scholarly journals A Virtual Supermarket Program for the Screening of Mild Cognitive Impairment in Older Adults: Diagnostic Accuracy Study

10.2196/30919 ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. e30919
Author(s):  
Mingli Yan ◽  
Huiru Yin ◽  
Qiuyan Meng ◽  
Shuo Wang ◽  
Yiwen Ding ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Concurrent Validity ◽  
Cutoff Score ◽  
Strong Positive Correlation ◽  
Healthy Controls ◽  
Optimal Cutoff ◽  
Retest Reliability ◽  
Positive Correlation

Background Mild cognitive impairment (MCI) is often a precursor of dementia, and patients with MCI develop dementia at a higher rate than healthy older adults. Early detection of cognitive decline at the MCI stage supports better planning of care and interventions. At present, the use of virtual reality (VR) in screening for MCI in older adults is promising, but there is little evidence regarding the use of virtual supermarkets to screen for MCI. Objective The objectives of this study are to validate a VR game–based test, namely, the Virtual Supermarket Program (VSP), for differentiating patients with MCI and healthy controls and to identify cutoff scores for different age levels. Methods Subjects were recruited from several nursing homes and communities in Changchun, China. They were divided into a healthy control group (n=64) and an MCI group (n=62). All subjects were administered the VSP and a series of neuropsychological examinations. The study determined the optimal cutoff, discriminating validity, concurrent validity, and retest reliability of the VSP. We used the area under the receiver operating characteristic curve (AUC) to evaluate the discriminating validity and obtain the optimal cutoff values. Pearson correlation analysis and the intraclass correlation coefficient were used to evaluate the concurrent validity and retest reliability, respectively. Results A cutoff score of 46.4 was optimal for the entire sample, yielding a sensitivity of 85.9% and specificity of 79.0% for differentiating individuals with MCI and healthy controls, and the AUC was 0.870 (95% CI 0.799-0.924). The median index of VSP score was 51.1 (range 42.6-60.0). There was a moderate positive correlation between the VSP total score and Mini-Mental State Examination score (r=0.429, P<.001). There was a strong positive correlation between VSP total score and Montreal Cognitive Assessment score (r=0.645, P<.001). The retest reliability of the VSP was feasible (r=0.588, P=.048). Conclusions The VSP is interesting and feasible for subjects. It shows high sensitivity and specificity for the identification of MCI in older adults, which makes it a promising screening method. The VSP may be generalized to older adults in other countries, although some cultural adaptation may be necessary. Trial Registration Chinese Clinical Trial Registry ChiCTR2000040074; https://www.chictr.org.cn/showprojen.aspx?proj=64639

Virtual Supermarket Program for the Screening of Mild Cognitive Impairment in Older Adults: Feasibility Study (Preprint)

2021 ◽  
Author(s):  
Mingli Yan ◽  
Huiru Yin ◽  
Qiuyan Meng ◽  
Shuo Wang ◽  
Yiwen Ding ◽  
...  
Keyword(s):  
Older Adults ◽  
Clinical Trial ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Concurrent Validity ◽  
Trial Registry ◽  
Clinical Trial Registry ◽  
Optimal Cutoff ◽  
Retest Reliability ◽  
Registration Number

BACKGROUND Mild cognitive impairment (MCI) is often a precursor of dementia, and MCI patients develop dementia at a higher rate than healthy older adults. Early detection of cognitive decline at the MCI stage supports better planning of care and interventions. At present, the use of virtual reality (VR) in screening for MCI in older adults is promising, but there is little evidence on the use of virtual supermarkets to screen for MCI. OBJECTIVE The objectives were to validate a VR game-based test, namely, the Virtual Supermarket Program (VSP), for differentiating MCI patients and healthy controls (HCs) and to identify cutoff scores for different age levels. METHODS Subjects were recruited from several nursing homes and communities in Changchun, China. They were divided into an HC group (N = 64) and an MCI group (N = 62). All subjects were administered the VSP and a series of neuropsychological examinations. The study determined the optimal cutoff, discriminating validity, concurrent validity and retest reliability of the VSP. We used the area under the curve (AUC) of the receiver operating characteristic to evaluate the discriminating validity and obtain the optimal cutoff values. Pearson correlation analysis and the intraclass correlation coefficient were used to evaluate the concurrent validity and retest reliability, respectively. RESULTS A cutoff score of 46.4 was optimal for the entire sample, yielding a sensitivity of 85.9% and a specificity of 79.0% for differentiating those with MCI and HCs, and the AUC was 0.870 (95% CI = 0.799~0.924). The median index of VSP score was 51.1, and the score range was 42.6 to 60.0. There was a moderate positive correlation between VSP total score and Mini-Mental State Examination score (r = 0.429, P < .001). There was a strong positive correlation between VSP total score and Montreal Cognitive Assessment score (r = 0.645, P < .001). The retest reliability of the VSP was feasible (r = 0.588, P = .048). CONCLUSIONS The VSP is interesting and feasible for subjects. It shows high sensitivity and specificity for the identification of MCI in older adults, which makes it a promising screening method. The VSP may be generalized to older adults in other countries, although some cultural adaptation may be necessary. Trial Registration: The study was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2000040074). CLINICALTRIAL Trial Registration: The study was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2000040074).

