

Development of a Screening Algorithm for Alzheimer's Disease Using Categorical Fluency and Confrontational Naming Abilities

OBJECTIVE: Declines in naming ability and semantic memory are well-known features of early Alzheimer's disease (AD). We developed a new screening algorithm for AD using two brief language tests : the Categorical Fluency Test (CFT) and 15-item Boston Naming Test (BNT15). METHODS: We administered the CFT, BNT15, and Mini-Mental State Examination (MMSE) to 150 AD patients with a Clinical Dementia Rating of 0.5 or 1 and to their age- and gender-matched cognitively normal controls. We developed a composite score for screening AD (LANGuage Composite score, LANG-C) that comprised demographic characteristics, BNT15 subindices, and CFT subindices. We compared the diagnostic accuracies of the LANG-C and MMSE using receiver operating curve analysis. RESULTS: The LANG-C was calculated using the logit of test scores weighted by their coefficients from forward stepwise logistic regression models : logit (case)=12.608−0.107×age+1.111×gender+0.089×education−0.314×HS(1st)−0.362×HS(2nd)+0.455×perseveration+1.329×HFCR(2nd)−0.489×MFCR(1st)−0.565×LFCR(3rd). The area under the curve of the LANG-C for diagnosing AD was good (0.894, 95% confidence interval=0.853–0.926 ; sensitivity=0.787, specificity=0.840), although it was smaller than that of the MMSE. CONCLUSION: The LANG-C, which is easy to automate using PC or smart devices and to deliver widely via internet, can be a good alternative for screening AD to MMSE.

Development and Validation of the Full Version of Story Memory in the Korean-Mini Mental State Examination, 2nd Edition: Expanded Version (K-MMSE-2: EV)

BACKGROUND AND PURPOSE: The Korean version of Story Memory (SM) in the Korean-Mini Mental State Examination, 2nd Edition: Expanded Version (K-MMSE-2: EV) was developed. Based on the SM, we additionally developed a full version of SM including delayed recall (DR) and recognition adding to immediate recall (IR). This study aimed to examine the reliabilities and validities of the newly developed SM in the K-MMSE-2: EV and its full version. METHODS: Ninety-five healthy elderly individuals (HE), 90 patients with amnestic mild cognitive impairment (aMCI), and 53 patients with dementia of the Alzheimer's type (DAT) participated in the study. They were administered the full version of SM with the Seoul Verbal Learning Test-Elderly's version (SVLT-E) and Rey Complex Figure Test (RCFT). In addition, the SM was re-administered to 51 participants after a 5-week interval. Two clinical neuropsychologists independently rated the performance of 50 participants. RESULTS: The test-retest reliabilities of the IR, DR, and recognition of the SM were statistically significant. The inter-rater reliabilities (Cohen's kappa) were high (0.87–1.00) for all the measures. The IR, DR, and recognition of SM had significant positive correlations with those of the SVLT-E and RCFT. Significant group differences in IR and DR of SM were found among the HE, aMCI, and DAT groups. The recognition scores were significantly different between the aMCI and DAT groups, but not between the HE and aMCI groups. CONCLUSIONS: The newly developed full version of SM in the K-MMSE-2: EV was proven to be a reliable and valid memory measure for clinical use.

Effects of Low-carbohydrate and High-fat Diet Supplemented with Ketogenic Drink on Cognitive Function and Physical Performance in the Elderly at High Risk for Dementia / 대한지역사회영양학회지

OBJECTIVES: Reduced glucose utilization in the main parts of the brain involved in memory is a major cause of Alzheimer's disease, in which ketone bodies are used as the only and effective alternative energy source of glucose. This study examined the effects of a low-carbohydrate and high-fat (LCHF) diet supplemented with a ketogenic nutrition drink on cognitive function and physical activity in the elderly at high risk for dementia.METHODS: The participants of this study were 28 healthy elderly aged 60-91 years showing a high risk factor of dementia or whose Korean Mini-Mental State Examination (K-MMSE) score was less than 24 points. Over 3 weeks, the case group was given an LCHF diet with nutrition drinks consisting of a ketone/non-ketone ratio of 1.73:1, whereas the control group consumed well-balanced nutrition drinks while maintaining a normal diet. After 3 weeks, K-MMSE, body composition, urine ketone bodies, and physical ability were all evaluated.RESULTS: Urine ketone bodies of all case group subjects were positive, and K-MMSE score was significantly elevated in the case group only (p=0.021). Weight and BMI were elevated in the control group only (p<0.05). Grip strength was elevated in all subjects (p<0.01), and measurements of gait speed and one leg balance were improved only in the case group (p<0.05).CONCLUSIONS: We suggest that adherence to the LCHF diet supplemented with a ketogenic drink could possibly influence cognitive and physical function in the elderly with a high risk factor for dementia. Further, we confirmed the applicability of this dietary intervention in the elderly based on its lack of any side effects or changes in nutritional status.

