Lower Levels of Education Are Associated with Cognitive Impairment in the Old Order Amish

2021 ◽  
Vol 79 (1) ◽  
pp. 451-458
Author(s):  
Jairo Ramos ◽  
Aneesa R. Chowdhury ◽  
Laura J. Caywood ◽  
Michael Prough ◽  
M. Denise Fuzzell ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Educational Attainment ◽  
Formal Education ◽  
Cognitive Status ◽  
Formal Schooling ◽  
Old Order Amish ◽  
Old Order ◽  
Normal Individuals ◽  
8Th Grade ◽  
State Examination

Background: Lower education has been reported to be associated with dementia. However, many studies have been done in settings where 12 years of formal education is the standard. Formal schooling in the Old Order Amish communities (OOA) ends at 8th grade which, along with their genetic homogeneity, makes it an interesting population to study the effect of education on cognitive impairment. Objective: The objective of this study was to examine the association of education with cognitive function in individuals from the OOA. We hypothesized that small differences in educational attainment at lower levels of formal education were associated with risk for cognitive impairment. Methods: Data of 2,426 individuals from the OOA aged 54–99 were analyzed. The Modified Mini-Mental State Examination (3MS-R) was used to classify participants as CI or normal. Individuals were classified into three education categories: <8, 8, and >8 years of education. To measure the association of education with cognitive status, a logistic regression model was performed adding age and sex as covariates. Results: Our results showed that individuals who attained lowest levels of education (<8 and 8) had a higher probability of becoming cognitvely impaired compared with people attending >8 years (OR = 2.96 and 1.85). Conclusion: Even within a setting of low levels of formal education, small differences in educational attainment can still be associated with the risk of cognitive impairment. Given the homogeneity of the OOA, these results are less likely to be biased by differences in socioeconomic backgrounds.

scholarly journals Preoperative Cognitive Impairment as a Predictor of Postoperative Outcomes in Elderly Patients Undergoing Spinal Surgery for Degenerative Spinal Disease

2021 ◽  
Vol 10 (7) ◽  
pp. 1385
Author(s):  
Hyung Cheol Kim ◽  
Seong Bae An ◽  
Hyeongseok Jeon ◽  
Tae Woo Kim ◽  
Jae Keun Oh ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Elderly Patients ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Operation Time ◽  
Cognitive Status ◽  
Blood Analysis ◽  
Spinal Disease ◽  
Degenerative Spinal Disease ◽  
State Examination

Cognitive status has been reported to affect the peri-operative and post-operative outcomes of certain surgical procedures. This prospective study investigated the effect of preoperative cognitive impairment on the postoperative course of elderly patients (n = 122, >65 years), following spine surgery for degenerative spinal disease. Data on demographic characteristics, medical history, and blood analysis results were collected. Preoperative cognition was assessed using the mini-mental state examination, and patients were divided into three groups: normal cognition, mild cognitive impairment, and moderate-to-severe cognitive impairment. Discharge destinations (p = 0.014) and postoperative cardiopulmonary complications (p = 0.037) significantly differed based on the cognitive status. Operation time (p = 0.049), white blood cell count (p = 0.022), platelet count (p = 0.013), the mini-mental state examination score (p = 0.033), and the Beck Depression Inventory score (p = 0.041) were significantly associated with the length of hospital stay. Our investigation demonstrated that improved understanding of preoperative cognitive status may be helpful in surgical decision-making and postoperative care of elderly patients with degenerative spinal disease.

scholarly journals Effect of Demographic and Health Dynamics on Cognitive Status in Mexico between 2001 and 2015: Evidence from the Mexican Health and Aging Study

Geriatrics ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 63
Author(s):  
Silvia Mejia-Arango ◽  
Jaqueline Avila ◽  
Brian Downer ◽  
Marc A. Garcia ◽  
Alejandra Michaels-Obregon ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cognitive Impairment ◽  
Cardiovascular Diseases ◽  
Educational Attainment ◽  
Access To Health Care ◽  
Sociodemographic Factors ◽  
Cognitive Status ◽  
Access To Health ◽  
Mexican Adults