scholarly journals Similar Theory of Mind Deficits in Community Dwelling Older Adults with Vascular Risk Profile and Patients with Mild Cognitive Impairment: The Case of Paradoxical Sarcasm Comprehension

2021 ◽  
Vol 11 (5) ◽  
pp. 627
Author(s):  
Glykeria Tsentidou ◽  
Despina Moraitou ◽  
Magda Tsolaki
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Theory Of Mind ◽  
Vascular Risk Factors ◽  
Community Dwelling ◽  
Healthy Controls ◽  
Vascular Risk ◽  
Prediction And Prevention

Recent studies deal with disorders and deficits caused by vascular syndrome in efforts for prediction and prevention. Cardiovascular health declines with age due to vascular risk factors, and this leads to an increasing risk of cognitive decline. Mild cognitive impairment (MCI) is defined as the negative cognitive changes beyond what is expected in normal aging. The purpose of the study was to compare older adults with vascular risk factors (VRF), MCI patients, and healthy controls (HC) in social cognition and especially in theory of mind ability (ToM). The sample comprised a total of 109 adults, aged 50 to 85 years (M = 66.09, SD = 9.02). They were divided into three groups: (a) older adults with VRF, (b) MCI patients, and (c) healthy controls (HC). VRF and MCI did not differ significantly in age, educational level or gender as was the case with HC. Specifically, for assessing ToM, a social inference test was used, which was designed to measure sarcasm comprehension. Results showed that the performance of the VRF group and MCI patients is not differentiated, while HC performed higher compared to the other two groups. The findings may imply that the development of a vascular disorder affecting vessels of the brain is associated from its “first steps” to ToM decline, at least regarding specific aspects of it, such as paradoxical sarcasm understanding.

scholarly journals Assessing a Sensory-Motor-Cognition Triad in Amnestic Mild Cognitive Impairment With Dichotic Listening While Walking: A Dual-Task Paradigm

2021 ◽  
Vol 13 ◽  
Author(s):  
Marta Maria Gorecka ◽  
Olena Vasylenko ◽  
Knut Waterloo ◽  
Claudia Rodríguez-Aranda
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Attentional Control ◽  
Dichotic Listening ◽  
Healthy Controls ◽  
Hearing Acuity ◽  
Amci Group ◽  
Dual Task Paradigm

A contemporary topic in aging research relates to the significance of cognitive changes proper to mild cognitive impairment (MCI) to higher risk of falls and gait deteriorations. The present study addresses this question in the amnestic type of MCI (aMCI) by examining a triad of interrelated comorbidities occurring in the MCI condition: attentional impairments, hearing loss and gait disturbances. To this end, we applied a dichotic listening (DL) test during over-ground walking. DL assesses spontaneous and lateralized auditory attention in three conditions (i.e., free report or Non-forced (NF), Forced-Right (FR) ear and Forced-Left (FL) ear). Earlier reports suggest that this dual-task paradigm evoke asymmetric gait effects on healthy controls, which are moderated by degree of hearing loss. Therefore, the aim of the present study was to evaluate the effects of DL on bilateral (data from both limbs) and lateralized (each limb separately) gait outcomes in a group of forty-three aMCI participants (mean = 71.19) and fifty-two healthy older controls (mean = 70.90) by using hearing loss as a covariate in all analyses. Results showed the aMCI group presented overall compromised gait parameters, especially higher gait variability in all DL conditions during lateralized attentional control. These findings were observed bilaterally, and no lateralized effects on gait were observed. Only after controlling for hearing acuity, gait asymmetries on step length variability emerged almost exclusively in healthy controls. It was concluded that hearing loss in the aMCI group together with higher attentional impairments preclude aMCI individuals to properly execute DL and therefore, they do not display gait asymmetries. The present data demonstrate that varied demands on attentional control dependent on hearing acuity affects gait negatively in healthy older adults and aMCI individuals in very different ways. The appearance of asymmetric effects seems to be a perturbation related to normal aging, while the lack of asymmetries but exaggerated gait variability characterizes aMCI. The present findings show the intricate interplay of sensory, cognitive, and motor deteriorations in different group of older adults, which stresses the need of addressing co-occurring comorbidities behind gait perturbations in individuals prone to develop a dementia state.

