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Mild cognitive impairment (MCI) is an intermediate state between normal cognition and early dementia and is not considered as a typical outcome of brain aging. It has been estimated that 10% to 20% of individuals above 65 years of age will be diagnosed as having MCI. The increased rate of dementia and the importance of early detection of its forerunners have encouraged researchers to focus on detecting MCI and modifiable risk factors with the hope of developing better ways of managing dementia and its consequences. The main aim of this study was to systematically review the related literature concerning the cognitive changes in the spectrum of cognitive aging to cognitive impairment. Articles included in this review were identified through searching the databases of PubMed, Psych Info, Embase, ProQuest, and Scopus. Many domains like verbal memory, language, executive function, visual memory, attentional skills, and working memory showed acceptable predictive power. Testing subdomains such as executive function, speed of processing, working memory and semantic language are critical and others may indicate some suggestions for further clinical deteriorations in normal individuals. Although various cognitive instruments have been used for evaluation of impaired cognitive domains, it remains challenging to select the most appropriate ones having high‐level accuracy and their related cognitive subdomains. It also revealed that none of the identified cognitive domains solely fulfilled the criteria for MCI screening; in clinical settings, multiple neuropsychological batteries may be used for one single cognitive domain, while longitudinal studies prefer the use of at least two cognitive measures for each domain to improve accuracy and research settings might focus on only a single neuropsychological test. However, along with episodic memory, testing for amnestic MCI, executive function could increase the chance of early detection of MCI. Executive control has been found to deteriorate the earliest in MCI patients.

Objectives: Early detection of mild cognitive impairment (MCI) is necessary to prevent irreversible brain damage caused by incipient Alzheimer's disease. It has been showing that amnestic MCI (a-MCI) subjects exhibit subtle deficits in executive function that can be tested using saccade eye movements. Eyetracking technology is a sensitive method to measure cognitive impairments in dementia and MCI. Methods: In this study, we used eye-tracking technology to explore saccade impairments to distinguish between a-MCI and the variants of reference controls. 21 patients with AD, 40 patients with a-MCI, and 59 normal participants were recruited in current study. We measured saccade reaction time, saccade errors, saccade omission, and uncorrected saccades using anti-saccade and pro-saccade tasks with 'gap' and 'overlap' procedures. These parameters were used as markers of executive function and visual attention deficits. Results: The findings revealed that more errors, more omissions, and fewer corrections characterized the saccade behavior of the a-MCI group compared to the reference group. These eye-tracking characteristics can be considered as inhibitory control and working memory deficits in a-MCI subjects. Our results thus demonstrate the applicability of the anti-saccade task as a cognitive marker in a-MCI. Conclusion:The work provides further support for eye-tracking as a useful diagnostic biomarker in the assessment of executive function in aging with cognitive impairments.

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Introduction: The Montreal Cognitive Assessment (MoCA) is a cognitive screening test widely used in clinical practice and suited for the detection of Mild Cognitive Impairment (MCI). The aims were to evaluate the psychometric properties of the Persian MoCA as a screening test for mild cognitive dysfunction in Iranian older adults and to assess its accuracy as a screening test for MCI and mild Alzheimer disease (AD). Method: One hundred twenty elderly with a mean age of 73.52 ± 7.46 years participated in this study. Twenty-one subjects had mild AD (MMSE score ≤21), 40 had MCI, and 59 were cognitively healthy controls. All the participants were administered the Mini-Mental State Examination (MMSE) to evaluate their general cognitive status. Also, a battery of comprehensive neuropsychological assessments was administered. Results: The mean score on the Persian version of the MoCA and the MMSE were 19.32 and 25.62 for MCI and 13.71 and 22.14 for AD patients, respectively. Using an optimal cutoff score of 22 the MoCA test detected 86% of MCI subjects, whereas the MMSE with a cutoff score of 26 detected 72% of MCI subjects. In AD patients with a cutoff score of 20, the MoCA had a sensitivity of 94% whereas the MMSE detected 61%. The specificity of the MoCA was 70% and 90% for MCI and AD, respectively. Discussion: The results of this study show that the Persian version of the MoCA is a reliable screening tool for detection of MCI and early stage AD. The MoCA is more sensitive than the MMSE in screening for cognitive impairment, proving it to be superior to MMSE in detecting MCI and mild AD.

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Background:Early diagnosis of mild cognitive impairment is important in Alzheimer's disease management before brain damage is profoundly established and irreversible. Eye-tracking technology is a sensitive method to measure cognitive impairments in dementia and MCI. We examined the saccade movement deficits in amnestic MCI and compared them with the normal controls and Alzheimer to define early cognitive markers in MCI.Method:This study was a cross-sectional observational study. Twenty-one patients with AD, 40 patients with aMCI, and 59 normal participants were examined by eye tracking using anti-saccade task and pro-saccade task with ‘gap’ and ‘overlap’ procedures.Results:Patients with Alzheimer's made more errors, and corrected fewer errors than a-MCI and age-matched controls. Moreover, a-MCI had higher error rates in the prosaccade gap and overlap (38±1.5, p≤ 0.001; 21± 1.8, p≤ 0.001) and antisaccade gap and overlap (64± 1.4, p≤ 0.001; 45± 1.6, p≤ 0.001) than normal controls. Compared with the control group, a-MCI also showed more uncorrected responses in the prosaccade gap (6± 0.5, p≤ 0.001) and antisaccade gap and overlap (13± 0.4, p≤ 0.001; 10± 0.7, p≤ 0.001). Saccade Omission also revealed significant differences between normal controls and amnestic mild cognitive impairment in prosaccade (p≤ 0.001) and antisaccade (p≤ 0.001) tasks, in both gap and overlap paradigms.Conclusion:Error proportion, target omission and uncorrected saccades impairments in a- a-MCI, support the concept of executive function deterioration, as an early marker of neurocognitive disorder. Our findings also confirm inhibitory and working memory impairments t in a-MCI.

Objectives Increasing frailty syndrome is one consequence of the aging population. Frailty syndrome can adversely affect the independent life and social activities of the elderly by threatening their balance and mobility. This study aimed to investigate the effect of short-term postural-balance training on balance and functional limitations in elderly women with frailty syndrome. Methods & Materials The present clinical trial study was performed on 54 elderly women with frailty syndrome. Participants were randomly selected from one of the daycare centers for the elderly in Shiraz and were divided into two groups intervention (n=27) and control (n=27). For the intervention group, 12 sessions of short-term postural-balance exercises were held. Data were collected using the Fried Frailty Index, berg balance scale (BBS-9), and the survey of activities and fear of falling in the elderly (SAFE) Questionnaire at the beginning of the study and the end of the intervention and analyzed using SPSS software v. 25. Results The mean age of participants was 66.77 years, and 94.4% had at least one chronic disease. Following the intervention, there was a significant improvement in the mean scores of frailties such as physical activity, walk time, balance, and motor limitation of the elderly in the intervention group. In contrast, the intervention could not significantly affect other frailty indicators, i.e., unwanted weight loss, exhaustion, and grip strength in the intervention group Conclusion Postural-balance exercises significantly improve the physical characteristics of malnutrition and motor and functional limitations in daily life activities in the elderly.