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Objective Cognitive impairment constitutes one of the major risk factors of delirium after coronary artery bypass graft (CABG) surgery; however, it is unclear whether only patients with global cognitive decline are at increased risk for delirium or if individuals with preserved global cognitive functions but impairments in specific cognitive domains are also more vulnerable to developing delirium. Thus, this study aimed to analyze the neurocognitive status of patients scheduled for CABG surgery with the use of an advanced computerized cognitive battery (CNS Vital Signs) and to investigate possible associations between impaired performance in selective cognitive areas and the risk of postoperative delirium development. Methods The study enrolled 127 participants with a median age of 67 years (IQR: 63–71). Postoperative delirium developed in 32 (25%) patients. Before surgery, the patients were screened for global cognitive impairment with the use of the Mini-Mental State Examination Test, and the individuals were asked to perform the CNS Vital Signs battery to investigate 12 specific cognitive domains. The Confusion Assessment Method and the Memorial Delirium Assessment Scale were used to screen for a diagnosis of delirium postoperatively. Results In multivariate models, a lower score of verbal memory-assessed preoperatively was independently associated with the risk of postoperative delirium development. Other independent predictors of delirium included more advanced age, gender female, depression, postoperative pyrexia, and the presence of extracorporeal circulation. Conclusions As decreased verbal memory constitutes an independent risk factor for postoperative delirium, a verbal memory test may be a useful predictor of postoperative delirium development. [ABSTRACT FROM AUTHOR]

Background Intracranial interventional embolization and intracranial clipping have been two typical therapies for the emergent rescue of intracranial aneurysm. However, there are still controversies over the impact of these two surgical treatments of aneurysms on cognitive and neurological functions of patients. Methods A total of 144 patients with intracranial aneurysms were enrolled as the test subjects, who were randomly and evenly divided into the Intracranial Clipping group and the Interventional Embolization group. Cognitive and neurologic functions were evaluated by Glasgow Outcome Scale, Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE) scales, National Institutes of Health Stroke Scale (NIHSS) and Activities of Daily Living (ADL) scale. Enzyme-linked immunosorbent assay was used to analyze the serum levels of neuron-specific enolase (NSE) and S100β. Results There were no significant differences in the preoperative MMSE, MoCA, NIHSS or ADL scale between two groups (p  > 0.05). However, after operation, the MMSE and MoCA scores of the interventional embolization group were significantly higher, whereas the NIHSS and ADL scales were significantly lower than those of the intracranial clipping group (p  < 0.05). The levels of NSE and S100β in the intracranial clipping group were significantly higher than in the interventional embolization group. Conclusion Intracranial interventional embolization exerts better effects on the cognitive and neurologic functions than intracranial clipping. [ABSTRACT FROM AUTHOR]

Introduction Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are frequent causes of dementia and, therefore, instruments for differential diagnosis between these two conditions are of great relevance. Objective To investigate the diagnostic accuracy of Addenbrooke's Cognitive Examination-Revised (ACE-R) for differentiating AD from bvFTD in a Brazilian sample. Methods The ACE-R was administered to 102 patients who had been diagnosed with mild dementia due to probable AD, 37 with mild bvFTD and 161 cognitively healthy controls, matched according to age and education. Additionally, all subjects were assessed using the Mattis Dementia Rating Scale and the Neuropsychiatric Inventory. The performance of patients and controls was compared by using univariate analysis, and ROC curves were calculated to investigate the accuracy of ACE-R for differentiating AD from bvFTD and for differentiating AD and bvFTD from controls. The verbal fluency plus language to orientation plus name and address delayed recall memory (VLOM) ratio was also calculated. Results The optimum cutoff scores for ACE-R were <80 for AD, <79 for bvFTD, and <80 for dementia (AD + bvFTD), with area under the receiver operating characteristic curves (ROC) (AUC) >0.85. For the differential diagnosis between AD and bvFTD, a VLOM ratio of 3.05 showed an AUC of 0.816 (Cohen's d  = 1.151; p  < .001), with 86.5% sensitivity, 71.4% specificity, 72.7% positive predictive value, and 85.7% negative predictive value. Conclusions The Brazilian ACE-R achieved a good diagnostic accuracy for differentiating AD from bvFTD patients and for differentiating AD and bvFTD from the controls in the present sample. [ABSTRACT FROM AUTHOR]

