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The increasing awareness of cognitive deficits in different medical conditions makes the implementation of cognitive screening a priority in the light of limited access to neuropsychological assessment. However, there is no universally recognised cognitive screening tool. There are shorter and longer tests, more or less focused on detecting particular impairment profiles, more or less adapted to the limitations of patients, and also more or less culturally-free and independent of education status. It is impossible to ideally balance both sensitivity and specificity. With high sensitivity, there is a risk of overestimating impairment, while with high specificity, individuals with very mild difficulties may be misdiagnosed as having intact cognitive performance. Adequate tool selection, suiting the clinical context (e.g. memory clinic or acute stroke unit), the patient's language, motor and sensory function as well as educational and cultural background, is crucial. In this paper, we present tools that are useful in screening for dementia in diseases associated with memory impairment, as well as those useful in detecting early and mild non-amnestic problems: language deficits (e.g. Addenbrooke's Cognitive Examination III, ACE-III), executive deficits (e.g. Edinburgh Cognitive and Behavioral ALS Screen, ECAS; Mattis Dementia Rating Scale, DRS). Scales dedicated to specific group of patients are also discussed (e.g. Parkinson's Disease-Cognitive Rating Scale, PD-CRS). In addition, we present tests designed for stroke patients (e.g. Oxford Cognitive Screen, OCS; Cognitive Assessment scale for Stroke Patients, CASP). No test will be universally useful in all settings, and in most cases the clinician may choose between a few scales feasible in a given context. [ABSTRACT FROM AUTHOR]

Copyright of General Medicine & Health Sciences / Medycyna Ogólna i Nauki o Zdrowiu is the property of Witold Chodzki Institute of Rural Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Dementia has become a major public health concern due to population aging. Recent failures in clinical drug trials highlight the importance of evaluating and treating patients with dementia as early as possible. Weight loss is common in people with dementia, particularly Alzheimer's disease, and it is correlated with increased mortality. Epidemiological studies have shown that late-life weight loss can precede the cognitive decline and begins years before the diagnosis of dementia. Concomitantly late-life elevated body mass index (BMI) confers a lower risk of having dementia. Several factors directly related to neurodegeneration could lead to weight loss in dementia, including cognitive and psychiatric problems, altered olfaction and gustation, and pathology of important structures in the brain, particularly the hypothalamus. The hormone leptin may partially explain the mechanism of how weight loss can precede the cognitive decline. There are differences in the association between midlife BMI and dementia compared to late-life BMI and dementia. Being overweight or obese in mid-life is a risk factor for dementia. Previous studies were mainly based on BMI as a measurement of weight loss, which does not allow one to determine the direction of the association between weight loss and the dementing process. Body composition analysis should be included in further research. [ABSTRACT FROM AUTHOR]

Copyright of Current Neurology / Aktualno?ci Neurologiczne is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: People over the age of 65 are at a significant risk of vitamin D deficiency. This a result of many factors. Based on the studies conducted so far, it can be concluded that there is a relationship between vitamin D deficiency and the elderly age as well as the cognitive efficiency of people in this age group. The aim of the study was to assess the levels of vitamin D, the extent of its deficiency and cognitive performance in people over the age of 65. Material and methods: The study was carried out in 2014–2015 at the Clinic of Old Age Psychiatry and Psychotic Disorders of the Central Clinical Hospital of the Medical University of Lodz, as part of the DemNutr research project. One hundred eighty-seven people were qualified for the study. Among the research methods used, there were: interview, physical examination, clinical-demographic questionnaire and vitamin D [25(OH) D] concentration in blood serum. Results: The mean age of the subjects was 71.3 ± 5.9 years. The majority of the respondents were women – 78.6% (n = 147), men were only 21.4% (n = 40). The mean vitamin D concentrations in the groups of men and women were respectively 23.9 ± 7.46 ng/mL and 24.9 ± 7.21 ng/mL, and were below the norm in both groups. There was a statistically significant difference in the distribution of vitamin D concentration depending on the age of the subjects (p < 0.05). It turned out that in all people aged 85 or more the concentration of vitamin D was below 30 ng/mL vs. 78.7% of those surveyed aged 65–74 vs. 61.4% of people aged 75–84. A statistically significant difference in the average vitamin D concentration was also found in people who were examined in the summer (July – August) compared to the subjects in the period from September to June (p < 0.01). Significantly higher concentrations of vitamin D3were observed in the summer (July – August) than in the remaining months of the year. The respective averages were: 27.2 ± 6.78 ng/mL vs. 23.9 ± 7.24 ng/mL. The mean values in Mini-Mental State Examination (MMSE) were 28.5 ± 1.71 points. There was a statistically significant difference between the number of points obtained in MMSE and age (rank = −0.227, p = 0.0009). There was no statistically significant relationship between the MMSE score the sex of the subjects and the vitamin D concentration (p > 0.05). Conclusions: Among the people over the age of 65, vitamin D deficiency is a common phenomenon. In the study, however, there was no correlation between the vitamin D concentration and the results achieved in MMSE. [ABSTRACT FROM AUTHOR]

W miarę starzenia się społeczeństwa coraz więcej osób doświadcza związanego z wiekiem osłabienia pamięci i zaburzeń innych funkcji poznawczych. Dla części tych osób zaburzenia te mogą być zwiastunem otępienia. Wiadomo, że jego najczęstszą przyczyną jest choroba Alzheimera (Alzheimer’s disease, AD). Stosowane obecnie metody farmakologicznego zapobiegania i leczenia AD są mało skuteczne. Powoduje to, że podejmowane są próby terapii mających na celu spowolnienie przebiegu AD i opóźnienie początku objawowej fazy klinicznej choroby. Może to znacząco wpływać na zmniejszenie zapadalności na AD. Wyniki biologicznych, epidemiologicznych i randomizowanych badań kontrolowanych wskazują na korzystny wpływ regularnej aktywności fizycznej na zapobieganie występowaniu zaburzeń poznawczych u osób w podeszłym wieku i spowolnienie przebiegu AD. Okazuje się, że aktywność fizyczna, szczególnie w połączeniu z aktywnością umysłową i intensywną aktywnością społeczną, może być użyteczną, a przy tym tańszą i bezpieczniejszą metodą zapobiegania AD niż profilaktyka farmakologiczna. Dalszych badań wymaga określenie precyzyjnych zaleceń dotyczących rodzaju, czasu trwania i intensywności tych form terapii. Istnieje jednak szansa, że w bliskiej przyszłości będziemy mogli stosować potwierdzone zasady zapobiegania AD dotyczące zachowań dietetycznych, aktywności społecznej, umysłowej i fizycznej. Wymienione wyżej rodzaje interwencji niefarmakologicznych wpływają również pozytywnie na codzienne funkcjonowanie i ogólną jakość życia osób w podeszłym wieku i pacjentów z AD.