The Role of Brief Global Cognitive Tests and Neuropsychological Expertise in the Detection and Differential Diagnosis of Dementia

Riello, Marianna; Rusconi, Elena; Treccani, Barbara

doi:10.3389/fnagi.2021.648310

Cited by 23 publications

(12 citation statements)

References 64 publications

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“…In this regard, cognitive tests could be categorized according to the specific cognitive ability they purport to quantify ( Pontifex et al, 2019 ). However, global cognitive tests (e.g., the DemTect or CDT) are intended to capture multiple cognitive abilities ( Riello et al, 2021 ). Thus, it can be inferred that several distinct cognitive abilities are required for the completion of the DemTect and CDT.…”

Section: Discussionmentioning

confidence: 99%

Effects of Intermittent Hypoxia-Hyperoxia Exposure Prior to Aerobic Cycling Exercise on Physical and Cognitive Performance in Geriatric Patients—A Randomized Controlled Trial

et al. 2022

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Background: It was recently shown that intermittent hypoxic-hyperoxic exposure (IHHE) applied prior to a multimodal training program promoted additional improvements in cognitive and physical performance in geriatric patients compared to physical training only. However, there is a gap in the literature to which extent the addition of IHHE can enhance the effects of an aerobic training. Therefore, the aim of this study was to investigate the efficacy of IHHE applied prior to aerobic cycling exercise on cognitive and physical performance in geriatric patients.Methods: In a randomized, two-armed, controlled, and single-blinded trial, 25 geriatric patients (77–94 years) were assigned to two groups: intervention group (IG) and sham control group (CG). Both groups completed 6 weeks of aerobic training using a motorized cycle ergometer, three times a week for 20 min per day. The IG was additionally exposed to intermittent hypoxic and hyperoxic periods for 30 min prior to exercise. The CG followed the similar procedure breathing sham hypoxia and hyperoxia (i.e., normoxia). Within 1 week before and after the interventions, cognitive performance was assessed with the Dementia-Detection Test (DemTect) and the Clock Drawing Test (CDT), while physical performance was measured using the Timed “Up and Go” Test (TUG) and the Short-Physical-Performance-Battery (SPPB).Results: No interaction effect was found with respect to the DemTect (ηp2 = 0.02). An interaction effect with medium effect size (ηp2 = 0.08) was found for CDT performance with a higher change over time for IG (d = 0.57) compared to CG (d = 0.05). The ANCOVA with baseline-adjustment indicated between-group differences with a large and medium effect size at post-test for the TUG (ηp2 = 0.29) and SPPB (ηp2 = 0.06) performance, respectively, in favour of the IG. Within-group post-hoc analysis showed that the TUG performance was worsened in the CG (d = 0.65) and remained unchanged in the IG (d = 0.19). Furthermore, SPPB performance was increased (d = 0.58) in IG, but no relevant change over time was found for CG (d = 0.00).Conclusion: The current study suggests that an additional IHHE prior to aerobic cycling exercise seems to be more effective to increase global cognitive functions as well as physical performance and to preserve functional mobility in geriatric patients in comparison to aerobic exercise alone after a 6-week intervention period.

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Section: Discussionmentioning

confidence: 99%

Effects of Intermittent Hypoxia-Hyperoxia Exposure Prior to Aerobic Cycling Exercise on Physical and Cognitive Performance in Geriatric Patients—A Randomized Controlled Trial

et al. 2022

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“…After agreeing to be interviewed and signing a written consent, we arranged interviews in an independent interview room. The interview lasted about 1-2 h. It consisted of the following sessions: (1) an open-ended conversation to learn about the participants' life patterns and past medical history, (2) inquiry about the Clinical Dementia Rating (CDR), the activity of daily living (ADL), and the instrumental activities of daily living (IADLs), and (3) cognitive tests of the MMSE, MoCA, and ADAS-cog. Notably, the shared items of the three cognitive tests were not repeatedly given during the administration of cognitive tests.…”

Section: Participant Interview and Cognitive Testsmentioning

confidence: 99%

Normative Data of Mini-Mental State Examination, Montreal Cognitive Assessment, and Alzheimer’s Disease Assessment Scale-Cognitive Subscale of Community-Dwelling Older Adults in Taiwan