Objective Due to the lack of a validated translation, the mini-mental state examination (MMSE) cannot be used to screen for suspected dementia in deaf people who communicate in French Sign Language (FSL). Taking into consideration the cultural and linguistic features of this specific population, we transposed the validated French version of the MMSE into a version adapted to FSL users: mini-mental state-langue des signes (MMS-LS). The objective of our work was to obtain screening norms for the MMS-LS. Methods The MMS-LS was tested on 194 deaf users of FSL with clinical dementia rating as the gold standard. Healthy and demented participants were seen for two or three consecutive testing sessions at 1-year intervals. Results The MMS-LS exhibited excellent internal coherence validity (Cronbach's α = .81), unidimensionality (p  = .002), and excellent sensitivity (p  < .001). The MMS-LS score declined with overt and severe dementia. Conclusion The percentiles obtained are useful norms for clinical assessment but must be interpreted with precaution due to the small number of participants (related to recruitment constraints) in the present study. In order to facilitate clinical use, the MMS-LS has been made available online, together with an instructions manual and clinical advice useful for improved awareness of the specific nature of this population. [ABSTRACT FROM AUTHOR]

Objective The aim of the present work was to develop and validate a recognition task to be used with the Spanish version of the 16 items Free and Cued Selective Reminding Test (FCSRT). Method A total of 96 (67.7% women) cognitively healthy, functionally independent community-dwelling participants aged 55 years or older underwent a comprehensive neuropsychological assessment. A recognition task for the FCSRT was developed that included the original 16 items, 16 semantically related items, and eight unrelated foils. Indices of discriminability (d') and response bias (C), as well as 95% confidence intervals for chance-level responding were calculated. Results On average, our sample was 65.71 years old (SD  = 6.68, range: 55–87), had 11.39 years of formal education (SD  = 3.37, range: 3–19), and a Mini-Mental State Examination score = 28.42 (SD  = 1.49, range: 25–30). Recognition scores did not differ statistically between sexes, nor did they correlate with demographics. Participants scored at ceiling levels (mean number of Hits = 15.52, SD  = 0.906, mean number of False Alarms = 0.27, SD  = 0.589). All the participants scored above chance levels. Conclusions Normative data from a novel recognition task for the Spanish version of the FCSRT are provided for use in clinical and research settings. Including a recognition task in the assessment of memory functioning might help uncover the pattern of memory impairments in older adults, and can help improve the memory profile of people with amnestic Mild Cognitive Impairment. Future research is warranted to validate and expand the recognition task. [ABSTRACT FROM AUTHOR]

Introduction Short cognitive screening instruments (CSIs) are widely used to stratify patients presenting with cognitive symptoms. The Quick Mild Cognitive Impairment (Q mci) screen is a new, brief (<5mins) CSI designed to identify mild cognitive impairment (MCI), which can be used across the spectrum of cognitive decline. Here we present the translation of the Q mci into Greek (Q mci -Gr) and its validation against the widely-used Standardised Mini-Mental State Examination (SMMSE). Methods Consecutive patients aged ≥55 years presenting with cognitive complaints were recruited from two outpatient clinics in Greece. All patients completed the Q mci -Gr and SMMSE and underwent an independent detailed neuropsychological assessment to determine a diagnostic classification. Results In total, 140 patients, median age 75 years, were included; 30 with mild dementia (median SMMSE 23/30), 76 with MCI and 34 with subjective memory complaints (SMC) but normal cognition. The Q mci -Gr had similar accuracy in differentiating SMC from cognitive impairment (MCI & mild dementia) compared with SMMSE, area under the curve (AUC) of 0.84 versus 0.79, respectively; while accuracy was higher for the Q mci -Gr, this finding was not significantly different, (p  = .19). Similarly, the Q mci -Gr had similar accuracy in separating SMC from MCI, AUC of 0.79 versus 0.73 (p  = .23). Conclusions The Q mci -Gr compared favorably with the SMMSE. Further research with larger samples and comparison with other instruments such as the Montreal Cognitive Assessment is needed to confirm these findings but given its established brevity, it may be a better choice in busy clinical practice in Greece. [ABSTRACT FROM AUTHOR]

