Objective To evaluate the reliability and validity and perform cost-consequence analysis of the brief version of the Montreal cognitive assessment(MoCA)for identifying cognitive impairment in a community-based population ≥50 years of age.Methods The internal consistency and retest reliability of the brief version of the MoCA were analyzed,and the area under the curve(AUC),sensitivity,and specificity were determined to discriminate mild cognitive impairment(MCI)and dementia with the clinical dementia rating(CDR)as the diagnostic criterion.The consistency between the brief version and the full version was analyzed by the Kappa test and the Bland-Altman method,and the number of individuals entering the diagnostic assessment and the overall assessment time were estimated and compared between the two versions.Results A total of 303 individuals were included in this study,of whom 192,94,and 17 had normal cognitive function,MCI,and dementia,respectively.The Cronbach's α and re-test coefficients of the brief version of MoCA were 0.754 and 0.711(P<0.001),respectively.The brief version showed the AUC,sensitivity,and specificity of 0.889,74.5%,and 93.8% for identifying MCI,and 0.994,100%,and 93.8% for identifying dementia,respectively.When the brief version of MoCA was used to identify 94 patients with MCI in 303 individuals,107 individuals required additional diagnostic assessment,with an overall assessment time of 142.4 h,which represented decreases of 21.3% and 32.7%,respectively,compared with those of the full version.When the brief version of MoCA was used to identify 17 patients with dementia in 303 individuals,35 individuals required additional diagnostic assessment,with an overall assessment time of 70.4 h,a decrease of 29.5% in the time cost compared with the full version.Conclusions The brief version of MoCA can identify cognitively impaired individuals in a community-based middle-aged and elderly population,with diagnostic validity comparable to that of the full version but less time cost and fewer individuals needing additional diagnostic assessment to detect true-positive cases.It could be expanded for use in the community-based primary screening setting.
Humans ; Aged ; Middle Aged ; Cognitive Dysfunction/diagnosis* ; Male ; Female ; Mental Status and Dementia Tests ; Reproducibility of Results ; Dementia/diagnosis* ; Sensitivity and Specificity ; Aged, 80 and over ; Cost-Benefit Analysis

Dementia is an acquired loss of cognitive ability and is found to have a significant physical, psychological, social, and economic impact on patients, families, and communities. Diagnosis of dementia should be based on history and physical examination, together with cognitive, functional, and behavioral assessment. Validated tools such as the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MOCA) should be used to screen for cognitive impairment. Functionality or Activities of Daily Living (ADL) should be assessed using the Katz and Lawton Index. Work-up of patients with dementia includes ruling out dementia-mimicking conditions, including routine hematology (full blood count and ESR), biochemistry (electrolytes, calcium, glucose, renal and liver function), Thyroid function tests, and Serum B12 and folate levels. Neuroimaging is performed to detect reversible causes of cognitive impairment and to determine the subtype of dementia. Family-based and community-based interventions should be offered to patients with dementia.

Objective:To explore the effect of mild hearing loss on cognitive function by evaluating the Montreal Cognitive Assessment（MoCA） in idiopathic tinnitus patients with mild hearing loss. Methods:102 patients with idiopathic tinnitus（68 patients with normal hearing and 34 patients with mild hearing loss） whose first complaint is tinnitus and 34 healthy volunteers（control group） were included. All subjects were asked to fill the MoCA, Tinnitus Handicap Inventory（THI）, Self-rating Anxiety Scale（SAS）, Self-rating Depression Scale（SDS）, and Pittsburgh Sleep Index（PQSI） after collecting medical history, pure tone audiometry, tinnitus matching and masking test. The clinical characteristics and scores of each scale were compared among the groups. Results:The score and each dimension score of MoCA in idiopathic tinnitus patients with normal hearing were significantly lower than the normal population（P<0.05）; compared with patients with idiopathic tinnitus with normal hearing, patients with mild hearing loss were older（P<0.01） and had lower MoCA scores（P<0.05）. There was no significant difference in MoCA scores（P>0.05） between tinnitus patients with normal hearing and mild hearing loss after correcting confounding factors（age, gender, years of education, duration of tinnitus, frequency of tinnitus tones, side of tinnitus, THI score, SAS score, SDS score, and PQSI score）; idiopathic tinnitus patients with mild hearing loss scored significantly lower in attention and working memory dimensions than idiopathic tinnitus patients with normal hearing（P<0.01）. Conclusion:Patients with idiopathic tinnitus may have cognitive dysfunction, and mild hearing loss may not be a factor that promotes the further aggravation of cognitive dysfunction in patients with idiopathic tinnitus. The role of hearing loss in cognitive dysfunction in patients with idiopathic tinnitus needs further research.
Humans ; Tinnitus/psychology* ; Male ; Female ; Hearing Loss/complications* ; Middle Aged ; Mental Status and Dementia Tests ; Cognition ; Audiometry, Pure-Tone ; Case-Control Studies ; Adult

