P3-158: Performance of mild cognitive impairment and Alzheimer's disease patients in the Fuld...
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examining gender effects in studies of the association between cogni- tive function and DTI measures. P3-156 THE POLISH ADAPTATION OF THE MONTREAL COGNITIVE ASSESSMENT AND PRELIMINARY RESULTS OF ITS CLINICAL UTILITY IN THE SCREENING FOR COGNITIVE IMPAIRMENT Joanna Magierska, Radoslaw Magierski, Tomasz Sobow, Iwona Kloszewska, Medical University of Lodz, Lodz, Poland. Contact e-mail: [email protected] Background: The Mini-Mental State Examination (MMSE) is a standard tool used for screening purposes but it often fails to detect early cognitive decline. The Montreal Cognitive Assessment (MoCA) is a brief cognitive screening tool with high sensitivity and specificity for detecting mild cognitive impairment (MCI). Aim of this study was to adapt the Polish version of The Montreal Cognitive Assessment test and to evaluate and compare the usefulness of the MoCA test vs MMSE in the early detection of cognitive decline in MCI. Methods: The scale was adapted through translation and back translation to guarantee the semantic equivalence. Afterwards, it was tested on a group of 70 subjects (n 30 meeting criteria DSM IV for Alzheimer’s disease, AD; 20 meeting Petersen’s criteria for MCI; 20 cognitively intact controls) in the University-based Alzheimer’s Outpatients Clinic. All subject underwent general medical, neurological, psychiatric and neuropsychological investigation. The applied testing bat- tery included MMSE, Clinical Dementia Rating (CDR), short version (15-items) of the Geriatric Depression Scale (GDS), Apathy subscale from the Neuropsychiatric Inventory (NPI). Results: Only patients with a mild severity of AD (CDR 1) were included. Both MCI and AD groups exhibited impaired performance on MoCA compared to controls. Patients with AD showed significantly greater deficits on MoCA than on MMSE. In the tested population the MoCA test was superior to MMSE in discriminating AD patients from MCI and control populations. Conclusions: The Polish version of MoCA seems appropriate for the differentiation of healthy and deteriorated cognitive performance in a population of Polish patients. P3-157 HISTORY OF MEMORY DECLINE IN HEALTHY OLDER PEOPLE PREDICTS FUTURE MEMORY DECLINE Paul T. Maruff, Jane Weaver Cargin, Colin Masters, University of Melbourne, Melbourne, Australia. Contact e-mail: [email protected] Background: Objective measurement of cognitive function over time may provide the most sensitive and reliable method for detecting preclinical Alzheimer’s disease. Methods: Older adults identified as having either episodic memory decline (n 27) or stable memory performance (n 64) over 6 years were reassessed one year later using a broad neuropsycho- logical battery. Results: Older adults with memory decline continued to demonstrate subtle decline on the same task when assessed one year later, while those with stable memory remained stable. This pattern of memory decline and stability was only apparent when performance over the entire duration of the study was taken into account and performance over one year was considered insufficient in length to determine memory and other cognitive function over time. Deficits in memory and learning observed at the final assessment could not be explained by age-related changes, edu- cation, intelligence, mood, health-related factors, or the individuals’ APOE 4 status. Decline in memory performance was not associated with greater complaints regarding cognition. Conclusions: Decline in memory function is consistent with early deterioration in MCI and preclinical AD and confirms the need to monitor individuals with objective memory decline over extended periods of time, even when these individuals fall within normal limits for a given neuropsychological task. P3-158 PERFORMANCE OF MILD COGNITIVE IMPAIRMENT AND ALZHEIMER’S DISEASE PATIENTS IN THE FULD OBJECT-MEMORY EVALUATION (FOME) Cla ´udia