Objective To analyze (1) whether there are ethnic differences in the severity of depressive symptoms between groups of elders classified as cognitively normal (CN) or amnestic mild cognitive impairment (aMCI) and (2) the influence of depressive symptoms on specific cognitive performance by ethnicity across diagnoses, controlling for covariates. Methods 164 Hispanics residing in the United States (HAs) and European Americans (EAs) (100 women; M age = 72.1, SD  = 8.0) were diagnosed as either CN or aMCI. Depressive symptoms were measured with the Geriatric Depression Scale (GDS-15). Cognition was assessed using the Loewenstein-Acevedo Scales for Semantic Interference and Learning (semantic memory), Multilingual Naming Test (confrontation naming), and the Stroop Test (Color–Word condition; executive function). A 2 × 2 univariate ANCOVA as well as linear and logistic regressions explored differences in depressive symptoms among diagnostic and ethnic groups. Results Higher depression was seen in aMCI compared to the CN group for both ethnicities, after controlling for age, education, gender, and Mini-Mental State Examination score. Greater levels of depression also predicted lower scores in confrontation naming and semantic memory for only the EA group and marginally in scores of executive function for HA participants. GDS-15 scores of ≤ 4 also predicted less likelihood of aMCI diagnosis. Conclusions Severity of depressive symptoms was associated with greater cognitive impairment, independent of ethnicity. Significant results suggest detrimental effects of depression on clinical diagnoses most evidently for subjects from the EA group. [ABSTRACT FROM AUTHOR]

Objective A progressive cognitive impairment is one of the frequent non-motor symptoms during Parkinson's disease (PD) course. A short and valid screening tool is needed to detect an incipient cognitive deficit at the mild cognitive impairment stage in Parkinson's disease (PD–MCI). Method The present study aims to evaluate the classification accuracies of four cognitive screenings: Montreal Cognitive Assessment (MoCA), Mattis Dementia Rating Scale second edition (DRS–2), Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) in a cohort of PD patients (PD–MCI, n  = 46; and Parkinson's disease with normal cognition, PD-NC, n  = 95) and Controls (n  = 66). All subjects underwent a standard neuropsychological battery as recommended by the International Parkinson and Movement Disorder Society and underwent all four screening tools. Results In the detection of PD-MCI versus PD-NC, the MoCA showed a sensitivity of 84% and a specificity of 66% with a screening cutoff score at ≤25 points. The MoCA's AUC was 86% (95% CI 78.7–93.1). In the detection of PD-MCI versus Controls, the FAB displayed 84% sensitivity and 79% specificity with a cutoff ≤16 points, to screen. The FAB's AUC was 87% (79.0–95.0). Conclusions Our results show that the MoCA is the most discriminative tool for screening MCI in the PD population. [ABSTRACT FROM AUTHOR]

Objective Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) frequently represents the prodromal stage of alpha-synucleinopathies, and similar to these pathologies, iRBD patients show neuropsychological deficits, particularly in the domain of visuospatial abilities and executive functions. We hypothesized that the qualitative scoring of the Mini-Mental State Examination pentagon test (QSPT) may detect subtle visuospatial deficits in these subjects, and we evaluated its relationship with indexes of sleep quality, as measured by polysomnography. Methods A total of 80 polysomnography-confirmed iRBD patients and 40 healthy controls (HCs) were retrospectively recruited. Global and specific qualitative performances were evaluated according to QSPT procedure. Comparisons between iRBD and HC regarding all QSPT parameters, neuropsychological tests, and polysomnographic recordings were performed. Results Patients displayed significantly lower scores in both "closing-in" and total score parameters in comparison to HC. The QSPT total score exhibited significant positive correlations with verbal comprehension, fluency, visuospatial abilities, and executive functions. Notably, iRBD patients with impaired performance at QSPT showed decreased neuropsychological performances and higher percentages of slow wave sleep (SWS). In addition, SWS percentages negatively correlated with verbal comprehension, fluency, visuospatial abilities, executive functions, and QSPT total score. Conclusion QSPT may represent a brief and easy to administer tool for the detection of subtle visuospatial changes in iRBD patients. Furthermore, polysomnographic findings suggest a possible slowdown of electroencephalographic pattern during non-REM sleep in iRBD patients in line with the presence of cognitive decline. [ABSTRACT FROM AUTHOR]

