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Background: Teenage is an important stage for brain development, with significant impacts on education and health. Exploring how high-intensity interval training (HIIT) affects cognitive function in this population is crucial to comprehending how HIIT can improve general well-being and academic performance. Objective: To determine the effects of high-intensity interval training on cognitive flexibility among female teenagers. Methodology: A randomized clinical trial was conducted on n=40 female participants between 13-19 years without any serious medical, physical, or psychological illness for 6 months. All participants (n=40) were randomly divided into experimental (HIIT) and control groups equally. The protocols were performed in 4 mins in the first three weeks, 8 mins in the 4th to 6th week, and 12 mins in the 7th and 8th week, with sessions thrice a week. Data on cognitive flexibility was collected at baseline, after 4th week and 8th week from both groups through Digit Span (DST). Results: With-in-group analysis the experimental group showed significant improvement (p

Background Chronic kidney disease (CKD) is associated with an elevated risk of neurocognitive disorders (NCDs). It remains unclear whether CKD-related NCDs have a specific cognitive pattern or are earlier-onset phenotypes of the main NCDs (vascular NCDs and Alzheimer's disease). Methods We used the Mini Mental State Examination score (MMSE) to assess cognitive patterns in 3003 CKD patients (stage 3–4) followed up over 5 years in the Chronic Kidney Disease–Renal Epidemiology and Information Network (CKD-REIN) cohort. After normalizing MMSE scores to a 0-to-100 scale, the associations between the baseline estimated glomerular filtration rate (eGFR, using the Chronic Kidney Disease Epidemiology Collaboration creatinine formula) and changes in each MMSE domain score were assessed in linear mixed models. Results Patients (age: 67 ± 13 years old; males: 65%, mean eGFR: 33± 12 mL/min/1.73 m2) had a good baseline cognitive functions: the mean MMSE score was 26.9/30 ± 2.9. After adjustment for age, sex, educational level, depression (past or present), cardiovascular risk factors and cerebrovascular disease, a lower baseline eGFR (per 10 mL/min/1.73 m2) was associated with a 0.53-point decrement [ P  < .001; 95% confidence interval (CI) (–0.98, –0.08)] for orientation, a 1.04-point decrement [ P  = .03; 95% CI (–1.96, –0.13)] for attention and calculation, a 0.78-point decrement [ P  = .003; 95% CI (–1.30, –0.27)] for language, and a 0.94-point decrement [ P  = .02; 95% CI (–1.75, –0.13)] for praxis. Baseline eGFR was not, however, associated with significant changes over time in MMSE domain scores. Conclusion A lower eGFR in CKD patients was associated with early impairments in certain cognitive domains: praxis, language and attention domains before an obvious cognitive decline. Early detection of NCD in CKD patients must be performed before clinically cognitive decline using preferably tests assessing executive, attentional functions and language, rather than memory tests. This early cognitive screening could lead to a better management of cognitive impairment and their consequences on CKD management. [ABSTRACT FROM AUTHOR]

Relevance. Cognition is an important physiological and higher mental functions in human being. There are various studies showing that inflammatory condition could negatively affect fronto temporal cognitive abilities such as memory, attention and executive functions. A non-invasive test P300 a component of Auditory events related potentials and Mini mental state examination (MMSE), a questionnaire based test reflect cognitive function, and haematological parameter neutrophil/lymphocyte ratio (NLR) is a convenient parameter of systemic inflammation. Aim of present study was to assess the cognitive function assessment by P-300, MMSE and academic performance and find an association with neutrophil to lymphocyte ratio in first year medical students. Materials and Methods. This was an observational study conducted on 79 first year medical students of age group 18-25 years in the department of physiology RUHS College of medical sciences Jaipur. For cognitive assessment non-invasive test P300, MMSE and academic performance was recorded. A haematological parameter NLR was calculated by dividing the absolute neutrophil count with the absolute lymphocyte count. To find an association statistical analysis was done by MEDCALC 16.4 version software. Results and Discussion. The association between P-300 amplitude and latency and MMSE with NLR was found non-significant. Marks have a significant positive correlation with NLR (0.015). Conclusion. In the present study neurocognitive function test P-300 and MMSE found non-significant association with inflammatory marker NLR although academic performance (marks) have a significant positive correlation with NLR.

BackgroundPatients with chronic pain suffer from psychological effects such as anxiety due to the pain itself. Pain can not only impair activities of daily living (ADL) and quality of life (QOL), but also impair cognitive function. Therefore, in this study, we aimed to estimate the cognitive function of chronic pain patients using a deep neural network (DNN) model that has already been implemented in society. We investigated the characteristics of patients presumed to have mild cognitive impairment (MCI) and, at the same time, verified the relationship with the questionnaire commonly used in chronic pain research, which is administered by 43 university affiliated hospitals and medical institutions participating in the chronic pain research group of the Ministry of Health, Labor and Welfare in Japan (assessment batteries).MethodThe study included 114 outpatients from a multidisciplinary pain clinic, and we estimated their Mini-Mental State Examination (MMSE) scores based on age and basic blood test data (23 items). Furthermore, we classified the estimated MMSE scores of chronic pain patients into two groups based on a cutoff score of 27, which indicates MCI, and compared the blood data and assessment batteries. Additionally, we used a control group of 252 healthy adults aged 45 years or older who visited a dementia prevention outpatient clinic for comparison with the MMSE scores of chronic pain patients.ResultThe MMSE scores in chronic pain patients were below the cutoff for MCI. When classified into two groups based on the estimated MMSE score of 27 points, WBC, RBC, Hb, Hct, PLT, UA, BUN, creatinine, Triglyceride, and γ-GT were significantly higher in the blood data. In the MCI group, PDAS values were significantly lower. Furthermore, only in the non-MCI group, a significant correlation was found between the estimated MMSE value and BPI, PDAS, and Locomo. The estimated MMSE scores were significantly lower in chronic pain patients than in healthy adults (p = 0.04).ConclusionPatients with chronic pain may exhibit cognitive impairment due to systemic metabolic disturbances. This suggests that chronic pain affects activities of daily living, resulting in systemic metabolic disorders.

Background: Alzheimer's disease (AD) is a chronic neurodegenerative disorder characterized by impaired memory and progressive cognitive and behavioral decline. Angiotensin converting enzyme (ACE) was suggested to have a role in inhibition of Aβ peptides accumulation with formation of plaque in vitro. The role of ACE (I/D) genotypes regarding AD development and severity is questionable. Objectives: to assess the role of ACE (I/D) single nucleotide polymorphism (SNP) as a possible genetic risk factor for AD occurrence and for prediction of the disease severity. Patients and Methods: This case- control study was carried out in the Neuropsychiatry Department, Qena University Hospital during the period between March 1st 2019 and February 28th 2020. The study included 50 AD patients and 50 healthy age, sex and education matched controls. All cases underwent clinical assessment using Mini Mental State Examination (MMSE), Advanced medical imaging with computed tomography (CT) or magnetic resonance imaging (MRI) of the brain. Genetic analysis for ACE (I/D) (rs4646994) was done using conventional PCR with primers without restriction enzyme. Results: Mean age of the included patients was 70.1 ± 9.35 years with female predominance (60%). About 46% of patients had mild disease, 42% had moderate disease and 12% had severe disease based on MMSE assessment tool. Diabetes had higher frequency among AD group (30%). ACE homozygous DD genotype had higher frequency (OD=35.9; 95%CI= [2.8-440.2]) and D allele was significantly commoner among AD group than control group (OD=2.13; 95% CI= [1.05-3.2]), (P ˂ 0.05 for all). However, no statistically significant differences in relation to degree of dementia and ACE (I/D) genotypes were recorded. Although homozygous DD genotype and D alleles had higher frequency among severe AD group (P˃0.05). Conclusion: an evidence of significant association between homozygous ACE (DD) and D allele among sample of AD patients in Upper Egypt. However, there is lack of significance association of ACE (I/D) SNP in prediction of disease severity.

