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A Comparative Study of the Behavioral Profile of the Behavioral Variant of Frontotemporal Dementia and Parkinson's Disease Dementia. 额颞叶痴呆行为变异型与帕金森氏症痴呆行为特征的比较研究
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-12-15 eCollection Date: 2020-09-01 DOI: 10.1159/000512042
Dinesh Saini, Adreesh Mukherjee, Arijit Roy, Atanu Biswas

Background: Executive dysfunction is the common thread between pure cortical dementia like the behavioral variant of frontotemporal dementia (bvFTD) and subcortical dementia like Parkinson's disease dementia (PDD). Although there are clinical and cognitive features to differentiate cortical and subcortical dementia, the behavioral symptoms differentiating these 2 conditions are still not well known.

Objective: To evaluate the behavioral profile of bvFTD and PDD and compare them to find out which behavioral symptoms can differentiate between the two.

Methods: Twenty consecutive patients with bvFTD (>1 year after diagnosis) and 20 PDD patients were recruited according to standard diagnostic criteria. Behavioral symptoms were collected from the reliable caregiver by means of a set of questionnaires and then compared between the 2 groups.

Results: bvFTD patients had more severe disease and more behavioral symptoms than PDD. bvFTD patients were different from PDD patients due to their significantly greater: loss of basic emotion (p < 0.001, odds ratio [OR] 44.33), loss of awareness of pain (p < 0.001, OR 44.33), disinhibition (p < 0.001, OR 35.29), utilization phenomenon (p = 0.008, OR 22.78), loss of taste discrimination (p < 0.001, OR 17), neglect of hygiene (p = 0.001, OR 13.22), loss of embarrassment (p = 0.003, OR 10.52), wandering (p = 0.004, OR 9.33), pacing (p = 0.014, OR 9), selfishness (p = 0.014, OR 9), increased smoking (p = 0.014, OR 9), increased alcohol consumption (p = 0.031, OR 7.36), social avoidance (p = 0.012, OR 6.93), mutism (p = 0.041, OR 5.67), and failure to recognize objects (p = 0.027, OR 4.33). The bvFTD patients were also significantly less suspicious (p = 0.001, OR 0.0295), less inclined to have a false belief that people were in their home (p = 0.014, OR 0.11) and had fewer visual illusions/hallucinations (p = 0.004, OR 0.107) than PDD patients.

Conclusion: Behavioral symptoms are helpful to distinguish bvFTD from PDD, and thus also cortical dementia with frontal-lobe dysfunction from subcortical dementia.

背景:执行功能障碍是额颞叶痴呆行为变异型(bvFTD)等纯皮质痴呆与帕金森病痴呆(PDD)等皮质下痴呆之间的共同点。虽然有一些临床和认知特征可以区分皮质性痴呆和皮质下痴呆,但区分这两种疾病的行为症状仍不十分清楚:评估 bvFTD 和 PDD 的行为特征,并将两者进行比较,以找出哪些行为症状可以区分这两种疾病:方法:根据标准诊断标准,连续招募 20 名 bvFTD 患者(确诊后超过 1 年)和 20 名 PDD 患者。结果:与 PDD 相比,bvFTD 患者的病情更严重,行为症状更多。bvFTD 患者与 PDD 患者的不同之处在于:基本情感丧失(p < 0.001,比值比 [OR] 44.33)、痛觉丧失(p < 0.001,OR 44.33)、抑制(p < 0.001,OR 35.29)、利用现象(p = 0.008,OR 22.78)、味觉辨别能力丧失(p < 0.001,OR 17)、忽视卫生(p = 0.001,OR 13.22)、窘迫感丧失(p = 0.003,OR 10.52)、游荡(p = 0.004,OR 9.33)、踱步(p = 0.014,OR 9)、自私(p = 0.014,OR 9)、吸烟增加(p = 0.014,OR 9)、饮酒增加(p = 0.031,OR 7.36)、社交回避(p = 0.012,OR 6.93)、缄默症(p = 0.041,OR 5.67)和无法识别物体(p = 0.027,OR 4.33)。与 PDD 患者相比,bvFTD 患者的多疑性(p = 0.001,OR 0.0295)、误认家中有人的倾向(p = 0.014,OR 0.11)和视觉错觉/幻觉(p = 0.004,OR 0.107)也明显减少:行为症状有助于区分bvFTD和PDD,因此也有助于区分额叶功能障碍的皮质痴呆和皮质下痴呆。
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引用次数: 0
Underestimation of Cognitive Impairment in Older Inpatients by the Abbreviated Mental Test Score versus the Montreal Cognitive Assessment: Cross-Sectional Observational Study. 通过简略智力测验得分与蒙特利尔认知评估低估老年住院患者的认知障碍:横断面观察研究。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-12-15 eCollection Date: 2020-09-01 DOI: 10.1159/000509357
Alexander Emery, James Wells, Stephen P Klaus, Melissa Mather, Ana Pessoa, Sarah T Pendlebury

Background/aims: Cognitive impairment is prevalent in older inpatients but may be unrecognized. Screening to identify cognitive deficits is therefore important to optimize care. The 10-point Abbreviated Mental Test Score (AMTS) is widely used in acute hospital settings but its reliability for mild versus more severe cognitive impairment is unknown. We therefore studied the AMTS versus the 30-point Montreal Cognitive Assessment (MoCA) in older (≥75 years) inpatients.

