Trait-anxiety, depressive symptoms, family support and life satisfaction as determinants conditioning the degree of adherence of people in pre-older adults and older adults.

The objective of the study was to determine the degree of adherence to pharmacological treatment in people in pre-older adults and older adults age groups and to analyse the correlation between selected sociodemographic parameters, severity of anxiety as a trait, symptoms of depression, a sense of family support and satisfaction with life, and adherence in people over 55 years of age. The study was conducted in a group of 2,040 people (1,406 women, 634 men) aged 55 to 100 (the average age was 65.4). The following sociodemographic variables were analysed: age, gender, education. The following scales were used: State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Satisfaction With Life Scale (SWLS) and the Multidimensional Scale of Perceived Social Support (MSPSS). The Adherence in Chronic Diseases Scale (ACDS) was used to test adherence, understood as the implementation of the therapeutic plan. The results obtained in the ACDS ranged from 6 to 28 points; the median was 24 points (21-28). The multiple coefficients of determination (multiple R2 = 0.11; p < 0.001) indicated an explanation of approximately 11% of the value of the ACDS dependent variable. The total correlation of all variables (multiple R) with the ACDS general variable in the mean correlation was 0.33. Independent factors affecting adherence assessed in the ACDS were: severity of anxiety as a trait (p = -0.21 ± 0.03; p < 0.001), family support (p = 0.10 ± 0.04; p = 0.029), severity of depression symptoms (p = -0.08 ± 0.03; p = 0.005), age of respondents (p = 0.07 ± 0.02; p = 0.003) and satisfaction with life (p = 0.06 ± 0 0.03; p = 0.027). Severity of anxiety as a trait, age, severity of depressive symptoms, a sense of satisfaction with life and family support are important factors affecting adherence.

The Analysis of Oxidative Stress Markers May Increase the Accuracy of the Differential Diagnosis of Alzheimer's Disease with and without Depression.

INTRODUCTION: The aim of work is to assess the usefulness of oxidative stress parameters in the differential diagnosis of dementia of the Alzheimer's type and dementia of the Alzheimer's type with coexisting depression. METHODS: The study involved three groups of people: patients with Alzheimer's disease (AD) (AD; N=27), patients with Alzheimer's disease and depression (D) (AD+D; N=30), and a control group that consisted of people without dementia and without depression (C; N=24). The assessment of cognitive functioning was carried out using among alia, Auditory Verbal Learning Test and Verbal Fluency Test. Furthermore, we determined the activity of superoxide dismutase (SOD-1) and superoxide anion radical. RESULTS: Multiple models with different combinations of independent variables showed that SOD together with Rey delayed recall were the best significant predictors of AD with the area under curve (AUC) of 0.893 (p = 0.001) and superoxide anion radical (O2•-) together with verbal fluency - sharp objects were the best significant predictors of AD +D diagnosis with the AUC of 0.689 (p = 0.034). CONCLUSION: This study confirmed the value of neuropsychological diagnosis and analysis of oxidative stress markers in the diagnosis of AD and major depressive disorder (MDD) in the course of AD. The combination of the use of biochemical markers and neuropsychological tests seems particularly important for differential diagnosis.

Usefulness of the Polish versions of the Montreal Cognitive Assessment 7.2 and the Mini-Mental State Examination as screening instruments for the detection of mild neurocognitive disorder.

INTRODUCTION: Screening tests are a key step in the diagnosis of dementia and should therefore be highly sensitive to the detection of mild neurocognitive disorders (NCD). The Mini Mental State Examination (MMSE) is the most commonly used screening method. The Montreal Cognitive Assessment (MoCA) is a newer and less well-known screening tool, which has none of the limitations of the MMSE. AIM: The aim of this study was to analyse the reliability of the Polish versions of MoCA 7.2 vs MMSE in the detection of mild NCD among people aged over 60. MATERIAL AND METHODS: The study was carried out at the Department and Clinic of Geriatrics from September 2014 to March 2017. The study included 281 participants, 91 of whom were assigned to the group without NCD. The other 190 had been diagnosed with mild NCD. RESULTS: In the analysis of the ROC curve of the MoCA 7.2 results, the AUC was 0.925 (p < 0.001). The optimal cut-off point for mild NCD was 23/24 points, with sensitivity and specificity of 83.2% and 79.1%. In the ROC curve of MMSE results, the AUC was 0.847 (p < 0.001). The optimal cut-off point for mild NCD was 27/28 points, with sensitivity and specificity of 75.8% and 66.7%. The difference between AUC MoCA 7.2 and MMSE was 0.078 (p = 0.036). CONCLUSIONS: MoCA 7.2 detects mild NCD with more sensitivity than MMSE. We recommend using the cut-off point for MoCA of 23/24 points, because this is characterised by a higher sensitivity than the previously recommended cut-off point of 25/26 points. For the MMSE, the recommended cut-off point should be 27/28, which gives greater diagnostic accuracy than the previously recommended 25/26 points.