Introduction: The study aims to test whether an increase in memory load could improve the efficacy in detection of Alzheimer’s disease and prediction of the Mini-Mental State Examination (MMSE) score. Methods: Speech from 45 mild-to-moderate Alzheimer’s disease patients and 44 healthy older adults were collected using three speech tasks with varying memory loads. We investigated and compared speech characteristics of Alzheimer’s disease across speech tasks to examine the effect of memory load on speech characteristics. Finally, we built Alzheimer’s disease classification models and MMSE prediction models to assess the diagnostic value of speech tasks. Results: The speech characteristics of Alzheimer’s disease in pitch, loudness, and speech rate were observed and the high-memory-load task intensified such characteristics. The high-memory-load task outperformed in AD classification with an accuracy of 81.4% and MMSE prediction with a mean absolute error of 4.62. Discussion: The high-memory-load recall task is an effective method for speechbased Alzheimer’s disease detection. [ABSTRACT FROM AUTHOR]

Background: Stroke is the leading cause for premature deaths and disability in India. For more than 30 years, assessing Quality of Life (QoL) has been a significant component in assessing stroke patients and their treatment. QoL is a multidimensional term with at least three major domains–physical, mental, and social. Because stroke may have an adverse effect on many facets of life, its effects on health-related quality of life might be severe. Aim and Objectives: To investigate the impact of stroke on mental status and health-related QoL among survivors in a tertiary care hospital. Material and Methods: An observational study was conducted in a tertiary care hospital in Pune, Maharashtra between November 2020 and November 2021. A total of 76 stroke survivors were interviewed using Stroke Specific-Quality of Life Scale (SS-QOL), Mini Mental State Examination (MMSE) and Modified Rankin Scale (MRS) to assess the patients' disability, along with their sociodemographic details. Results: In this study of 76 stroke survivors, there were more male patients than women. Mean age was 55years. It was observed that 71% stroke survivors had normal cognitive assessment using MMSE. Mean score of SS-QOL was 131 hence majority had poor quality of life. Only 2% had severe impairment on MMSE and on further analysis, it was found that they had grade 5 MRS for disability, belonged to rural area, were from a nuclear type of family and had education up to higher secondary. Conclusion: Stroke has proven to have psychosocial effect on patients in terms of poor quality of life. Since functional status was the primary determinant of QoL, it has been hypothesised that increasing physical function may aid to improve QoL for stroke patients. It is imperative that more research be done on treatment and rehabilitation to improve the poor quality of life so that structured and focused interventions may be developed by policy makers.

Objective: To evaluate the relation between retinal vascular impairment and cognitive decline in patients with amnestic mild cognitive impairment (aMCI) over time. Methods: Spectral domain-optical coherence tomography (SD-OCT) and OCT angiography study was performed in aMCI patients over 2 years followup and compared to baseline. Results: Thirty-eight eyes from 19 aMCI patients were evaluated. Structural and vascular OCT measures were reduced at follow-up except for vessel density (VD) of the choriocapillaris, unchanged, and foveal avascular zone, which was increased; no changes in any parameter were found in 18 agematched healthy controls. Overall, these findings were confirmed when patients were evaluated separately according to progression to dementia. Only non-converters to dementia showed significant VD reduction in the deep capillary plexuses (coeff. ß = -4.20; p < 0.001), may be for an initial massive VD depletion becoming less evident with progression of the disease. MMSE reduction was associated with a higher ganglion cell complex reduction (coeff. ß = 0.10; p = 0.04) and a higher VD reduction in the radial peripapillary capillary (RPC) plexus (coeff. ß = 0.14; p = 0.02) in the whole patient group, while it was associated with a higher VD reduction only in RPC plexus in converters (coeff. ß = 0.21; p < 0.001). Conclusion: Our data shows vascular impairment progression in the inner retina of aMCI patients and support the hypothesis that vascular changes may contribute to the onset and progression of Alzheimer's disease. Other followup studies, with a larger number of patients, are needed to better define VD as a potential biomarker. [ABSTRACT FROM AUTHOR]

Background: The clock drawing test (CDT) and the Mini Mental State Examination (MMSE) are frequently used screening instruments for cognitive impairment, however, the precise contribution of the CDT to the MMSE is largely unknown. Methods: We studied patients with subjective cognitive impairment (SCI, n = 481), mild cognitive impairment (MCI, n = 628) and Alzheimer's disease (AD, n = 1099). Discrimination between patients was examined with multiple logistic regression, adjusted for age, sex, and education. Four groups were constructed based on a normal/abnormal MMSE (cut‐off <24/30) versus normal/abnormal CDT (cut‐off ≤2/3). Visually rated medial temporal lobe atrophy (MTA) on CT was used as parameter of neurodegeneration. Results: The CDT significantly contributed to the MMSE in discriminating SCI from both MCI and AD patients. Our four group analyses showed that of those patients with a normal MMSE and incorrectly classified as SCI, an abnormal CDT could significantly identify 10.0% as MCI and 13.2% as AD. Among those with an abnormal MMSE, the percentage AD patients shifted from 53.1% to 82.1% due to an abnormal CDT. Presence of an abnormal CDT was significantly related to MTA increase, regardless of the MMSE score. Conclusion: The CDT is an important additional screening tool to the MMSE. An abnormal CDT with a normal MMSE is an indicator for cognitive impairment. An abnormal CDT in combination with an abnormal MMSE can be considered as an indicator of disease progression. Key points: The clock drawing test (CDT) is widely used as a screening tool for cognitive impairment, often in combination with the Mini Mental State Examination (MMSE), however, very few studies focus on the specific contribution of the CDT when the MMSE is known.To our knowledge, our study is the first to examine the additional value of the CDT to the MMSE in a large elderly memory clinic population to differentiate patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) from those with subjective cognitive impairment (SCI). We focus on the clinical use of both tests using predefined cut‐off scores.When patients have an MMSE of 24 or higher, and are thus classified as having no cognitive impairment by the MMSE, the CDT can significantly identify close to 25% as having either MCI or AD. When the MMSE is below 24, the combination with an abnormal CDT yielded a percentage of 82% AD.When the MMSE is known, an abnormal CDT can give additional information on progression along the SCI‐MCI‐AD trajectory. We therefore recommend the CDT as a highly relevant, quick and easy to administrate screening tool. [ABSTRACT FROM AUTHOR]

BackgroundNowadays, elderly patients represent a significant number of accesses to the Emergency Department (ED). Working rhythms do not allow to perform complete cognitive analysis, which would, however, be useful for the health care. This study aims to define the optimal cut-off values of the six-item Cognitive Impairment Test (6-CIT) as a cognitive screening tool in ED.MethodsThis study included 215 subjects, evaluated at the Emergency Department of the University Hospital of Monserrato, Cagliari, Italy, from July to December 2021. The accuracy of 6-CIT as a cognitive screening tool was assessed by comparison with Mini Mental State Examination (MMSE).ResultsThe correlation coefficient between the two tests was −0.836 (CI: −0.87 to −0.79; p

Cognitive impairment in older adults refers to a decline in mental abilities such as memory, attention, and problem-solving, often associated with aging. This study aimed to show the prevalence of cognitive impairment among older people and examine the risk factors in acquiring the disease. This cross-sectional, community-based study was implemented between August 2022 and August 2023. The study population involved older adults (n= 400) living in urban regions aged ≥60 years. A questionnaire used to collect sociodemographic data. Further, mini mental state examination tool to assess cognitive function, activities of daily living tool to assess physical functional capacity, patient health questionnaire-9 tool to identify depressive symptoms, Snellen chart to examine visual acuity and whispered voice test to examine hearing acuity were used. Chi-square test used to investigate the association between risk factors and cognitive impairment. The prevalence of cognitive impairment was 31.25% in examined community. The risk of the disease was higher in the following participants: age group 90-100 (71.4%), female (45.9%), unemployed (47.1%), having insufficient socioeconomic level (51.2%), being illiterate (49.3%), having low hearing acuity (77.4%), having sever functional impairment (78.6%), being widowed (56.8%), living with others rather than a spouse (54.4%), having low visual acuity (33.3%), and having depressive symptoms (65.1%). The severity of cognitive impairment is statistically significantly related to age group of 90-100 years old (80%), smokers (n = 21) is mostly mild [n=9/21 (42.85%)], the decrease in hearing acuity is more frequent among those with sever cognitive impairment [n= 9/24 (37.5%)], and most of the features were of mild severity [n= 45/69 (65.2%)]. Cognitive impairment is a prevalent disease, and the risk factors are being females, unemployed, have a low socioeconomic level, illiterate, and widowed. Moreover, the disease is substantially related with increasing age, low hearing and visual acuity, depressive symptoms, and physical functional impairment.

