Development of a method for quantifying cognitive ability in the elderly through adaptive test administration

Development of a digital memory and learning test for elderly individuals

BACKGROUND

Population aging and the increase in memory-related diseases have motivated the search for accessible cognitive screening instruments. To develop a digital memory and learning test (DMLT) based on Rey's Auditory Verbal Learning Test (RAVLT) principles to assess cognition in the elderly and identify early cognitive decline.

METHODS

The research was divided into two phases: developing the digital test and the experimental phase of comparison with a reference test. The test was designed to assess episodic declarative memory through auditory-verbal learning. The experimental procedure involved 18 elderly participants and aimed to compare the performance on the digital test with the traditional RAVLT, followed by an evaluation of participant satisfaction.

RESULTS

Performance on the digital test and the RAVLT was comparable, with no significant statistical differences, indicating convergent validity between the instruments. Electroencephalographic activity analyses revealed correlations between wave patterns and test performance, suggesting that the digital test may provide additional insights into the neurophysiological processes underlying cognitive performance. Satisfaction assessment revealed high participant acceptance.

CONCLUSION

The DMLT is a promising tool for cognitive assessment in the elderly, offering an accessible alternative. The high acceptance among elderly participants suggests that the test has potential for clinical and research use, although further studies are needed to validate its effectiveness in broader clinical settings.

Tracking Cognitive Performance in the General Population and in Patients with Mild Cognitive Impairment with a Self-Applied Computerized Test (Brain on Track)

Repeated measurements could be helpful to identify patients with early cognitive decline. We compare the variation of cognitive performance over one year in patients with mild cognitive impairment (MCI) and healthy individuals using the Brain on Track self-applied computerized test (BoT). The study was initiated 30 patients with probable MCI and 377 controls from a population-based cohort, who performed the BoT test from home every three months for one year. The scores were compared using a linear mixed-effects model. All participants increased their scores in the first tests, after 120 days MCI patients started to decline, with a statistically significant higher rate. The area under the curve to detect MCI was 0.94. We identified a significant decline in cognitive performance over one year in patients with MCI using BoT and the test presented a high discriminative ability.

Comparison of Alternate and Original Items on the Montreal Cognitive Assessment

Background

The Montreal Cognitive Assessment (MoCA) is a screening tool for mild cognitive impairment (MCI) in elderly individuals. We hypothesized that measurement error when using the new alternate MoCA versions to monitor change over time could be related to the use of items that are not of comparable difficulty to their corresponding originals of similar content. The objective of this study was to compare the difficulty of the alternate MoCA items to the original ones.

Methods

Five selected items from alternate versions of the MoCA were included with items from the original MoCA administered adaptively to geriatric outpatients (N = 78). Rasch analysis was used to estimate the difficulty level of the items.

Results

None of the five items from the alternate versions matched the difficulty level of their corresponding original items.

Conclusions

This study demonstrates the potential benefits of a Rasch analysis-based approach for selecting items during the process of development of parallel forms. The results suggest that better match of the items from different MoCA forms by their difficulty would result in higher sensitivity to changes in cognitive function over time.

Serum miR-132 is a risk marker of post-stroke cognitive impairment

BACKGROUND/AIMS

Recently, it has been reported that the microRNA-132(miR-132) is linked with synaptic plasticity and cognitive impairment. The present study investigates that whether miR-132 is altered in circulating blood serum samples of post-stroke cognitive impairment (PSCI) patients.

METHODS

We collected samples from 39 subjects with PSCI, 37 subjects with post-stroke cognitive normality (PSCN), and 38 age-matched controls (AMC) for which ages, gender and education level were matched. MiR-132 was detected using a quantitative real-time PCR (qRT-PCR) method. To test the predictive value of miR-132 for PSCI, prediction capabilities were compared using the receiver operating characteristic (ROC) curves and area under curve (AUC) analysis.

RESULTS

The level of miR-132 in PSCI patient serum was significantly elevated compared to that of PSCN and AMC subjects. The ROC curve showed that miR-132 achieved an AUC of 0.961 (p<0.0001). Importantly, the miR-132 level was correlated with the Montreal Cognitive Assessment (MoCA) score in PSCI patients.

CONCLUSIONS

These results indicated that there was a substantial correlation between serum miR-132 expression and post-stroke cognitive functionality, suggesting that miR-132 may be a risk marker for PSCI. Because of the limitations of this study, the results should be treated with caution.

Scaling Cognitive Domains of the Montreal Cognitive Assessment: An Analysis Using the Partial Credit Model

The psychometric properties of the Montreal Cognitive Assessment (MoCA) were examined by using the Partial Credit Model. The study sample included 897 participants who were distributed into two main subgroups: (I) the clinical group (90 patients with Mild Cognitive Impairment, 90 patients with Alzheimer's disease, 33 patients with Frontotemporal Dementia, and 34 patients with Vascular dementia, whose diagnoses were previously established according to a consensus that was reached by a multidisciplinary team, based on the international criteria) and (II) the healthy group (composed of 650 cognitively healthy community dwellers). The results show (i) an overall good fit for both the items and the persons' values, (ii) high variability for the cognitive performance level of the cognitive domains (ranging between 1.90 and -3.35, where "Short-term Memory" was the most difficult item and "Spatial Orientation" was the easiest item) and between the subjects on the scale, (iii) high reliability for the estimation of the persons' values, (iv) good discriminant validity and high diagnostic utility, and (v) a minimal differential item functioning effect related to of pathology, gender, age, and educational level. MoCA and its cognitive domains are suitable measures to use for screening the cognitive status of cognitively healthy subjects and patients with cognitive impairment.

Effect of Western medicine therapy assisted by Ginkgo biloba tablet on vascular cognitive impairment of none dementia

OBJECTIVE

To discuss the clinical effects of Western medicine therapy assisted by Ginkgo biloba tablet (GBT) on patients with vascular cognitive impairment of none dementia (VCIND).

METHODS

A total of 80 patients with VCIND were divided into two groups randomly: Conventional treatment group (control group) and combined treatment group. Conventional treatment group was given conventional treatment with anti-platelet aggregation. In this group, 75 mg aspirin was given three times a day for 3 months. While in combined treatment group, 19.2 mg GBT was given three times a day for 3 months together with conventional treatment (anti-platelet aggregation drugs). Montreal cognitive assessment (MoCA) and transcranial Doppler (TCD) were used to observe changes of cognitive ability and cerebral blood flow in VCIND patients before and after treatment in both groups. Then the clinical data were analyzed so as to compare the efficacy in two groups.

RESULTS

After 3 month-treatment in combined treatment group, the scores of executive ability, attention, abstract, delayed memory, orientation in the MoCA were significantly increased compared with those before treatment and those in control group after treatment. Besides, blood flow velocity of anterior cerebral artery increased significantly than that before treatment and that in control group after treatment.

CONCLUSIONS

GBT tablet can improve the therapeutic efficacy as well improve cognitive ability and cerebral blood flow supply of patients with VCIND.