Objective The aim of the study was to research test outcomes in Dementia Rating Scale-2 (DRS-2; Spanish adapted version), Montreal Cognitive Assessment (MoCA), Mini Mental Status Exam (MMSE), and Geriatric Depression Scale short form (GDS-SF), as predictors of the different Mild Cognitive Impairment (MCI) subtypes. Participants and Method Our sample constituted of 169 total participants (113 females and 56 males), with ages ranging from 44 to 88 (M = 68.20, SD = 9.59). Educational level presented by sample included 67.5% with professional degrees, 21.9% with a high school diploma, and 10.1% with less than a high school education. We conducted hierarchical logistic regression analysis to generate predicted probabilities of the cognitive tests' total scores in identifying MCI subtypes. We tested four individual models- each utilized a different MCI subtype (amnestic MCI, single; amnestic MCI, multiple; non-amnestic MCI, single; non-amnestic MCI, multiple) as the dependent variable. The MoCA, DRS-2, MMSE, and the GDS-SF total scores were used as predictors in each analysis. Results We found statistical significance in our four regression models: χ2(1) = 46.26, p <.05 for the model with amnestic MCI, multiple; χ2 (1) = 17.62, p <.05 for the model with amnestic MCI, single; χ2(1) = 15.35, p <.05 for the model with non-amnestic MCI, multiple; and χ2(1) = 18.74, p <.05 for the model with non-amnestic MCI, single. Conclusions Overall, the results in this study suggest that the DRS-2 and the MoCA, two relatively brief and comprehensive screening instruments, are able to discriminate between individuals with varying forms of cognitive impairment. Participants in the amnestic subtypes of MCI performed significantly lower on both of these tests. Our results also suggest that MMSE better discriminates for non-amnestic subtypes. Finally, the GDS-SF suggests better discriminability between memory related cognitive impairment and emotionally related cognitive impairment. [ABSTRACT FROM AUTHOR]

Objective The immediate copy of the Rey–Osterrieth Complex Figure (ROCF) is considered a visuo-spatial test. However, reproducing this complex structure possibly involves also executive functions, such as planning and organizational strategies. In a previous study, we found a high rate of impaired performances in this test in a sample of subcortical vascular mild cognitive impairment patients. Executive functions contribution in the immediate copy of the ROCF can be assessed with the Boston Qualitative Scoring System (BQSS). We aimed at examining whether BQSS executive scores of ROCF immediate copy: (1) differ between vascular (v-MCI) and degenerative MCI (d-MCI) patients; (2) can at least partly explain the high rate of abnormal ROCF immediate copy performances in v-MCI patients. Method Thirty d-MCI patients (age 75.2 ± 4.4) and 27 v-MCI (age 73.2 ± 6.9) were enrolled. The performances of patients were scored using the BQSS executive scores (Fragmentation, Planning, Organization, Perseveration) during the accomplishment of ROCF immediate copy. Results Comparing d-MCI and v-MCI performances, d-MCI patients scored worse on ROCF delayed recall (9.9 ± 4.7 vs. 13.4 ± 5.9, p =.020) and MMSE (23.9 ± 2.6 vs. 27.8 ± 2.3, p =.001) while v-MCI patients had more frequently impaired performances in ROCF immediate copy (40% vs. 81%, p =.001) and showed worse scores on Fragmentation (2.4 ± 0.9 vs. 1.8 ± 1.3, p =.035), Planning (2.4 ± 0.8 vs. 1.8 ± 1, p =.039), Organization (4.8 ± 1.3 vs. 3.6 ± 2.1, p =.017), and Perseveration (3.5 ± 0.8 vs. 2.9 ± 1.2, p =.048). Conclusions The performance of v-MCI patients in ROCF immediate copy seemed to be more affected by executive dysfunction than the performance obtained by d-MCI. When analyzing ROCF performances, a qualitative approach allows to evaluate patients' strategies during the reproduction, and thus to discriminate between executive and visuo-constructional abilities. [ABSTRACT FROM AUTHOR]