Mild cognitive impairment (MCI) is the preliminary stage of dementia, which is a serious social problem worldwide. This study aimed to investigate whether the Cognitive Composition Test (CCT) is effective for the early diagnosis of MCI. A total of 104 older adults underwent the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), the Trail Making Test Parts A (TMT-A) and B (TMT-B), and our newly prototyped cognitive composition test (CCT). We created three types of CCT (CCT-A, CCT-B, and CCT-C) with different degrees of difficulty. First, we examined the concurrent validity of CCT-A, CCT-B, and CCT-C with the MoCA, MMSE, TMT-A, and TMT-B. All participants were classified into the healthy control (HC) and MCI groups based on their scores in the Japanese versions of the MoCA and MMSE. The HC and MCI groups were compared using the TMT-A, TMT-B, CCT-A, CCT-B, and CCT-C. Finally, we examined the sensitivity for discrimination of CCT-C. CCT-C had a higher discrimination sensitivity than TMT-A, TMT-B, CCT-A, and CCT-B, with a cut-off value of 65.75 s, a sensitivity level of 0.844, and a specificity of 0.776. It may be a useful screening tool for the early diagnosis of the early-stages of dementia, such as MCI, in asymptomatic older adults. [ABSTRACT FROM AUTHOR]

Aims Post-traumatic epilepsy is one of the most common and disabling sequels of traumatic brain injury and is defined as repeated unprovoked seizures seven days after traumatic brain injury. The present study aimed to determine the late consequences of epilepsy in veterans with traumatic brain injury during the imposed Iran-Iraq war. Instruments & Methods This study was observational cohort research in 2022. The sample of the study included all living veterans with a history of Post-traumatic epilepsy who were covered by the sendees of the "Veterans Affairs Foundation" of Isfahan, Iran. 218 veterans with epilepsy, who were available, were identified, 100 of them had a traumatic brain injury, and 118 did not have any traumatic brain injury. Data were collected using the Mini Mental State Examination (MMSE) and Instrumental Activities of Daily Living and Physical SelfMaintenance Scale (IADL-PSMS). Findings There was a significant difference between veterans with and without traumatic brain injuries in the age at post-traumatic epilepsy debut (p<0.05). Epilepsy characteristics were not significantly different between the two groups (p>0.05). The mean score of MMSE in veterans with and without traumatic brain injuries was significantly different (p<0.05). The Recall and Registration subscales were significantly different in veterans with/without traumatic brain injuries (p<0.05). Conclusion The ability to perform daily activities and cognitive function are lower in veterans with epilepsy with traumatic brain injuries compared to veterans with epilepsy without traumatic brain injuries. [ABSTRACT FROM AUTHOR]

BACKGROUND: Mechanical neck pain is most prevalent in this era, fascia is the soft tissue component of the connective tissue network that pervades the human body and creates a continuous, three-dimensional structural support matrix throughout the entire body .stretching the fascia with the principles of fascial stretch therapy enables us to treat those patients. Methodology: 15 Subjects were assigned in single group and underwent fascial stretch therapy -Proprioceptive neuromuscular facilitation pattern technique for a period of 1 weeks and this study used a purposeful sampling technique to assign patients. CONCLUSION: The data were analysed using paired T test at 5% level of significance. There was a significant improvement on pain and range of motion in the group. This study revealed that there is a significant improvement in pain and ROM on subjects who underwent fascial stretch therapy. [ABSTRACT FROM AUTHOR]

Anna Segernäs,1,&ast; Johan Skoog,2,&ast; Eva Ahlgren Andersson,3 Sofia Almerud Österberg,4,5 Hans Thulesius,6,7,&ast; Helene Zachrisson2,&ast; 1Primary Health Care Center Ekholmen in Linköping and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; 2Department of Clinical Physiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; 3Department of Thoracic Surgery and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; 4Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden; 5Department of Research and Development, Region Kronoberg, Växjö, Sweden; 6Department of Clinical Sciences, Malmö, Faculty of Medicine, Lunds University, Lund, Sweden; 7Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden&ast;These authors contributed equally to this workCorrespondence: Johan Skoog, Department of Clinical Physiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden, Tel +46 10 103 00 00, Email johan.skoog@liu.sePurpose: To evaluate if preoperative assessment with A Quick Test of Cognitive Speed (AQT) could increase the accuracy of predicting delirium after cardiac surgery compared to Mini-Mental State Examination (MMSE), and examine if a composite of variables, including cognitive function and depressive symptoms, could be useful to predict delirium.Patients and Methods: Cardiac surgery was performed in 218 patients (mean age 72 years). Preoperative evaluation involved AQT, MMSE and Hospital Anxiety And Depression Scale (HADS). Postoperative delirium was assessed using Nursing Delirium Screening Scale (Nu-DESC) and Confusion Assessment Method-ICU (CAM-ICU). Logistic regression was performed to detect predictors of postoperative delirium and receiver operator characteristic curves (ROC) with area under the curve (AUC) to determine the accuracy.Results: Postoperative delirium occurred in 47 patients (22%) who had lower MMSE scores (median (range), 27 (19– 30) vs 28 (20– 30), p=0.009) and slower AQT (median (range), 76 (48– 181) vs 70 (40– 182) seconds, p=0.030) than patients without delirium. Predictive power measured as AUC (95% CI) was 0.605 (0.51– 0.70) for AQT and 0.623 (0.53– 0.72) for MMSE. Logistic regression (OR, 95% CI) showed MMSE < 27 points (2.72, 1.27– 5.86), AQT > 70 sec (2.26, 1.03– 4.95), HADS-D > 4 points (2.60, 1.21– 5.58) and longer cardiopulmonary bypass-time (1.007, 1.002– 1.013) to be associated with postoperative delirium. Combining these parameters yielded an AUC of 0.736 (0.65– 0.82).Conclusion: The ability of predicting delirium using AQT was similar to MMSE, and only slightly higher by combining AQT and MMSE. Adding HADS-D and cardiopulmonary bypass-time to MMSE and AQT increased the predictive power to a borderline acceptable discriminatory value. Preoperative cognitive tests and screening for depressive symptoms may help identify patients at risk of postoperative delirium. Yet, there is still a need to establish useful preoperative tests.Keywords: postoperative delirium, cardiopulmonary bypass, Mini Mental State Examination, A Quick Test of Cognitive Speed, The Hospital Anxiety and Depression Scale

Objective: To evaluate the relation between retinal vascular impairment and cognitive decline in patients with amnestic mild cognitive impairment (aMCI) over time. Methods: Spectral domain-optical coherence tomography (SD-OCT) and OCT angiography study was performed in aMCI patients over 2 years followup and compared to baseline. Results: Thirty-eight eyes from 19 aMCI patients were evaluated. Structural and vascular OCT measures were reduced at follow-up except for vessel density (VD) of the choriocapillaris, unchanged, and foveal avascular zone, which was increased; no changes in any parameter were found in 18 agematched healthy controls. Overall, these findings were confirmed when patients were evaluated separately according to progression to dementia. Only non-converters to dementia showed significant VD reduction in the deep capillary plexuses (coeff. β = -4.20; p < 0.001), may be for an initial massive VD depletion becoming less evident with progression of the disease. MMSE reduction was associated with a higher ganglion cell complex reduction (coeff. β = 0.10; p = 0.04) and a higher VD reduction in the radial peripapillary capillary (RPC) plexus (coeff. β = 0.14; p = 0.02) in the whole patient group, while it was associated with a higher VD reduction only in RPC plexus in converters (coeff. β = 0.21; p < 0.001). Conclusion: Our data shows vascular impairment progression in the inner retina of aMCI patients and support the hypothesis that vascular changes may contribute to the onset and progression of Alzheimer's disease. Other followup studies, with a larger number of patients, are needed to better define VD as a potential biomarker. [ABSTRACT FROM AUTHOR]

