Background: Cognitive impairment becomes more common with ageing and may benefit from intervention. In a Spanish speaking population, detection of cognitive impairment by a general practitioner in Primary Care can be a problem, as many of the standard tests target English speaking populations. The Memory Impairment Screen (MIS-A) is a validated test using English words to detect Alzheimer's Disease (AD) and other dementias. We have modified this test to suit a Spanish speaking population and added a new component, delayed recall. We have called our new test the Memory Impairment Screen with Delayed Recall (MIS-D). Objectives: 1) To test a Spanish version of MIS-A and MIS-D. 2) To assess the discriminative validity of MIS-D as a screening tool for the amnestic variant of Mild Cognitive Impairment (aMCI) in a group of Spanish speaking people aged 65 years old and over. Methods: A case-control study of a cohort of 739 native Spanish speaking residents of Buenos Aires aged 65 years old and over, of whom 436 were healthy controls and 303 had a diagnosis of aMCI. Measurements: Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NVP) were estimated for MIS-D and MIS-A. Results: Normative values for MIS-A and MIS-D were obtained from the control population. Both age and education significantly affected these values (p < 0.0001). Control participants showed significant differences for both modalities, MIS-A and MIS-D. The cutoff for MIS-A should be 7.5 and for MIS-D, 5.5. Comparison between control population and aMCI population using ROC curve gave a result of 5.5 in MIS-D, with 97% specificity and 76% sensitivity. Conclusion: MIS-D was positively predictive of aMCI, with 97% specificity and 76% sensitivity in a sample of Spanish speaking patients aged 65 years old and over in Buenos Aires. L. Edith et al.

Background: Early detection of dementia is currently of great interest and of crucial importance for the implementation of preventive measures and treatment of the disease. Impairment in verbal episodic memory, and in particular in a delayed recall phase, is considered one of the early markers of progression from mild cognitive impairment (MCI) to dementia. Therefore, having cognitive screening instruments with predictive value for progression is of utmost importance. Objective: The purpose of this work is to show the predictive value, sensitivity and specificity of the Memory Impairment Screen with delayed recall (MIS-DR) to predict conversion to dementia in patients with MCI. Methods: In retrospective study 502 patients over 60 years old, evaluated in the Older Adult Functional Evaluation Unit of our hospital for cognitive complaint, were diagnosed with MCI. They were followed up to assess conversion to dementia. Results: During follow up, 144 participants developed dementia (28.6%, 95% CI 24.76-32.85) and the average time of progression to dementia were 23 months (SD 13.2). The cutoff point was established below 6 for MIS-DR and it showed a sensitivity of 76% (95% CI 68.77-77.84) and a specificity of 56% (95% CI 50.44-61.58), with a positive predictive value of 41% (95% CI 34.78-47.6) and a negative predictive value of 85% (95% CI 80.53-91.11) for predicting progression to dementia. Of those patients who obtained a MIS-DR score below 6, 41% developed dementia, in contrast to 14.53% of those with a score above or equal to 6, OR 4.09 (95% CI 2.64-6.34), p < 0.00001. There were no significant differences in terms of gender, education level or vascular risk factors among patients who converted and those who did not convert to dementia. Conclusion: We believe that MIS-DR is a useful and valid test to detect episodic memory impairment and to identify patients at risk of progression to dementia.

Background: There is a close interaction between cognitive and functional performance in the normal brain. It increases in cases of brain disease, where a worse initial cognitive performance is associated with subsequent functional decline.Objective: To describe the cognitive and functional performance profile and their interaction in a population of patients with Vascular Dementia (VD). Methods:We studied 79 patients (Group 1, G1) with VD and 80 healthy subjects without brain disease (Group 2, G2). The following tests were administered to all the study population: ADAS Cog., Trail Making Test (TMT), Mini Mental State Examination (MMSE), Basic and instrumental activities of daily living (ADL, IADL), Disability Assessment for Dementia (DAD), and Gottfries-Brane-Steen Scale (GBS). Scores were statistically evaluated usingthe ANOVA Test, Spearman's correlation matrix and Principal Component Analysis (PCA). Results:The average age of G1 was 72.6 + 7.1 and their literacy level was 8.05 + 4.76 years. The cognitive profile showed a significant global decline in the MMSE (19.9 + 3.77 points) and in the ADAS Cog (29.2 + 8.80 points). In this group, the cognitive functions most compromised were Memory, Orientation and Recognition and, to a lesser degree, Attention, Language and Praxis. The functional profile showed the greatest impairment in IADL. The PCA showed a correlation of ADAS with TMT and Katz Index, and of MMSE and DAD. Conclusions:The results highlight the interaction between complex functional performance and cognition, suggesting an impact of cognitive impairments linked to executive function on functional performance, of potential therapeutic significance.