scholarly journals Predictive Factors of Rapid Cognitive Decline in Patients with Alzheimer Disease

2016 ◽  
Vol 6 (3) ◽  
pp. 549-558 ◽  
Author(s):  
Coralie Barbe ◽  
Isabella Morrone ◽  
J.L. Novella ◽  
Moustapha Dramé ◽  
Aurore Wolak-Thierry ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Cognitive Decline ◽  
Caregiver Burden ◽  
Predictive Factors ◽  
Mini Mental State Examination ◽  
Care Plan ◽  
Factors Associated ◽  
Medical Needs ◽  
Rapid Cognitive Decline ◽  
State Examination

Aim: To determine predictive factors associated with rapid cognitive decline (RCD) in elderly patients suffering from Alzheimer disease (AD). Methods: Patients suffering from mild to moderate AD were included. RCD was defined as the loss of at least 3 points on the Mini-Mental State Examination (MMSE) over 12 months. Factors associated with RCD were identified by logistic regression. Results: Among 123 patients included, 61 were followed up until 12 months. RCD occurred in 46% of patients (n = 28). Polymedication (p < 0.0001), the fact that the caregiver was the child or spouse of the patient (p < 0.0001) and autonomy for washing (p < 0.0001) were protective factors against RCD, while the presence of caregiver burden (p < 0.0001) was shown to be a risk factor for RCD. Conclusion: Early detection of the RCD risk in AD patients could make it possible to anticipate the patient’s medical needs and adjust the care plan for caregiver burden.

Predictors of Rapid Cognitive Decline in Patients with Mild-to-Moderate Alzheimer Disease: A Prospective Cohort Study with 12-Month Follow-Up Performed in Memory Clinics

2018 ◽  
Vol 45 (1-2) ◽  
pp. 56-65 ◽  
Author(s):  
Achille E. Tchalla ◽  
Jean-Pierre Clément ◽  
Isabelle Saulnier ◽  
Betty Beaumatin ◽  
Florent Lachal ◽  
...  
Keyword(s):  
Cohort Study ◽  
Alzheimer Disease ◽  
Cognitive Decline ◽  
Mmse Score ◽  
Female Gender ◽  
Psychotic Symptoms ◽  
Factors Associated ◽  
History Of ◽  
Rapid Cognitive Decline ◽  
Treatment Onset

Background/Aims: Alzheimer disease (AD) is particularly devastating, with no cure, no means of prevention, and no proven way to slow progression. AD is associated with the worsening of cognitive function attributable to a variety of factors of which little is known. Our main objective was to determine factors associated with rapid cognitive decline (RCD) in older AD patients. Methods: We conducted a 12-month, prospective, multi-centre cohort study. Community-living individuals aged ≥65 years with mild-to-moderate AD were included. RCD was defined as the loss of ≥3 points/year in the Mini-Mental State Examination (MMSE) score. Potential individual-level predictors were collected at baseline. Results: A total of 521 individuals were included. The mean age was 80.8 ± 9.0 years and 66.0% were females. The average baseline MMSE score was 20.5 ± 4.5. The incidence of RCD was 40.9% (95% confidence interval [CI], 36.7–45.1). RCD was more common in patients with moderate (53.5%) than mild (22.3%) AD. The factors associated with RCD were: a parental history of dementia (odds ratio [OR], 2.32 [95% CI, 1.24–4.21], p = 0.011), psychotic symptoms (OR, 2.06 [95% CI, 1.22–3.48], p = 0.007), malnutrition (OR, 1.61 [95% CI, 1.06–2.63], p = 0.028), and the female gender (OR, 1.48 [95% CI, 1.03–2.15], p = 0.036). An MMSE score < 20 at treatment onset was also associated with RCD (p < 0.001). Conclusion: The factors associated with RCD were an MMSE score < 20 at treatment onset, female gender, psychotic symptoms, malnutrition, and a family history of dementia. These results may be directly relevant to patients, their families, and their physicians, enabling early anticipation of difficult clinical trajectories and poor functional outcomes.

scholarly journals Atrial fibrillation, antithrombotic treatment, and cognitive aging

Neurology ◽  
2018 ◽  
Vol 91 (19) ◽  
pp. e1732-e1740 ◽  
Author(s):  
Mozhu Ding ◽  
Laura Fratiglioni ◽  
Kristina Johnell ◽  
Giola Santoni ◽  
Johan Fastbom ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Alzheimer Disease ◽  
Cognitive Decline ◽  
Mental State ◽  
Mini Mental State Examination ◽  
National Study ◽  
Antithrombotic Treatment ◽  
Increased Risk ◽  
Anticoagulant Drugs ◽  
State Examination