Background: Stroke is the leading cause for premature deaths and disability in India. For more than 30 years, assessing Quality of Life (QoL) has been a significant component in assessing stroke patients and their treatment. QoL is a multidimensional term with at least three major domains-physical, mental, and social. Because stroke may have an adverse effect on many facets of life, its effects on health-related quality of life might be severe. Aim and Objectives: To investigate the impact of stroke on mental status and health-related QoL among survivors in a tertiary care hospital. Material and Methods: An observational study was conducted in a tertiary care hospital in Pune, Maharashtra between November 2020 and November 2021. A total of 76 stroke survivors were interviewed using Stroke Specific-Quality of Life Scale (SS-QOL), Mini Mental State Examination (MMSE) and Modified Rankin Scale (MRS) to assess the patients' disability, along with their sociodemographic details. Results: In this study of 76 stroke survivors, there were more male patients than women. Mean age was 55years. It was observed that 71% stroke survivors had normal cognitive assessment using MMSE. Mean score of SS-QOL was 131 hence majority had poor quality of life. Only 2% had severe impairment on MMSE and on further analysis, it was found that they had grade 5 MRS for disability, belonged to rural area, were from a nuclear type of family and had education up to higher secondary. Conclusion: Stroke has proven to have psychosocial effect on patients in terms of poor quality of life. Since functional status was the primary determinant of QoL, it has been hypothesised that increasing physical function may aid to improve QoL for stroke patients. It is imperative that more research be done on treatment and rehabilitation to improve the poor quality of life so that structured and focused interventions may be developed by policy makers. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies have shown that Polyunsaturated Fatty Acids (PUFAs), including Eicosapentaenoic Acid (EPA), and Arachidonic Acid (AA), are associated with cognitive functions in patients with Coronary Artery Disease (CAD). Nevertheless, controversial results have been reported, too. The current study aimed to clarify the association of serum EPA and AA levels with cognitive decline in an Iranian sample with CAD. Methods: We evaluated cognitive function with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), in relation to serum levels of EPA and AA, in 179 CAD patients. The associations between the MMSE and MoCA scores and the other demographic parameters were evaluated. Results: Patients with CAD generally had mild cognitive impairment. But we could not find any significant correlation between PUFAs and cognitive function. However, BMI was associated with EPA/MoCA; age was associated with MMSE/MoCA and BMI. Finally, the correlation between sex and MMSE/MoCA was significant. Conclusion: Subjects generally had mild cognitive impairment, but we could not find any significant correlation between serum EPA and AA levels with cognitive function.

Abstract Background In recent decades, previous studies have noted the importance of frailty, which is a frequently used term in perioperative risk evaluations. Psychological and socioeconomical domains were investigated as part of frailty syndrome. The aim of this study was to assess the importance of these factors in mortality after vascular surgery. Methods In our prospective, observational study (ClinicalTrials.gov Identifier: NCT02224222), we examined 164 patients who underwent elective vascular surgery between 2014 and 2017. At the outpatient anaesthesiology clinic, patients completed a questionnaire about cognitive functions, depression and anxiety, social support and self-reported quality of life were assessed using a comprehensive frailty index, in addition to medical variables. Propensity score matching was performed to analyse the difference between patients and controls in a nationwide population cohort. The primary outcome was 4 year mortality. The Kaplan-Meier method and Cox regression analysis were used for statistical analyses. Results The patients’ mean age was 67.05 years (SD: 9.49 years). Mini-Mental State Examination scores of less than 27 points were recorded for 41 patients. Overall mortality rates were 22.4 and 47.6% in the control and cognitive impairment groups, respectively (p = 0.013). In the univariate Cox regression analysis, cognitive impairment measured using age- and education-adjusted MMSE scores increased the risk of mortality (AHR: 2.842, 95% CI: 1.389-5.815, p = 0.004). Conclusion Even mild cognitive dysfunction measured preoperatively using the MMSE represents a potentially important risk factor for mortality after vascular surgery.

Abstract Background The Montreal Cognitive Assessment (MoCA) has good sensitivity for mild cognitive impairment, but specificity is low when the original cut-off (25/26) is used. We aim to revise the cut-off on the German MoCA for its use in clinical routine. Methods Data were analyzed from 496 Memory Clinic outpatients (447 individuals with a neurocognitive disorder; 49 with cognitive normal findings) and from 283 normal controls. Cut-offs were identified based on (a) Youden’s index and (b) the 10th percentile of the control group. Results A cut-off of 23/24 on the MoCA had better correct classification rates than the MMSE and the original MoCA cut-off. Compared to the original MoCA cut-off, the cut-off of 23/24 points had higher specificity (92% vs 63%), but lower sensitivity (65% vs 86%). Introducing two separate cut-offs increased diagnostic accuracies with 92% specificity (23/24 points) and 91% sensitivity (26/27 points). Scores between these two cut-offs require further examinations. Conclusions Using two separate cut-offs for the MoCA combined with scores in an indecisive area enhances the accuracy of cognitive screening.

Latar Belakang dan Tujuan: Cedera Otak Traumatik (COT) merupakan cedera yang mempengaruhi tingkat kesadaran serta fungsi neurologis. Pemeriksaan GCS dilakukan untuk mengkategorikan keparahan yang terjadi pada COT. Kondisi pasca COT dapat menyebabkan terjadinya penurunan fungsi kognitif karena terjadi kerusakan pada sel-sel otak serta vaskularisasinya. Tujuan penelitian ini untuk mengetahui apakah terdapat hubungan antara skor GCS dengan pemeriksaan fungsi kognitif menggunakan Mini Mental State Examination (MMSE) dan Clock Drawing Test (CDT) pada pasien COT di Instalasi Gawat Darurat (IGD) RSUD Ulin Banjarmasin. Subjek dan Metode: Penelitian ini bersifat observasional analitik dengan pendekatan cross sectional. Sebanyak 48 sampel didapatkan secara consecutive sampling. Hasil: Pada COT ringan terdapat 2 pasien (10%) mengalami penurunan fungsi kognitif, COT sedang 15 pasien (83,3%), dan COT berat 9 pasien (90%). Analisis data menggunakan uji Chi-Square dengan tingkat kepercayaan 95% menunjukkan penurunan fungsi kognitif seiring dengan semakin beratnya COT (p=0,000). Simpulan: Terdapat hubungan antara skor GCS dengan fungsi kognitif menggunakan MMSE dan CDT pada pasien COT. Relationship between Glasgow Coma Scale (GCS) Score with Cognitive Function in Traumatic Brain Injury Patient at Emergency Department of Ulin General Hospital Banjarmasin Abstract Background and Objective: Traumatic Brain Injury (TBI) is an injury that affects the level of consciousness and neurological function. GCS examination is done to categorize the severity that occurs in TBI. Conditions after traumatic brain injury cause cognitive function impairment due to damage of brain cells and its vascularization. Analyze the relationship between GCS scores and cognitive function test using MMSE and CDT in TBI patients. Subject and Method: This study was observational analytic in design with a cross sectional approach. A total of 48 samples were obtained by consecutive sampling. Result: In mild TBI there were 2 patients (10%) experienced decrease in cognitive function, moderate TBI was 15 patients (83.3%), and 9 patients (90%) in severe TBI. Data analysis used Chi-Square test with 95% confidence level which showed a decrease in cognitive function along with the increasing severity of TBI (p=0.000). Conclusion: There was a relationship between GCS scores and cognitive function using MMSE and CDT in TBI patients.

