Questions related to Mild Cognitive Impairment
I have been having some difficulty in understanding the OASIS-3 (Open Access Series of Imaging Studies) database for neuroimaging datasets for cognitively normal and cognitively declining patients (e.g., Alzheimer's disease). There are several respondents who received a "Cognitively Normal" remark for the first diagnosis, while having various remarks for the second diagnosis, particularly: Active/Remote Mood Disorder, Remote Hypothyroidism, Active Bereavement, and Active Alcoholism. Can these "disorders" or "impairments" be classified under Mild Cognitive Impairment (MCI) to eventually lead to Alzheimer's disease or other decline/change in cognitive performance?
I am trying to see how can I identify those patients who have converted to AD from MCI within a certain period, in the ADNI database without having to go through each and every scan in the database.
I know that there are some meta-data given through CSV files on the scan, in the ADNI website but I did not manage to identify a pattern which can help me achieve my goal.
am working on machine learning for early prevention technique
for mild cognitive impairment symptoms
that prevent dementia
and I need DataSet resources
any suggestions/recommendations ?
depression can be a prodrome or a comorbidity of lewy body disease or other cognitive issues (alzheimer, mci, ...)
In which case the psychiatrist must investigate for the lewy body disease ?
With which tools ?
I am interested in the topic of mild cognitive impairment and how early diagnosis will help prevent progression to Alzheimer's disease or dementia. Can someone suggest an intervention or tool that could measure MCI and maintain or improve functional independence respectively? Thank you.
There are many different terms for SCI, thus I also refer to subjective memory impairment (SMI), subjective cognitive complaints (SCC) etc... and subjective cognitive decline (SCD) which is the more appropriate term when referring to the decline associated with further cognitive impairment (i.e. to MCI or AD).
Hi, I need a computer program that can do a baseline and then a retest after a 4 week intervention for patients with MCI, and preferably the same program should be able to test patients with negative symptoms/cognitive symptoms of schizophrenia. Thanks
We would like to use the FCSRT in our clinical routine but we don't find any standardized norms for the German version. Could maybe someone, who is using the FCSRT not only for Research, tell me where I could find reliable norms or which cut-offs they use?
I'm conducting quali research with women with Turner Syndrome, which is associated with a particular cognitive profile. I'm pretty sure how I'm going to adapt the interview methodology around this but would like to find out what other people have done.
Anything where researchers show how they've adapted methods to be more accessible would be of interest.
I am aware of a University of Georgia doctoral candidate who is studying this test as a means of detecting early onset dementias. This test has also been used to indicate fatigue in sleep research. I am interested in this test as a simple and fundamental way of using sensory perception variability to track episodic mild cognitive impairment over time (as a clinical tool in primary care).
The Rapid Cognitive Screen(RCS): A quick screen for Mild Cognitive Impairment
An in depth validation of the RCS has recently been validated. This test takes two and a half minutes to complete. It is superior to the Minimental status(MMSE) and the MiniCog at identifying persons with early cognitive dysfunction. It is derived from the well validated St Louis University Mental Status (SLUMS) examination. It is available in 25 languages http://aging.slu.edu/index.php?page=multi-language-slums.
This is an ideal screener for general practitioners and primary care practitioners.
The Rapid Cognitive Screen (RCS): A Point-of-Care Screening for Dementia and Mild Cognitive Impairment. - PubMed - NCBI
J Nutr Health Aging.The Rapid Cognitive Screen (RCS): A Point-of-Care Screening for Dementia and Mild Cognitive Impairment.
Malmstrom TK Voss VB Cruz-Oliver DM Cummings-Vaughn LA Tumosa NGrossberg GT Morley JEAuthor information
1Theodore K. Malmstrom, PhD, Department of Neurology and Psychiatry, School of Medicine, Saint Louis University, 1438 South Grand Boulevard, St. Louis, Missouri 63104,
I'm looking broadly into the possibility to offer cognitive training to our patients with MCI. What are your experiences? I am interested in which types of training has been tested, the outcome and what the patients themselves have thought about it. Thank you for any comments!