Methods: The AMTS and MoCA were administered to consecutive hospitalized patients at ≥72 h after admission in a prospective observational study. MoCA testing time was recorded. Reliability of the AMTS for the reference standard defined as mild (MoCA <26) or moderate/severe (MoCA <18) cognitive impairment was assessed using the area under the receiver-operating curve (AUC). Sensitivity, specificity, positive and negative predictive values of low AMTS (<8) for cognitive impairment were determined.

Results: Among 205 patients (mean/SD age = 84.9/6.3 years, 96 (46.8%) male, 74 (36.1%) dementia/delirium), mean/SD AMTS was 7.2/2.3, and mean/SD MoCA was 16.1/6.2 with mean/SD testing time = 17.9/7.2 min. 96/205 (46.8%) had low AMTS whereas 174/185 (94%) had low MoCA: 74/185 (40.0%) had mild and 100 (54.0%) had moderate/severe impairment. Moderate/severe cognitive impairment was more prevalent in the low versus the normal AMTS group: 74/83 (90%) versus 25/102 (25%, p < 0.0001). AUC of the AMTS for mild and moderate/severe impairment were 0.86 (95% CI = 0.80-0.93) and 0.88 (0.82-0.93), respectively. Specificity of AMTS <8 for both mild and moderate/severe cognitive impairment was high (100%, 71.5-100, and 92.7%, 84.8-97.3) but sensitivity was lower (44.8%, 37.0-52.8, and 72.8%, 62.6-81.6, respectively). The negative predictive value of AMTS <8 was therefore low for mild impairment (10.9%, 5.6-18.7) but much higher for moderate/severe impairment (75.2%, 65.7-83.3). All MoCA subtests discriminated between low and normal AMTS groups (all p < 0.0001, except p = 0.002 for repetition) but deficits in delayed recall, verbal fluency and visuo-executive function were prevalent even in the normal AMTS group.

Conclusion: The AMTS is highly specific but relatively insensitive for cognitive impairment: a quarter of those with normal AMTS had moderate/severe impairment on the MoCA with widespread deficits. The AMTS cannot therefore be used as a "rule-out" test, and more detailed cognitive assessment will be required in selected patients.

背景/目的:认知障碍在老年住院患者中普遍存在,但可能未被发现。因此,识别认知缺陷的筛查对于优化护理非常重要。10分简短智力测验分数(AMTS)广泛用于急性医院环境,但其对轻度和较严重认知障碍的可靠性尚不清楚。因此,我们研究了老年(≥75岁)住院患者的AMTS与30分蒙特利尔认知评估(MoCA)。方法:在前瞻性观察研究中,连续住院患者在入院后≥72 h给予AMTS和MoCA。记录MoCA测试时间。结果:205例患者(平均/SD年龄= 84.9/6.3岁,96例(46.8%)为男性,74例(36.1%)为痴呆/谵妄),平均/SD AMTS为7.2/2.3,平均/SD MoCA为16.1/6.2,平均/SD测试时间= 17.9/7.2分钟。96/205例(46.8%)为低AMTS, 174/185例(94%)为低MoCA, 74/185例(40.0%)为轻度,100例(54.0%)为中度/重度损害。中度/重度认知障碍在低AMTS组比正常AMTS组更普遍:74/83(90%)比25/102 (25%,p < 0.0001)。轻度和中度/重度损伤的AMTS AUC分别为0.86 (95% CI = 0.80-0.93)和0.88(0.82-0.93)。AMTS的特异性p < 0.0001,重复p = 0.002除外),但延迟回忆、语言流畅性和视觉执行功能的缺陷即使在正常AMTS组中也很普遍。结论:AMTS对认知障碍具有高度特异性,但相对不敏感:四分之一的AMTS正常患者在MoCA上有中度/重度损伤,并有广泛的缺陷。因此,AMTS不能用作“排除”测试,需要对选定的患者进行更详细的认知评估。
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引用次数: 6
Development of Chinese Versions of Quality of Life in Late-Stage Dementia and Cognitive Tests for Severe Dementia. 晚期痴呆患者生活质量中文版及重度痴呆患者认知测试的发展。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-12-09 eCollection Date: 2020-09-01 DOI: 10.1159/000511703
Suet-Lai Leung, Hiroyuki Tanaka, Timothy C Y Kwok

Introduction: Valid assessments of quality of life (QoL) and cognition are important in caring for individuals with severe dementia; there is an urgent need for validated assessment tools for specific populations. This study aimed to develop and validate Chinese versions of the Quality of Life in Late-Stage Dementia (QUALID-C) scale and the Cognitive Test for Severe Dementia (CTSD-C) for Chinese older adults.

Methods: This was a cross-sectional validation study comprised of 93 Chinese older adults with severe dementia recruited from 6 residential homes. The content and cultural validity of the QUALID-C and CTSD-C were evaluated by a 7-member expert panel, and interrater reliability, test-retest reliability, internal consistency, concurrent validity, and factorial structure were examined.

Results: The QUALID-C showed acceptable internal consistency (Cronbach α = 0.65), good interrater reliability (intraclass correlation coefficient [ICC] = 0.99), and good test-retest reliability (ICC = 0.96). Principal component analysis yielded 3 factors; the items loaded on the factors were comparable to those in previous studies and suggested the scale's multidimensionality to measure QoL. The CTSD-C showed satisfactory internal consistency (Cronbach α = 0.862), good interrater reliability (ICC = 0.99), and good test-retest reliability (ICC = 0.958). Principal component analysis yielded 3 factors; the items loaded on factors 1 and 2 resembled the items of the automatic response and attentional control factors of the original study.