Background and Aim: Most patients suffering from traumatic brain injury (TBI) are those with mild injuries (mTBI). However, due to the absence of symptoms in brain imaging until long after the injury, the manifestations of cognitive impairments remain undiagnosed. Therefore, cognitive screening is considered a key measure in these patients. One of the common screening tools for evaluating cognitive impairments is the mini-mental state examination (MMSE) test. The present study aimed to determine the cut-off point, sensitivity, and specificity of the MMSE test in mTBI patients. Methods and Materials/Patients: In this observational and cross-sectional-analytical study, the statistical population included all patients with mTBI who were injured in the 1st half of 2022. The case group included 79 mTBI patients admitted to the trauma, neurosurgery, and intensive care unit (ICU) departments of Poursina Hospital in Rasht City, Iran, in the 1st half of 2022, who had been referred to the same hospital and Velayat specialized clinic for rehabilitation and re-visit, and the control group included 79 normal healthy individuals. Both groups were cognitively evaluated by the MMSE test on two occasions with an average time interval of 2-3 weeks. Results: The results of the discriminant analysis showed a cut-off point of 27 to 28 as the probable point of cognitive impairment. Also, to identify the cognitive impairment in mTBI patients, this test reported low sensitivity of 0.43-0.58 and a moderate specificity of 0.69-0.80 in two tests. Conclusion: In screening for possible mild cognitive impairment in mTBI patients, the MMSE is relatively useful and should not be used solely to replace a comprehensive neuropsychological evaluation with diagnostic purposes.

Tujuan: Mengetahui hubungan antara gangguan pendengaran dengan penurunan fungsi kognitif pada usia lanjut. Metode: Menggunakan metode studi potong lintang pada kelompok usia lanjut yang menghuni panti sosial Tresna Werdha Kasih Sayang Ibu di Batusangkar dari bulan Juli sampai September 2017. Terdapat 38 orang usia lanjut lebih dari 60 tahun yang masing-masingnya dilakukan pemeriksaan fungsi kognitif dengan Mini Mental State Examination (MMSE) dan pemeriksaan fungsi pendengaran dengan Oto Acoustic Emission (OAE). Data kemudian dianalisis dengan Fisher Exact Test dimana nilai p

Introduction: Postoperative delirium is a common complication after cardiac surgery with cardiopulmonary bypass (CPB). Compromised regulation of the cerebral circulation may be a predisposing factor for delirium. However, the potential relationship between cerebrovascular reserve capacity and delirium is unknown. The aim of this study was to investigate if impaired cerebrovascular reserve capacity was associated with postoperative delirium.Methods: Forty-two patients scheduled for cardiac surgery with CPB were recruited consecutively. All patients underwent preoperative transcranial Doppler (TCD) ultrasound with calculation of breath-hold index (BHI). BHI < 0.69 indicated impaired cerebrovascular reserve capacity. In addition, patients were examined with preoperative neuropsychological tests such as MMSE (Mini Mental State Examination) and AQT (A Quick Test of cognitive speed). Postoperative delirium was assessed using Nursing Delirium Screening Scale (Nu-DESC) in which a score of ≥2 was considered as delirium.Results: Six patients (14%) scored high for postoperative delirium and all demonstrated impaired preoperative cerebrovascular reserve capacity. Median (25th−75th percentile) BHI in patients with postoperative delirium was significantly lower compared to the non-delirium group [0.26 (−0.08–0.44) vs. 0.83 (0.57–1.08), p = 0.002]. Preoperative MMSE score was lower in patients who developed postoperative delirium (median, 25th−75th percentile; 26.5, 24–28 vs. 28.5, 27–29, p = 0.024). Similarly, patients with postoperative delirium also displayed a slower performance during the preoperative cognitive speed test AQT color and form (mean ± SD; 85.8 s ± 19.3 vs. 69.6 s ± 15.8, p = 0.043).Conclusion: The present findings suggest that an extended preoperative ultrasound protocol with TCD evaluation of cerebrovascular reserve capacity and neuropsychological tests may be valuable in identifying patients with increased risk of developing delirium after cardiac surgery.

Background and Purpose: The Korean-Mini Mental State Examination, 2nd edition (K-MMSE~2) was recently released. This study aimed to determine whether the K-MMSE~2: Standard Version (K-MMSE~2:SV) had the same test characteristics as the K-MMSE., Methods: A total of 1,514 healthy community-based participants aged 19 to 90 years were administered the K-MMSE~2:SV Blue Form along with the language items from the K-MMSE. The item and test characteristics and test information for the K-MMSE~2:SV and K-MMSE were compared using Item Response Theory analysis., Results: Item discriminations for the K-MMSE~2:SV and K-MMSE were above the moderate range for all items except Recall. Most of the items on the K-MMSE~2:SV and K-MMSE had item category difficulty in the very easy or easy range. The test information curve (TIC) showed that the K-MMSE~2:SV and K-MMSE provide almost the same amount of information (27.86 vs. 28.44), with both tests providing the most information at an ability level of -1.57. The generalizability (G) coefficient for the K-MMSE~2:SV and K-MMSE was 0.99., Conclusions: These results indicate that the K-MMSE~2:SV and K-MMSE are equally optimal tests for screening for mild cognitive impairment and early dementia. Given that the amount of test information provided by the two tests was almost identical, the shapes of the TICs were very similar, and the G coefficient was close to 1, we can conclude that the K-MMSE and K-MMSE~2:SV are equivalent tests., Competing Interests: Conflict of Interest: The authors have no financial conflicts of interest., (© 2024 Korean Dementia Association.)

Objective: The consequences of overt hypothyroidism on CNS are well known. In contrast, there is less evidence regarding the effects of subclinical hypothyroidism (SCH) on cognitive functions. Studies have shown a variable association between SCH and cognitive dysfunction. This study was done to assess the prevalence of cognitive impairment among subjects with SCH. Methods: The participants were 100 subjects (aged 40-60 years) with SCH and similar number of age-matched euthyroid controls. Subclinical hypothyroidism was defined as serum TSH level > 4.5 mIU/L with normal FT3 and FT4. Participants were interviewed by a single observer. Cognitive function was assessed by mini mental state examination (MMSE) and clock drawing test (CDT). MMSE scores =24 is indicative of cognitive impairment. For CDT a score of =3 represents a cognitive deficit, while a score of 1 or 2 was considered normal. Results: The mean age of patient group was 47.4 years, and BMI of 26.1kg/m2 which were comparable to controls who had a mean age of 46.1 years (P=0.16) and mean BMI of 25.9 kg/m2 (P=0.25). All other baseline variables including sex ratio, co-morbidities, family history of dementia, smoking, alcohol use, education and exercise were also comparable in both groups. The mean TSH was 7.8 mIU/L in patients and 2.7 mIU/L in controls (P< 0.05). The mean MMSE score was 26.1 in patient group and 27.7 in controls (P=0.31) The patients had mean CDT of 2.32 and controls 2.44 (P=0.61). Cognitive impairment by MMSE (score =24) was found in 22.0% of patients and in 16.0% of controls (P=0.14), also the cognitive impairment by CDT (score of =3) was present in 27.0% of patients and 25.0% of controls (P=0.29). Conclusion: In the present study we have found that the prevalence of cognitive impairment in subjects with SCH is similar to the age matched controls. Therefore the potential benefit of levothyroxine therapy if used with an aim of improving cognitive functions becomes doubtful. [ABSTRACT FROM AUTHOR]

Abstract Fabry disease (FD) patients may suffer from objective cognitive impairment (OCI). This study assessed the accuracy of the Mini Mental State Examination (MMSE) to screen for OCI in FD patients. Presence or absence of OCI was established using a neuropsychological test battery. For different MMSE cutoffs sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and clinical utility index (CUI) to identify OCI were calculated. Eighty‐one patients were included (mean age 44.5 ± 14.3, 35% men, 74% classical phenotype) of which 13 patients (16%) had OCI. The median MMSE score was 29 (range: 25‐30). MMSE cutoffs ≤28 and ≤29 had the highest sensitivity and specificity, with higher specificity reached at cutoff ≤28 (sensitivity: .46, specificity: .73) and higher sensitivity at cutoff ≤29 (sensitivity: .92, specificity: .40). PPV was low for both cutoffs (PPV ≤28: .25, PPV ≤29: .23) resulting in a low positive CUI (case finding ability). The results of our study indicate that the MMSE does not accurately screen for OCI in FD, with poor sensitivity‐specificity trade‐off at all cutoffs. The low PPV shows that the majority of FD patients that score below the cutoffs do not suffer from OCI. Administering the MMSE as a screening test will lead to unnecessary referrals for neuropsychological testing, which is time consuming and burdensome. Screening tools designed to accurately detect mild (executive) impairment might prove more appropriate to screen for OCI in FD.

