Neuropsychologie KP13
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Screening for Very Mild Subcortical Vascular Dementia Patients Aged 75 and Above Using the Montreal Cognitive Assessment and Mini-Mental State Examination in a Community: The Kurihara Project - Kar...

Screening for Very Mild Subcortical Vascular Dementia Patients Aged 75 and Above Using the Montreal Cognitive Assessment and Mini-Mental State Examination in a Community: The Kurihara Project - Kar... | Neuropsychologie KP13 | Scoop.it

Abstract

Aims: To examine the effectiveness of the Montreal Cognitive Assessment (MoCA) to screen people with mild cognitive impairment (MCI), to associate the MoCA score with the presence of infarction, and to detect the characteristics of people with very mild subcortical vascular dementia (vmSVD). Methods: 392 out of 886 community dwellers aged 75 years and above living in Kurihara, Northern Japan, agreed to participate in our study; 164 scored a Clinical Dementia Rating (CDR) of 0 (healthy), 184 scored a CDR of 0.5 (MCI) and 44 scored a CDR of 1+ (dementia). The participants scoring a CDR of 0.5 were divided into 2 subtypes: 37 had vmSVD and 147 had other types of dementia. The objective variables were the total MoCA, the MoCA subscale and the Mini-Mental State Examination (MMSE). Results: There was a difference in the MoCA and MMSE scores between the 3 CDR groups. The MoCA score overlapped in participants with CDR 0 and 0.5. There were significant CDR effects, while there were no significant infarction effects for the MoCA and MMSE. vmSVD participants had lower scores on the total MoCA, the MoCA attention subscale and MMSE than healthy elderly people and participants with other types of dementia. Conclusion: Our results suggested that MMSE performed rather well and that the MoCA is not superior to MMSE in MCI and vmSVD participants aged 75 and above in a community.

 


Via Simon Lemay
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Simon Lemay's curator insight, January 31, 2013 9:17 AM

Résultats étonnants...

 
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Montreal Cognitive Assessment: Validation Study for Mild Cognitive Impairment and Alzheimer Disease

Montreal Cognitive Assessment: Validation Study for Mild Cognitive Impairment and Alzheimer Disease | Neuropsychologie KP13 | Scoop.it

Abstract 

The Montreal Cognitive Assessment (MoCA) was recently proposed as a cognitive screening test for milder forms of cognitive impairment, having surpassed the well-known limitations of the Mini-Mental State Examination (MMSE). This study aims to validate the MoCA for screening Mild Cognitive Impairment (MCI) and Alzheimer disease (AD) through an analysis of diagnostic accuracy and the proposal of cut-offs. Patients were classified into 2 clinical groups according to standard criteria: MCI (n=90) and AD (n=90). The 2 control groups (C-MCI: n=90; C-AD: n=90) consisted of cognitively healthy community dwellers selected to match patients in sex, age, and education. The MoCA showed consistently superior psychometric properties compared with the MMSE, and higher diagnostic accuracy to discriminate between MCI (area under the curve=0.856; 95% confidence interval, 0.796-0.904) and AD patients (area under the curve=0.980; 95% confidence interval, 0.947-0.995). At an optimal cut-off of below 22 for MCI and below 17 for AD, the MoCA achieved significantly superior values in comparison with MMSE for sensitivity, specificity, positive predictive value, negative predictive value, and classification accuracy. Furthermore, the MoCA revealed higher sensitivity to cognitive decline in longitudinal monitoring. This study provides robust evidence that the MoCA is a better cognitive tool than the widely used MMSE for the screening and monitoring of MCI and AD in clinical settings.

 


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Simon Lemay's curator insight, February 21, 2013 10:39 AM

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Twitter / NeuroNotes: The brain... #neuroanatomy ...

RT @NeuroNotes: The brain... #neuroanatomy #medicine #MedSchool #medicina http://t.co/aYWqHaT1mU
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Clinicopathologic differences among patients with behavioral variant frontotemporal dementia

Abstract

Objective: To characterize the presenting symptoms and signs of patients clinically diagnosed with behavioral variant frontotemporal dementia (bvFTD) and who had different neuropathologic findings on autopsy.

Methods: This study reviewed all patients entered as clinical bvFTD in the National Alzheimer's Coordinating Center's database and who had both clinical and neuropathologic data from 2005 to 2011. Among the 107 patients identified, 95 had unambiguous pathologic findings, including 74 with frontotemporal lobar degeneration (bvFTD-FTLD) and 21 with Alzheimer disease (bvFTD-AD). The patients with bvFTD-FTLD were further subdivided into τ-positive (n = 23) or τ-negative (n = 51) histopathology subgroups. Presenting clinical signs and symptoms were compared between these neuropathologic groups.

Results: The patients with bvFTD-FTLD were significantly more likely than patients with bvFTD-AD to have initially predominant personality changes and poor judgment/decision-making. In contrast, patients with bvFTD-AD were more likely than patients with bvFTD-FTLD to have memory difficulty and delusions/hallucinations and agitation. Within the bvFTD-FTLD group, the τ-positive subgroup had more patients with initial behavioral problems and personality change than the τ-negative subgroup, who, in turn, had more patients with initial cognitive impairment and speech problems.

Conclusion: During life, patients with AD pathology may be misdiagnosed with bvFTD if they have an early age at onset and prominent neuropsychiatric features despite having greater memory difficulties and more intact personality and executive functions than patients with bvFTD-FTLD. Among those with FTLD pathology, patients with τ-positive bvFTD were likely to present with behavior/personality changes. These findings offer clues for antemortem recognition of neuropathologic subtypes of bvFTD.

 


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Simon Lemay's curator insight, February 18, 2013 12:01 PM

DTA à présentation frontale

 
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Neuroanatomy: An Atlas of Structures, Sections, and Systems (Neuroanatomy: An Atlas of Strutures,...

Neuroanatomy: An Atlas of Structures, Sections, and Systems (Neuroanatomy: An Atlas of Strutures,... | Neuropsychologie KP13 | Scoop.it
Neuroanatomy: An Atlas of Structures, Sections and Systems (Neuroanatomy: Strutures.
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