Predictors of Performance on the MMSE and the DRS-2 Among American Indian Elders

Jervis, Lori L.; Fickenscher, M.P.H. Alexandra; Beals, Janette; Cullum, C M; Novins, Douglas K.; Manson, Spero M.; Arciniegas, David B.

doi:10.1176/appi.neuropsych.22.4.417

Cited by 9 publications

(6 citation statements)

References 34 publications

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“…In previous studies to psychometrically evaluate the Mini-Mental State Examination and the Consortium to Establish a Registry for AD tests, 20,40 albeit with smaller numbers of participants, American Indian participant scores were compared with age-adjusted and education-adjusted normative data from NHW, 41 with 11% of American Indians scoring below threshold. In addition, previous research has shown that education length, quality, and degree of achievement are associated with variance and validity on MoCA (and 3MSE) testing, with high score variance in low educational settings.…”

Section: Discussionmentioning

confidence: 99%

Educational and Clinical Associations With Longitudinal Cognitive Function and Brain Imaging in American Indians

et al. 2022

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BACKGROUNDLittle is known about incidence of vascular and Alzheimer’s dementias in American Indians. METHODS We conducted a large, heterogeneous, population-based, longitudinal cohort study of brain aging in community-dwelling American Indians aged 64-95 years from 11 tribes across 3 states, with neurological examinations, 1.5T magnetic resonance imaging (MRI), and extensive cognitive testing. Visit 1 in 2010-2013 (n=817) and Visit 2 in 2017-2019 (n=403) included all willing, surviving participants. Standardized cognitive tests at both visits included Modified Mini Mental Status Examination (3MSE), Wechsler Adult Intelligence Scale digit symbol coding (WAIS), Controlled Oral Word Association fas (COWA), California Verbal Learning Test short form (CVLT). Test materials added at follow-up included Wide Range Achievement (reading) Test (WRAT) and National Alzheimer’s Coordinating Center Uniform Data Set cognitive battery (v3 form C2) , including Montreal Cognitive Assessment (MoCA). MRI neuroradiologists coded infarcts, hemorrhages, white matter hyperintensities, sulcal atrophy, and ventricle enlargement. RESULTS Mean time between exams was 6.7 years (SD 1.1, range 3.8-9.1). Years of formal education had modest correlation with WRAT reading score (r=0.45). Prevalence and incidence of infarcts were (respectively) 32% and 12.8/1000 person-years (PY); hemmorhages 6% and 4.4/1000 PY; worsening sulci 74% and 19.0/1000 PY; wosening ventricle 79% and 30.1/1000 PY; worsening leukoaraiosis 44% and 26.1/1000 PY. Linear losses per year in cognitive scores were 0.6% 3MSE, 1.2% WAIS, 0.6% COWA, 2.2% CVLT. Mean MoCA scores were 18.9 (SD 4.3). DISCUSSION These are the first data on longitudinal cognitive and imaging changes in American Indians, as well as first reports of AD related features. Mean scores in MoCA were similar or lower than standard cutoffs used to diagnose dementia in other racial/ethnic groups, suggesting that standardized cognitive tests may not perform well in this population. Test validation, adaptation, and score adjustment are warranted. Years of education was a poor proxy for premorbid function, suggesting novel methods for cognitive score contextualization is also needed in this population. Evaluation of selective survival suggests attrition from death and frailty should be accounted for in causal analyses. Overall, these data represent a unique opportunity to examine neurology topics of critical importance to an understudied population.

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Section: Discussionmentioning

confidence: 99%

Educational and Clinical Associations With Longitudinal Cognitive Function and Brain Imaging in American Indians

et al. 2022

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“…We used raw MMSE scores in our analysis, because we wished to directly compare findings in a premanifest and manifest cohort (Table 3), and previous studies have also found problems in the interpretation of transformed MMSE scores in specific populations (44). When we conducted an analysis after transforming MMSE scores to Z scores using established normative data (published 26 years ago) (45) to ascertain the potential influence of this approach to MMSE score interpretation on the study results, we observed two differences in the results of the multivariate regression following this analysis.…”

Section: Limitations and Future Researchmentioning

confidence: 99%

Alcohol Use, Mental Health, and Functional Capacity as Predictors of Workplace Disability in a Cohort With Manifest Huntington’s Disease

Goh

You

Perin

et al. 2020

JNP

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Objective: Huntington's disease (HD) is an inherited neurodegenerative disease involving motor, cognitive, psychiatric, and behavioral impairments that eventually affect work-role functioning. There is limited research regarding predictors of workplace disability in HD. The authors examined predictors of work impairment and disability in a cross-sectional cohort of employed persons with symptomatic HD participating in the worldwide Enroll-HD study.Methods: The study sample (N=316) comprised individuals with manifest HD and a CAG repeat length range between 39 and 60 and were currently engaged in paid full-or parttime employment. Univariate and multivariate logistic regression analyses identified predictors and the effect of all predictors in a fully adjusted model. Results:Of the sample, 20.3% reported missing work due to HD, 60.1% reported experiencing impairment while working due to HD, 79.1% reported having work-related activity impairment due to HD, and 60.8% reported impairment in overall work productivity due to HD. Individuals had 25% higher odds of missing work time if they had a higher level of functional impairment (odds ratio=0.76, 95% CI=0.64, 0.91) and had three times greater odds of missing work if they were current alcohol drinkers, compared with nondrinkers (odds ratio52.86, 95% CI51.62, 5.03). Individuals with lower self-perceived mental health were also 5% more likely to experience impairment at work due to HD. Motor impairment was not a strong predictor of workplace disability.Conclusions: These findings provide important new knowledge that can inform the development of strategies or targeted intervention trials to support persons with symptomatic HD to maintain their work roles.

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“…Among the elderly, the American Indian and Alaska Native population is increasing twice as fast as the American population as a whole (Norris et al, 2012). In addition to more American Indians living to an advanced age, this population has higher rates of conditions (e.g., diabetes, heart disease) that can adversely affect cognitive functioning (Center for Disease Control, 2003;Denny, Holtzman, & Cobb, 2003;Evans & Kantrowitz, 2002;Harris, Albaugh, Goldman, & Enoch, 2003;Jervis et al, 2010;Langlois et al, 2003;Patterson Silver Wolf [Adelv unegv Waya], Duran, Dulmus, & Manning, 2014;Spicer et al, 2003;Steele, Cardinez, Richardson, Tom-Orme, & Shaw, 2008). Whereas the literature suggests that Alzheimer disease (AD) may be less common in some American Indian tribes than in Caucasians (Henderson et al, 2002;Hendrie et al, 1993) and may have a later age of onset (Rosenberg et al, 1996), relatively little is known about cognitive assessment in this population (Jervis et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Remote Neuropsychological Assessment in Rural American Indians with and without Cognitive Impairment

Wadsworth

Galusha-Glasscock

Womack

et al. 2016

Arch Clin Neuropsychol

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Predictors of Performance on the MMSE and the DRS-2 Among American Indian Elders

Cited by 9 publications

References 34 publications

Educational and Clinical Associations With Longitudinal Cognitive Function and Brain Imaging in American Indians

Educational and Clinical Associations With Longitudinal Cognitive Function and Brain Imaging in American Indians

Alcohol Use, Mental Health, and Functional Capacity as Predictors of Workplace Disability in a Cohort With Manifest Huntington’s Disease

Remote Neuropsychological Assessment in Rural American Indians with and without Cognitive Impairment

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