Latar Belakang dan Tujuan: Disfungsi kognitif sering terjadi pada pasien cedera otak traumatik (COT). Gangguan neuropsikologik yang disebabkan oleh cedera otak traumatik ringan dan sedang berupa penurunan kecepatan memproses informasi, gangguan perhatian, orientasi, dan fungsi eksekutif. Pemeriksaan disfungsi kognitif yang sering digunakan adalah Mini Mental State Examination (MMSE). Saat ini sedang dicari pemeriksaan lain yang lebih mudah dilakukan dan memiliki sensitifitas dan spesifisitas yang lebih baik, yaitu dengan Clock Drawing Test (CDT). Penelitian ini bertujuan membandingkan MMSE dan CDT dalam mendeteksi disfungsi kognitif pada COT ringan dan sedang. Subjek dan Metode: Penelitian menggunakan observasi analitik cross sectional, dilakukan di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan Januari hingga April 2018. Pasien dibagi menjadi kelompok COT ringan (n=16) dan sedang (n=16) yang masing-masing dilakukan pemeriksaan MMSE dan CDT. Hasil: Dengan nilai cut-off MMSE 26,5 didapatkan sensitivitas 93,8% dan nilai spesifisitas 81,3%, sedangkan menggunakan nilai cut-off CDT 2,5 didapatkan sensitifitas dan spesifisitas CDT 100%. Simpulan: CDT memiliki sensitivitas dan spesifisitas yang lebih baik untuk mendeteksi disfungsi kognitif pada COT ringan dan sedang. Comparison of Mini Mental State Examination (MMSE) and Clock Drawing Test (CDT) on Detecting Cognitive Dysfunction on Mild and Moderate Traumatic Brain Injury Abstract Background and Objective: Cognitive dysfunction often found in Traumatic Brain Injury (TBI). TBI can triggers neurophysicological, such as slower information processing, attention deficit, orientation disturbance, and executive function. There are methods to evaluate cognitive dysfunction, but none are showing 100% sensitivity and specificity. The frequently used method is Mini Mental State Examination (MMSE). Currently, other examinations are being sought that are easier to do and have better sensitivity and specificity, namely the Clock Drawing Test (CDT). This study is aimed to compare MMSE and CDT to detect cognitive dysfunction in Mild and Moderate TBI. Subject and Method: This study is using analytical observation and cross-sectional study design, it was held in Hasan Sadikin Hospital Bandung throughout January 2017 to April 2018. Subjects are divided into Mild TBI group (n=16) and Moderate TBI group (n=16), both groups were given MMSE and CDT. Result: Using cut-off point 26,5 for MMSE the sensitivity and specificity are 93.8% and 81.3%, while CDT achieved 100% sensitivity and specificity. Conclusion: CDT has a better sensitivity and specificity on detecting cognitive dysfunction in Mild and Moderate TBI.

Purpose – This study aims to establish a correlation between a patient’s mini mental state examination (MMSE) score and their ability to remember how to use common assistive dressing devices. Design/methodology/approach – The study was a prospective, cross-sectional and correlational study. A final sample of 63 patients formed the study. Patients’ cognition was measured using the MMSE, and a new assessment tool was developed to assess patients’ ability to use three assistive devices and piloted on 15 patients to address normality, reliability, validity and clinical usefulness. Pearson’s rank correlation coefficient was used to establish direct correlations between the MMSE score and the assessment tool score. Eta squared was used to calculate the effect size to achieve an indication of the difference between the groups. Ethical approval had been granted by the regional ethics committee. The null hypothesis states that patients with an MMSE score of 22 or less show no difference in their ability to safely and appropriately use assistive devices provided and demonstrated by an occupational therapist than patients with an MMSE score of 23 or higher. Findings – The null hypothesis was rejected and patients with an MMSE score of 22 or less showed a significant difficulty in their ability to use the three devices. Correlation coefficients showed significant positive correlations between MMSE scores and assistive devices scoring tool results for all three devices: Helping hand (r = 6.677, n = 60, p = 0.01), shoe horn (r = 0.649, n = 54, p = 0.01) and sock aid (r = 0.877, n = 54, p = 0.01). Originality/value – The study is in an Irish context and demonstrated primary, objective evidence of the impact of impaired cognition on functional ability. Patients with cognitive deficits pose a larger safety challenge but still should be afforded an opportunity to use and benefit from assistive devices. The assessment tool is a new and unique instrument and although requires further development, may conceivably act not just as an assessment instrument but also an effective treatment tool.

Background Brain volume is associated with dementia and depression in the elderly. An easy way to predict relative brain volume is to measure head circumference. In this study, we investigated the relationship between head circumference and cognition as well as depression in a non-demented elderly community. Methods Baseline and follow-up surveys were conducted in 2007 and 2010. At baseline, community residents aged 65 years or over (n=382) within a rural area of South Korea were screened for dementia and symptoms of depression and were followed using the same screening battery after 3 years (n=279). Data from anthropometric measurements (head circumference, height, and body weight), demographics, and blood tests were gathered. Neuropsychological tests, including the Korean version of mini-mental state examination (K-MMSE), clinical dementia rating (CDR) including the CDR-sum of boxes, the Korean version of instrumental activities of daily living, and geriatric depression scale (GDS), were performed. None of the 279 subjects followed were demented. Results Baseline performance on the K-MMSE and GDS was poorer for participants with smaller head circumferences. Follow-up performance on the MMSE was also poorer for participants with smaller head circumferences. Interestingly, participants with smaller head circumference showed worse GDS scores at baseline but on follow-up examination, participants with larger head circumference showed rapid worsening than those with smaller head circumference with marginal significance by ANOVA test. In regression coefficient analysis, GDS decline showed significant difference. Conclusion Head circumference was not associated with cognitive change but was associated with symptoms of depression in non-demented community residents.

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Background: In order to develop a new screening test of cognitive impairment, we studied whether cognitive function can be estimated from basic blood test data by applying deep learning models. This model was constructed based on the effects of systemic metabolic disorders on cognitive function.Methods: We employed a deep neural network (DNN) to predict cognitive function based on subject's age and blood test items (23 items). We included 202 patients (73.48 ± 13.1 years) with various systemic metabolic disorders for training of the DNN model, and the following groups for validation of the model: (1) Patient group, 65 patients (73.6 ± 11.0 years) who were hospitalized for rehabilitation after stroke; (2) Healthy group, 37 subjects (62.0 ± 8.6 years); (3) Health examination group, 165 subjects (54.0 ± 8.6 years) admitted for a health examination. The subjects underwent the Mini-Mental State Examination (MMSE).Results: There were significant positive correlations between the predicted MMSE scores and ground truth scores in the Patient and Healthy groups (r = 0.66, p < 0.001). There were no significant differences between the predicted MMSE scores and ground truth scores in the Patient group (p > 0.05); however, in the Healthy group, the predicted MMSE scores were slightly, but significantly, lower than the ground truth scores (p < 0.05). In the Health examination group, the DNN model classified 94 subjects as normal (MMSE = 27–30), 67 subjects as having mild cognitive impairment (24–26), and four subjects as having dementia (≤ 23). In 37 subjects in the Health examination group, the predicted MMSE scores were slightly lower than the ground truth MMSE (p < 0.05). In contrast, in the subjects with neurological disorders, such as subarachnoid hemorrhage, the ground truth MMSE scores were lower than the predicted scores.Conclusions: The DNN model could predict cognitive function accurately. The predicted MMSE scores were significantly lower than the ground truth scores in the Healthy and Health examination groups, while there was no significant difference in the Patient group. We suggest that the difference between the predicted and ground truth MMSE scores was caused by changes in atherosclerosis with aging, and that applying the DNN model to younger subjects may predict future cognitive impairment after the onset of atherosclerosis.