Objective: This review aimed to examine and compare norm stratification of available normative data of neuropsychological tests for Spanish-speakers in the United States, Latin America, the Caribbean, and Spain. Data Selection: English and Spanish studies focused on acquiring normative data for Latinx/Hispanics in Latin America, the Caribbean, the United States, and Spain, were searched from Embase, PubMed, PsycINFO APA, ClinicalTrials.gov, Science Direct, and ProQuest with the date before August 31st, 2022. We used the terms "Neuropsychological testing", "Cognitive assessment", "Hispanic", "Latinx" and "Latinos". Studies were imported to COVIDENCE, and reviewed by two Spanish-English bilingual reviewers, and one proficient English-only reviewer. Out of 345 records identified, 55 met inclusion and exclusion criteria and were not two standard deviations below the quality criteria index. Data Synthesis: Age, education, and sex were the most common variables included in the stratification of normative data. Age was a predictor of lower performance in adults, and higher education was a predictor of better performance. With children and adolescents, increased age was related to better cognitive performance. Most of the studies were written in English and included a cognitively intact sample that was assessed either with the Mini-Mental State Examination, health history, or other clinical interviews or exams. Conclusion: There is an evident improvement in the availability of measures for Spanish speakers. However, there is a need for better-developed tests for this population. Future studies in this area should consider adding variables such as acculturation and bilingualism into research, as well as developing novel measures for Spanish speakers. [ABSTRACT FROM AUTHOR]

Objective: Declines in non-verbal reasoning abilities have been linked to Alzheimer's disease (ad) progression. Individuals with autosomal dominant ad (ADAD) are genetically determined to develop early-onset dementia. We examined the relation between non-verbal reasoning abilities and brain pathology in a Colombian cohort with ADAD due to the Presenilin-1 (PSEN1) E280A mutation. Method: A total of 25 carriers of the PSEN1 E280A mutation (16 cognitively-unimpaired carriers [x- age = 35.25 +/− 4.04]; 9 with mildly impaired (age = 45.56 +/− 2.60), and 27 non-carriers (age = 36.11 +/− 5.59) were included. A summary non-verbal reasoning score was calculated from performance on the Judgment of Line Orientation and the Spanish WAIS-IV Matrix Reasoning and Visual Puzzles subtests. Participants also completed the Mini-mental State Examination (MMSE) and underwent amyloid and tau PET imaging. Mann–Whitney U test and education-adjusted Spearman partial correlations were used to examine group differences and associations between pathology levels and non-verbal reasoning. Results: Compared to carriers, non-carriers had higher MMSE and non-verbal reasoning scores (p = 0.006). In carriers only, lower non-verbal reasoning was associated with greater mean cortical amyloid (r = −0.427, p = 0.037) and greater precuneus tau (r = −0.516, p = 0.010). No significant associations were observed after excluding the impaired carriers from the analyses. Conclusion: Our findings suggest that changes in non-verbal reasoning abilities are evident in early symptomatic ADAD stages and are related to ad brain pathology. Future longitudinal work is needed to characterize the progression of non-verbal reasoning deficits in ADAD. Future research should also examine performance between older adults and people at risk for sporadic ad. [ABSTRACT FROM AUTHOR]

Objective: Previous research has identified that MMSE scores vary by education raising concern that examinees with lower educational level may be inaccurately identified as cognitively impaired. Most studies, however, used the English MMSE and may not generalize to Spanish speakers. We compared MMSE scores in primary Spanish-speakers tested in English (S-E) with primary Spanish-speakers tested in Spanish (S-S). Method: This project involved secondary analysis of de-identified National Alzheimer's Coordinating Center data. Cases with visit one MMSE data and demographics were included if the primary language was Spanish yielding a sample of S-S (n = 1514) and S-E (n = 346) participants. Coarsened exact matching derived a subset of S-E and S-S participants matched on age, education, and Clinical Dementia Rating global score (n = 630). Results: In the overall sample, groups were not different in age, but education was lower in S-S (M = 9.2; SD = 5.1) than S-E (M = 12.9; SD = 5.1; p < 0.001) participants. MMSE scores were lower in S-S (M = 22.4, SD = 7.1) than S-E participants (M = 23.7, SD = 6.2; p = 0.002). More S-S participants (45%) had an abnormal (< 24) MMSE compared to S-E participants (38%; p = 0.02). In the matched sample, MMSE scores were not significantly different between S-S (M = 24.4; SD = 6.0) and S-E (M = 23.9; SD = 6.1; p = 0.30) participants, and rates of abnormal MMSE scores were not significantly different between S-S (32%) and S-E (37%; p = 0.16) participants. Conclusions: Overall sample MMSE scores differed by test administration language groups, but group differences were not observed in the matched subset. Consistent with other research, educational level is associated with MMSE scores in Spanish-speakers regardless of test administration language. [ABSTRACT FROM AUTHOR]