Sources of health disparities such as educational attainment, cardiovascular risk factors, and access to health care affect cognitive impairment among older adults. To examine the extent to which these counteracting changes affect cognitive aging over time among Mexican older adults, we examine how sociodemographic factors, cardiovascular diseases, and their treatment relate to changes in cognitive function of Mexican adults aged 60 and older between 2001 and 2015. Self and proxy respondents were classified as dementia, cognitive impairment no dementia (CIND), and normal cognition. We use logistic regression models to examine the trends in dementia and CIND for men and women aged 60 years or older using pooled national samples of 6822 individuals in 2001 and 10,219 in 2015, and sociodemographic and health variables as covariates. We found higher likelihood of dementia and a lower risk of CIND in 2015 compared to 2001. These results remain after adjusting for sociodemographic factors, cardiovascular diseases, and their treatment. The improvements in educational attainment, treatment of diabetes and hypertension, and better access to health care in 2015 compared to 2001 may not have been enough to counteract the combined effects of aging, rural residence disadvantage, and higher risks of cardiovascular disease among older Mexican adults.

Influence of Cognitive Impairment on Rehabilitation Received and Its Mediating Effect on Functional Recovery

2021 ◽  
pp. 1-12
Author(s):  
Ilona Dutzi ◽  
Michael Schwenk ◽  
Marietta Kirchner ◽  
Eva Jooss ◽  
Jürgen M. Bauer ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Status ◽  
Mediating Effect ◽  
Future Research ◽  
Rehabilitation Outcome ◽  
Rehabilitation Outcomes ◽  
Rehabilitation Programs ◽  
Observational Cohort ◽  
The Relationship ◽  
State Examination

Background: Cognitive impairment (CI) has been reported to negatively impact rehabilitation outcomes. Knowledge about differences in rehabilitation received in dependence of CI as a potential mediating factor is limited. Objective: To analyze whether CI affects amount and frequency of rehabilitation received and if associations between CI and rehabilitation outcome are mediated by the provided amount of therapy. Methods: Observational cohort study in ward-based geriatric rehabilitation consecutively including 373 patients (mean age 82.0±6.69 years, mean MMSE 23.66±5.31). Outcome measures were amount, frequency, and type of multi-professional therapy sessions and rehabilitation outcome assessed with the Barthel Index (BI). Cognitive status was measured with the Mini-Mental-State Examination (MMSE) classifying three patient subgroups according to cognitive status were considered. Results: Patients with more severe CI received least total therapy hours (TTH) (MMSE <  17, 13.67±6.58 versus MMSE 17–26, 16.12±7.19 and MMSE >  26, 17.79±8.88 h, p = 0.014) and were less often included in occupational therapy (MMSE <  17, 48.9%versus MMSE 17–26, 65.5%and MMSE >  26, 71.4%, p = 0.019) and group-based physiotherapy (MMSE <  17, 73.3%versus MMSE 17–26, 88.5%and MMSE >  26, 81.2%, p = 0.027). Regression models showed that CI negatively impacted TTH (β= 0.24, p = 0.003) and rehabilitation outcome (β= 0.41, p = 0.008). In the mediation model, TTH accounted for 23.18%(p <  0.001) of the relationship between CI and rehabilitation outcome. Conclusion: Cognitive impairment negatively impacted rehabilitation received. The lower TTH partly mediated the negative association between CI and rehabilitation outcome. Future research should identify specific barriers to therapy provision and optimal length, intensity, and dosage of rehabilitation programs to optimize rehabilitation outcomes in CI.

Cognitive Functioning in Patients with Cerebral Aneurysms Measured with the Mini Mental State Examination and the Telephone Interview for Cognitive Status

Neurosurgery ◽  
2006 ◽  
Vol 59 (4) ◽  
pp. 803-811 ◽  
Author(s):  
Joseph T. King ◽  
Michael L. DiLuna ◽  
Domenic V. Cicchetti ◽  
Joel Tsevat ◽  
Mark S. Roberts
Keyword(s):  
Cognitive Impairment ◽  
Subarachnoid Hemorrhage ◽  
Cognitive Functioning ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Telephone Interview ◽  
Cerebral Aneurysms ◽  
Cognitive Status ◽  
State Examination

