Mindful aging: an insightful examination of cognitive impairment in the elderly population of Chengalpattu, Tamil Nadu, using Mini-Cog scale

Background: By 2050, United Nations projects that one in five Indians would be 60 years of age or older. This demographic transition is likely to be accompanied by substantial rise in prevalence of cognitive problems, which will have an impact on quality of life among elderly people. Effective screening at primary level would help in identification of burden of diseases and better planning at secondary and tertiary level. Methods: A community-based cross-sectional study over a period of three months was conducted at Pulipakkam in Chengalpattu district. The estimated sample size was 215, and simple random sampling method was used. Elderly people aged 60 years and above who consented to participate were included in the study. After obtaining informed consent, they were screened using the Mini-Cog tool which combines a short memory test with a simple clock- drawing test followed by a recall component. Results: The 215 participants in total were screened. The mean age of participants was 66.02±3.83 years. The prevalence of cognitive impairment (CI) based on Mini-Cog scale was 44.2%. Females (44.8%) had marginally higher prevalence than males (43.8%). CI was more prevalent among people over 65 years (57.6%). The likelihood of experiencing CI was higher among those who lived without their spouse (59.4%), were unemployed (53.7%), and who were smokers / alcoholics (63.7%). Conclusions: Considering the high burden of CI, there is need for long term prospective research for a comprehensive profile of mental disorders at community level. Early assessment and detection of CI could help in improving quality of life of elderly. Implementing initiatives aimed at increasing awareness, reducing stigma, and conducting widespread screening using reliable tools.

Mini-Cog versus Codex (cognitive disorders examination) Is there a difference? / Mini-Cog versus Codex (exame de distúrbios cognitivos): existe alguma diferença?

Abstract. Mini-Cog and Codex (cognitive disorders examination) are brief cognitive screening tests incorporating word-recall and clock drawing tests. Objective: To assess and compare the screening accuracy of Mini-Cog and Codex for diagnosis of dementia and mild cognitive impairment (MCI) in patients attending a dedicated cognitive disorders clinic. Methods: Tests were administered to a consecutive cohort of 162 patients, whose reference standard diagnoses based on clinical diagnostic criteria were dementia (44), MCI (26), and subjective memory complaint (92). Results: Both Mini-Cog and Codex had high sensitivity (>0.8) for dementia diagnosis, but Codex was more specific. For diagnosis of MCI, Mini-Cog had better sensitivity than Codex. Weighted comparisons of Mini-Cog and Codex showed only marginal net benefit for Mini-Cog for dementia diagnosis but larger net benefit for MCI diagnosis. Conclusion: In this pragmatic study both Mini-Cog and Codex were accurate brief screening tests for dementia but Mini-Cog was better for identification of MCI.

Resumo. Mini-Cog e Codex são testes breves de triagem cognitiva incorporando testes de recuperação de palavras e desenho de relógio. Objetivo: Avaliar e comparar a precisão da triagem de Mini-Cog e Codex (exame de distúrbios cognitivos) para o diagnóstico de demência e comprometimento cognitivo leve (CCL) em pacientes atendidos em uma clínica dedicada a distúrbios cognitivos. Métodos: Os testes foram administrados a uma coorte consecutiva de 162 pacientes, cujos diagnósticos padrão de referência com base em critérios clínicos de diagnóstico foram demência (44), CCL (26) e queixa subjetiva de memória (92). Resultados: O Mini-Cog e o Codex apresentaram alta sensibilidade (>0,8) para o diagnóstico de demência, mas o Codex foi mais específico. Para o diagnóstico de CCL, o Mini-Cog teve melhor sensibilidade que o Codex. As comparações ponderadas de Mini-Cog e Codex mostraram apenas um benefício líquido marginal para o Mini-Cog para o diagnóstico de demência, mas um benefício líquido maior para o diagnóstico de CCL. Conclusão: Neste estudo pragmático, o Mini-Cog e o Codex foram testes breves de triagem precisos para demência, mas o Mini-Cog foi melhor para a identificação de CCL.

Screening for dementia in older adults using Mini-Cog scale from a rural setting of Kashmir division

Background: Dementia is common in the geriatric population. It has been suggested that early detection leads to benefits for the patient and their family and cuts the costs. The solution to this problem lies in the development of brief and easily applicable tests that are acceptable to patients, their caregivers, and health professionals. The current study was undertaken for screening for dementia using Mini-Cog scale.Methods: Cross sectional study from District Budgam of Kashmir Division done on individuals aged >60 yrs after providing informed consent. All participants underwent comprehensive evaluations using the Mini-Cog scale for Dementia.Results: The overall prevalence of dementia was 57.5%. Majority of the individuals with dementia were illiterate (49.8%) and had completed up to primary education (63.2%). However no statistical significance was seen between marital and educational status with dementia. About 70.8% of the individuals with dementia were not aware of the availability of facilities related to mental issues.Conclusions: Need of the hour is to develop culturally appropriate interventions that could be integrated with dementia services within the primary health care system.