[show abstract][hide abstract] ABSTRACT: ABSTRACT INTRODUCTION:Cognitive impairment is a frequent feature of chronic obstructive pulmonary disease (COPD). However, the proportion of COPD patients with mild cognitive impairment (MCI) is still unknown, and no screening test has been validated to date for detecting MCI in this population. OBJECTIVE:To determine the frequency and subtypes of MCI in COPD patients and to assess the validity of two cognitive screening tests, the Mini-Mental State Examination (MMSE), and the Montreal Cognitive Assessment (MoCA), in detecting MCI in COPD. METHODS:Forty-five moderate to severe COPD patients and 50 healthy controls underwent a comprehensive neuropsychological assessment using standard MCI criteria. Receiver operating characteristic curves were obtained to assess the validity of the MMSE and the MoCA to detect MCI in COPD patients. RESULTS:MCI was found in 36% of COPD patients compared to 12% of healthy subjects. COPD patients with MCI had mainly the nonamnestic MCI single domain subtype with predominant attention and executive dysfunctions. The optimal MoCA screening cut-off was 26 (≤25 indicates impairment, with 81% sensitivity, 72% specificity and 76% correctly diagnosed). No MMSE cut-off had acceptable validity. CONCLUSIONS:In this preliminary study, a substantial proportion of COPD patients were found to have MCI, a known risk factor for dementia. Longitudinal follow-up on these patients is needed to determine the risk of developing more severe cognitive and functional impairments. Moreover, the MoCA is superior to the MMSE in detecting MCI in COPD patients.
[show abstract][hide abstract] ABSTRACT: Impaired sense of smell is one of the earliest clinical features in both Alzheimer's disease (AD) and Parkinson's disease (PD). A meta-analysis was performed on articles obtained from the PubMed database in order to determine what aspects of olfaction are affected in these two diseases. By applying strict criteria, we included a total of 81 studies meeting the following criteria: (1) patients had a clinical diagnosis of AD or PD; (2) patients were compared to a healthy control group; (3) patients and controls were age-matched; (4) olfactory function was assessed by means of a psychophysical olfactory test; (5) mean and standard deviation were reported. Results indicate that AD and PD patients are more impaired on odor identification and recognition tasks than on odor detection thresholds task. In addition, PD patients are more impaired on detection thresholds than AD patients. These results suggest that PD patients are more impaired on low-level perceptual olfactory tasks whereas AD patients are more strongly impaired on higher-order olfactory tasks involving specific cognitive processes. The effect appears more pronounced for AD than PD, which seem to be affected more homogeneously. In conclusion, olfactory identification and recognition appear as the most interesting candidates to be included in a battery to detect subclinical cases in AD. In parallel, detection thresholds should be included in such a battery for subclinical PD patients.
Behavioural brain research 03/2012; 231(1):60-74. · 3.22 Impact Factor