Abstract BACKGROUND: Clinicians and researchers use brief instruments, such as the Mini Mental State Examination (MMSE) and the Telephone Interview for Cognitive Status (TICS), to measure cognitive functioning in patients with cerebral aneurysms. MMSE and TICS scores are often dichotomized to classify patients as cognitively impaired or not. Frequently, after an initial MMSE face-to-face evaluation, the TICS is used for follow-up assessments by telephone. METHODS: A cross-sectional cohort of patients with cerebral aneurysms completed the MMSE at baseline and the MMSE or TICS at the 12-month follow-up examination. Multivariate logistic regression adjusting for demographics was used to model cognitive impairment. MMSE and TICS results were compared using the MMSE as the “gold standard.” RESULTS: Eleven out of 171 (6%) patients had baseline MMSE scores less than 24, indicating cognitive impairment. Multivariate analysis showed that a history of subarachnoid hemorrhage was associated with cognitive impairment measured with the MMSE (odds ratio, 13.9; P = 0.021; C statistic = 0.87); there was no relationship between subarachnoid hemorrhage or treatment and TICS cognitive impairment (i.e., score &lt; 27). In patients without recent or interim invasive interventions that might affect cognition (n = 65), raw baseline MMSE and 12-month TICS scores had fair correlations (r = 0.30, P = 0.015); however, dichotomized scores had poor agreement, and TICS sensitivity and positive predictive value was 0% compared with the MMSE. CONCLUSION: The MMSE may be more sensitive than the TICS to the effects of subarachnoid hemorrhage on cognitive functioning. Raw MMSE and TICS scores are well correlated, but dichotomized MMSE and TICS scores are probably not interchangeable in this patient population.

scholarly journals Soluble ST2 and risk of cognitive impairment after acute ischemic stroke: a prospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yinwei Zhu ◽  
Chongquan Fang ◽  
Qi Zhang ◽  
Yaling Lu ◽  
Rui Zhang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Acute Ischemic Stroke ◽  
Sex Education ◽  
Mmse Score ◽  
Cognitive Status ◽  
Stroke Patients ◽  
The Impact ◽  
State Examination ◽  
Conventional Risk Factors

Abstract Background Soluble suppression of tumorigenesis-2 (sST2) was reported to be associated with cognitive performance and risk of incident stroke. However, the impact of sST2 on cognitive function after ischemic stroke is unclear. We aimed to assess the association of sST2 and cognitive impairment at 3 months in acute ischemic stroke patients. Methods Baseline plasma sST2 levels were measured in 619 ischemic stroke patients (mean age: 60.0 ± 10.5 years) from 7 participating hospitals of the China Antihypertensive Trial in Acute Ischemic Stroke. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to assess cognitive status. Cognitive impairment was defined as a MoCA score < 23 or MMSE score < 27. The association between sST2 and cognitive impairment was evaluated by logistic regression analysis. Results 325 (52.5%) or 323 (52.2%) participants developed cognitive impairment according to MoCA or MMSE. After adjustment for age, sex, education, and other covariates, the odds ratio for the highest vs lowest quartile of sST2 was 2.38 (95% CI, 1.42–4.00) and 1.82 (95% CI 1.09–3.03) risk of cognitive impairment defined by MoCA and MMSE score, respectively. Incorporation sST2 into a model containing conventional risk factors significantly improved reclassification. Conclusions Elevated plasma sST2 levels were significantly associated with post-stroke cognitive impairment.

scholarly journals Comparative assessment of Montreal Cognitive Assessment (MOCA) and Minimental State Examination (MMSE) in apolipoprotein E (APOE) ɛ4 allele carriers in epilepsy

2016 ◽  
Vol 03 (01) ◽  
pp. 007-011 ◽  
Author(s):  
Amirthalingam Palanisamy ◽  
Natham Rajendran ◽  
Mukundhu Narmadha ◽  
Ruckmani Ganesvaran
Keyword(s):  
Cognitive Impairment ◽  
Apolipoprotein E ◽  
Cognitive Assessment ◽  
High Sensitivity ◽  
Educational Status ◽  
Cognitive Status ◽  
Montreal Cognitive Assessment ◽  
Normal Cognitive Function ◽  
E4 Allele ◽  
State Examination