Conclusion: The QUALID-C and the CTSD-C are reliable and valid scales to measure the QoL and cognitive functions of Chinese older adults with severe dementia. These assessments can be utilized to evaluate the effectiveness of treatment and future research work.

有效的生活质量(QoL)和认知评估对于照顾重度痴呆患者非常重要;迫切需要针对特定人群的有效评估工具。本研究旨在开发和验证中国老年人晚期痴呆生活质量量表(Quality - c)和重度痴呆认知测试(CTSD-C)的中文版。方法:这是一项横断面验证研究,包括来自6个住宅的93名中国重度痴呆老年人。QUALID-C和CTSD-C的内容和文化效度由7人专家小组评估,并检验了判读信度、重测信度、内部一致性、并发效度和析因结构。结果:quality - c具有良好的内部一致性(Cronbach α = 0.65),良好的组间信度(类内相关系数[ICC] = 0.99),良好的重测信度(ICC = 0.96)。主成分分析得到3个因子;这些因素所载的条目与以往的研究结果相当,表明该量表测量生活质量的多维性。CTSD-C具有良好的内部一致性(Cronbach α = 0.862)、良好的测间信度(ICC = 0.99)和良好的重测信度(ICC = 0.958)。主成分分析得到3个因子;加载因子1和因子2的项目与原研究的自动反应和注意控制因素的项目相似。结论:quality - c和CTSD-C量表是衡量我国老年重度痴呆患者生活质量和认知功能的可靠有效量表。这些评估可以用来评估治疗的有效性和未来的研究工作。
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引用次数: 1
Cognitive Function Is a Prognostic Factor for Mortality of Nursing Home Residents during a 3-Year Observational Period. 认知功能是疗养院居民3年观察期间死亡的预后因素。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-11-16 eCollection Date: 2020-09-01 DOI: 10.1159/000509543
Dorota Pytka, Bozena Czarkowska-Paczek

Introduction: Assessing cognitive function could help to provide appropriate care for nursing home residents. The aim of the study was to identify the factors affecting cognitive function in nursing home residents in Poland and assess how it influenced the mortality rate during a 3-year observational period.

Methods: This study included 202 elderly individuals from a nursing home in 2015. The investigation included examination of cognitive function using the MMSE and bioelectrical impedance analysis. Collected data included sex, age, blood pressure (BP), heart rate, number of comorbidities, years spent in the nursing home, educational level, and cigarette-smoking.

Results: The mean MMSE score was 21.36 ± 6.35, which was negatively correlated with age and diastolic BP (p = 0.001 and p = 0.024, respectively) and positively correlated with body mass, BMI, fat-free mass, fat, muscle mass, and education level (p = 0.004, p = 0.004, p = 002, p = 0.049, p = 0.005, and p ˂ 0.001, respectively). Patients who died during the observational period had lower MMSE scores than those who survived (23.34 ± 5.68 vs. 20.16 ± 6.45; p < 0.001). Smokers had better MMSE results than nonsmokers (23.34 ± 5.98 vs. 20.08 ± 4.94; p < 0.001).

Discussion: Polish nursing home residents had mild cognitive impairment depending on their age, sex, educational level, and nutritional status. Lower MMSE score was a prognostic factor for mortality in the 3-year observational period.

简介:评估认知功能有助于为养老院居民提供适当的护理。该研究的目的是确定影响波兰养老院居民认知功能的因素,并评估其如何影响3年观察期间的死亡率。方法:本研究纳入2015年某养老院的202名老年人。调查包括使用MMSE和生物电阻抗分析检查认知功能。收集的数据包括性别、年龄、血压(BP)、心率、合并症数量、在养老院度过的时间、教育水平和吸烟情况。结果:MMSE平均评分为21.36±6.35分,与年龄、舒张压呈负相关(p = 0.001、p = 0.024),与体重、BMI、无脂质量、脂肪、肌肉质量、文化程度呈正相关(p = 0.004、p = 0.004、p = 002、p = 0.049、p = 0.005、p小于0.001)。观察期内死亡患者的MMSE评分低于存活患者(23.34±5.68∶20.16±6.45;P < 0.001)。吸烟者的MMSE结果优于非吸烟者(23.34±5.98∶20.08±4.94;P < 0.001)。讨论:波兰养老院居民有轻度认知障碍取决于他们的年龄、性别、教育水平和营养状况。在3年的观察期内,较低的MMSE评分是死亡率的预后因素。
{"title":"Cognitive Function Is a Prognostic Factor for Mortality of Nursing Home Residents during a 3-Year Observational Period.","authors":"Dorota Pytka,&nbsp;Bozena Czarkowska-Paczek","doi":"10.1159/000509543","DOIUrl":"https://doi.org/10.1159/000509543","url":null,"abstract":"<p><strong>Introduction: </strong>Assessing cognitive function could help to provide appropriate care for nursing home residents. The aim of the study was to identify the factors affecting cognitive function in nursing home residents in Poland and assess how it influenced the mortality rate during a 3-year observational period.</p><p><strong>Methods: </strong>This study included 202 elderly individuals from a nursing home in 2015. The investigation included examination of cognitive function using the MMSE and bioelectrical impedance analysis. Collected data included sex, age, blood pressure (BP), heart rate, number of comorbidities, years spent in the nursing home, educational level, and cigarette-smoking.</p><p><strong>Results: </strong>The mean MMSE score was 21.36 ± 6.35, which was negatively correlated with age and diastolic BP (<i>p</i> = 0.001 and <i>p</i> = 0.024, respectively) and positively correlated with body mass, BMI, fat-free mass, fat, muscle mass, and education level (<i>p</i> = 0.004, <i>p</i> = 0.004, <i>p</i> = 002, <i>p</i> = 0.049, <i>p</i> = 0.005, and <i>p</i> ˂ 0.001, respectively). Patients who died during the observational period had lower MMSE scores than those who survived (23.34 ± 5.68 vs. 20.16 ± 6.45; <i>p</i> < 0.001). Smokers had better MMSE results than nonsmokers (23.34 ± 5.98 vs. 20.08 ± 4.94; <i>p</i> < 0.001).</p><p><strong>Discussion: </strong>Polish nursing home residents had mild cognitive impairment depending on their age, sex, educational level, and nutritional status. Lower MMSE score was a prognostic factor for mortality in the 3-year observational period.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"10 3","pages":"163-171"},"PeriodicalIF":2.3,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000509543","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38816733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Quality of Life in Elders with Suspected Alzheimer Disease: An Urban Health Centers-Based Study from Iran. 怀疑患有阿尔茨海默病的老年人的生活质量:一项来自伊朗城市卫生中心的研究
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-11-16 eCollection Date: 2020-09-01 DOI: 10.1159/000511397
Behnam Honarvar, Elahe Khaksar, Fatemeh Jafari, Mohammad Hassan Zahedroozegar, Sanaz Amiri