Background: Due to its progressive nature, substance use impacts the entire aspects of life, and can result in adverse repercussions on mental status. Accordingly, the current article seeks to compare the mental status of substance abusers with that of normal individuals.Methods: The study is a cross-sectional research. The study population is comprised of 50 methamphetamine users, 52 opium users, and 100 normal individuals referred to Farabi Psychiatric Hospital in Kermanshah, 2018, in Iran. The subjects were selected by convenience sampling method and matched in terms of demographic characteristics. Data collection was performed using Mental State Examination (MMSE) and demographic questionnaire.Results: The results showed that mean scores of orientation, attention, and mental status were significantly different between the normal and substance abusers (P <.05). However, the above-mentioned difference was not significant between methamphetamine abusers and opioid abusers (P >.05). In addition, the mean score of the language tests was statistically significant only among the normal and methamphetamine abusers (P <.05). Conclusions: Based on the obtained results, it can be concluded that the opium and methamphetamine users showed poorer performance in MMSE than the normal group. [ABSTRACT FROM AUTHOR]

Background: In recent decades, previous studies have noted the importance of frailty, which is a frequently used term in perioperative risk evaluations. Psychological and socioeconomical domains were investigated as part of frailty syndrome. The aim of this study was to assess the importance of these factors in mortality after vascular surgery.Methods: In our prospective, observational study (ClinicalTrials.gov Identifier: NCT02224222), we examined 164 patients who underwent elective vascular surgery between 2014 and 2017. At the outpatient anaesthesiology clinic, patients completed a questionnaire about cognitive functions, depression and anxiety, social support and self-reported quality of life were assessed using a comprehensive frailty index, in addition to medical variables. Propensity score matching was performed to analyse the difference between patients and controls in a nationwide population cohort. The primary outcome was 4 year mortality. The Kaplan-Meier method and Cox regression analysis were used for statistical analyses.Results: The patients' mean age was 67.05 years (SD: 9.49 years). Mini-Mental State Examination scores of less than 27 points were recorded for 41 patients. Overall mortality rates were 22.4 and 47.6% in the control and cognitive impairment groups, respectively (p = 0.013). In the univariate Cox regression analysis, cognitive impairment measured using age- and education-adjusted MMSE scores increased the risk of mortality (AHR: 2.842, 95% CI: 1.389-5.815, p = 0.004).Conclusion: Even mild cognitive dysfunction measured preoperatively using the MMSE represents a potentially important risk factor for mortality after vascular surgery. [ABSTRACT FROM AUTHOR]

Background: Patients with chronic pain suffer from psychological effects such as anxiety due to the pain itself. Pain can not only impair activities of daily living (ADL) and quality of life (QOL), but also impair cognitive function. Therefore, in this study, we aimed to estimate the cognitive function of chronic pain patients using a deep neural network (DNN) model that has already been implemented in society. We investigated the characteristics of patients presumed to have mild cognitive impairment (MCI) and, at the same time, verified the relationship with the questionnaire commonly used in chronic pain research, which is administered by 43 university affiliated hospitals and medical institutions participating in the chronic pain research group of the Ministry of Health, Labor and Welfare in Japan (assessment batteries)., Method: The study included 114 outpatients from a multidisciplinary pain clinic, and we estimated their Mini-Mental State Examination (MMSE) scores based on age and basic blood test data (23 items). Furthermore, we classified the estimated MMSE scores of chronic pain patients into two groups based on a cutoff score of 27, which indicates MCI, and compared the blood data and assessment batteries. Additionally, we used a control group of 252 healthy adults aged 45 years or older who visited a dementia prevention outpatient clinic for comparison with the MMSE scores of chronic pain patients., Result: The MMSE scores in chronic pain patients were below the cutoff for MCI. When classified into two groups based on the estimated MMSE score of 27 points, WBC, RBC, Hb, Hct, PLT, UA, BUN, creatinine, Triglyceride, and γ-GT were significantly higher in the blood data. In the MCI group, PDAS values were significantly lower. Furthermore, only in the non-MCI group, a significant correlation was found between the estimated MMSE value and BPI, PDAS, and Locomo. The estimated MMSE scores were significantly lower in chronic pain patients than in healthy adults ( p  = 0.04)., Conclusion: Patients with chronic pain may exhibit cognitive impairment due to systemic metabolic disturbances. This suggests that chronic pain affects activities of daily living, resulting in systemic metabolic disorders., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Moriya, Hu, Sakatani and Kitahara.)

Background: In order to develop a new screening test of cognitive impairment, we studied whether cognitive function can be estimated from basic blood test data by applying deep learning models. This model was constructed based on the effects of systemic metabolic disorders on cognitive function. Methods: We employed a deep neural network (DNN) to predict cognitive function based on subject's age and blood test items (23 items). We included 202 patients (73.48 ± 13.1 years) with various systemic metabolic disorders for training of the DNN model, and the following groups for validation of the model: (1) Patient group, 65 patients (73.6 ± 11.0 years) who were hospitalized for rehabilitation after stroke; (2) Healthy group, 37 subjects (62.0 ± 8.6 years); (3) Health examination group, 165 subjects (54.0 ± 8.6 years) admitted for a health examination. The subjects underwent the Mini-Mental State Examination (MMSE). Results: There were significant positive correlations between the predicted MMSE scores and ground truth scores in the Patient and Healthy groups (r = 0.66, p < 0.001). There were no significant differences between the predicted MMSE scores and ground truth scores in the Patient group (p > 0.05); however, in the Healthy group, the predicted MMSE scores were slightly, but significantly, lower than the ground truth scores (p < 0.05). In the Health examination group, the DNN model classified 94 subjects as normal (MMSE = 27–30), 67 subjects as having mild cognitive impairment (24–26), and four subjects as having dementia (≤ 23). In 37 subjects in the Health examination group, the predicted MMSE scores were slightly lower than the ground truth MMSE (p < 0.05). In contrast, in the subjects with neurological disorders, such as subarachnoid hemorrhage, the ground truth MMSE scores were lower than the predicted scores. Conclusions: The DNN model could predict cognitive function accurately. The predicted MMSE scores were significantly lower than the ground truth scores in the Healthy and Health examination groups, while there was no significant difference in the Patient group. We suggest that the difference between the predicted and ground truth MMSE scores was caused by changes in atherosclerosis with aging, and that applying the DNN model to younger subjects may predict future cognitive impairment after the onset of atherosclerosis. [ABSTRACT FROM AUTHOR]

Introduction: Cognition is composed of intellectual function, memory, speech and language, complex perception, orientation, attention, judgment, planning and decision-making. Behaviour is the exhibition of these cognitive functions. Cognitive function can be assessed by different methods. The most commonly used are P300 and Mini Mental State Examination (MMSE). As both measures evaluate cognitive functions but objective method P300 evaluate endogenously and give the best picture of cognitive functions. Aim: To check the correlation between the results of MMSE with event related potential (P300). Materials and Methods: A prospective cross-sectional study was done on 100 healthy young adult subjects of both genders, aged between 18-25 years after taking written informed consent from January 2019 to June 2019. Cognitive functions were assessed by using MMSE questionnaire through face to face interview and event related potential (P300) latency and amplitude were assessed by using octopus NCV/EMG/EP- 4 Ch. Machine (model- CMEMG 01). Pearson correlation was performed to identify correlation. Results: The mean MMSE score was 24.28±2.89. The mean P300 (latency and amplitude) was 269.61±43.11 ms and 3.1±4.13 μV. Pearson correlation were used to calculate the correlation between P300 (latency and amplitude) with MMSE. The inverse correlation (-0.086) was in between P300 latency and MMSE. There was no correlation between P300 amplitude and MMSE. Conclusion: There was no correlation established between P300 amplitude and MMSE and inverse correlation was seen between P300 latency and MMSE. Hence, P300 cannot replace the MMSE in clinical settings.

Vitamin C is a powerful antioxidant and facilitates neurotransmission. This study explored association between vitamin C deficiency and cognitive impairment in older hospitalised patients. This prospective study recruited 160 patients ≥ 75 years admitted under a Geriatric Unit in Australia. Cognitive assessment was performed by use of the Mini-Mental-State-Examination (MMSE) and patients with MMSE scores p-value = 0.03). Logistic regression analysis suggested that vitamin C deficiency was 2.9-fold more likely to be associated with cognitive impairment after adjustment for covariates (aOR 2.93, 95% CI 1.05–8.19, p-value = 0.031). Vitamin C deficiency is common and is associated with cognitive impairment in older hospitalised patients.