M. Memo ´ria, Mo ˆ nica Yassuda, Mariana Flaks, Luciane Viola, Fernanda Pereira, Orestes Forlenza, University of Sa ˜o Paulo, Sa ˜o Paulo, Brazil. Contact e-mail: [email protected] Background: The FOME is a routinely used neuropsychological test which evaluates the different aspects of verbal memory (storage, retrieval and reten- tion) and learning slope. Deficits in episodic memory are an early feature of Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD). Objectives: we aimed to describe the performance of MCI and AD patients, compared to patients without evidence of cognitive disorders, in the FOME scores (storage, retrieval, repeated retrieval, ineffective reminders and delayed recall). Meth- ods: The FOME was part of a comprehensive neuropsychological battery administered in patients enrolled in the Psychogeriatric Unit of the LIM-27, Institute of Psychiatry, University of Sa ˜ o Paulo. Diagnoses of MCI and AD were reached at multidisciplinary consensus meetings. Results: AD patients had significantly worse performance than MCI patients and controls in all FOME scores. On the other hand, MCI patients had significantly worse performance in the storage (p .001), delayed recall (p .002), and repeated retrieval (p .001), compared to controls. Conclusions: The FOME can help to recognize patients with subtle memory deficits and may aid in the identi- fication of individuals at higher risk of AD, i.e. patients with MCI. P3-159 PRACTICE EFFECTS: FACTORS ASSOCIATED WITH REPEATED MEMORY IMPAIRMENT SCREEN SCORES IN THE ANTIOXIDANT ALZHEIMER’S DISEASE PREVENTION (PREADVISE) TRIAL Marta S. Mendiondo, Richard J. Kryscio, Erin L. Abner, Allison M. Caban-Holt, Cecil Runyons, William R. Markesbery, Frederick A. Schmitt, University of Kentucky, Lexington, KY, USA. Contact e-mail: [email protected] Background: The primary aim of the NIA-sponsored PREADVISE trial is to determine the effectiveness of vitamin E and selenium in preventing the onset of Alzheimer’s disease (AD) in over 6,667 men in collaboration with the NCI-sponsored SELECT prostate cancer preven- tion study. Methods: PREADVISE participants have annual Memory Impairment Screen (MIS) evaluations. Participants who score below cutoff on the MIS are evaluated to verify cognitive impairment. 5,216 men presently enrolled in PREADVISE have had two MIS evaluations one year apart. Results: The mean age of the 86.2% white repeat cohort at baseline was 67.6 5.1 years at enrollment with 15.0 2.6 years of education. Further, 21.6% had at least one first degree relative with a dementing disorder. MIS scores ranged from 3 to 8 with 67.9% scoring a perfect 8, and 80.0% of these participants also scoring 8 at the second assessment. Of the 1,650 enrollees who scored less than 8 at baseline, 30.3% had greater scores on the second MIS. A logistic regression showed that having 16 years of education (adjusted odds ratio 0.63; 95% CI 0.48-0.82), age at enrollment (adjOR 1.04; 95% CI 1.02- 1.06), and presence of CABG (adjOR 1.96; 95% CI 1.12-3.41) were associated with improvement in MIS performance. Of the 4,626 men who scored 7 or 8 at baseline, 4.8% showed a decline to a score below 7 at the second screen (increased risk for MCI or dementia). In a logistic model, white race (adjOR 2.78; 95% CI 1.47-5.26), 16 years of education (adjOR 2.66; 95% CI 1.90-3.74), age at baseline (adjOR 0.93; 95% CI 0.90-0.95), and at least some college (adjOR 1.56; 95% CI 1.09-2.21), presence of diabetes (adjOR 0.54; 95% CI 0.37-0.79) were associated with a decline. Conclusions: We conclude that college education has a positive effect, whereas age and CABG have a negative effect, on the odds that a practice effect is observed among those who scored less than 8 on the baseline MIS. In addition, the data suggest that T566 Poster Presentations P3:
Transcript of P3-158: Performance of mild cognitive impairment and Alzheimer's disease patients in the Fuld...
examining gender effects in studies of the association between cogni-tive function and DTI measures.
