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

AIM: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: The MoCA executive tasks are more sensitive in detecting executive dysfunction compared with the MMSE executive tasks. Geriatr Gerontol Int 2017; 17: 2329-2335.

Metabolic Syndrome and Cognitive Performance Among Chinese ≥50 Years: A Cross-Sectional Study with 3988 Participants.

BACKGROUND: To date, the relationship between metabolic syndrome (MetS) and cognitive performance has not been well defined. This study aimed to explore the relationship between MetS and cognitive performance among Chinese elderly population. METHODS: A cross-sectional study was performed, with data collected in seven clinical centers from five provinces of Northern China. All recruited participants were ≥50 years of age and complained with cognitive impairment or were reported with cognitive impairment by his/her caregiver(s). MetS was diagnosed according to the criteria issued by Chinese Medical Association Diabetes Association. Cognitive function was scored by Montreal Cognitive Assessment (MoCA). RESULTS: Three thousand nine hundred eighty-eight participants (in an average of 66.4 ± 8.8 years of age, male 53.1%) were included in the analysis. Six hundred seventy-three (16.9%) participants were diagnosed with MetS, and 3013 (75.6%) participants had mild cognitive impairment (MCI) (MoCA score <26). There was no statistically significant difference in the MoCA scores between participants with MetS (21.0 ± 5.4) and without MetS (21.3 ± 5.3). In the logistic regression, after adjusting factors of age, education, marital status, smoking, and physical activity, diabetes and dyslipidemia were associated with MCI, whereas hypertension and overweight or obesity were not. Participants with diabetes had a higher risk of MCI (OR = 1.24, 95% CI: 1.03-1.50). Participants with dyslipidemia had a lower risk of MCI (OR = 0.81, 95% CI: 0.68-0.97). CONCLUSION: In our study, MetS is not associated with cognitive performance in elderly Chinese population. However, elderly Chinese with diabetes would have lower cognition function, and the dyslipidemia might be reversely associated with the cognitive function.

Quantitative study evaluating perception of general public towards role of pharmacist in health care system of Pakistan.

To investigate general public perception towards the role of pharmacist in developing countries' healthcare system was the main aim of this study, which would be the basic foundation for researching the treatment pattern of cognitive disorder after stroke in communities. The study population (sample size = 385) consisted of general public from Islamabad, Faisalabad and Lahore, Pakistan. Main sections of the questionnaire comprised of series of statements pertaining to consumer's perception and experience with the pharmacists. The response rate of study was 77.1%. A majority (80.1%) of the consumers knows who is pharmacist; 49.8% (n = 148) of the respondents found the pharmacist working in the pharmacies; 74.1% (n = 220) believed that pharmacist can guide them regarding their medicine. With respect to government efforts to improve services provided by community pharmacies, less percentage (31.0%) of the consumers were satisfied. Half of the respondents (59.9%) were expecting from the pharmacists to be knowledgeable drug therapy experts, whereas 61.3% (n = 182) expect from the pharmacists to educate them regarding safe and appropriate use of medication. The findings of this study conclude that the quality of pharmaceutical services provided is very low in Pakistan. There is a gap between the public and the pharmacist, which can only be filled by creating awareness among public regarding the pharmacist's role in healthcare system and by focusing on how services provided by the pharmacists can add improvement to general public health.