scholarly journals Correlates of Sleep Disturbance among Older Adults with Mild Cognitive Impairment: A Cross-Sectional Study

2020 ◽  
Vol 17 (13) ◽  
pp. 4862
Author(s):  
Dan Song ◽  
Doris S. F. Yu ◽  
Qiuhua Sun ◽  
Guijuan He
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Sleep Disturbance ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Comorbidity Burden

Individuals with mild cognitive impairment (MCI) are at high risk for dementia development. Sleep disturbance is often overlooked in MCI, although it is an important risk factor of cognitive decline. In the absence of a cure for dementia, managing the risk factors of cognitive decline in MCI is likely to delay disease progression. To develop interventions for sleep disturbance in MCI, its related factors should be explored. This study aimed to identify and compare the correlates of sleep disturbance in older adults with MCI and those in cognitively healthy older adults. A comparative cross-sectional study was adopted. Data were obtained from 219 Chinese community-dwelling older adults (female: 70.3%), which consisted of 127 older adults with MCI and 92 age-matched cognitively healthy controls. The candidate correlates of sleep disturbance included socio-demographic correlates, health-related factors, lifestyle-related factors and psychological factor. Descriptive, correlational and regression statistics were used for data analysis. The prevalence of sleep disturbance in MCI was 70.1% compared to that of 56.5% in cognitively healthy controls (p < 0.001). The multivariate analysis indicated that, in participants with MCI, depressive symptoms (Beta = 0.297, p = 0.001), comorbidity burden (Beta = 0.215, p = 0.012) and physical activity (Beta = −0.297, p = 0.001) were associated with sleep disturbance. However, in the cognitively healthy controls, only depressive symptoms (Beta = 0.264, p = 0.028) and comorbidity burden (Beta = 0.361, p = 0.002) were associated with sleep disturbance. This finding highlights that sleep disturbance is sufficiently prominent to warrant evaluation and management in older adults with MCI. Furthermore, the findings elucidate several important areas to target in interventions aimed at promoting sleep in individuals with MCI.

scholarly journals Validation of the Malay Version of Addenbrooke’s Cognitive Examination III in Detecting Mild Cognitive Impairment and Dementia

2019 ◽  
Vol 9 (1) ◽  
pp. 66-76 ◽  
Author(s):  
Kwai Ching Kan ◽  
Ponnusamy Subramaniam ◽  
Nortina Shahrizaila ◽  
Shahrul Bahyah Kamaruzzaman ◽  
Rosdinom  Razali ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Intraclass Correlation ◽  
Area Under The Curve ◽  
Teaching Hospitals ◽  
Cutoff Score ◽  
Strong Positive Correlation ◽  
Validity And Reliability ◽  
State Examination ◽  
Addenbrooke’S Cognitive Examination

Background/Aims: This study aimed to investigate the validity and reliability of the Malay version of Addenbrooke’s Cognitive Examination III (ACE-III) for detecting mild cognitive impairment (MCI) and dementia. Methods: A total of 152 participants (dementia = 53, MCI = 38, controls = 61) were recruited from two teaching hospitals. The Malay version of ACE-III was translated following the standard guidelines for cross-cultural adaptation of measure. All the participants were assessed with the Malay version of ACE-III and Mini-Mental State Examination (MMSE). Results: The reliability of the Malay version of ACE-III was good with Cronbach’s α coefficient of 0.829 and intraclass correlation coefficient of 0.959. There was a strong positive correlation between the Malay version of ACE-III and MMSE (r = 0.806). Age (r = –0.335) and years of education (r = 0.536) exerted a significant correlation with total score performance. The cutoff score to discriminate dementia from healthy controls was 74/75 (sensitivity = 90.6%, specificity = 82.0%) whereas to discriminate MCI, the cutoff score was 77/78 (sensitivity = 63.2%, specificity = 63.9%). The diagnostic accuracy of ACE-III was higher than that of MMSE in the detection of dementia (area under the curve: ACE-III = 0.929 vs. MMSE = 0.915). Conclusions: The Malay version of ACE-III demonstrated to be a reliable and valid screening tool for dementia.