The study purpose was to compare the diagnostic utility of the Brief Cognitive Status Exam (BCSE) to that of the Mini-Mental State Examination (MMSE) and to develop equated scores to facilitate comparisons. One hundred and eighty-two patients underwent cognitive evaluation andwere placed into three groups: dementia (DEM), cognitive impairment, no dementia (CIND), and no cognitive impairment (NCI). One hundred and eighty-two healthy controls from the BCSE standardization sample served as a comparison group. On both measures, the DEM group obtained significantly lower scores than the other two groups, and the CIND group scored significantly lower than the NCI group. The BCSE was more sensitive in all clinical groups, although at extremely low scores, the two tests displayed similar sensitivity. Results indicate the BCSE has diagnostic utility as a cognitive screening measure in a mixed clinical sample and is more sensitive at detecting cognitive impairment, particularly milder levels, than the MMSE. [ABSTRACT FROM AUTHOR]

We examined the utility of illusory contours (ICs) for the differentiation of dementia withLewybodies (DLB) from Alzheimer's disease (AD). Thirty-five probable DLB patients, 35 probable AD patients controlled by age, years of education, and Mini-Mental State Examination (MMSE) score, and 30 cognitively normal subjects controlled by age and years of education underwent visuoperceptual examinations including ICs, pentagon copying in MMSE, overlapping figures, clock drawing test, cube copying, and line orientation. Four items in ICs (ICs-4) were found to be significantly impaired in DLB compared with AD, and a sensitivity and a specificity of total score of ICs-4 were 88.6% and 37.1%, respectively. When a score of ICs-4 is combined with a 10-point scaled score of pentagon copying in MMSE, a sensitivity and a specificity were 77.1% and 82.9%, respectively. The present study suggests that ICs-4 can be included in neuropsychological examinations to assess visuoperceptual impairment in DLB. [ABSTRACT FROM AUTHOR]

We explored the capacity of Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) patients to recognize facial expressions. Twenty-three consecutive CADASIL patients and 23 age-matched, gender-matched, and education-matched controls were assessed with a semi-structured psychiatric interview, cognitive tests, and the Ekman and Friesen test. Cases and controls (5 males, 18 females) had a mean age (+SD) of 52.4 + 15.7 and 54.0 + 15.3 years, respectively, and a Mini-Mental State Examination (MMSE) mean score of 27.8 + 2.2 and 28.9 + 1.3 (p < .05). Eighteen out of the 23 (78.3%) CADASIL patients and 10 (43.5%) controls were diagnosed as affected by major depression according to DSM-IV criteria (p < .05). The CADASIL patients had an impaired ability of emotion recognition in comparison with controls, particularly for fear expression. This effect was not mediated by depression, cognitive impairment, and MMSE score. Facial affect recognition is reduced in the CADASIL patients and this impairment might represent an early manifestation of the disease. [ABSTRACT FROM PUBLISHER]

The Montreal Cognitive Assessment (MoCA) is a relatively newly designed test that was developed as a tool to screen patients with mild cognitive problems that are not typically detected by the Mini-Mental State Exam (MMSE). While early research suggests that the MoCA is more sensitive to subtle cognitive impairment than the MMSE, there is concern about potential decreased specificity when using the MoCA. The aim of the present study was to examine the comparative utility of using the MoCA and the MMSE to detect subtle cognitive impairment among a group of 82 middle-aged U.S. military veterans referred for outpatient neuropsychological testing. Using receiver operating characteristic analyses, the MoCA was shown to be a better predictor of subtle cognitive impairment on neuropsychological testing than the MMSE. When using an adjusted cutoff, the MoCA was shown to be more sensitive (i.e., 0.72 vs. 0.52) and nearly as specific as the MMSE (0.75 vs. 0.77). [ABSTRACT FROM AUTHOR]