Wei

Chen

Lin

et al. 2022

Dement Geriatr Cogn Disord

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Introduction: Appropriate tools and references are essential for evaluating individuals’ cognitive levels. This study validated the Taiwan version of the Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-cog) and provided normative data for the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and ADAS-cog in community-dwelling older adults. Methods: MMSE, MoCA, and ADAS-cog were administered to 150 nondemented healthy adults aged 55–85 years during 2018–2020 as part of the Northeastern Taiwan Community Medicine Research Cohort. ADAS-cog was translated from the original English version to traditional Chinese with cultural and language considerations in Taiwan. Cronbach’s alpha (α) tested the reliability of ADAS-cog, and Pearson correlations examined its external validity using MMSE and MoCA as comparisons. Normative data were generated and stratified by age and education, and the one-way analysis of variance compared scores between age and education groups. Another 20 hospital-acquired participants with cognitive impairment joined the 150 healthy participants. Comparisons in the Clinical Dementia Rating (CDR) tiers tested the discriminability of the tests for different cognitive levels. The area under the receiver operating characteristic curve (AUROC) analyzed the power of ADAS-cog in predicting CDR 0.5 from CDR 0. Results: The Taiwan version of ADAS-cog had fair reliability between items (α = 0.727) and good correlations to MMSE (r = −0.673, p < 0.001) and MoCA (r = −0.746, p < 0.001). The normative data of MMSE, MoCA, and ADAS-cog showed ladder changes with age (p = 0.006, 0.001, and 0.437) and education (p < 0.001, <0.001, and <0.001) in the 150 nondemented older adults. Next, in the 170 mixed participants from the communities and the hospital, MMSE, MoCA, and ADAS-cog scores were well differentiable between CDR 0, 0.5, and 1. In addition, ADAS-cog discriminated CDR 0.5 from 0 by an AUROC of 0.827 (p < 0.001). Discussion/Conclusion: The three structured cognitive tests consistently reflect cognitive levels of healthy older adults. The Taiwan version of ADAS-cog is compatible with MMSE and MoCA to distinguish people with mildly impaired from normal cognition. In addition, this study derived MMSE, MoCA, and ADAS-cog norms tailored to demographic factors. The findings highlight the need for stratification of age and education rather than applying a fixed cutoff for defining normal and abnormal cognition.

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“…Moreover, screenings may provide a concise picture of cognition, rather than a patchy frame of different cognitive functions (Riello et al., 2021 ). In many cases, for example, it is more useful to identify the general cognitive functioning of a patient rather than their specific disorders in order to evaluate day‐to‐day capacities (Block et al., 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Global Examination of Mental State: An open tool for the brief evaluation of cognition

et al. 2022

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Background The aim of this paper is to present a freely accessible new instrument for the evaluation of cognition: the Global Examination of Mental State (GEMS). Methods It is made up of 11 items tapping into a range of skills, such as Orientation in time and space, Memory, Working memory, Visuo‐spatial, Visuo‐constructional and Planning abilities, Perceptual and visual Attention, Language (Naming, Comprehension, and Verbal fluency), and Pragmatics. Results The psychometric strengths of this screening are: (1) extensive and updated normative data on the adult Italian population (from 18 to 100 years old); (2) absence of ceiling effect in healthy individuals, which allows to better detect interindividual variability; (3) comparison of the global scores with normative data taking into account Cognitive Reserve rather than only education, thus increasing diagnostic accuracy; (4) thresholds for significant change over time and the possibility to use parallel versions (GEMS‐A/GEMS‐B) for test‐retest; (5) solid psychometric properties and data on discriminant validity; and (6) free access to all materials (record forms, instructions, and cut‐off scores) on the web under a Creative Common License. Conclusions With all these characteristics, GEMS could be a very useful paper‐and‐pencil instrument for cognitive screening.

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The Role of Brief Global Cognitive Tests and Neuropsychological Expertise in the Detection and Differential Diagnosis of Dementia

Cited by 23 publications

References 64 publications

Effects of Intermittent Hypoxia-Hyperoxia Exposure Prior to Aerobic Cycling Exercise on Physical and Cognitive Performance in Geriatric Patients—A Randomized Controlled Trial

Effects of Intermittent Hypoxia-Hyperoxia Exposure Prior to Aerobic Cycling Exercise on Physical and Cognitive Performance in Geriatric Patients—A Randomized Controlled Trial

Normative Data of Mini-Mental State Examination, Montreal Cognitive Assessment, and Alzheimer’s Disease Assessment Scale-Cognitive Subscale of Community-Dwelling Older Adults in Taiwan

Global Examination of Mental State: An open tool for the brief evaluation of cognition

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