AbstractBackground/Aim Mini mental state examination (MMSE) is a widely accepted tool till date to investigate cognitive status; however, its sensitivity is questioned by few studies. Alternately, Montreal cognitive assessment (MOCA) is considered more effective with high sensitivity to assess cognitive status than MMSE. The usefulness of MOCA is well established in assessing cognitive status in patients in various disorders. Apolipoprotein E (APOE) ɛ4 allele is identified as one of the risk factors associated with cognitive impairment on MMSE; however, the usefulness of MOCA on the association between APOE ɛ4 allele and cognitive impairment is not clearly established and hence the present study.Methods This prospective study recruited 123 subjects diagnosed as tonic-clonic seizures in the study site during the study period.Results Gender and educational status showed normal cognitive function on MMSE but showed cognitive impairment on MOCA. Among epilepsy patients, all APOE ɛ4 carriers showed mild to severe cognitive impairment on MOCA but differences in cognitive status were observed in this population as well as in APOE ɛ4 non-carriers on MMSE.Conclusion Thus, the present study demonstrates the sensitivity of MOCA over MMSE in detecting cognitive impairment in epilepsy.

Contributions of the Computer-Administered Neuropsychological Screen for Mild Cognitive Impairment (CANS-MCI) for the diagnosis of MCI in Brazil

2014 ◽  
Vol 26 (9) ◽  
pp. 1483-1491 ◽  
Author(s):  
Cláudia M. Memória ◽  
Mônica S. Yassuda ◽  
Eduardo Y. Nakano ◽  
Orestes V. Forlenza
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Goodness Of Fit ◽  
Formal Education ◽  
Factor Model ◽  
Characteristic Curve ◽  
Reliability And Validity ◽  
Cognitive Status ◽  
Cognitive Screening ◽  
Extensive Evaluation

ABSTRACTBackground:The Computer-Administered Neuropsychological Screen for Mild Cognitive Impairment (CANS-MCI) is a computer-based cognitive screening instrument that involves automated administration and scoring and immediate analyses of test sessions. The objective of this study was to translate and culturally adapt the Brazilian Portuguese version of the CANS-MCI (CANS-MCI-BR) and to evaluate its reliability and validity for the diagnostic screening of MCI and dementia due to Alzheimer's disease.Methods:The test was administered to 97 older adults (mean age 73.41 ± 5.27 years) with at least four years of formal education (mean education 12.23 ± 4.48 years). Participants were classified into three diagnostic groups according to global cognitive status (normal controls, n = 41; MCI, n = 35; AD, n = 21) based on clinical data and formal neuropsychological assessments.Results:The results indicated high internal consistency (Cronbach's α = 0.77) in the total sample. Three-month test-retest reliability correlations were significant and robust (0.875; p < 0.001). A moderate level of concurrent validity was attained relative to the screening test for MCI (MoCA test, r = 0.76, p < 0.001). Confirmatory factor analysis supported the three-factor model of the original test, i.e., memory, language/spatial fluency, and executive function/mental control. Goodness of fit indicators were strong (Bentler Comparative Fit Index = 0.96, Root Mean Square Error of Approximation = 0.09). Receiver operating characteristic curve analyses suggested high sensitivity and specificity (81% and 73% respectively) to screen for possible MCI cases.Conclusions:The CANS-MCI-BR maintains adequate psychometric characteristics that render it suitable to identify elderly adults with probable cognitive impairment to whom a more extensive evaluation by formal neuropsychological tests may be required.

scholarly journals Creativity, paranormal beliefs and cognitive impairment in the elderly

2015 ◽  
Vol 5 (2) ◽  
pp. 253-265
Author(s):  
Inmaculada Méndez ◽  
Julia García-Sevilla ◽  
Juan P. Martínez ◽  
Isabel García-Munuera ◽  
Ana Mª Bermúdez ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Religious Beliefs ◽  
Mini Mental State Examination ◽  
Belief System ◽  
The Elderly ◽  
Cognitive Status ◽  
Sociodemographic Characteristics ◽  
Paranormal Beliefs ◽  
The Relationship ◽  
State Examination