The present study compared the performance of English- and Spanish-speaking healthy controls (HCs) on the Spanish translation of the Dementia Rating Scale-Second edition (ST-DRS-2) and examined the classification accuracy of the ST-DRS-2 and Mini-Mental State Examination (MMSE) with an age- and education-matched clinical sample. In contrast to previous findings with English-speakers, a stronger relationship was observed between ST-DRS-2 Total scores and education than with age, and despite being matched on both of these variables, English-speaking HCs significantly out-performed their Spanish-speaking counterparts on the ST-DRS-2. The greatest between-group difference was found on the Memory subscale, wherein the majority of errors committed by Spanish-speaking HCs were significantly related to level of acculturation. ST-DRS-2 Total and Memory subscale scores produced greater classification accuracy than the MMSE; however, ST-DRS-2 Total scores yielded the greatest corresponding rates of sensitivity and specificity. Normative data are provided and recommended to improve the ST-DRS-2's diagnostic accuracy with Spanish-speakers. [ABSTRACT FROM AUTHOR]

The Mini-Mental State Exam (MMSE) is a clinically ubiquitous yet incompletely standardized instrument. Though the test offers considerable examiner leeway, little data exist on the normative consequences of common administration variations. We sought to: (a) determine the effects of education, age, gender, health status, and a common administration variation (serial 7s subtraction vs. “world” spelled backward) on MMSE score within a minority sample, (b) provide normative data stratified on the most empirically relevant bases, and (c) briefly address item failure rates. African American citizens (N = 298) aged 55–87 living independently in the community were recruited by advertisement, community recruitment, and word of mouth. Total score with “world” spelled backward exceeded total score with serial 7s subtraction across all levels of education, replicating findings in Caucasian samples. Education is the primary source of variance on MMSE score, followed by age. In this cohort, women out-performed men when “world” spelled backward was included, but there was no gender effect when serial 7s subtraction was included in MMSE total score. To ensure an appropriate interpretation of MMSE scores, reports, whether clinical or in publications of research findings, should be explicit regarding the administration method. Stratified normative data are provided. [ABSTRACT FROM AUTHOR]

Gender differences in visuospatial cognition favoring men are larger in tasks requiring active information manipulation than in tasks requiring passive storage. This study was designed to determine whether male advantage in active manipulation of visuospatial information can still be evidenced in Alzheimer's disease (AD). Twenty male and 20 female AD patients with equivalent age, education, dementia severity (Mini-Mental State Examination and Mattis Dementia Rating Scale), and visual discrimination abilities were recruited. We administered the forward span of Corsi block-tapping task and Vecchi's matrix memory task involving passive temporary retention of stimuli location. Active manipulation of visuospatial information was assessed with the backward span of Corsi block-tapping task and Vecchi's pathway task in which patients were required to mentally generate a pathway within a matrix. The results showed that scores on the tasks involving passive storage of visuospatial information were equivalent between the two groups of patients, whereas men performed significantly better than women in tasks requiring active manipulation of visuospatial information. This result was limited to visuospatial processing since no difference between male and female patients was evidenced in the verbal short-term memory tasks, neither when the task involved passive storage nor when the task required active processing. Therefore, this study suggests that, besides other variables such as education or lifestyle factors, gender might also modulate the cognitive manifestation of AD. [ABSTRACT FROM PUBLISHER]

The Mini-Mental State Exam (MMSE) is commonly used to screen cognitive function in a clinical setting. The measure has been published in over 50 languages; however, the validity and reliability of the MMSE has yet to be assessed with the culturally Deaf elderly population. Participants consisted of 117 Deaf senior citizens, aged 55–89 (M = 69.44, SD = 8.55). Demographic information, including state of residence, age, and history of depression, head injury, and dementia diagnoses, were collected. A standard form of the MMSE was used with modification of test administration and stimuli including translation of English test items into a sign-based form and alteration of two items in order to make them culturally and linguistically appropriate. Significant correlations were observed between overall test score and education level (r = .23, p = .01) as well as test score and age (r = −.33, p < .001). Patterns of responses were analyzed and revealed several items that were problematic and yielded a fewer correct responses. These results indicate that clinicians need to be aware of cultural and linguistic factors associated with the deaf population that may impact test performance and clinical interpretation of test results. On the basis of these data, there is an increased risk of false positives obtained when using this measure. Further research is needed to validate the use of this measure with the culturally Deaf population. [ABSTRACT FROM PUBLISHER]