Background/aims: Quality of life (QOL) and Alzheimer disease (AD) among older people have been recognized as public health challenges. Here, we investigated the association between QOL and AD in the elders.

Methods: In this cross-sectional study, elderly people were selected from urban health centers (Shiraz, Iran) by multistage cluster random sampling and were interviewed using LEIPAD (for QOL) and Montreal Cognitive Assessment (for AD) questionnaires. The data was analyzed using Mplus (version 6.12) and IBM SPSS (version 25) software.

Results: The participants consisted of 182 elderly with a mean age of 67 ± 5.05 years, and 95 (52.2%) of them were females. There were 161 (88.5%) and 130 (71.4%) cases educated up to 12 years and married, respectively. Furthermore, 46 (25.3%) had low-to-moderate QOL, and 132 (72.5%) were suspected to have AD. QOL was inversely associated with AD, and men (β = -0.310) were more affected than women (β = -0.290). AD (β = -0.298), age (β = -0.288), hypertension (β = -0.267), education (β = 0.260), and body mass index (β = -0.198) were determinants of QOL. Also, physical activity was indirectly associated with QOL (β = 0.076). AD was correlated with the cognitive functioning component of QOL (r = -0.72).

Conclusion: One elder out of 4, did not have desirable QOL and 3 elders out of 4 were suspected to have AD. AD can decrease QOL among the older people. Screening of the elders for AD is recommended to improve their QOL by health centers.

背景/目的:老年人的生活质量(QOL)和阿尔茨海默病(AD)已被认为是公共卫生挑战。在这里,我们研究了老年人生活质量与AD之间的关系。方法:采用多阶段整群随机抽样的方法,在伊朗设拉子(Shiraz)的城市卫生中心抽取老年人,采用LEIPAD (QOL)和Montreal Cognitive Assessment (AD)问卷进行访谈。采用Mplus (version 6.12)软件和IBM SPSS (version 25)软件对数据进行分析。结果:老年人182人,平均年龄67±5.05岁,其中女性95人(52.2%)。受教育程度在12岁以下的有161例(88.5%),已婚的有130例(71.4%)。此外,46例(25.3%)生活质量中低,132例(72.5%)怀疑患有AD。生活质量与AD呈负相关,男性(β = -0.310)比女性(β = -0.290)受影响更大。AD (β = -0.298)、年龄(β = -0.288)、高血压(β = -0.267)、受教育程度(β = 0.260)和体重指数(β = -0.198)是影响生活质量的因素。体力活动与生活质量间接相关(β = 0.076)。AD与生活质量的认知功能成分相关(r = -0.72)。结论:1 / 4的老年人生活质量不理想,3 / 4的老年人怀疑患有AD。老年痴呆症会降低老年人的生活质量。健康中心建议对老年人进行阿尔茨海默病筛查以改善他们的生活质量。
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引用次数: 3
Cardiovascular Risk Factors, Cognitive Dysfunction, and Mild Cognitive Impairment. 心血管危险因素、认知功能障碍和轻度认知障碍。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-11-16 eCollection Date: 2020-09-01 DOI: 10.1159/000511103
Raul Vintimilla, Kishore Balasubramanian, James Hall, Leigh Johnson, Sid O'Bryant

Objectives: The present study sought to evaluate the contribution of cardiovascular risk factors to cognitive functioning in a sample of Mexican Americans diagnosed with mild cognitive impairment (MCI).

Methods: Hypertension, diabetes, dyslipidemia, and obesity were diagnosed based on self-report and/or standardized procedures. Cognitive function was measured with MMSE, Logical Memory I and II, Trail A & B, FAS, animal naming, and digit span tests. Independent samples t tests and two-way ANOVAs were conducted for analyses, adjusting for relevant covariates. We studied 100 Mexican Americans (65 female) with MCI, ages 50-86, from a longitudinal study of cognitive aging conducted at the University of North Texas Health Science Center.