ObjectiveTo examine the association of atrial fibrillation (AF) with cognitive decline and dementia in old age, and to explore the cognitive benefit of antithrombotic treatment in patients with AF.MethodsThis population-based cohort study included 2,685 dementia-free participants from the Swedish National Study on Aging and Care in Kungsholmen, who were regularly examined from 2001–2004 to 2010–2013. AF was ascertained from clinical examination, ECG, and patient registry. Global cognitive function was assessed using the Mini-Mental State Examination. We followed the DSM-IV criteria for the diagnosis of dementia, the NINDS-AIREN (National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherché et l'Enseignement en Neurosciences) criteria for vascular dementia, and the NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association) criteria for Alzheimer disease. Data were analyzed using multiple linear mixed-effects and Cox regression models.ResultsWe identified 243 participants (9.1%) with AF at baseline. During the 9-year follow-up period, 279 participants (11.4%) developed AF and 399 (14.9%) developed dementia. As a time-varying variable, AF was significantly associated with a faster annual Mini-Mental State Examination decline (β coefficient = −0.24, 95% confidence interval [CI]: −0.31 to −0.16) and an increased hazard ratio (HR) of all-cause dementia (HR = 1.40, 95% CI: 1.11–1.77) and vascular and mixed dementia (HR = 1.88, 95% CI: 1.09–3.23), but not Alzheimer disease (HR = 1.33, 95% CI: 0.92–1.94). Among people with either prevalent or incident AF, use of anticoagulant drugs, but not antiplatelet treatment, was associated with a 60% decreased risk of dementia (HR = 0.40, 95% CI: 0.18–0.92).ConclusionAF is associated with a faster global cognitive decline and an increased risk of dementia in older people. Use of anticoagulant drugs may reduce dementia risk in patients with AF.

scholarly journals Mini mental state examination and evaluation of factors associated with cognitive decline in HIV/AIDS-infected people

2012 ◽  
Vol 34 (2) ◽  
Author(s):  
Ana Luiza Sereia ◽  
Miguel Spack Junior ◽  
Talita Perdigão Domiciano ◽  
Eliana Shimauti ◽  
Áurea Regina Telles Pupulin
Keyword(s):  
Cognitive Decline ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Infected People ◽  
Factors Associated ◽  
State Examination ◽  
Hiv Aids

scholarly journals Postoperative Delirium after Urological Surgery: A Literature Review

2019 ◽  
Vol 13 (3) ◽  
pp. 133-140 ◽  
Author(s):  
Ioannis Leotsakos ◽  
Ioannis Katafigiotis ◽  
Ofer N. Gofrit ◽  
Mordechai Duvdevani ◽  
Dionysios Mitropoulos
Keyword(s):  
Risk Factors ◽  
Literature Search ◽  
Postoperative Delirium ◽  
Mini Mental State Examination ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Factors Associated ◽  
Confusion Assessment ◽  
Urological Surgery ◽  
State Examination

Purpose: We aimed to thoroughly search and identify studies referring to risk factors associated with postoperative delirium (POD) in patients undergoing open as well as en-doscopic urological surgery. Methods: The review after a systematic literature search included 5 studies. Results: The incidence of POD was reported to be between 7.8 and 30% depending on the type of the urologic surgery, while in the majority of the studies the onset happened on the first postoperative day and the symptoms lasted 3 ± 0.8 days. Seventeen different risk factors for POD were identified and presented in detail. Conclusion: The Mini-Mental State Examination score and older age were significantly associated with the development of POD. However, the Confusion Assessment Method is very well validated against the diagnosis of delirium from the specialists.

Do cognitive complaints either predict future cognitive decline or reflect past cognitive decline? A longitudinal study of an elderly community sample

1997 ◽  
Vol 27 (1) ◽  
pp. 91-98 ◽  
Author(s):  
A. F. JORM ◽  
H. CHRISTENSEN ◽  
A. E. KORTEN ◽  
A. S. HENDERSON ◽  
P. A. JACOMB ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cognitive Decline ◽  
Mini Mental State Examination ◽  
Community Sample ◽  
Cognitive Change ◽  
Cognitive Disorder ◽  
Anxiety And Depression ◽  
Cognitive Complaints ◽  
Cognitive Changes ◽  
State Examination

Data from a two-wave longitudinal study of an elderly community sample were used to assess whether cognitive complaints either predict subsequent cognitive decline or reflect past cognitive decline. Cognitive complaints and cognitive functioning were assessed on two occasions three and a half years apart. Cognitive complaints at Wave 1 were found not to predict future cognitive change on the Mini-Mental State Examination, an episodic memory test or a test of mental speed. Similarly, cognitive complaints at Wave 2 were unrelated to past cognitive changes on these tests after statistically controlling for the effects of anxiety and depression. Furthermore, cognitive complaints did not predict either mortality (after controlling for anxiety and depression) or future dementia. These results are evidence against the inclusion of cognitive complaints in diagnostic criteria for proposed disorders such as age-associated memory impairment, mild cognitive disorder and ageing-associated cognitive decline.