Background: Breast cancer is the leading cause of cancer death among women worldwide. Studies showed conflicting results regarding presence of cancer, cancer treatment, and its association with dementia. Likewise, depression is often associated with cognitive problems. Objectives: This study aims to determine the prevalence and association of cognitive impairment and depression among breast cancer patients Methods: This is a prospective cross-sectional study utilizing Montreal Cognitive Assessment – Philippines (MOCA-P) and Patient Health Questionnaire (PHQ-9) Filipino version questionnaires through face-to-face interview. In analyzing the presence of cognitive impairment and depression, Chi-square was performed; all significant factors from this test underwent binary logistic regression to ascertain the statistical effect size for the presence of cognitive impairment and depression. Results: Results showed that 80.8% (97 out of 120 patients) have cognitive impairment while 27.5% of the patients have depression. Among the patients with cognitive impairment, 24.2% of them had depression. Results also showed significant association between the level of education and MOCA-P score suggesting that the higher the level of education, the better the MOCA-P score. This study showed no significant association between presence of cognitive impairment and depression. Conclusion In analyzing and managing patients with cognitive impairment, the level of educational attainment should be put into consideration since it is correlated significantly with MOCA-P results. As such, concomitant depression should be addressed accordingly since it may affect the patients’ overall health status.
Cognitive Dysfunction ; Depression ; Breast Neoplasms ; Mental Status and Dementia Tests

Aged ; Aged, 80 and over ; Alzheimer Disease/diagnosis* ; Animals ; Biomarkers/blood* ; Cognitive Dysfunction ; Female ; Humans ; Male ; Membrane Glycoproteins/blood* ; Mental Status and Dementia Tests ; Mice ; Middle Aged ; Models, Animal ; Morris Water Maze Test ; Parkinson Disease/diagnosis* ; ROC Curve ; Receptors, Immunologic/blood* ; Sensitivity and Specificity

BACKGROUND: Single subcortical infarction (SSI) is caused by two main etiological subtypes, which are branch atheromatous disease (BAD) and cerebral small vessel disease (CSVD)-related SSI. We applied the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ), the Shape Trail Test (STT), and the Stroop Color and Word Test (SCWT) to investigate the differences in cognitive performance between these two subtypes of SSI. METHODS: Patients with acute SSIs were prospectively enrolled. The differences of MoCA-BJ, STT, and SCWT between the BAD group and CSVD-related SSI group were analyzed. A generalized linear model was used to analyze the associations between SSI patients with different etiological mechanisms and cognitive function. We investigated the correlations between MoCA-BJ, STT, and SCWT using Spearman's correlation analysis and established cut-off scores for Shape Trail Test A (STT-A) and STT-B to identify cognitive impairment in patients with SSI. RESULTS: This study enrolled a total of 106 patients, including 49 and 57 patients with BAD and CSVD-related SSI, respectively. The BAD group performances were worse than those of the CSVD-related SSI group for STT-A (83 [60.5-120.0] vs. 68 [49.0-86.5], P = 0.01), STT-B (204 [151.5-294.5] vs. 153 [126.5-212.5], P = 0.015), and the number of correct answers on Stroop-C (46 [41-49] vs. 49 [45-50], P = 0.035). After adjusting for age, years of education, National Institutes of Health Stroke Scale and lesion location, the performance of SSI patients with different etiological mechanisms still differed significantly for STT-A and STT-B. CONCLUSIONS BAD patients were more likely to perform worse than CSVD-related SSI patients in the domains of language, attention, executive function, and memory. The mechanism of cognitive impairment after BAD remains unclear.
Cerebral Infarction ; Cerebral Small Vessel Diseases ; Cognitive Dysfunction/etiology* ; Executive Function ; Humans ; Mental Status and Dementia Tests

