Mild cognitive impairment history and current procedures in low- and middle-income countries: a brief review

Hartle, Larissa; Charchat‐Fichman, Helenice

doi:10.1590/1980-57642021dn15-020001

Cited by 7 publications

(5 citation statements)

References 81 publications

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“…Another significant consideration is the role of ADLs and IADLs as pivotal factors in the assessment of cognitive impairment, particularly in low- and middle-income countries, thus complementing the evaluation [ 80 ]. This study demonstrated a progressive decline in ADLs and IADLs scores as cognitive impairment stages advanced, alongside varying outcomes observed in parts A and B of the TMT.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Efficacy of Two Cognitive Screening Tools in Identifying Gray and White Matter Brain Damage among Older Adults

Andreatta Maduro,

Guimarães,

de Sousa Rodrigues

et al. 2024

Journal of Aging Research

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Background. Ageing is associated with structural changes in brain regions and functional decline in cognitive domains. Noninvasive tools for identifying structural damage in the brains of older adults are relevant for early treatment. Aims. This study aims to evaluate and compare the accuracy of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA©) in identifying gray and white matter brain damage in older individuals with varying degrees of cognitive impairment. Methods. Ninety older adults (62 women) with an average age of 69 ± 7 years were enrolled and categorized as having no cognitive impairment (NCI), mild cognitive impairment (MCI), or moderate cognitive impairment (MoCI). Magnetic resonance imaging (MRI) was utilized to assess the number, volume, and distribution of brain damage. The Fazekas and Scheltens scales were applied to the brain MRIs, and inferential statistics were employed to compare variables among the groups. Results. Cognitive impairment was observed in 56.7% of the participants (95% confidence interval (CI): 46.4–66.4%), with thirty-six older adults (40%) classified as MCI and 15 (17%) as MoCI. Cognitive impairment and medial temporal lobe (MTL) atrophy were found to be associated (p=0.001), exhibiting higher mean volume scales of the MTL atrophied area in the MoCI group (p<0.001). The MMSE accurately revealed MTL atrophy based on the Scheltens (p<0.05) and Fazekas (p<0.05) scales. At the same time, the MoCA accurately identified periventricular white matter (PWM) abnormalities according to the Fazekas scale (p<0.05). Conclusions. The MMSE and MoCA screening tools effectively identified gray and white matter brain damage in older adults with varying degrees of cognitive impairment. Lower MMSE scores are associated with MTL atrophy and lesions, and lower MoCA scores are related to PWM lesions. The concurrent use of MMSE and MoCA is recommended for assessing structural changes in distinct brain regions.

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Section: Discussionmentioning

confidence: 99%

Comparing the Efficacy of Two Cognitive Screening Tools in Identifying Gray and White Matter Brain Damage among Older Adults

Andreatta Maduro,

Guimarães,

de Sousa Rodrigues

et al. 2024

Journal of Aging Research

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“…Thus, this method could form a low-cost option for screening for MCI on a large scale. Low-cost options are especially necessary in low and middle-income countries 54 . It is not our proposal to use the test as a diagnostic tool but to bring in technology that allows doctors or caregivers to perform simple screening on individuals who are at the threshold of old age.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of CompCog: reaction time as a screening measure for mild cognitive impairment

Hartle

Martorelli

Balboni

et al. 2022

Arq. Neuro-Psiquiatr.

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Background Reaction time is affected under different neurological conditions but has not been much investigated considering all types of mild cognitive impairment (MCI). Objective This study investigated the diagnostic accuracy of CompCog, a computerized cognitive screening battery focusing on reaction time measurements. Methods A sample of 52 older adults underwent neuropsychological assessments, including CompCog, and medical appointments, to be classified as a control group or be diagnosed with MCI. The accuracy of CompCog for distinguishing between the two groups was calculated. Results The results from diagnostic accuracy analyses showed that the AUCs of ROC curves were as high as 0.915 (CI 0.837-0.993). The subtest with the highest sensitivity and specificity (choice reaction time subtest) had 91.7% sensitivity and 89.3% specificity. The logistic regression final model correctly classified 92.3% of individuals, with 92.9% specificity and 91.7% sensitivity, and included only four variables from different subtests. Conclusions In summary, the study showed that reaction time assessed through CompCog is a good screening measure to differentiate between normal aging and MCI. Reaction time measurements in milliseconds were more accurate than correct answers. This test can form part of routine clinical tests to achieve the objectives of screening for MCI, indicating further procedures for investigation and diagnosis and planning interventions.

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“…As informant-report consistently showed differences between PwD and both other diagnostic groups in all ADL levels, using informant measures may be crucial for clinical assessment of functional capacity. Using ADL screening may be especially important to LMIC countries, where more expensive methods are not available ( 60 ). Regarding cognition, testing fluency can also have an important role as it appeared as a predictor of all ADL types of performance.…”

Section: Discussionmentioning

confidence: 99%

Predictors of functional impairment and awareness in people with dementia, mild cognitive impairment and healthy older adults from a middle-income country

et al. 2022

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ObjectiveTo investigate the demographic, clinical and cognitive correlates of functional capacity and its awareness in people with dementia (PwD; n = 104), mild cognitive impairment (PwMCI; n = 45) and controls (healthy older adults; n = 94) in a sample from a middle-income country.MethodsDementia and MCI were diagnosed, respectively, with DSM-IV and Petersen criteria. Performance in activities of daily living (ADL) at three different levels [basic (The Katz Index of Independence), instrumental (Lawton instrumental ADL scale) and advanced (Reuben’s advanced ADL scale)], measured through self- and informant-report, as well as awareness (discrepancy between self- and informant-report), were compared between groups. Stepwise regression models explored predictors of ADL and their awareness.ResultsPwD showed impairment in all ADL levels, particularly when measured through informant-report. No differences were seen between controls and PwMCI regardless of measurement type. PwD differed in awareness of instrumental and basic, but not of advanced ADL, compared to controls. Age, gender, education and fluency were the most consistent predictors for ADL. Diagnosis was a significant predictor only for instrumental ADL. Awareness of basic ADL was predicted by memory, and awareness of instrumental ADL was predicted by general cognitive status, educational level, and diagnosis.ConclusionResults reinforce the presence of lack of awareness of ADL in PwD. Use of informant-reports and cognitive testing for fluency are suggested for the clinical assessment of ADL performance. Finally, assessment of instrumental ADL may be crucial for diagnostic purposes.

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Mild cognitive impairment history and current procedures in low- and middle-income countries: a brief review

Cited by 7 publications

References 81 publications

Comparing the Efficacy of Two Cognitive Screening Tools in Identifying Gray and White Matter Brain Damage among Older Adults

Comparing the Efficacy of Two Cognitive Screening Tools in Identifying Gray and White Matter Brain Damage among Older Adults

Diagnostic accuracy of CompCog: reaction time as a screening measure for mild cognitive impairment

Predictors of functional impairment and awareness in people with dementia, mild cognitive impairment and healthy older adults from a middle-income country

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