The use of laboratory tests in patients with Mild Cognitive Impairment

Pereira, Ana; Couto, Frederico Simões do; Mendonça, Alexandre de

doi:10.3233/jad-2006-10109

Cited by 8 publications

(5 citation statements)

References 14 publications

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“…It is interesting to note that, in spite of vitamin B12 being tested as part of the standard laboratory diagnostic workup for patients with cognitive complaints at the Memory Clinic in Lisbon, only 3.2% of all MCI patients observed in this institution during the period of 2002 to 2012 had decreased serum values of vitamin B12, confirming a low frequency of vitamin B12 deficiency in MCI patients [6]. Nowadays, in clinical practice, the prevalence of reversible dementias is declining [42] and the identified metabolic abnormalities are often not the main cause responsible for the cognitive symptoms when compared with the neurodegenerative pathology [43].…”

Section: Discussionmentioning

confidence: 99%

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Do MCI patients with vitamin B12 deficiency have distinctive cognitive deficits?

et al. 2013

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BackgroundVitamin B12 deficiency is common in older people, and may be responsible for reversible dementia. Low serum vitamin B12 levels were also observed in patients with Mild Cognitive Impairment (MCI). It is not known whether patients with vitamin B12 deficiency have a distinctive profile of cognitive impairment different from the episodic memory deficit usually observed in MCI.ResultsFrom a cohort of 310 patients with MCI followed in a memory clinic in Lisbon, only 10 cases with vitamin B12 deficiency were found. From collaboration with other neurologists, 5 further patients with vitamin B12 deficiency were added. These cases were compared to MCI patients with normal vitamin B12 levels in a ratio 1:3. The duration of subjective cognitive symptoms was significantly shorter in MCI patients with B12 deficiency (1.2±1.0 years) as compared to MCI patients with normal vitamin B12 levels (3.4±3.0 years, p<0.001, Student’ t test). There were no statistically significant differences in the neuropsychological tests between MCI patients with and without vitamin B12 deficiency. Vitamin B12 was started in MCI patients with vitamin B12 deficiency, with no noticeable clinical improvement.ConclusionMCI patients with low levels of vitamin B12 had no particular profile of cognitive impairment, however vitamin B12 deficiency might have precipitated the onset of symptoms. The effect of vitamin B12 supplementation in patients with MCI and low vitamin B12 levels should be clarified by future prospective studies.

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Section: Discussionmentioning

confidence: 99%

“…In a consecutive series of patients observed in a memory clinic, 3.3% of patients with Mild Cognitive Impairment (MCI) had low serum values of vitamin B12 [6]. MCI is usually considered a transitional state between normal cognitive aging and dementia [7].…”

Section: Introductionmentioning

confidence: 99%

Do MCI patients with vitamin B12 deficiency have distinctive cognitive deficits?

et al. 2013

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“…of subjects > 65 years: 3103 (63.3%) 44.8% F Hyponatremia related to heart failure, liver cirrhosis, diabetes, malignancy, diuretic use Dementia diagnosed according to ICD-9-CM Furosemide, thiazides. Dosage not reported Hyponatremia as a predictor of dementia C. Fujisawa et al (2021) [ 49 ] Prospective cohort Not reported Serum sodium < 135 mEq/l Single at baseline 2982 82.0 (76.0–84.0) in hyponatremic vs 79.0 (75–83) in normonatremic Median years (IQR) 48% F Hyponatremia related to cardiac disease, liver disease, diabetes, diuretic use MMSE, FAB, Digit span forward, Digit span backward, category fluency, logical memory Type and dosage of diuretics not specified Association between hyponatremia and cognitive impairment, muscle mass, physical performance Gosch et al (2012) [ 13 ] Case control 128 ± 3.2 mEq/l (mean ± SD) in hyponatremic group Serum sodium < 135 mEq/l Single at admission 2880 78.6 (6.98) Mean years (SD) 75.6% F Hypo- (4.7%), and normo-osmolar (1.6%) hyponatremia, adverse drug reaction (15.5%), hyponatremia related to heart failure (3.1%), severe liver disease (0.8%), cancer (1.6%), adrenal insufficiency (1.6%), SIADH (0.8%) MMSE, clock completion Type and dosage of diuretic not specified Effect of hyponatremia on CGA Pereira et al (2006) [ 50 ] Prospective cohort Not reported Serum sodium < 135 mEq/l Single at baseline 306 74 (8.7) Mean years (SD) 50.33% F Not evaluated BLAD Not evaluated Frequency of laboratory abnormality in MCI and dementia Suárez et al (2020) [ …”