Accuracy of the Montreal Cognitive Assessment in Detecting Mild Cognitive Impairment and Dementia in the Rural African Population

2020 ◽  
Author(s):  
Golden M Masika ◽  
Doris S F Yu ◽  
Polly W C Li
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Cognitive Assessment ◽  
Concurrent Validity ◽  
Community Dwelling ◽  
Discriminatory Power ◽  
Screening Tools ◽  
Montreal Cognitive Assessment

Abstract Objective The incidence of dementia in the sub-Saharan Africa is rising. However, screening tools for cognitive decline that fits their linguistic and cultural context are lacking. The aim of this study was to determine the accuracy of the Kiswahili version of Montreal Cognitive Assessment (K-MoCA) to detect mild cognitive impairment or dementia among older adults in the rural Tanzania. Methods We recruited 259 community-dwelling older adults in Chamwino district, Tanzania. The concurrent validity and discriminatory power of K-MoCA were examined by comparing its score with IDEA cognitive screening and psychiatrist’s diagnosis using DSM-V, respectively. All the questionnaires were administered in face-to-face interview. Results K-MoCA demonstrated acceptable reliability (Cronbach’s alpha = 0.780). Concurrent validity was evident by its significant correlation with the IDEA screening test (Pearson’s r = 0.651, p &lt; 0.001). Using the psychiatrist’s rating as the reference, the optimal cut-off score for MCI and dementia was 19 and 15, respectively, which yielded the sensitivity of 70% and specificity of 60% for MCI, and sensitivity of 72% and specificity of 60% for dementia. Further analysis indicated that education and age influence performance on K-MoCA. Conclusion Overall, the K-MoCA is a reliable and valid tool for measuring cognitive decline. However, its limited discriminatory power for MCI and dementia may be compromised by the cultural irrelevance of some items.

Comparing cardiovascular risk factors in older persons with mild cognitive impairment and lifetime history of major depressive disorder

2021 ◽  
pp. 1-7
Author(s):  
Wael K. Karameh ◽  
Ines Kortebi ◽  
Sanjeev Kumar ◽  
Damien Gallagher ◽  
Angela Golas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Cardiovascular Risk ◽  
Mild Cognitive Impairment ◽  
Cardiovascular Risk Factors ◽  
Baseline Data ◽  
Healthy Controls ◽  
Lifetime History ◽  
History Of

ABSTRACT Objectives: To compare the prevalence of select cardiovascular risk factors (CVRFs) in patients with mild cognitive impairment (MCI) versus lifetime history of major depression disorder (MDD) and a normal comparison group using baseline data from the Prevention of Alzheimer’s Dementia with Cognitive Remediation plus Transcranial Direct Current Stimulation (PACt-MD) study. Design: Baseline data from a multi-centered intervention study of older adults with MCI, history of MDD, or combined MCI and history of MDD (PACt-MD) were analyzed. Setting: Community-based multi-centered study based in Toronto across 5 academic sites. Participants: Older adults with MCI, history of MDD, or combined MCI and history of MDD and healthy controls. Measurements: We examined the baseline distribution of smoking, hypertension and diabetes in three groups of participants aged 60+ years in the PACt-MD cohort study: MCI (n = 278), MDD (n = 95), and healthy older controls (n = 81). Generalized linear models were fitted to study the effect of CVRFs on MCI and MDD as well as neuropsychological composite scores. Results: A higher odds of hypertension among the MCI cohort compared to healthy controls (p < .05) was noted in unadjusted analysis. Statistical significance level was lost on adjusting for age, sex and education (p > .05). A history of hypertension was associated with lower performance in composite executive function (p < .05) and overall composite neuropsychological test score (p < .05) among a pooled cohort with MCI or MDD. Conclusions: This study reinforces the importance of treating modifiable CVRFs, specifically hypertension, as a means of mitigating cognitive decline in patients with at-risk cognitive conditions.

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