Behavioral Memory Assessment for Traumatic Brain Injury Patients with Normal Result in Mini-Mental State Examination / 中国康复理论与实践

Objective:To observe the performance of the traumatic brain injury (TBI) patients with normal results in Mini-Mental State Examination (MMSE) in the Montreal Cognitive Assessment (MoCA) and Rivermead Behavioral Memory Test-3 (RBMT-3). Methods:From March, 2015 to June, 2018，40 TBI patients with cognitive complaints but normally in MMSE and other 30 healthy persons (controls) were assessed with MoCA and RBMT-3. Results:There were 14 patients sounded normally in MoCA. The scores of MoCA, as well as both the raw score and scale score of RBMT-3, were less in the patients than in the controls (t > 2.822, P < 0.01), especially in the verbal and delayed recall subtests of MoCA (t > 2.790, P < 0.01), and delayed story recall, skill learning instant recall, delayed skills recall (both raw and scale scores) (t > 2.507, P < 0.05), and remember name delay recall and story instant recall (raw score only) (t > 2.018, P < 0.05) of RBMT-3. Conclusion:For TBI patients with cognitive complaints, it is necessary to assesse with both MMSE and MoCA. If there is any memory impairment, RBMT-3 is needed.

Characterization of quantitative EEG in patients with postoperative cognitive dysfunction / 医学研究生学报

Objective Very few studies have been reported on the application of quantitative electroencephalogram (qEEG) in patients with postoperative cognitive dysfunction (POCD). This study was to investigate the qEEG features of POCD and provide some help for the early detection and diagnosis of the condition. Methods We enrolled 31 postoperative patients treated in our Department of Critical Care Medicine from January 2018 to October 2018. Based on the pre- and post-operative scores on the Mini-Mental State Examination (MMSE), we divided the patients into a POCD (MMSE score >2, n = 11) and a non-POCD control group (MMSE score ≤2, n = 20). Using the brain function instrument, the electrode set according to the standard international 10-20 system and with bipolar longitudinal F3-P3 and F4-P4 four channels, we conducted bedside monitoring for all the patients and calculated the average value of the consecutive clips of 10-min qEEG. Then, we analyzed the amplitude-integrated EEG (aEEG), relative frequency band energy, relative α variability and spectrum entropy, and the correlation of relative frequency band energy and relative α variability with the MMSE scores. Results Compared with the non-POCD controls, the POCD patients showed significant decreases in the total MMSE scores (28.35 ± 1.27 vs 18.91 ± 2.34, P < 0.05), orientation score (9.75 ± 0.44 vs 6.82 ± 1.47, P < 0.05) and memory score (2.90 ± 0.31 vs 2.09 ± 1.04, P < 0.05) as well as in the concentration, calculation, recalling and language scores (all P < 0.05); and the POCD patients also exhibited marked reduction in the left α variability ([22.59 ± 10.98]% vs [14.39 ± 8.25]%, P < 0.05), right α variability ([24.07 ± 9.73]% vs [15.70 ± 9.59]%, P < 0.05), left α frequency band energy ([7.17 ± 4.73] vs [3.83 ± 2.62] μV2, P < 0.05) and right α frequency band energy ([6.94 ± 4.53] vs [3.82 ± 2.51] μV2, P < 0.05). The MMSE scores were found to be negatively correlated with left α variability (r = -0.793, P = 0.004), right α variability (r = -0.835, P = 0.001), left α frequency band energy (r = -0.633, P = 0.037) and right α frequency band energy (r = -0.682, P = 0.021). Conclusion Quantitative EEG of POCD patients is characterized by significantly decreased α variability and α frequency band energy, which may contribute to the early detection and diagnosis of POCD.