Section: Methodsmentioning

confidence: 99%

Hyponatremia and aging-related diseases: key player or innocent bystander? A systematic review

Fratangelo

Nguyen

2023

Syst Rev

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Background Hyponatremia is frequent in older age; whether it is a key player, a surrogate marker, or an innocent bystander in age-related diseases is still unclear. Objective: To understand the role of hyponatremia in falls, osteoporosis, fractures, and cognitive impairment in old patients. Method Eligibility criteria for study inclusions were: written in English, peer-reviewed observational and intervention studies, clinical trial, prospective and retrospective controlled cohort studies, and case-controlled studies without limitations regarding the date of publication. Information sources: Protocol available on the International Prospective Register of Systematic Reviews (PROSPERO, CRD42021218389). MEDLINE, Embase, and PsycINFO were searched. Final search done on August 8, 2021. Risk-of-bias assessment: Risk-of-Bias Assessment tool for Non-randomized Studies (RoBANS) and the Bradford Hill’s criteria for causality. Results Includes studies: One-hundred thirty-five articles retained for the revision. Synthesis of results — Falls: Eleven studies were included. Strong association between hyponatremia and falls in all the studies was found. Osteoporosis and fractures: nineteen articles were included. The association between hyponatremia and osteoporosis is unclear. Cognitive impairment: Five articles were included. No association between hyponatremia and cognitive impairment was found. Discussion Interpretation: Falls, osteoporosis, and fractures are multifactorial. Hyponatremia is not temporally related with the outcomes; we suggest that hyponatremia may be regarded as a marker of unhealthy aging and a confounder instead of a causal factor or an innocent bystander for falls and fractures. Concerning cognitive impairment, there are no evidence supporting a real role of hyponatremia to be regarded as an innocent bystander in neurodegeneration.

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“…published between 2006 and 2021 were included (12,33,(57)(58)(59). Three studies were prospective (57-59) and two retrospective (12,33) (Table 3).…”

Section: Hyponatremia and Cognitive Impairmentmentioning

confidence: 99%

Hyponatremia and aging-related diseases: key player or innocent bystander? A systematic review.

Fratangelo

Nguyen

2022

Preprint

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Purpose. Hyponatremia is frequent in older age, whether it is a key player, a surrogate marker, or an innocent bystander in age related diseases is still unclear. Method. To further understand the role of hyponatremia in falls, osteoporosis, fractures, and cognitive impairment in old patients, we conducted a systematic literature review. The protocol of this study is available on the International prospective register of systematic reviews (PROSPERO, number CRD42021218389). MEDLINE, EMBASE and PsycINFO database were searched. Three reviewers identified studies meeting inclusion criteria and check decisions. Each study was independently evaluated by two reviewers, discrepancies between the two reviewers were solved by the third. Two hundred and fifteen articles were retrieved. Thirty-two were included in the review. Results. The majority of the studies found a significant association between hyponatremia and falls even after correction for confounding factors. Some studies suggested an association between persistent hyponatremia and increased osteoporosis and fracture risk. On the contrary, the evidence of an association between hyponatremia and cognitive impairment is lacking. Conclusion. Here we suggest that hyponatremia may be regarded as a marker of unhealthy aging and a confounder rather than a causal factor or an innocent bystander for falls and fractures. As regards cognitive impairment, the evidence provided until now, are not sufficient to explain a real role of hyponatremia that may be regarded rather as an innocent bystander in neurodegeneration.

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The use of laboratory tests in patients with Mild Cognitive Impairment

Cited by 8 publications

References 14 publications

Do MCI patients with vitamin B12 deficiency have distinctive cognitive deficits?

Do MCI patients with vitamin B12 deficiency have distinctive cognitive deficits?

Hyponatremia and aging-related diseases: key player or innocent bystander? A systematic review

Hyponatremia and aging-related diseases: key player or innocent bystander? A systematic review.

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