Aim: This is a cross-sectional study of relation between metabolic syndrome and cognitive function in community-dwelling non-demented older adults in Japan. We examine the effect of metabolic syndrome and its components on global cognitive function. We also aim to clarify differences of specific cognitive domains between the subjects with and without metabolic syndrome. Methods: We studied 2150 subjects aged between 60 and 90 years whose scores on mini mental state examination (MMSE) were over 23 points. We analyzed difference in MMSE scores between the subjects with and without metabolic syndrome. Logistic regression analysis was performed with MMSE score as the dependent variable and metabolic syndrome components as the independent variable adjusted with age. We also examined differences in attention, logical memory, and verbal and category fluency between the subjects with and without metabolic syndrome. Results: MMSE scores were not significantly different between subjects with and without metabolic syndrome. In logistic regression analysis, the score of MMSE was significantly negatively associated with triglycerides in males and significantly negatively associated with abdominal circumference in females. Subjects with metabolic syndrome showed significantly lower performance of attention tasks compared to subjects without metabolic syndrome. Conclusions: Our results suggest that in community-dwelling non-demented Japanese older adults, attention but not global cognitive function may be impaired by metabolic syndrome. Inverted association between some components of metabolic syndrome and global cognitive function indicate necessity of further studies on the relation between undernutrition and cognitive function. [ABSTRACT FROM AUTHOR]

Background: The Montreal Cognitive Assessment (MoCA) has good sensitivity for mild cognitive impairment, but specificity is low when the original cut-off (25/26) is used. We aim to revise the cut-off on the German MoCA for its use in clinical routine. Methods: Data were analyzed from 496 Memory Clinic outpatients (447 individuals with a neurocognitive disorder; 49 with cognitive normal findings) and from 283 normal controls. Cut-offs were identified based on (a) Youden's index and (b) the 10th percentile of the control group. Results: A cut-off of 23/24 on the MoCA had better correct classification rates than the MMSE and the original MoCA cut-off. Compared to the original MoCA cut-off, the cut-off of 23/24 points had higher specificity (92% vs 63%), but lower sensitivity (65% vs 86%). Introducing two separate cut-offs increased diagnostic accuracies with 92% specificity (23/24 points) and 91% sensitivity (26/27 points). Scores between these two cut-offs require further examinations. Conclusions: Using two separate cut-offs for the MoCA combined with scores in an indecisive area enhances the accuracy of cognitive screening. [ABSTRACT FROM AUTHOR]

We build personalized relevance parameterization method (prep-ad) based on artificial intelligence (ai) techniques to compute Alzheimer's disease (ad) progression for patients at the mild cognitive impairment (mci) stage. Expressions of ad related genes, mini mental state examination (mmse) scores, and hippocampal volume measurements of mci patients are obtained from the Alzheimer‘s Disease Neuroimaging Initiative (adni) database. In evaluation of cognitive changes under pharmacological therapies, patients are grouped based on available clinical measurements and the type of therapy administered, namely donepezil monotherapy and polytherapy of donepezil with memantine. Average leave one out cross validation (loocv) error rates are calculated for prep-ad results as less than 8 percent when mmse scores are used to compute disease progression for a 60 month period, and 3 percent with hippocampal volume measurements for 12 months. Statistical significance is calculated as p = 0.003 for using ad related genes in disease progression and as p < 0. 05 for the results computed by prep-ad. These relatively small average loocv errors and p-values suggest that our prep-ad methods employing gene expressions, mmse scores and hippocampal volume loss measurements can be useful in supporting pharmacologic therapy decisions during early stages of ad. [ABSTRACT FROM AUTHOR]

Background: The exact mechanism of cognitive impairment in PD is not known. Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a possible treatment for cognitive impairment and to treat the motor symptoms in Parkinson's disease (PD) where its effects seem additive to those of dopaminergic medications. Objective: In this pilot study we investigated whether repeated sessions of rTMS have an effect on measures of cognitive impairment in patients with PD dementia. Methods: 33 patients with PD dementia were randomly assigned sham or real rTMS (2000 pulses; 20 Hz; 90% RMT; 10 trains of 10 s with 25 s between each train) over the hand area of each motor cortex (5 min between hemispheres) for 10 days (5 days/week) followed by 5 booster sessions every month for 3 months. Assessments included the Unified Parkinson's Disease Rating Scale part III (UPDRS), Montreal Cognitive Assessment (MoCA); Mini Mental State Examination (MMSE), Clinical Dementia Rating Scale (CDR); Memory and Executive Screening (MES) and Instrumental activity of Daily Living (IADL). Event related potentials (P300) and cortical excitability were measured before treatment and after the last session. Results: There were no significant differences in the effects of rTMS between groups. Although rTMS improved motor function in the active group it had only a minor effect on two of the dementia rating scores (the MMSE and MoCA) but not the others (CDR and MES). There was also a reduction in the latency of the P300 in the active group. Conclusions: rTMS over M1 is useful for motor function and may have a small positive effect on cognition. However, better approaches for the latter are necessary, may be require multisite rTMS to target both motor and frontal cortical region. [ABSTRACT FROM AUTHOR]

Objective: To observe the intervention effects of Tiaobu Xinshen Recipe (调补心肾方, TXR) on patients with mild cognitive impairment caused by Alzheimer's disease (MCI-AD). Methods: Totally 88 MCI-AD patients with syndrome of Xin (Heart) and Shen (Kidney) deficiency were assigned to the experimental group (47 cases, treated with TXR) and the control group (41 cases, treated with donepezil hydrochloride) using a random number table. Final recruited qualified patients were 44 cases in the experimental group and 39 cases in the control group. The therapeutic course was 12 weeks. Neuropsychological scales [mini mental state examination (MMSE) and Montreal cognitive assessment (MoCA)], and Chinese medicine (CM) dementia syndromes scales were performed in all patients, and results were compared between groups or intra-group before and after treatment. Results: MMSE and MoCA scores of the two groups were increased after treatment compared with those before treatment (P<0.05). But there was no statistical difference in MMSE or MOCA scores after treatment between the two groups (P>0.05). CM dementia syndrome score was significantly decreased after treatment in the experimental group compared with the control group (P<0.01). Visual spatial and executive function scores and delayed recall scores of the two groups were increased compared with those before treatment (P<0.01). Conclusion: TXR could effectively improve cognitive impairment of MCI-AD patients with syndrome of Xin and Shen deficiency. [ABSTRACT FROM AUTHOR]

We performed this research to 1) evaluate a novel deep learning method for the diagnosis of Alzheimer's disease (AD) and 2) jointly predict the Mini Mental State Examination (MMSE) scores of South Korean patients with AD. Using resting-state functional Magnetic Resonance Imaging (rs-fMRI) scans of 331 participants, we obtained functional 3-dimensional (3-D) independent component spatial maps for use as features in classification and regression tasks. A 3-D convolutional neural network (CNN) architecture was developed for the classification task. MMSE scores were predicted using: linear least square regression (LLSR), support vector regression, bagging-based ensemble regression, and tree regression with group independent component analysis (gICA) features. To improve MMSE regression performance, we applied feature optimization methods including least absolute shrinkage and selection operator and support vector machine-based recursive feature elimination (SVM-RFE). The mean balanced test accuracy was 85.27% for the classification of AD versus healthy controls. The medial visual, default mode, dorsal attention, executive, and auditory related networks were mainly associated with AD. The maximum clinical MMSE score prediction accuracy with the LLSR method applied on gICA combined with SVM-RFE features had the lowest root mean square error (3.27 ± 0.58) and the highest R2 value (0.63 ± 0.02). Classification of AD and healthy controls can be successfully achieved using only rs-fMRI and MMSE scores can be accurately predicted using functional independent component features. In the absence of trained clinicians, AD disease status and clinical MMSE scores can be jointly predicted using 3-D deep learning and regression learning approaches with rs-fMRI data. [ABSTRACT FROM AUTHOR]