Abstract: The present study explored several different procedures for determining the amount of change that occurred on the Mini-Mental State Exam [MMSE; Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). “Mini-Mental State”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198] and Modified Mini-Mental State Exam [3MS; Teng, E. L., & Chui, H. C. (1987). The Modified Mini-Mental State (3MS) examination. Journal of Clinical Psychiatry, 48, 314–318] over short and extended test-retest intervals. The test-retest scores were drawn from a selected sample of elderly individuals who participated in the Canadian Study of Health and Aging [Canadian Study of Health and Aging. (1994). The Canadian study of health and aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150, 899–913] and were tested on two occasions (CSHA-1 and CSHA-2) separated by 5 years. On each occasion the MMSE and 3MS were administered twice at approximately 3-month intervals. Thus, the mental status tests were administered four times: times 1 and 2 at CSHA-1 and times 3 and 4 at CSHA-2. Mean difference scores and percent of baseline scores showed relatively small group changes over both short and long test-retest intervals for the MMSE and the 3MS. A reliable change index based on a linear regression model controlled for practice effects, psychometric errors due to low reliability, regression to the mean, and accounted for the effects of various demographic variables. Consequently, this reliable change index provided a better estimate of the amount of change that occurred for individual participants than did the mean Retest-Test 1 difference, percent of baseline change, or a reliable change index based on a Retest-Test 1 difference score. Normative data for the change scores are provided. [Copyright &y& Elsevier]

Objective A previous meta-analysis assessing the impact of heart failure (HF) on cognition found the HF group performed more poorly than the healthy control (HC) on global cognition measures. The study observed a medium effect and moderate heterogeneity when using the Mini-Mental Status Examination (MMSE) to measure HF's impact on global cognition. The current meta-regression explores whether the mean age of the HF group moderates performance on the MMSE when comparing HF patients to HC. Data Selection Two researchers independently searched eight databases, extracted data, and calculated effect sizes as part of a larger study. Inclusion criteria were: (a) adults with a diagnosis of HF, (b) comparison of HF patients to HC, and (c) adequate data to calculate effect sizes. Articles were excluded if patients had other types of organ failure, the article was not available in English, or there was a risk of sample overlap with another included study. Twelve articles (HF n = 1166 and HC n = 1948) were included. The unrestricted maximum likelihood computational model was used for the meta-regression. Data Synthesis Studies included in the meta-regression evidenced a statistically significant medium effect size estimate with moderate heterogeneity (k = 12, g = 0.671, p < 0.001, I2 = 80.91%). The meta-regression was statistically significant (slope = −0.023, p = 0.0022, Qmodel = 5.26, df = 1, p = 0.022). Conclusions Individuals with HF performed more poorly on the MMSE than HC. Larger effect sizes on the MMSE were observed in studies with participants who were younger compared to studies with participants who were older. Future research should continue to delineate the impact of age on global cognition in individuals with HF. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to gather information on the relationship between judgement/reasoning and global mental status (HC = healthy controls, MCI = Mild Cognitive Impairment, and MND = Major Neurocognitive Disorder) by examining the relationship between performance on the Test of Practical Judgment (TOP-J) and mental status screening in a Veteran population. Method: The retrospective data sample consisted of 218 Veterans, aged 28–96 (M = 69.67, SD = 12.9434), 95.87% male, 98.62% Caucasian, with a mean education of 12.55 years (SD = 2.32). Mental status screening consisted of the raw scores of Mini-Mental Status Examination-2nd edition (MMSE-2) and the Mini-Mental State Examination (3MS, using MMSE equivalent scores). Participants were placed into three categories based on mental status scores: HC (n = 79), MCI (n = 75), and MND (n = 64). TOP-J scores consisted of raw score across 9 items. Results: TOPJ and mental status were mildly correlated for HC (r = .27) and MND (r = 0.34); however, there was minimal correlation for Veterans identified as MCI (r = 0.18). Conclusion: A relationship between judgement/reasoning and global mental status was remarkable for HC and MNC but not for MCI. This may be related to the fact that deficits in judgement/reasoning, by definition, tend to be subtle or non-existent for individuals with MCI. Additionally, studies have revealed the MMSE-2 and TOP-J both have limited specificity in accurately identifying MCI patients. [ABSTRACT FROM AUTHOR]