Cognitive assessment in the elderly: a review of clinical methods

Woodford, Henry J.; George, James

doi:10.1093/qjmed/hcm051

Cited by 288 publications

(227 citation statements)

References 113 publications

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“…Mental screening tests are good at detecting the presence of dementia but not its origin. Cognitive assessment scales vary largely with regard to sensitivity, specificity, and cutoffs, and currently there is no gold standard for detecting cognitive function and impairment (85). Standardization of cognitive assessment methods could improve comparison of results from different studies and allow for meta-analyses to be performed.…”

Section: Resultsmentioning

confidence: 99%

Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence

Petersson

Philippou

2016

Advances in Nutrition

367

212

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A growing body of evidence suggests that adherence to the Mediterranean diet (MD) may protect against cognitive decline and dementia. Many epidemiologic studies and several randomized controlled trials (RCTs) have found positive effects of the MD on cognitive function, but findings remain inconsistent. The aim of this systematic review was to provide an update on the current knowledge of the effects of the MD on cognitive function, cognitive impairment, Alzheimer disease (AD), and all-type dementia. Five databases were searched-PubMed, Embase, CINAHL, CENTRAL, and PsycINFO (1806 to 25 May 2015)-with the use of prespecified criteria. Human studies that were published in English without any restriction on study type, population assessed, intervention period, follow-up time, or publication date, and that examined the association between adherence to the MD and cognitive function or dementia symptoms (as measured by cognitive function tests), were included. Only primary publication types were included. Thirty-two studies from 25 unique cohorts, including 5 RCTs and 27 observational studies, met the inclusion criteria. The majority of studies showed that the MD was associated with improved cognitive function, a decreased risk of cognitive impairment or decreased risk of dementia, or AD. Three studies found no correlation between the MD and AD, 3 further studies found no association between the MD and cognitive impairment, and 5 studies found no association between the MD and cognitive function. There was large heterogeneity, and studies differed with regard to quality. Based on the findings and the limitations in study design, we conclude that adherence to the MD is associated with better cognitive performance. However, it should be noted that the majority of findings come from epidemiologic studies that provide evidence for a correlation between the MD and cognition but not for a cause-and-effect relation. More controlled trials are required to establish a causational relation. Adv Nutr 2016;7:889-904.

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Section: Resultsmentioning

confidence: 99%

Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence

Petersson

Philippou

2016

Advances in Nutrition

367

212

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“…Cultural background had an influence on MMSE performance, and education is closely related to cultural background 22. MMSE scores generally decline with advancing age and can be biased by baseline educational level and language 23. Therefore, study sample in BLSA, which comprised a more‐uneducated elderly population than previous studies, may contribute to the strong association of MMSE and CVD mortality risk.…”

Section: Discussionmentioning

confidence: 99%

“…However, our study also has some limitations. First, the MMSE is a common screening instrument, rather than a clinical assessment, and has limited ability to test executive or visuospatial functions and detect vascular cognitive dysfunction 23. Second, the MMSE includes 10 categories representing different domain items 7.…”

Section: Discussionmentioning

confidence: 99%

Cognitive Impairment and Risk of All‐Cause and Cardiovascular Disease Mortality Over 20‐Year Follow‐up: Results From the BLSA

Tang

et al. 2018

JAHA

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BackgroundCognitive impairment may increase the risk of all‐cause and cardiovascular disease (CVD) mortality. This study examined the association between cognitive function and risk of all‐cause and CVD mortality among the elderly in Beijing, China.Methods and ResultsA total of 1996 participants aged ≥55 years at baseline were enrolled from the BLSA (Beijing Longitudinal Study of Aging). Cognitive function was assessed using the Mini‐Mental State Examination (MMSE), and participants were categorized as: <18, 18 to 23, 24 to 27, and 28 to 30. Cox proportional hazard models were used to estimate the association. Hazard ratio (HR) and 95% confidence interval (CI) were reported. During a 20‐year follow‐up, 1122 (56.21%) participants died, 478 (42.60%) of whom died of CVD. Compared with MMSE scores of 28 to 30, participants with MMSE scores of <18 were independently associated with all‐cause mortality (hazard ratio, 2.14; 95% confidence interval, 1.59–2.87; P<0.001) and CVD mortality (hazard ratio, 4.52; 95% confidence interval, 2.80–7.30, P<0.001). Each 5‐point decrease in MMSE score was associated with a 34% increased risk of all‐cause mortality and a 56% increased risk of CVD mortality. This relationship remained statistically significant after using the competing risk model to consider non‐CVD death as a competing risk event.ConclusionCognitive impairment measured by MMSE score was associated with elevated risk of all‐cause and CVD mortality among the elderly in Beijing, China.

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“…The values of reliability and validity were comparable or higher than those obtained from previous studies [6,7]. Although MMSE has some limitations, it was used to validate RBANS-S over other instruments like MoCA, as it has been repeatedly used in dementia studies, particularly as a "standard" easily communicated and cited tool [8]. MMSE enables results to be compared across many in Table 3.…”

Section: Discussionmentioning

confidence: 61%

Validation of the Sinhala version of the Repeatable Battery for Assessment of Neuropsychological Status (RBANS)

et al. 2016

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Cognitive assessment in the elderly: a review of clinical methods

Cited by 288 publications

References 113 publications

Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence

Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence

Cognitive Impairment and Risk of All‐Cause and Cardiovascular Disease Mortality Over 20‐Year Follow‐up: Results From the BLSA

Validation of the Sinhala version of the Repeatable Battery for Assessment of Neuropsychological Status (RBANS)

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