P3-156 THE POLISH ADAPTATION OF THE MONTREALCOGNITIVE ASSESSMENT AND PRELIMINARYRESULTS OF ITS CLINICAL UTILITY IN THESCREENING FOR COGNITIVE IMPAIRMENT
Joanna Magierska, Radoslaw Magierski, Tomasz Sobow,Iwona Kloszewska, Medical University of Lodz, Lodz, Poland. Contacte-mail: [email protected]
Background: The Mini-Mental State Examination (MMSE) is a standardtool used for screening purposes but it often fails to detect early cognitivedecline. The Montreal Cognitive Assessment (MoCA) is a brief cognitivescreening tool with high sensitivity and specificity for detecting mildcognitive impairment (MCI). Aim of this study was to adapt the Polishversion of The Montreal Cognitive Assessment test and to evaluate andcompare the usefulness of the MoCA test vs MMSE in the early detectionof cognitive decline in MCI. Methods: The scale was adapted throughtranslation and back translation to guarantee the semantic equivalence.Afterwards, it was tested on a group of 70 subjects (n�30 meeting criteriaDSM IV for Alzheimer’s disease, AD; 20 meeting Petersen’s criteria forMCI; 20 cognitively intact controls) in the University-based Alzheimer’sOutpatients Clinic. All subject underwent general medical, neurological,psychiatric and neuropsychological investigation. The applied testing bat-tery included MMSE, Clinical Dementia Rating (CDR), short version(15-items) of the Geriatric Depression Scale (GDS), Apathy subscale fromthe Neuropsychiatric Inventory (NPI). Results: Only patients with amild severity of AD (CDR�1) were included. Both MCI and ADgroups exhibited impaired performance on MoCA compared to controls.Patients with AD showed significantly greater deficits on MoCA thanon MMSE. In the tested population the MoCA test was superior toMMSE in discriminating AD patients from MCI and control populations.Conclusions: The Polish version of MoCA seems appropriate for thedifferentiation of healthy and deteriorated cognitive performance in apopulation of Polish patients.
P3-157 HISTORY OF MEMORY DECLINE IN HEALTHYOLDER PEOPLE PREDICTS FUTURE MEMORYDECLINE
Paul T. Maruff, Jane Weaver Cargin, Colin Masters, University ofMelbourne, Melbourne, Australia. Contact e-mail:[email protected]
Background: Objective measurement of cognitive function over time mayprovide the most sensitive and reliable method for detecting preclinicalAlzheimer’s disease. Methods: Older adults identified as having eitherepisodic memory decline (n�27) or stable memory performance (n�64)over 6 years were reassessed one year later using a broad neuropsycho-logical battery. Results: Older adults with memory decline continued todemonstrate subtle decline on the same task when assessed one year later,while those with stable memory remained stable. This pattern of memorydecline and stability was only apparent when performance over the entireduration of the study was taken into account and performance over oneyear was considered insufficient in length to determine memory and othercognitive function over time. Deficits in memory and learning observed atthe final assessment could not be explained by age-related changes, edu-cation, intelligence, mood, health-related factors, or the individuals’ APOE�4 status. Decline in memory performance was not associated with greatercomplaints regarding cognition. Conclusions: Decline in memory functionis consistent with early deterioration in MCI and preclinical AD andconfirms the need to monitor individuals with objective memory declineover extended periods of time, even when these individuals fall withinnormal limits for a given neuropsychological task.
