Comparing the Mini-Mental State Examination and the modified Mini-Mental State Examination in the detection of mild cognitive impairment in older adults

Patten, Ryan Van; Britton, Karysa; Tremont, Geoffrey

doi:10.1017/s1041610218001023

Cited by 33 publications

(43 citation statements)

References 33 publications

(57 reference statements)

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“…Various tests were used by the selected studies, including the MMSE, Modified MMSE (3MS), and Digit Symbol‐Coding subtest of the WAIS‐III. Broadly speaking, WAIS‐III is similar to an IQ test, and there are data favoring widespread substitution of the MMSE with the 3MS in older adults with concerns about cognitive decline (Van Patten, Britton, & Tremont, ). If a diagnostic test with higher sensitivity had been used in all three selected studies (such as replacing the MMSE with the 3MS), the reported prevalence of cognitive impairment would be higher, and this increase would be greater among the high serum folate group than the group with normal/low folate due to the higher true prevalence of cognitive impairment among the B12‐deficient population with high folate levels.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Dose–Response Relationship Between Folate Exposure and Cognitive Impairment: Synthesizing Data from Documented Studies

et al. 2019

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The dose–response relationship between folate levels and cognitive impairment among individuals with vitamin B12 deficiency is an essential component of a risk‐benefit analysis approach to regulatory and policy recommendations regarding folic acid fortification. Epidemiological studies provide data that are potentially useful for addressing this research question, but the lack of analysis and reporting of data in a manner suitable for dose–response purposes hinders the application of the traditional evidence synthesis process. This study aimed to estimate a quantitative dose–response relationship between folate exposure and the risk of cognitive impairment among older adults with vitamin B12 deficiency using “probabilistic meta‐analysis,” a novel approach for synthesizing data from observational studies. Second‐order multistage regression was identified as the best‐fit model for the association between the probability of cognitive impairment and serum folate levels based on data generated by randomly sampling probabilistic distributions with parameters estimated based on summarized information reported in relevant publications. The findings indicate a “J‐shape” effect of serum folate levels on the occurrence of cognitive impairment. In particular, an excessive level of folate exposure is predicted to be associated with a higher risk of cognitive impairment, albeit with greater uncertainty than the association between low folate exposure and cognitive impairment. This study directly contributes to the development of a practical solution to synthesize observational evidence for dose–response assessment purposes, which will help strengthen future nutritional risk assessments for the purpose of informing decisions on nutrient fortification in food.

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Section: Discussionmentioning

confidence: 99%

Assessment of the Dose–Response Relationship Between Folate Exposure and Cognitive Impairment: Synthesizing Data from Documented Studies

et al. 2019

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“…Participants between the ages of 18 and 50 years were recruited through the University of California, Los Angeles, and local community advertisements. A nurse practitioner performed a clinical assessment of all participants, which included a mini‐mental state exam . The sample was composed of 186 right‐handed participants (84 men and 102 women), with the absence of significant medical or psychiatric conditions.…”

Section: Methodsmentioning

confidence: 99%

History of early life adversity is associated with increased food addiction and sex‐specific alterations in reward network connectivity in obesity

Osadchiy

Mayer

Bhatt

et al. 2019

Obesity Science & Practice

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BackgroundNeuroimaging studies have identified obesity-related differences in the brain's resting state activity. An imbalance between homeostatic and reward aspects of ingestive behaviour may contribute to obesity and food addiction. The interactions between early life adversity (ELA), the reward network and food addiction were investigated to identify obesity and sex-related differences, which may drive obesity and food addiction. MethodsFunctional resting state magnetic resonance imaging was acquired in 186 participants (high body mass index [BMI]: ≥25: 53 women and 54 men; normal BMI: 18.50-24.99: 49 women and 30 men). Participants completed questionnaires to assess ELA (Early Traumatic Inventory) and food addiction (Yale Food Addiction Scale). A tripartite network analysis based on graph theory was used to investigate the interaction between ELA, brain connectivity and food addiction. Interactions were determined by computing Spearman rank correlations, thresholded at q < 0.05 corrected for multiple comparisons. ResultsParticipants with high BMI demonstrate an association between ELA and food addiction, with reward regions playing a role in this interaction. Among women with high BMI, increased ELA was associated with increased centrality of reward and emotion regulation regions. Men with high BMI showed associations between ELA and food addiction with somatosensory regions playing a role in this interaction. ConclusionsThe findings suggest that ELA may alter brain networks, leading to increased vulnerability for food addiction and obesity later in life. These alterations are sex specific and involve brain regions influenced by dopaminergic or serotonergic signalling.

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“…Third, the instruments used in this study to assess cognitive changes are screening instruments. 3MS has discriminant ability for dementia 26 and even mild cognitive impairment from healthy aging 41 . However, comprehensive neuropsychological evaluation is the gold standard for identifying cognitive decline.…”

Section: Discussionmentioning

confidence: 99%

Cognitive decline in older adults with epilepsy: The Cardiovascular Health Study

et al. 2020

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ObjectiveCognitive decline is a major concern for older adults with epilepsy. Whether and how much faster older adults with epilepsy experience cognitive decline beyond expected age‐related cognitive change remain unclear. We sought to estimate and compare rates of cognitive decline in older adults with and without epilepsy.MethodsThe Cardiovascular Health Study is a population‐based longitudinal cohort study of 5888 US adults aged 65+. Cognitive function was assessed annually with Modified Mini‐Mental State Exam (3MS) and Digit Symbol Substitution Test (DSST). We used linear mixed models to estimate average rates of decline in 3MS and DSST scores by epilepsy status (prevalent, incident, or no epilepsy), adjusted for risk factors associated with cognitive decline.ResultsThe rate of decline in 3MS was significantly faster in prevalent epilepsy (P < .001) and after incident epilepsy (P = .002) compared with no epilepsy. Prevalent epilepsy and apolipoprotein E gene (APOE) ε4 (ApoE4) had a synergistic interaction, whereby prevalent epilepsy and ApoE4 together were associated with 1.51 points faster annual decline in 3MS than would be expected if prevalent epilepsy and ApoE4 did not interact (P < .001). Older adults with prevalent epilepsy had a significantly lower initial DSST score and faster rate of decline compared to those with no epilepsy (P < .001).SignificanceFaster decline in global cognitive ability seen in this study validates concerns of patients. ApoE4 allele status was an effect modifier of the relationship between cognitive decline and prevalent epilepsy. Further research is warranted to explore biological mechanisms and possible interventions to mitigate cognitive decline.

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Comparing the Mini-Mental State Examination and the modified Mini-Mental State Examination in the detection of mild cognitive impairment in older adults

Abstract: Broadly speaking, our data strongly favor the widespread substitution of the MMSE with the 3MS in older adults with concerns for cognitive decline.

Cited by 33 publications

References 33 publications

Assessment of the Dose–Response Relationship Between Folate Exposure and Cognitive Impairment: Synthesizing Data from Documented Studies

Assessment of the Dose–Response Relationship Between Folate Exposure and Cognitive Impairment: Synthesizing Data from Documented Studies

History of early life adversity is associated with increased food addiction and sex‐specific alterations in reward network connectivity in obesity

Cognitive decline in older adults with epilepsy: The Cardiovascular Health Study

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