Results: A difference between subjects with and without obesity and memory scores was shown by t tests. Two-way ANOVAs detected an association between the coexistence of hypertension and diabetes with language measures, diabetes and dyslipidemia with executive function, and diabetes and obesity with memory and language measures.

Conclusions: This study provides additional evidence about the link between cardiovascular risk factors and cognitive dysfunction in MCI subjects, and also demonstrated that comorbid risk factors increased the degree of cognitive deficit in many areas, which may indicate a higher risk of developing dementia.

目的:本研究旨在评估诊断为轻度认知障碍(MCI)的墨西哥裔美国人样本中心血管危险因素对认知功能的影响。方法:根据自我报告和/或标准化程序诊断高血压、糖尿病、血脂异常和肥胖。通过MMSE、逻辑记忆I和II、Trail A和B、FAS、动物命名和数字广度测试来测量认知功能。采用独立样本t检验和双向方差分析进行分析,并对相关协变量进行调整。我们研究了100名墨西哥裔美国人(65名女性)患有轻度认知障碍,年龄在50-86岁之间,来自北德克萨斯大学健康科学中心进行的认知衰老纵向研究。结果:肥胖和非肥胖受试者之间的差异和记忆得分通过t检验显示。双向方差分析发现高血压和糖尿病共存与语言测量、糖尿病和血脂异常与执行功能、糖尿病和肥胖与记忆和语言测量之间存在关联。结论:本研究为MCI受试者的心血管危险因素与认知功能障碍之间的联系提供了额外的证据,同时也证明了合并症危险因素增加了许多领域的认知缺陷程度,这可能表明发生痴呆的风险更高。
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引用次数: 5
The Effect of the Feuerstein Project on the Cognitive and Functional State of Community-Dwelling Individuals Aged 65 Years and Older with Mild Cognitive Impairment: A Pilot Study. Feuerstein项目对65岁及以上轻度认知障碍社区居民认知和功能状态影响的初步研究
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-11-13 eCollection Date: 2020-09-01 DOI: 10.1159/000509892
Uty Ostrei, Dikla Efrati-Chomsky, Ariela Zur, Yael Robes-Alkalay, Ayala Nave, Boris Punchik, Yan Press

Background: The rate of elderly individuals with mild cognitive impairment (MCI) has increased over recent decades. The Feuerstein Instrumental Enrichment (FIE) program for the elderly has been shown to be effective in various age groups but is has never been tested as a treatment for MCI in elderly patients. The aim of this study was to assess the effect of the FIE on the cognitive and functional state of elderly patients with MCI.

Methods: This was an interventional pilot study in community-dwelling patients aged ≥65 years diagnosed with MCI in the previous year. The protocol included 30 twice-weekly 90-min sessions with a full neurocognitive evaluation prior to the intervention (v1), at its conclusion (v2), and half a year later (v3).

Results: Nine of the 15 recruited participants completed the study. The mean age was 76.2 years. Compared to v1 and v2, the only significant improvements found at v3 were in the "visual perception" subtest of the NeuroTrax test and the total score of the MOCA test (p = 0.048 and 0.028, respectively). The effect size was >0.7 (r = 0.7), indicating a moderate-to-high clinical significance. The results of the qualitative questionnaire were consistent with the positive effect of the group on the fostering of social ties, the motivation to learn, the cognitive contribution, and the development of a sense of self-efficacy.

Conclusion: The study findings support the conclusion that an intervention with a focus on cognitive exercising can promote a feeling of self-efficacy and preserve some cognitive skills.

背景:近几十年来,老年人轻度认知障碍(MCI)的发病率有所上升。针对老年人的Feuerstein仪器浓缩(FIE)计划已被证明对各种年龄组有效,但从未作为老年轻度认知损伤患者的治疗方法进行过测试。本研究的目的是评估FIE对老年轻度认知损伤患者认知和功能状态的影响。方法:这是一项介入性的试点研究,研究对象是年龄≥65岁的社区居住患者,他们在前一年被诊断为轻度认知损伤。该方案包括30次,每周两次,每次90分钟,在干预前(v1),干预结束时(v2)和半年后(v3)进行全面的神经认知评估。结果:15名被招募的参与者中有9人完成了研究。平均年龄为76.2岁。与v1和v2相比,v3的唯一显著改善是在NeuroTrax测试的“视觉感知”子测试和MOCA测试的总分中(p分别= 0.048和0.028)。效应量>0.7 (r = 0.7),具有中高临床意义。定性问卷的结果与小组在培养社会关系、学习动机、认知贡献和自我效能感的发展方面的积极作用是一致的。结论:研究结果支持这样的结论,即以认知锻炼为重点的干预可以促进自我效能感并保留一些认知技能。
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引用次数: 0
Impact of Confinement on the Burden of Caregivers of Patients with the Behavioral Variant of Frontotemporal Dementia and Alzheimer Disease during the COVID-19 Crisis in France. COVID-19危机期间,法国禁闭对额颞叶痴呆和阿尔茨海默病行为变异患者照顾者负担的影响
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-11-12 eCollection Date: 2020-09-01 DOI: 10.1159/000511416
Claire Boutoleau-Bretonnière, Hélène Pouclet-Courtemanche, Aurélie Gillet, Amélie Bernard, Anne-Laure Deruet, Inès Gouraud, Estelle Lamy, Aurélien Mazoué, Laëtitia Rocher, Cédric Bretonnière, Mohamad El Haj

Introduction: The clinical presentation of the behavioral variant of frontotemporal dementia (bvFTD) differs from that of Alzheimer disease (AD), with major impairments in behavioral functions in bvFTD and cognitive impairment in AD. Both behavioral disturbances in bvFTD and cognitive impairment in AD contribute to caregiver burden.

