Cross validation of the Montreal Cognitive Assessment in community dwelling older adults residing in the Southeastern US

2009 ◽  
Vol 24 (2) ◽  
pp. 197-201 ◽  
Author(s):  
Cheryl A. Luis ◽  
Andrew P. Keegan ◽  
Michael Mullan
2014 ◽  
Author(s):  
Lauren B. Myers ◽  
Amanda E. Wakefield ◽  
Jacqueline Remondet Wall ◽  
Sarah E. Kuklish ◽  
Emily N. Luck ◽  
...  

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2275
Author(s):  
Razieh Hassannejad ◽  
Hamsa Sharrouf ◽  
Fahimeh Haghighatdoost ◽  
Ben Kirk ◽  
Farzad Amirabdollahian

Background: Metabolic Syndrome (MetS) is a cluster of risk factors for diabetes and cardiovascular diseases with pathophysiology strongly linked to aging. A range of circulatory metabolic biomarkers such as inflammatory adipokines have been associated with MetS; however, the diagnostic power of these markers as MetS risk correlates in elderly has yet to be elucidated. This cross-sectional study investigated the diagnostic power of circulatory metabolic biomarkers as MetS risk correlates in older adults. Methods: Hundred community dwelling older adults (mean age: 68.7 years) were recruited in a study, where their blood pressure, body composition and Pulse Wave Velocity (PWV) were measured; and their fasting capillary and venous blood were collected. The components of the MetS; and the serum concentrations of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Plasminogen Activator Inhibitor-I (PAI-I), Leptin, Adiponectin, Resistin, Cystatin-C, C-Reactive Protein (CRP), insulin and ferritin were measured within the laboratory, and the HOMA1-IR and Atherogenic Index of Plasma (AIP) were calculated. Results: Apart from other markers which were related with some cardiometabolic (CM) risk, after Bonferroni correction insulin had significant association with all components of Mets and AIP. These associations also remained significant in multivariate regression. The multivariate odds ratio (OR with 95% confidence interval (CI)) showed a statistically significant association between IL-6 (OR: 1.32 (1.06–1.64)), TNF-α (OR: 1.37 (1.02–1.84)), Resistin (OR: 1.27 (1.04–1.54)) and CRP (OR: 1.29 (1.09–1.54)) with MetS risk; however, these associations were not found when the model was adjusted for age, dietary intake and adiposity. In unadjusted models, insulin was consistently statistically associated with at least two CM risk factors (OR: 1.33 (1.16–1.53)) and MetS risk (OR: 1.24 (1.12–1.37)) and in adjusted models it was found to be associated with at least two CM risk factors and MetS risk (OR: 1.87 (1.24–2.83) and OR: 1.25 (1.09–1.43)) respectively. Area under curve (AUC) for receiver operating characteristics (ROC) demonstrated a good discriminatory diagnostics power of insulin with AUC: 0.775 (0.683–0.866) and 0.785 by cross validation and bootstrapping samples for at least two CM risk factors and AUC: 0.773 (0.653–0.893) and 0.783 by cross validation and bootstrapping samples for MetS risk. This was superior to all other AUC reported from the ROC analysis of other biomarkers. Area under precision-recall curve for insulin was also superior to all other markers (0.839 and 0.586 for at least two CM risk factors and MetS, respectively). Conclusion: Fasting serum insulin concentration was statistically linked with MetS and its risk, and this link is stronger than all other biomarkers. Our ROC analysis confirmed the discriminatory diagnostic power of insulin as CM and MetS risk correlate in older adults.


Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1310
Author(s):  
Carmen Moret-Tatay ◽  
Isabel Iborra-Marmolejo ◽  
María José Jorques-Infante ◽  
José Vicente Esteve-Rodrigo ◽  
Carla H. A. Schwanke ◽  
...  

Community-dwelling older adults have raised the scientific community’s interest during the COVID-19 era as their chronic conditions might be aggravated by the consequences of confinement. Digital devices in this field to monitor cognitive impairment are an emerging reality of an innovative nature. However, some groups may not have benefited from these developments as much as, for example, younger people. The aim of this manuscript is to carry out a review on the development of digital devices, and specifically virtual assistants, for the detection of cognitive impairment in older adults. After a screening process, eight studies were found under the given criteria, and this number was even smaller for those using virtual assistants. Given the opportunities offered by virtual assistants through techniques such as natural language processing, it seems imperative to take advantage of this opportunity for groups such as older adults.


2021 ◽  
pp. 153944922110218
Author(s):  
Timothy S. Marks ◽  
Gordon M. Giles ◽  
Muhammad O. Al-Heizan ◽  
Dorothy F. Edwards

Identification of functional cognitive deficits can facilitate intervention to improve outcomes among older adults. We aimed to determine if impairments on screening tests of cognition are associated with deficits in performance on a more extensive functional cognitive assessment. Using a cross-sectional study design we administered the Montreal Cognitive Assessment (MoCA), the Mini-Cog, the Menu Task, and Weekly Calendar Planning Activity (WCPA) to a convenience sample of 277 community-dwelling older adults (55–93 years old). We created impaired and unimpaired groups using an established cut-off score for each screening test and compared each group on WCPA scores. The WCPA scores that demonstrated significant differences across screening measures were: Accuracy, Efficiency, Strategies, Rules, and Appointments Entered. Effect sizes for the WCPA scores Accuracy and Efficiency were large. Each screening test demonstrated discriminant validity on select WCPA scores and appear to be appropriate for use as screening tests of functional cognition.