OBJECTIVES: Perioperative neurocognitive disorders (PND) is one of the important factors affecting the recovery of the elderly after surgery, and sleep disorders are also one of the common diseases of the elderly. Previous studies have shown that the quality of postoperative sleep may be factor affecting postoperative cognitive function, but there are few studies on the relationship between preoperative sleep disorders and postoperative cognitive dysfunction. This study aims to explore the relationship between preoperative sleep disorders and postoperative delayed neurocognitive recovery in elderly patients, and provide references for improving the prognosis and quality of life of patients. METHODS: This study was porformed as a prospective cohort study. Elderly patients (age≥65 years old) underwent elective non-cardiac surgery at Xiangya Hospital of Central South University from October 2019 to January 2020 were selected and interviewed 1 day before the operation. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) were used to assess the patient's baseline cognitive status. Patients with preoperative MMSE scores of less than 24 points were excluded. For patients meeting the criteria of inclusion, Pittsburgh Sleep Quality Index (PSQI) scale was used to evaluate the patients, and the patients were divided into a sleep disorder group and a non-sleep disorder group according to the score. General data of patients were collected and intraoperative data were recorded, such as duration of surgery, anesthetic time, surgical site, intraoperative fluid input, intraoperative blood product input, intraoperative blood loss and drug use. On consecutive 5 days after surgery, Numerical Rating Scale (NRS) was used to evaluate the sleep of the previous night and the pain of the day, which were recorded as sleep NRS score and pain NRS score; Confusion Assessment Method for ICU (CAM-ICU) scale and Confusion Assessment Method (CAM) scale were used to assess the occurrence of delirium. On the 7th day after the operation, the MMSE and MoCA scales were used to evaluate cognitive function of patients. We compared the incidence of postoperative complications, the number of deaths, the number of unplanned ICU patients, the number of unplanned secondary operations, etc between the 2 groups. The baseline and prognosis of the 2 groups of patients were analyzed by univariate and multivariate logistics to analyze their correlation. RESULTS: A total of 105 patients were collected in this study, including 32 patients in the sleep disorder group and 73 patients in the non-sleep disorder group. The general information of the 2 groups, such as age, gender, body mass index, and surgery site, were not statistically significant (all CONCLUSIONS Preoperative sleep disorders can increase the risk of delayed neurocognitive function recovery in elderly patients. Active treatment of preoperative sleep disorders may improve perioperative neurocognitive function in elderly patients.
Aged ; Humans ; Mental Status and Dementia Tests ; Postoperative Complications/epidemiology* ; Prospective Studies ; Quality of Life ; Sleep Quality ; Sleep Wake Disorders/etiology*

Objective: Evidence regarding alcohol consumption and cognitive impairment is controversial. Whether cessation of drinking alcohol by non-dependent drinkers alters the risk of cognitive impairment remains unknown. This study prospectively evaluated the potential association between the history of lifetime alcohol cessation and risk of cognitive impairment. Methods: This study included 15,758 participants age 65 years or older, selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that covered 23 provinces in China. Current alcohol use status, duration of alcohol cessation, and alcohol consumption before abstinence were self-reported by participants; cognitive function was evaluated using Mini-mental State Examination (MMSE). Cause-specific hazard models and restricted cubic splines were applied to estimate the effect of alcohol use on cognitive impairment. Results: Among the 15,758 participants, mean (± SD) age was 82.8 years (± 11.9 years), and 7,199 (45.7%) were males. During a mean of 3.9 years of follow-up, 3,404 cases were identified as cognitive impairment. Compared with current drinkers, alcohol cessation of five to nine years [adjusted Conclusion A longer duration of alcohol cessation was associated with a lower risk of cognitive impairment assessed by MMSE. Alcohol cessation is never late for older adults to prevent cognitive impairment.
Aged ; Aged, 80 and over ; Alcohol Abstinence ; Alcohol Drinking ; China ; Cognition ; Cognitive Dysfunction/epidemiology* ; Female ; Health Behavior ; Humans ; Longitudinal Studies ; Male ; Mental Status and Dementia Tests ; Risk

Acupuncture Points ; Cognition ; Cognitive Dysfunction/therapy* ; Diabetes Mellitus, Type 2/therapy* ; Humans ; Mental Status and Dementia Tests ; Moxibustion

Aged ; Cognition ; Cognitive Dysfunction/therapy* ; Female ; Humans ; Male ; Mental Status and Dementia Tests ; Middle Aged ; Pilot Projects