Objective: To investigate the impact of home confinement during the COVID-19 crisis on the burden of caregivers of bvFTD or AD patients.

Methods: During the COVID-19 lockdown in France, neurologists and neuropsychologists from the Memory Center of Nantes Hospital conducted teleconsultations for 38 AD patients and 38 bvFTD patients as well as for their caregivers. During these consultations, caregivers were invited to rate the change in their burden during home confinement. They were also invited to rate behavioral or emotional changes in the patients during, compared with before, the confinement.

Results: Twenty-two bvFTD caregivers and 14 AD caregivers experienced an increase in burden. For bvFTD caregivers, this increased burden occurred regardless of behavioral changes, while AD caregivers experienced an increased burden related to changes in patients' neuropsychiatric symptoms. Among the whole cohort, 2 factors were associated with increased caregiver burden: behavioral change and bvFTD.

Conclusion: The results demonstrate that during home confinement in the COVID-19 crisis, neuropsychiatric symptoms were the core factor that impacted caregiver burden in different ways depending on the disease.

前言:额颞叶痴呆(bvFTD)行为变异的临床表现不同于阿尔茨海默病(AD), bvFTD主要表现为行为功能障碍,AD表现为认知障碍。bvFTD患者的行为障碍和AD患者的认知障碍都加重了照顾者的负担。目的:探讨COVID-19危机期间居家隔离对bvFTD或AD患者护理人员负担的影响。方法:在法国COVID-19封锁期间,南特医院记忆中心的神经科医生和神经心理学家对38名AD患者和38名bvFTD患者及其护理人员进行了远程会诊。在这些咨询中,护理人员被邀请对其在家坐月子期间的负担变化进行评估。他们还被邀请对患者在禁闭期间的行为或情绪变化进行评分,并与禁闭前进行比较。结果:22名bvFTD护理人员和14名AD护理人员的负担增加。对于bvFTD护理人员,无论行为改变如何,这种增加的负担都会发生,而AD护理人员的负担增加与患者神经精神症状的变化有关。在整个队列中,2个因素与照顾者负担增加有关:行为改变和bvFTD。结论:新冠肺炎居家隔离期间,神经精神症状是影响照顾者负担的核心因素,不同疾病的影响方式不同。
{"title":"Impact of Confinement on the Burden of Caregivers of Patients with the Behavioral Variant of Frontotemporal Dementia and Alzheimer Disease during the COVID-19 Crisis in France.","authors":"Claire Boutoleau-Bretonnière,&nbsp;Hélène Pouclet-Courtemanche,&nbsp;Aurélie Gillet,&nbsp;Amélie Bernard,&nbsp;Anne-Laure Deruet,&nbsp;Inès Gouraud,&nbsp;Estelle Lamy,&nbsp;Aurélien Mazoué,&nbsp;Laëtitia Rocher,&nbsp;Cédric Bretonnière,&nbsp;Mohamad El Haj","doi":"10.1159/000511416","DOIUrl":"https://doi.org/10.1159/000511416","url":null,"abstract":"<p><strong>Introduction: </strong>The clinical presentation of the behavioral variant of frontotemporal dementia (bvFTD) differs from that of Alzheimer disease (AD), with major impairments in behavioral functions in bvFTD and cognitive impairment in AD. Both behavioral disturbances in bvFTD and cognitive impairment in AD contribute to caregiver burden.</p><p><strong>Objective: </strong>To investigate the impact of home confinement during the COVID-19 crisis on the burden of caregivers of bvFTD or AD patients.</p><p><strong>Methods: </strong>During the COVID-19 lockdown in France, neurologists and neuropsychologists from the Memory Center of Nantes Hospital conducted teleconsultations for 38 AD patients and 38 bvFTD patients as well as for their caregivers. During these consultations, caregivers were invited to rate the change in their burden during home confinement. They were also invited to rate behavioral or emotional changes in the patients during, compared with before, the confinement.</p><p><strong>Results: </strong>Twenty-two bvFTD caregivers and 14 AD caregivers experienced an increase in burden. For bvFTD caregivers, this increased burden occurred regardless of behavioral changes, while AD caregivers experienced an increased burden related to changes in patients' neuropsychiatric symptoms. Among the whole cohort, 2 factors were associated with increased caregiver burden: behavioral change and bvFTD.</p><p><strong>Conclusion: </strong>The results demonstrate that during home confinement in the COVID-19 crisis, neuropsychiatric symptoms were the core factor that impacted caregiver burden in different ways depending on the disease.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"10 3","pages":"127-134"},"PeriodicalIF":2.3,"publicationDate":"2020-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000511416","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39123328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 23
Social Cognition Deficits Are Pervasive across Both Classical and Overlap Frontotemporal Dementia Syndromes. 社会认知缺陷在经典和重叠额颞叶痴呆综合征中普遍存在。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-11-04 eCollection Date: 2020-09-01 DOI: 10.1159/000511329
Faheem Arshad, Avanthi Paplikar, Shailaja Mekala, Feba Varghese, Vandana Valiyaparambath Purushothaman, Darshini Jeevandra Kumar, Leena Shingavi, Seena Vengalil, Subasree Ramakrishnan, Ravi Yadav, Pramod Kumar Pal, Atchayaram Nalini, Suvarna Alladi

Objectives: Frontotemporal dementia (FTD) syndromes are a complex group of disorders characterised by profound changes in behaviour and cognition. Many of the observed behavioural abnormalities are now recognised to be due to impaired social cognition. While deficits in emotion recognition and empathy are well-recognised in behavioural-variant (Bv)FTD, limited information exists about the nature of social cognitive impairment in the language variant primary progressive aphasia (PPA) that includes progressive non-fluent aphasia (PNFA) and semantic dementia (SD), and in the motor variants FTD amyotrophic lateral sclerosis (FTD-ALS) and FTD progressive supranuclear palsy (FTD-PSP). This prospective study sought to explore the nature and profile of social cognition deficits across the spectrum of FTD.