2019 ◽  
Author(s):  
Golden Mwakibo Masika ◽  
Doris S.F. Yu ◽  
Polly W.C. Li ◽  
Adrian Wong ◽  
Rose S.Y. Lin

Abstract Introduction The prevalence of dementia in Tanzania, as in other developing countries is progressively increasing. Yet international screening instruments for mild cognitive impairment are lacking. The aim of this study was to determine the psychometrics and the diagnostic ability of the Montreal Cognitive Assessment 5 minutes protocol (MoCA-5-min) among older adult in the rural Tanzania. Methods The MoCA-5-min and the IDEA cognitive screening were concurrently administered through face to face to 202 community-dwelling older adults in Chamwino district. Exploratory factor analysis (EFA) using principal component method and oblique rotation was performed to determine the underlying factor structure of the scale. The concurrent, construct as well as predictive validities of the MoCA-5-min were examined by comparing its score with IDEA cognitive screening and psychiatrist’s diagnosis using DSM-V criteria respectively. Results The EFA found that all the MoCA-5-min items highly loaded into one component, with factor loading ranging from 0.550 to 0.879. The intraclass correlation coefficient for 6 weeks test-retest reliability was 0.85. Its strong significant correlation with the IDEA screening (Pearson's r = 0.614, p < 0.001) demonstrated a good concurrent validity. Using the psychiatrist’s rating as the gold standard, MoCA-5-min demonstrated the optimal cut-off score for MCI at 22, which yielded the sensitivity of 80% and specificity of 74%; and dementia at score of 16 giving a sensitivity of 90% and specificity of 80%. Upon stratifying the sample into different age groups, the optimal cut-off scores tended to decrease with the increase in age. Conclusion The MoCA-5-min is reliable and provides a valid and accurate measure of cognitive decline among older population in the rural settings of Tanzania. The use of varying cut-off scores across age groups may ensure more precise discriminatory power of the MoCA-5-min.


2014 ◽  
Vol 27 (2) ◽  
pp. 243-250 ◽  
Author(s):  
Elizabeth E. MacDougall ◽  
William E. Mansbach ◽  
Kristen Clark ◽  
Ryan A. Mace

ABSTRACTBackground:Cognitive impairment is underrecognized and misdiagnosed among community-dwelling older adults. At present, there is no consensus about which cognitive screening tool represents the “gold standard.” However, one tool that shows promise is the Brief Cognitive Assessment Tool (BCAT), which was originally validated in an assisted living sample and contains a multi-level memory component (e.g. word lists and story recall items) and complex executive functions features (e.g. judgment, set-shifting, and problem-solving).Methods:The present study cross-validated the BCAT in a sample of 75 community-dwelling older adults. Participants completed a short battery of several individually administered cognitive tests, including the BCAT and the Montreal Cognitive Assessment (MoCA). Using a very conservative MoCA cut score of <26, the base rate of cognitive impairment in this sample was 35%.Results:Adequate internal consistency and strong evidence of construct validity were found. A receiver operating characteristic (ROC) curve was calculated from sensitivity and 1-specificity values for the classification of cognitively impaired versus cognitively unimpaired. The area under the ROC curve (AUC) for the BCAT was .90,p< 0.001, 95% CI [0.83, 0.97]. A BCAT cut-score of 45 (scores below 45 suggesting cognitive impairment) resulted in the best balance between sensitivity (0.81) and specificity (0.80).Conclusions:A BCAT cut-score can be used for identifying persons to be referred to appropriate healthcare professionals for more comprehensive cognitive assessment. In addition, guidelines are provided for clinicians to interpret separate BCAT memory and executive dysfunction component scores.


2020 ◽  
Author(s):  
Junta Takahashi ◽  
Hisashi Kawai ◽  
Hiroyuki Suzuki ◽  
Yoshinori Fujiwara ◽  
Yutaka Watanabe ◽  
...  

BACKGROUND The Computer-Based Cognitive Assessment Tool (CompBased-CAT) has been reported to have concurrent validity with the Mini-Mental State Examination (MMSE) and discriminating ability for dementia, but it was not clear whether it could predict incidence of cognitive impairment. OBJECTIVE This study examined the ability of the CompBased-CAT to predict mild cognitive impairment (MCI) after 2 years among community-dwelling older adults. METHODS A longitudinal study was conducted, involving 455 older adults (median age 72 years, range 65-89 years, 62.0% female) dwelling in communities. Cognitive function was assessed using the MMSE. MCI was defined as an MMSE score <27. The CompBased-CAT was conducted at baseline, and each sub-test score was converted to a Z-score, the sum of which became the total Z-score. Receiver Operating Characteristic (ROC) curve analysis was performed to determine the predictive ability of the CompBased-CAT for incidence of MCI. Logistic regression analysis was conducted with the dependent variable (the incidence of MCI), and with the total Z-score as the independent variable, adjusted for all other covariates. RESULTS After 2 years, 32 (7.0%) of participants developed MCI. ROC curve analysis showed an area under the curve of 0.79, a sensitivity of 0.76, and a specificity of 0.75. Logistic regression analysis showed that total Z-score was significantly associated with prevention of MCI. The odds ratio (OR) was 1.34 (95% confidence interval 1.18-1.52, p<.001). CONCLUSIONS The present study showed that CompBased-CAT has sufficient predictive ability for MCI 2 years later and that it is useful for identifying dementia at an early stage.


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