Effects of virtual reality-based cognitive training in older adults living without and with mild dementia: a pretest-posttest design pilot study.

OBJECTIVE: Modern technologies are increasingly used in the development of cognitive interventions for older adults. Research into possible applications of virtual reality in such interventions has begun only recently. The aim of present study was to evaluate the effects of 8 sessions of VR-based cognitive training using the GRADYS game in healthy older adults (n = 72; aged 60-88) and older adults living with mild dementia (n = 27; aged 60-89). RESULTS: Older adults with mild dementia demonstrated worse baseline cognitive performance than participants without dementia. Both groups showed progress in training, which was greater in healthy older adults. There were also significant differences in cognitive functioning before and after the training. However, positive changes were revealed almost exclusively in the group of older adults without dementia. Based on the findings, we can recommend the GRADYS game for cognitive enhancement and as a possible counter-measure for cognitive decline experienced in normal cognitive ageing. Our results provide also support for the usefulness of VR technology in cognitive interventions in older adults. The use of the GRADYS game in persons living with dementia, however, would require several of the hardware and software modifications. Trial registration ISRCTN17613444, date of registration: 10.09.2019. Retrospectively registered.

Comparison of the effectiveness of the Montreal Cognitive Assessment 7.2 and the Mini-Mental State Examination in the detection of mild neurocognitive disorder in people over 60 years of age. Preliminary study. / Porównanie skutecznosci Montreal Cognitive Assessment 7.2 z Mini-Mental State Examination w wykrywaniu lagodnych zaburzen neuropoznawczych u osób po 60. roku zycia. Doniesienie wstepne.

OBJECTIVES: Analysis of reliability of the Polish version of the MoCA 7.2 vs. the MMSE in mild NCD detecting, while taking into consideration the sensitivity and specificity of cut-off points for each type of education. METHODS: Cross-sectional study was conducted at the Department of Geriatrics, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun. The study was conducted between September 2014 and December 2015. The study involved 131 participants, including 54 people assigned to the group without NCD and 77 to the group with mild NCD. Recruitment for both groups was performed on the basis of specific inclusion and exclusion criteria. RESULTS: Mean scores of the MoCA 7.2 and the MMSE showed a statistically significant difference between the groups with and without mild NCD. The optimal cut-off point on the MoCA scale for mild NCD was 24/25. The optimal cut-off point on the MMSE scale for mild NCD was 28/29. In the ROC curve analysis, area under the curve (AUC) for the MoCA was significantly greater than the AUC for the MMSE. CONCLUSIONS: The MoCA 7.2 detect mild NCD with greater sensitivity than the MMSE. In the case of this tool, we propose the use of 24/25 cut-off point which has a higher sensitivity than the recommended 25/26 cut-off point. The MoCA 7.2 therefore can be used by primary healthcare and in the geriatric practice as a screening tool in detecting early cognitive impairment.

Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis. / Czy test Montreal Cognitive Assessment (MoCA) moze byc skuteczniejszy od powszechnie stosowanego Mini-Mental State Examination (MMSE) w wykrywaniu lagodnych zaburzen funkcji poznawczych u osób po 60. roku zycia? Metaanaliza.

OBJECTIVES: Screening tests play a crucial role in dementia diagnostics, thus they should be very sensitive for mild cognitive impairment (MCI) assessment. Nowadays, the MiniMental State Examination (MMSE) is the most commonly used scale in cognitive function evaluation, albeit it is claimed to be imprecise for MCI detection. The Montreal Cognitive Assessment (MoCA), was created as an alternative method for MMSE. Aim. MoCA vs. MMSE credibility assessment in detecting MCI, while taking into consideration the sensitivity and specificity by cut-off points. METHODS: A systematic literature search was carried out by the authors using EBSCO host Web, Wiley Online Library, Springer Link, Science Direct and Medline databases. The following medical subject headings were used in the search: mild cognitive impairment, mini-mental state examination, Montreal cognitive assessment, diagnostics value. Papers which met inclusion and exclusion criteria were chosen to be included in this review. At the end, for the evaluation of MoCA 20, and MMSE 13 studies were qualified. Research credibility was established by computing weighted arithmetic mean, where weight is defined as population for which the result of sensitivity and specificity for the cut-off point was achieved. The cut-offs are shown as ROC curve and accuracy of diagnosis for MoCA and MMSE was calculated as the area under the curve (AUC). RESULTS: ROC curve analysis for MoCA demonstrated that MCI best detection can be achieved with a cut-off point of 24/25 (n = 9350, the sensitivity of 80.48% and specificity of 81.19%). AUC was 0.846 (95% CI 0.823-0.868). For MMSE, it turned out that more important cut-off was of 27/28 (n = 882, 66.34% sensitivity and specificity of 72.94%). AUC was 0.736 (95% CI 0.718-0.767). CONCLUSIONS: MoCA test better meets the criteria for screening tests for the detection of MCI among patients over 60 years of age than MMSE.