P3-158 PERFORMANCE OF MILD COGNITIVEIMPAIRMENT AND ALZHEIMER’S DISEASEPATIENTS IN THE FULD OBJECT-MEMORYEVALUATION (FOME)
Claudia M. Memoria, Mo nica Yassuda, Mariana Flaks, Luciane Viola,Fernanda Pereira, Orestes Forlenza, University of Sao Paulo, Sao Paulo,Brazil. Contact e-mail: [email protected]
Background: The FOME is a routinely used neuropsychological test whichevaluates the different aspects of verbal memory (storage, retrieval and reten-tion) and learning slope. Deficits in episodic memory are an early feature ofMild Cognitive Impairment (MCI) and Alzheimer’s disease (AD). Objectives:we aimed to describe the performance of MCI and AD patients, compared topatients without evidence of cognitive disorders, in the FOME scores (storage,retrieval, repeated retrieval, ineffective reminders and delayed recall). Meth-ods: The FOME was part of a comprehensive neuropsychological batteryadministered in patients enrolled in the Psychogeriatric Unit of the LIM-27,Institute of Psychiatry, University of Sa o Paulo. Diagnoses of MCI and ADwere reached at multidisciplinary consensus meetings. Results: AD patientshad significantly worse performance than MCI patients and controls in allFOME scores. On the other hand, MCI patients had significantly worseperformance in the storage (p�.001), delayed recall (p�.002), and repeatedretrieval (p�.001), compared to controls. Conclusions: The FOME can helpto recognize patients with subtle memory deficits and may aid in the identi-fication of individuals at higher risk of AD, i.e. patients with MCI.
P3-159 PRACTICE EFFECTS: FACTORS ASSOCIATEDWITH REPEATED MEMORY IMPAIRMENTSCREEN SCORES IN THE ANTIOXIDANTALZHEIMER’S DISEASE PREVENTION(PREADVISE) TRIAL
Marta S. Mendiondo, Richard J. Kryscio, Erin L. Abner,Allison M. Caban-Holt, Cecil Runyons, William R. Markesbery,Frederick A. Schmitt, University of Kentucky, Lexington, KY, USA.Contact e-mail: [email protected]
Background: The primary aim of the NIA-sponsored PREADVISEtrial is to determine the effectiveness of vitamin E and selenium inpreventing the onset of Alzheimer’s disease (AD) in over 6,667 men incollaboration with the NCI-sponsored SELECT prostate cancer preven-tion study. Methods: PREADVISE participants have annual MemoryImpairment Screen (MIS) evaluations. Participants who score belowcutoff on the MIS are evaluated to verify cognitive impairment. 5,216men presently enrolled in PREADVISE have had two MIS evaluationsone year apart. Results: The mean age of the 86.2% white repeat cohortat baseline was 67.6 � 5.1 years at enrollment with 15.0 � 2.6 years ofeducation. Further, 21.6% had at least one first degree relative with adementing disorder. MIS scores ranged from 3 to 8 with 67.9% scoringa perfect 8, and 80.0% of these participants also scoring 8 at the secondassessment. Of the 1,650 enrollees who scored less than 8 at baseline,30.3% had greater scores on the second MIS. A logistic regressionshowed that having 16� years of education (adjusted odds ratio � 0.63;95% CI 0.48-0.82), age at enrollment (adjOR � 1.04; 95% CI 1.02-1.06), and presence of CABG (adjOR � 1.96; 95% CI 1.12-3.41) wereassociated with improvement in MIS performance. Of the 4,626 menwho scored 7 or 8 at baseline, 4.8% showed a decline to a score below7 at the second screen (increased risk for MCI or dementia). In a logisticmodel, white race (adjOR � 2.78; 95% CI 1.47-5.26), 16� years ofeducation (adjOR � 2.66; 95% CI 1.90-3.74), age at baseline (adjOR �0.93; 95% CI 0.90-0.95), and at least some college (adjOR � 1.56; 95%CI 1.09-2.21), presence of diabetes (adjOR � 0.54; 95% CI 0.37-0.79)were associated with a decline. Conclusions: We conclude that collegeeducation has a positive effect, whereas age and CABG have a negativeeffect, on the odds that a practice effect is observed among those whoscored less than 8 on the baseline MIS. In addition, the data suggest that
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