Objective We sought to compare age-related performance on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) across the adult lifespan in an asymptomatic, presumably normal, sample. Background The MMSE is the most commonly used brief cognitive screening test; however, the MoCA may be better at detecting early cognitive dysfunction. Methods We gave the MMSE and MoCA to 254 community-dwelling participants ranging in age from 20 to 89, stratified by decade and we compared their scores using the Wilcoxon signed rank test. Results For the total sample, the MMSE and MoCA differed significantly in total scores as well as in visuospatial, language, and memory domains (for all of these scores, P <0.001). Mean MMSE scores declined only modestly across the decades; mean MoCA scores declined more dramatically. There were no consistent domain differences between the MMSE and MoCA during the 3rd and 4th decades; however, significant differences in memory (P <0.05) and language (P <0.001) emerged in the 5th through 9th decades. Conclusions We conclude that the MoCA may be a better detector of age-related decrements in cognitive performance than the MMSE, as shown in this community-dwelling adult population.

The Montreal Cognitive Assessment (MoCA) is a brief screening instrument for dementia that is sensitive to executive dysfunction. This study examined its usefulness for assessing cognitive performance in mild, moderate, and severe Huntington’s disease (HD), as compared to the MMSE. We compared MoCA and MMSE total scores and the number of correct answers in five cognitive-specific domains in 104 manifest HD patients and 100 matched controls. For the total HD sample, and for the moderate and severe patients, significant differences between both MoCA and MMSE total scores and almost all cognitive-specific domains emerged. Even mild HD subjects showed significant differences with regard to total score and several cognitive domains on both instruments. We conclude that the MoCA, although not necessarily superior to the MMSE, is a useful instrument for assessing cognitive performance over a broad level of functioning in HD.

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Objective. Fibromyalgia is a disabling, chronic pain condition of unknown etiology. Although many factors have been recognized as important contributors to the pain experiences and functional abilities of fibromyalgia patients, the factors that are most impactful (and therefore represent optimal targets for intervention) are still unclear. The aim of the present study was to examine the pathways among depression, self-efficacy, pain, and physical functioning in a large sample of fibromyalgia patients over a 1-year timeframe. Methods. Data from 462 participants (441 women) were analyzed using an autoregressive path analytical model with first-and second-order cross-lagged effects. Results. Self-efficacy was the only significant predictor of depression, physical functioning, and pain intensity ratings across time. Physical functioning at 6 months predicted self-efficacy at 1 year; no other factors related significantly to self-efficacy in the model. Conclusion. Our model suggests that self-efficacy is a salient factor in fibromyalgia symptomatology. Our findings support designing interventions that use a multimodal approach, with an explicit focus on combining exercise (or other means) to improve physical functioning and psychotherapy (e.g., cognitive-behavioral therapy) with the intention of reprocessing the functional improvements and the implications of these improvements for the patients' ability to manage their fibromyalgia symptoms. By doing so, self-efficacy should be enhanced, and this would produce the greatest and broadest benefits for fibromyalgia patients.

The Ways of Coping Questionnaire (WCQ) is a widely used measure of coping processes. Despite its use in a variety of populations, there has been concern about the stability and structure of the WCQ across different populations. This study examines the factor structure of the WCQ in a large sample of individuals diagnosed with fibromyalgia. The participants were 501 adults (478 women) who were part of a larger intervention study. Participants completed the WCQ at their 6-month assessment. Foundational factoring approaches were performed on the data (i.e., maximum likelihood factoring [MLF], iterative principal factoring [IPF], principal axis factoring (PAF), and principal components factoring [PCF]) with oblique oblimin rotation. Various criteria were evaluated to determine the number of factors to be extracted, including Kaiser's rule, Scree plot visual analysis, 5 and 10% unique variance explained, 70 and 80% communal variance explained, and Horn's parallel analysis (PA). It was concluded that the 4-factor PAF solution was the preferable solution, based on PA extraction and the fact that this solution minimizes nonvocality and multivocality. The present study highlights the need for more research focused on defining the limits of the WCQ and the degree to which population-specific and context-specific subscale adjustments are needed.

Purpose: Fibromyalgia syndrome (FMS) is a chronic musculoskeletal pain disorder that is characterized by persistent and widespread pain. FMS has been associated with sleep disturbance, mood disorders and depression. Racial/ethnic minorities are less likely to receive a diagnosis of FMS than White individuals. Although mood disorders and depression are prevalent among racial/ethnic minority groups, researchers have not examined whether there are differences between racial/ethnic minorities and White individuals with FMS. Participants and Methods: The participants were 600 people who were 18 years of age or older and who had a physician's diagnosis of FMS, which was confirmed using the 1990 American College of Rheumatology criteria. Most participants were female (95.5%) and White (85.0%). Sleep disturbance was assessed using the Pittsburgh Sleep Quality Index (PSQI), mood disturbance was assessed using the Profile of Mood States (POMS), and depression was assessed via the Center for Epidemiological Studies Depression Scale (CES-D). Results: Racial/ethnic minorities reported significantly greater levels of sleep disturbance, significantly greater levels of mood disturbance, and had significantly greater levels of depression than White participants. However, racial/ethnic minorities had significantly greater reductions in mood disturbance over the one-year period than White participants. Conclusion: Overall, the findings from the present study indicated that racial/ethnic minorities had "worse" physical and psychological outcomes than White participants.

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To determine whether the effects of symptom duration on fibromyalgia physical impairment are moderated by symptom self-efficacy, data from 572 female participants, who were members of a large health maintenance organization and had a diagnosis of fibromyalgia syndrome (FMS) were assessed. Age, symptom duration, history of physical, sexual, and emotional abuse, fibromyalgiaspecific self-efficacy (Arthritis Self-Efficacy Scale adapted for FMS [ASES]), depression (Centers for Epidemiological Studies Depression Scale [CES-D]), fibromyalgia physical impairment (Fibromyalgia Impact Questionnaire [FIQ]), and pain (McGill Present Pain Index [PPI]) were measured five times across 18 months. Linear regressions were performed to predict baseline FIQ and PPI cross-sectionally. Of primary interest was a hypothesized interaction between ASES and symptom duration, which was significant in relation to FIQ but not PPI. Multilevel mixed models were performed to determine whether the same pattern existed longitudinally controlling for baseline symptom duration as an effect of time and ASES. The interaction was significant in the models for both FIQ and PPI. These results suggest that the effects of age and symptom duration on FMS are unique, and that self-efficacy plays a crucial role in moderating disease course (measured by symptom duration or time) in FMS.