These results suggest that persons with MCI can improve their performance on cognitive and functional measures when provided with early cognitive training and it could persist in a long-term follow-up.
ObjectiveTo contrast early-onset (<60 years) and late-onset (>60 years) depression in geriatric patients by evaluating differences in cognition, vascular comorbidity and sociological risk factors. Both patient groups were compared with normal subjects.Materials and methodsWe recruited 76 patients with depressive symptoms (37 late onset and 39 early onset) and 17 normal controls matched by age and educational level. All subjects were assessed using a semistructured neuropsychiatric interview and an extensive neuropsychological battery. Vascular and sociological risk factors were also evaluated.ResultsWe found a significant variation in performance between depressive patients and normal controls in most cognitive functions, especially memory (P < 0.0001), semantic fluency (P < 0.0001), verbal fluency, and digit-symbol (P < 0.0001). Late-onset depression patients scored lower and exhibited more severe impairment in memory domains than early-onset depression patients (P < 0.05). Cholesterol levels and marital status were significantly (P < 0.05) different between the depressive groups. Both depressed groups (early- and late-onset) were more inactive than controls (P < 0.05; odds ratio: 6.02).ConclusionGeriatric depression may be a manifestation of brain degeneration, and the initial symptom of a dementia. It is important to consider this in the treatment of patients that exhibit late-onset depressive symptoms.
ABSTRACT. The MoCA is a brief useful test to diagnose mild cognitive impairment (MCI) and mild dementia (MD). To date, no Argentine cross-cultural adapted validations of the Spanish version have been reported. Objective: To validate the MoCA in the elderly and study its usefulness in MCI and MD. Methods: This study included 399 individuals over 60 years old evaluated in the Cognitive-Behavioral Department (2017-2018). Patients with<3 years of education, sensory disturbances, psychiatric disorders, or moderate-severe dementia were excluded. The control group comprised cognitively normal subjects. Participants were classified according to neuropsychological assessment and clinical standard criteria into Control, MCI or MD groups. A locally adapted MoCA (MOCA-A) was administered to the patients and controls. Results: Mean educational level was 10.34 years (SD 3.5 years). MoCA-A score differed significantly among groups (p<0.0001). MoCA-A performance correlated with educational level (r: 0.406 p<0.00001). Adopting a cut-off score ≥25 (YI=0.55), the sensitivity for MCI was 84.8% and for MD 100%, with specificity of 69.7%. When adding a single point to the score in patients with ≤12 years of education, the specificity of the test reached 81%. Conclusion: The MoCA-A is an accurate reliable screening test for MCI and MD in Argentina.
The different dementia types have different costs. Overall, costs increased with the presence of behavioral symptoms, depression and functional impairment of activities of daily living.
Background: "Forgetfulness" is frequent in normal aging and characteristic of the early
stages of dementia syndromes. The episodic memory test is central for detecting
amnestic mild cognitive impairment (MCI). The Memory Binding Test (MBT) is a
simple, easy and brief memory test to detect the early stage of episodic memory
impairment. Objective: To validate the Argentine version of the MBT in a Latin American population and
to estimate the diagnostic accuracy as a tool for early detection of MCI. Methods: 88 subjects (46 healthy controls and 42 patients with amnestic MCI) matched for
age and educational level were evaluated by an extensive neuropsychological
battery and the memory binding test. Results: A significantly better performance was detected in the control group; all MBT
scales were predictive of MCI diagnosis (p<.01). The MBT showed high
sensitivity (69%) and high specificity (88%), with a PPV of 93% and a NPV of 55%
for associative paired recall. A statistically significant difference
(c2=14,164, p<.001) was obtained when comparing the area under
the curve (AUC) of the MBT (0.88) and the MMSE (0.70). Conclusion: The Argentine version of the MBT correlated significantly with the MMSE and the
memory battery and is a useful tool in the detection of MCI. The operating
characteristics of the MBT are well suited, surpassing other tests commonly used
for detecting MCI.
Phototest is a simple, easy and very brief test with theoretical advantages over available dementia screening tests in Spain. The objective of this study was to estimate the diagnostic accuracy of the Phototest for cognitive impairment and dementia and to compare it with that of the MMSE and the Clock Drawing Test (CDT) in an Argentine population. A phase II cross-sectional study of diagnostic tests evaluation was performed in a sample of 30 controls, 61 with amnestic mild cognitive impairment (a-MCI), and 56 with mild Alzheimer type dementia (DAT). The diagnostic accuracy (DA) was assessed in relation to the clinical diagnosis by calculating the area under the ROC curve (UAC), Sensitivity (Sn), and Specificity (Sp).The DA of the Phototest for a-MCI and DAT (0.93 and 0.97 [UAC]) was higher than that of the MMSE and the CDT. The cut-off points of 27/28 for DAT (Sn = 89.29 [78.1-96.0], Sp = 96.67 [82.8-99.9]) and 30/31 for a-MCI (Sn = 85.25 [73.8-93.0], Sp = 90.00 [73.5-97.9]) maximized the sum of Sn and Sp. Phototest correlates significantly with MMSE and CDT. The Phototest is an efficient instrument for the detection of mild dementia or MCI, with good accuracy and good correlation with tests measuring overall cognitive impairment.
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