In the case of older people, aesthetic thought and creativity are ways to keep mind and imagination active by contributing to prevent cognitive decline. Furthermore, having a religious belief system or even a belief system or paranormal experiences has proved to be beneficial for the health of the elderly. The objective was to study the relationship between creativity, degree of cognitive impairment and paranormal beliefs. The existence of differences depending on sociodemographic characteristics was analyzed. A group of 36 elderly people (16 men) aged between 66 and 95 years were administered the Mini-Mental State Examination (MEC), the CREA Test and the Paranormal Beliefs Scale. The main outcomes include that: those with better cognitive status are more creative; the less creative subjects had more traditional religious beliefs and even greater superstition; the elderly with better cognitive status were the least superstitious. It is remarkable that men were more creative, while women excelled in traditional religious beliefs. The study allows reflecting on the importance of professionals who work with the elderly to carry out programs to encourage creativity and even collect information about the belief system.

scholarly journals Hypo-perfusion and hyper-resistance affect different cognitive functions

2021 ◽  
Author(s):  
Hideyuki Hoshi ◽  
Yoshihito Shigihara
Keyword(s):  
Cognitive Impairment ◽  
Executive Function ◽  
Learning And Memory ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Cognitive Impairments ◽  
Cognitive Status ◽  
Frontal Assessment Battery ◽  
Assessment Battery ◽  
State Examination

Abstract Cognitive impairment and dementia are conventionally categorised according to their causative disease, such as Alzheimer's disease and cerebrovascular disease. Cognitive impairments of different aetiologies often share pathological cerebral blood circulation patterns, characterised by perfusion and resistance. Here, we show that these two features are associated with distinct types of cognitive impairment. Using carotid ultrasonography, we evaluated the circulation status of individuals with little to no subjective cognitive symptoms. We assessed individuals’ cognitive status using the Frontal Assessment Battery for executive function and Mini-Mental State Examination for learning and memory. Regression analysis showed that the hyper-resistance and hypo-perfusion components predicted the Frontal Assessment Battery and Mini Mental State Examination scores, respectively. These results are consistent with previous findings of hyper-resistance being associated with atherosclerosis, which disproportionately affects the frontal lobe and contributes to executive function impairments; meanwhile, hypo-perfusion disproportionately affects temporal lobe functions associated with learning and memory. We propose a novel concept that cognitive impairments fall into two subtypes regardless of the brain disease: hyper-resistance and hypo-perfusion subtypes. As these subtypes can be measured noninvasively and are treatable, this distinction would help design preventive and therapeutic strategies for dementia.

scholarly journals Association of Leisure Activities With Cognitive Impairment and Dementia in Older Adults in Colombia: A SABE-Based Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Alejandra Guerrero Barragán ◽  
Diego Lucumí ◽  
Brian Lawlor
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Educational Attainment ◽  
Protective Factor ◽  
Leisure Activities ◽  
Later Life ◽  
Multinomial Regression ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
State Examination

Observational and interventional studies suggest that participation in leisure activities may help protect against cognitive decline in older people. This study aimed to examine the association between participation in leisure activities and cognitive impairment in older adults in Colombia. Data for this study were derived from the Colombian National Survey of Aging (SABE 2015), a cross-sectional survey with a sample size of 23,694 older adults representing the total population (mean age, 70.8 years; 57.3% females). Cognitive impairment was classified as cognitive impairment without dementia (CIWD) and dementia, according to the revised version of the Folstein Mini-Mental State Examination and the Lawton and Brody functional scale. Leisure activities were evaluated using six items of a questionnaire. Sex-stratified multinomial regression models were used to analyze the association of leisure activities with CIWD and dementia after adjusting for educational attainment, literacy, and other potential confounders. In adjusted models for men, leisure activities in later life were associated with a decreased risk of CIWD (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.68–0.78) and dementia (OR, 0,52; 95% CI, 0.48–0.58). For women, leisure activities in later life were associated with a decreased risk of CIWD (OR, 0.72; 95% CI, 0.66–0.78) and dementia (OR, 0.48; 95% CI, 0.43–0.53). The findings suggest that greater participation in leisure activities in later life may act as a protective factor against CIWD and dementia among older adults in Colombia, independent of educational attainment and literacy.

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