There is a consensus among researchers that late life depression and depression in AD comprehend two different pathologies, with some shared symptoms. For example, apathy and amnesia are common features in both diseases, and could be explained by consequences of a mood disorder or a cognitive syndrome. In addition, frontal lobe dysfunction is linked to a variety of geriatric neuropsychiatric syndromes, representing an area of intersection in depression and dementia (Steffens, 2012).
Therefore, identification of depression as marker for increased risk of conversion from depression to dementia among patients with MCI has become the main focus for those caring for individuals with depression or cognitive impairment. We now need further investigation.
Neuropsychiatric symptoms (NPS) in dementia have been described since Alois Alzheimer’s index case of Auguste D, who presented initially with emotional distress and delusions of infidelity. NPS are common in dementia with prevalence rates of up to 97%. Over time, NPS have become understood to becore symptoms of dementiaand are included in the most recent criteria for all cause dementia. NPS in dementia are associated with faster cognitive decline and acceleratedprogression to severe dementia or death, higher rates of institutionalization, greater functional impairment, greater caregiver stress, worse quality of life and higher burden of neuropathological markers of dementia. NPS are also present in Mild Cognitive Impairment (MCI) with a prevalence of 17-55% and are also associated with poorer outcomes, increased neuropathological burden and faster conversion to dementia, compared to patients without NPS. Evidence now suggests that NPSin the absence of cognitive symptoms may manifest as the initial symptoms of neurodegenerative disease. 28% of dementia cases are initially given psychiatric diagnoses and they present with psychiatric symptoms such as apathy, anxiety, depression or mania. However, there is no systematic method of diagnosing these early NPS and much further work in this area is required.
It is well established that patients with Parkinson's disease show impairments in various cognitive processes including executive function when assessed using computerised cognitive tasks such as the CANTAB battery. A number of pharmaceutical companies are developing drugs for the treatment of cognitive dysfunction in Parkinson's disease including Parkinson's disease MCI.
However, when one looks at research investigating "the patient prospective", cognitive dysfunction is not among the most troubling symptoms reported by patients with early or mid-stage Parkinson's disease.
I have two questions.
1. Do clinicians believe that cognitive dysfunction in early or mid-stage Parkinson's disease affects their day to day functioning (i.e. activities of daily living) and do patients worry about their cognition?
2. Do you think Pharmaceutical companies should keep investing in the development of novel compounds for cognitive enhancement in Parkinson's disease?
The standard tests used in memory clinics e.g. The Montreal Cognitive Assessment (MoCA); Mini Mental State Examination (MMSE); Addenbrooke’s Cognitive Examination (ACE-R); The Trail Making Test etc… are not sensitive enough to pick up very early signs of cognitive impairment. I am currently reviewing the SCI literature for my PhD but I have not yet come across any sensitive enough measures. Is anyone aware of any being developed?
I am looking for information regarding what different memory clinics do when they are presented with someone showing signs of subjective cognitive impairment (SCI). Specifically I am looking at people who present at a memory clinic complaining of a problem with their memory but no paper-based measures pick it up. These people will not have any objective cognitive impairment but know that something is not right. All clinics will look at possible alternative explanations for the SCI e.g. depression, but what I am interested in is what happens to that person when they cannot identify an alternative explanation. Some clinics operate an ‘open door policy’, thus they can contact the clinic for an appointment if they feel their impairment has worsened. Other clinics will discharge them from the service, and if their impairment worsens then they have to go back to their GP and be re-referred to the clinic. I welcome any additional thoughts or suggestions on this area.
Cognitive impairment is an under-recognized component in HF. Not only do clinicians fail to recognize it but it may have a substantial impact on the ability of patients to perform self-care and stay out of the hospital?