Methods: Sixty patients on the FTD spectrum, i.e., classical (16 with BvFTD and 20 with PPA) and overlap FTD syndromes (13 with FTD-ALS and 11 with FTD-PSP) were evaluated by means of the social cognition tasks, the Interpersonal Reactivity Index (IRI) for empathy, and pictures of facial affect (POFA) for emotion recognition. General cognition and behaviour were also assessed.

Results: A significant impairment in emotion recognition and empathy was detected in both the classical and overlap FTD syndromes. The recognition of positive emotions was relatively preserved compared to that of negative emotions. Among the FTD subtypes, maximal impairment of empathy was demonstrated in FTD-PSP.

Conclusion: Social cognition impairment is pervasive across the spectrum of FTD disorders, and tests of emotion recognition and empathy are clinically useful to identify the nature of behavioural problems in both classical and overlap FTD. Our findings also have implications for understanding the neural basis of social cognition in FTD.

目的:额颞叶痴呆(FTD)综合征是一组复杂的疾病,其特征是行为和认知的深刻变化。许多观察到的行为异常现在被认为是由于社会认知受损。虽然情绪识别和共情缺陷在行为变异性(Bv)FTD中得到了很好的认识,但关于语言变异性原发性进行性失语症(PPA)(包括进行性非流利性失语症(PNFA)和语义性痴呆(SD))以及运动变异性FTD肌萎缩性侧索硬化症(FTD- als)和FTD进行性核上性麻痹(FTD- psp)的社会认知障碍的性质的信息有限。本前瞻性研究旨在探讨跨谱系FTD的社会认知缺陷的性质和概况。方法:采用社会认知任务、共情人际反应指数(IRI)和情绪识别面部表情图(POFA)对60例FTD患者进行评价,分别为典型型(BvFTD 16例、PPA 20例)和重叠型(FTD- als 13例、FTD- psp 11例)。一般认知和行为也被评估。结果:经典型和重叠型FTD均存在显著的情绪识别和共情功能障碍。与消极情绪相比,积极情绪的认知相对保持不变。在FTD亚型中,FTD- psp亚型表现出最大的共情损害。结论:社会认知障碍在各种FTD障碍中普遍存在,情绪识别和共情测试在临床上有助于识别经典和重叠型FTD的行为问题的性质。我们的研究结果也对理解FTD社会认知的神经基础具有启示意义。
{"title":"Social Cognition Deficits Are Pervasive across Both Classical and Overlap Frontotemporal Dementia Syndromes.","authors":"Faheem Arshad,&nbsp;Avanthi Paplikar,&nbsp;Shailaja Mekala,&nbsp;Feba Varghese,&nbsp;Vandana Valiyaparambath Purushothaman,&nbsp;Darshini Jeevandra Kumar,&nbsp;Leena Shingavi,&nbsp;Seena Vengalil,&nbsp;Subasree Ramakrishnan,&nbsp;Ravi Yadav,&nbsp;Pramod Kumar Pal,&nbsp;Atchayaram Nalini,&nbsp;Suvarna Alladi","doi":"10.1159/000511329","DOIUrl":"https://doi.org/10.1159/000511329","url":null,"abstract":"<p><strong>Objectives: </strong>Frontotemporal dementia (FTD) syndromes are a complex group of disorders characterised by profound changes in behaviour and cognition. Many of the observed behavioural abnormalities are now recognised to be due to impaired social cognition. While deficits in emotion recognition and empathy are well-recognised in behavioural-variant (Bv)FTD, limited information exists about the nature of social cognitive impairment in the language variant primary progressive aphasia (PPA) that includes progressive non-fluent aphasia (PNFA) and semantic dementia (SD), and in the motor variants FTD amyotrophic lateral sclerosis (FTD-ALS) and FTD progressive supranuclear palsy (FTD-PSP). This prospective study sought to explore the nature and profile of social cognition deficits across the spectrum of FTD.</p><p><strong>Methods: </strong>Sixty patients on the FTD spectrum, i.e., classical (16 with BvFTD and 20 with PPA) and overlap FTD syndromes (13 with FTD-ALS and 11 with FTD-PSP) were evaluated by means of the social cognition tasks, the Interpersonal Reactivity Index (IRI) for empathy, and pictures of facial affect (POFA) for emotion recognition. General cognition and behaviour were also assessed.</p><p><strong>Results: </strong>A significant impairment in emotion recognition and empathy was detected in both the classical and overlap FTD syndromes. The recognition of positive emotions was relatively preserved compared to that of negative emotions. Among the FTD subtypes, maximal impairment of empathy was demonstrated in FTD-PSP.</p><p><strong>Conclusion: </strong>Social cognition impairment is pervasive across the spectrum of FTD disorders, and tests of emotion recognition and empathy are clinically useful to identify the nature of behavioural problems in both classical and overlap FTD. Our findings also have implications for understanding the neural basis of social cognition in FTD.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"10 3","pages":"115-126"},"PeriodicalIF":2.3,"publicationDate":"2020-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000511329","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38750959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 12
Montreal Cognitive Assessment as Screening Measure for Mild and Major Neurocognitive Disorder in a Chilean Population. 蒙特利尔认知评估作为智利人群轻度和重度神经认知障碍的筛查措施。
IF 2.3 Q4 CLINICAL NEUROLOGY Pub Date : 2020-10-14 eCollection Date: 2020-09-01 DOI: 10.1159/000506280
Sebastian Bello-Lepe, María Francisca Alonso-Sánchez, Alonso Ortega, Marcelo Gaete, Marcela Veliz, Juan Lira, Claudia Paz Perez Salas