Medical Complications Predict Cognitive Decline in Nondemented Hip Fracture Patients—Results of a Prospective Observational Study

2018 ◽  
Vol 31 (2) ◽  
pp. 84-89 ◽  
Author(s):  
Juliana Hack ◽  
Daphne Eschbach ◽  
Rene Aigner ◽  
Ludwig Oberkircher ◽  
Steffen Ruchholtz ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Influencing Factors ◽  
Hip Fractures ◽  
Mental State ◽  
Mini Mental State Examination ◽  
University Hospital ◽  
Medical Complications ◽  
Consecutive Series ◽  
State Examination

Objective: The aim of this study was to identify factors that are associated with cognitive decline in the long-term follow-up after hip fractures in previously nondemented patients. Methods: A consecutive series of 402 patients with hip fractures admitted to our university hospital were analyzed. After exclusion of all patients with preexisting dementia, 266 patients were included, of which 188 could be examined 6 months after surgery. Additional to several demographic data, cognitive ability was assessed using the Mini-Mental State Examination (MMSE). Patients with 19 or less points on the MMSE were considered demented. Furthermore, geriatric scores were recorded, as well as perioperative medical complications. Mini-Mental State Examination was performed again 6 months after surgery. Results: Of 188 previously nondemented patients, 12 (6.4%) patients showed a cognitive decline during the 6 months of follow-up. Multivariate regression analysis showed that age ( P = .040) and medical complications ( P = .048) were the only significant independent influencing factors for cognitive decline. Conclusions: In our patient population, the incidence of dementia exceeded the average age-appropriate cognitive decline. Significant independent influencing factors for cognitive decline were age and medical complications.

scholarly journals Interaction Between Odor Identification Deficit and APOE4 Predicts 6-Year Cognitive Decline in Elderly Individuals

2019 ◽  
Vol 50 (1) ◽  
pp. 3-13 ◽  
Author(s):  
Jonas K. Olofsson ◽  
Maria Larsson ◽  
Catalina Roa ◽  
Donald A. Wilson ◽  
Erika Jonsson Laukka
Keyword(s):  
Cognitive Decline ◽  
Mini Mental State Examination ◽  
Population Based ◽  
Odor Identification ◽  
National Study ◽  
Hierarchical Regression ◽  
Identification Performance ◽  
Elderly Individuals ◽  
Health Related ◽  
State Examination

AbstractOlfactory identification impairment might indicate future cognitive decline in elderly individuals. An unresolved question is to what extent this effect is dependent on the ApoE-ε4, a genotype associated with risk of Alzheimer’s Disease (AD). Given the current concern about reproducibility in empirical research, we assessed this issue in a large sample (n = 1637) of older adults (60 – 96 years) from the population-based longitudinal Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). A hierarchical regression analysis was carried out to determine if a low score on an odor identification test, and the presence of ApoE-ε4, would predict the magnitude of a prospective 6-year change in the Mini-Mental State Examination (MMSE) after controlling for demographic, health-related, and cognitive variables. We found that overall, lower odor identification performance was predictive of cognitive decline, and, as hypothesized, we found that the effect was most pronounced among ApoE-ε4 carriers. Our results from this high-powered sample suggest that in elderly carriers of the ApoE-ε4 allele, odor identification impairment provides an indication of future cognitive decline, which has relevance for the prognosis of AD.

Effects of Inappropriate Sexual Behaviors and Neuropsychiatric Symptoms of Patients With Alzheimer Disease and Caregivers’ Depression on Caregiver Burden

2019 ◽  
Vol 33 (5) ◽  
pp. 243-249 ◽  
Author(s):  
Faik Ilik ◽  
Hüseyin Büyükgöl ◽  
Fatih Kayhan ◽  
Devrimsel Harika Ertem ◽  
Timur Ekiz
Keyword(s):  
Alzheimer Disease ◽  
Caregiver Burden ◽  
Sexual Behaviors ◽  
Rating Scale ◽  
Neuropsychiatric Symptoms ◽  
Clinical Dementia Rating ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Prevalence Of Depression ◽  
State Examination

Objective: We investigated the effects of inappropriate sexual behaviors (ISBs) and neuropsychiatric symptoms (NPSs) of patients with Alzheimer disease (AD), and of caregivers’ depression, on the caregiver burden. Method: One hundred forty three patients with AD and their caregivers were included in the study. Sixty-five patients without AD who needed care due to their disability and their caregivers were enrolled for the comparison. Depression in caregivers was diagnosed using The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (SCID-I). The Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Scale were used to evaluate the severity of AD. The Neuropsychiatric Inventory (NPI) was used to assess the NPSs of patients. Caregiver burden was evaluated using the Zarit Burden Interview (ZBI). Results: Inappropriate sexual behaviors were found in 13 (9.1%) of the AD group. Inappropriate sexual behaviors were more common in moderate or severe AD ( P = .009, χ2 = 9.396). The prevalence of depression (n = 38, 26.6%) was higher in caregivers of AD group with ISBs ( P = .000, χ2 = 24.69). The ZBI scores of caregivers of patients with AD were higher than the comparison group. In addition, the ZBI scores of caregivers of patients with AD were significantly higher in the AD group with ISB, a high total score of NPI, and a low score of MMSE. The caregivers of AD group with depression had higher ZBI scores ( P < .05). Conclusions: The severity of AD, the presence of NPSs in patients, and major depression in caregivers were risk factors for an increased caregiver burden.

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