Provisional research diagnostic criteria for Mild Behavioral Impairment (MBI)
A. Behavioral concern reflecting a change in behavior observed by patient or informant or clinician, starting later in life (age≥50) and persisting at least intermittently for > 3 months. These represent clear change from the person’s usual behavior as evidenced by at least one of the following:
a. Decreased motivation (e.g. apathy, aspontaneity, indifference)
b. Affective lability (e.g. anxiety, dysphoria, changeability, euphoria, irritability)
c. Impulse dyscontrol (e.g. agitation, disinhibition, gambling, obsessiveness, behavioral perseveration, stimulus bound)
d. Social inappropriateness (e.g. lack of empathy, loss of insight, loss of social graces or tact)
e. Abnormal perception or thought content (e.g. delusions, hallucinations)
B. Behaviors are of sufficient severity to produce disability in at least one of the following areas:
a. Interpersonal relationships
b. Other aspects of social functioning
c. Ability to perform in the workplace
C. While co-morbid conditions may be present, the behavioral changes are not attributable to another psychiatric disorder, or vascular, traumatic or medical causes, or the physiological effects of a substance or medication.
D. The patient does not meet criteria for a dementia syndrome (e.g., Alzheimer’s dementia, frontotemporal dementia, dementia with Lewy bodies, vascular dementia, other dementia). Mild Cognitive Impairment can be concurrently diagnosed with Mild Behavioral Impairment.
In many publications, researchers compare measures using a screening procedure between extreme conditions of interests (those highly affected vs. healthy) without including patients for which the test is most likely to be used on; those for which the situation is not clear.
In your analysis, you compare AD patients to healthy patients without including those with MCI. However, in practice, we are likely to use the instrument on patients with the entire spectrum of severity of dementia. Your results are therefore only valid if we can previously exclude those with MCI and then use the test.
How is this clinically feasible?
Patient is a native German, Polish as a second language in her mid-twenties, still using both Polish and German, now presenting problems with discourse, fluency and naming in both languages. Memory and executive functions persevered, mild attentional deficits.
I am looking for some hands-on activities that could be utilized to educate a child with mild down syndrome, a moderate hearing defect and speech disorder.
I found in a case-control study that they smoke and drink much more. This is another interesting article: I think we have to pay attention to this because ADHD has a huge prevalence (3 to 6% in children and 50% of persistence in adults): Ivanchak, N., Fletcher, K., & Jicha, G. a. (2012, October). Attention-deficit/hyperactivity disorder in older adults: prevalence and possible connections to mild cognitive impairment. Current psychiatry reports. doi:10.1007/s11920-012-0305-8
The so-called depressive pseudodementia, also known as depression-related cognitive impairment, dementia syndrome of depression, depressive dementia, is controversial in its origin, its alleged reversibility and its epidemiology. It is well known that cognitive disturbances, especially regarding attention, memory and executive functions can be present in depressed patients, completely or partially reversible after antidepressant therapy, and cases of reversible MCI with depressive symptoms are reported in literature. However, a symptomatology that simulates a dementia condition due to depression or other psychiatric disorders seems quite rare if not exceptional. Is pseudodementia a realty or hope?
Mild cognitive impairment (MCI) diagnosis is generally accepted as an intermediate condition between cognitive non-normality and dementia. Nevertheless, the exact role of cognitive and daily living autonomy assessment remains quite indefinite. For example, ADL and IADL and MMSE must be normal? The concept of 1.5 standard deviation different from the cognitive performance of a standardized sample, is not very clear neither completely reliable. The use of equivalent points is not diffuse in all countries. Standardized neuropsychological tests are not always available as well as standardized translation of tests. A minimal but sufficient battery of neuropsychological tests has not yet been defined nor widely accepted. For these reasons, MCI diagnosis criteria can be quite different in the some studies, determining differences in findings of epidemiology and in conversion rate from MCI to dementia. What are the proposals to overcome these issues?