Background: The Montreal Cognitive Assessment (MoCA) is a sensitive screening instrument for mild neurocognitive disorder (mild NCD). However, cut-off scores and accuracy indices should be established using representative samples of the population. In this context, the aim of this study was to update the normative values, and diagnostic efficiency statistics of the MoCA to detect mild NCD in the Chilean population.

Methods: This study included 226 participants from the north, center, and south of the country, classified into 3 groups: healthy elderly (HE; n = 113), mild NCD (n = 65), and major neurocognitive disorder (major NCD; n = 48).

Results: The optimal cut-off score to discriminate mild NCD from HE participants was 20 points with a sensitivity of 82.8% and a specificity of 84.1%. The observed balance between sensitivity and specificity shows a good test performance either to confirm or discard a diagnosis. The cut-off between mild NCD and major NCD from HE participants was 19 points with 85.6% of sensitivity and 90.3% of specificity.

Conclusion: Overall diagnostic accuracy can be considered as outstanding (AUC ≥0.904) when discriminating HE from both mild NCD and major NCD. These results showed that the MoCA is a suitable tool to identify mild NCD and major NCD.

背景:蒙特利尔认知评估(MoCA)是一种敏感的轻度神经认知障碍(mild neurocognitive disorder, NCD)筛查工具。但是,应该使用具有代表性的总体样本来建立截止分数和准确性指标。在此背景下,本研究的目的是更新智利MoCA检测轻度非传染性疾病的规范性值和诊断效率统计数据。方法:本研究纳入226名来自全国北部、中部和南部的参与者,分为3组:健康老年人(HE;n = 113),轻度NCD (n = 65)和重度神经认知障碍(重度NCD;N = 48)。结果:区分轻度非传染性疾病和HE参与者的最佳临界值为20分,敏感性为82.8%,特异性为84.1%。观察到的敏感性和特异性之间的平衡表明,无论是确认诊断还是放弃诊断,测试性能都很好。HE参与者轻度非传染性疾病和重度非传染性疾病之间的临界值为19分,敏感性为85.6%,特异性为90.3%。结论:无论是轻度非传染性疾病还是重度非传染性疾病,HE的总体诊断准确率均可被认为是优秀的(AUC≥0.904)。这些结果表明,MoCA是鉴定轻度非传染性疾病和重度非传染性疾病的合适工具。
{"title":"Montreal Cognitive Assessment as Screening Measure for Mild and Major Neurocognitive Disorder in a Chilean Population.","authors":"Sebastian Bello-Lepe,&nbsp;María Francisca Alonso-Sánchez,&nbsp;Alonso Ortega,&nbsp;Marcelo Gaete,&nbsp;Marcela Veliz,&nbsp;Juan Lira,&nbsp;Claudia Paz Perez Salas","doi":"10.1159/000506280","DOIUrl":"https://doi.org/10.1159/000506280","url":null,"abstract":"<p><strong>Background: </strong>The Montreal Cognitive Assessment (MoCA) is a sensitive screening instrument for mild neurocognitive disorder (mild NCD). However, cut-off scores and accuracy indices should be established using representative samples of the population. In this context, the aim of this study was to update the normative values, and diagnostic efficiency statistics of the MoCA to detect mild NCD in the Chilean population.</p><p><strong>Methods: </strong>This study included 226 participants from the north, center, and south of the country, classified into 3 groups: healthy elderly (HE; <i>n</i> = 113), mild NCD (<i>n</i> = 65), and major neurocognitive disorder (major NCD; <i>n</i> = 48).</p><p><strong>Results: </strong>The optimal cut-off score to discriminate mild NCD from HE participants was 20 points with a sensitivity of 82.8% and a specificity of 84.1%. The observed balance between sensitivity and specificity shows a good test performance either to confirm or discard a diagnosis. The cut-off between mild NCD and major NCD from HE participants was 19 points with 85.6% of sensitivity and 90.3% of specificity.</p><p><strong>Conclusion: </strong>Overall diagnostic accuracy can be considered as outstanding (AUC ≥0.904) when discriminating HE from both mild NCD and major NCD. These results showed that the MoCA is a suitable tool to identify mild NCD and major NCD.</p>","PeriodicalId":38017,"journal":{"name":"Dementia and Geriatric Cognitive Disorders Extra","volume":"10 3","pages":"105-114"},"PeriodicalIF":2.3,"publicationDate":"2020-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000506280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38654251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 11
期刊
Dementia and Geriatric Cognitive Disorders Extra
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