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Keywords = Mini-Mental State Exam (MMSE)

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10 pages, 453 KiB  
Article
“Try to Build This Bunny as Fast as Possible without Using Red or Pink Bricks”: How Simple Assembly Tasks Might Aid in Detecting People with Mild Cognitive Impairment and Dementia
by Wolfgang Trapp, Andreas Heid, Susanne Röder, Franziska Wimmer, Helmar Weiß and Göran Hajak
Brain Sci. 2023, 13(12), 1693; https://doi.org/10.3390/brainsci13121693 - 8 Dec 2023
Viewed by 1457
Abstract
(1) Background: Dementia and mild cognitive impairment (MCI) are still underdiagnosed in the general population. Impaired odor identification has been identified as an early marker of MCI and dementia. We aim to investigate whether short tasks, in which simple forms must be assembled [...] Read more.
(1) Background: Dementia and mild cognitive impairment (MCI) are still underdiagnosed in the general population. Impaired odor identification has been identified as an early marker of MCI and dementia. We aim to investigate whether short tasks, in which simple forms must be assembled from single building blocks based on a template or while considering specific re-strictions, could increase the diagnostic quality of established cognitive screening tests in detecting MCI or dementia. (2) Methods: A brief assembly test, where participants had to assemble simple animal shapes from Lego® Duplo® building blocks, the Frontal Assessment Battery, and the Mini-Mental State Exam (MMSE) were administered to a consecutive series of 197 patients (89 with mild dementia, 62 with mild cognitive impairment, and 46 without cognitive impairment) referred for neuropsychological testing. (3) Results: Both participants with dementia and with MCI performed badly in the assembly tasks. The assembly tasks and the Frontal Assessment Battery were substantially correlated. Complementing MMSE scores with the assembly tasks improved the diagnostic accuracy of individuals with dementia and MCI. (4) Conclusions: People with suspected dementia or MCI may already benefit from simple assembly tasks. Although these tests require little additional time, they can notably increase sensitivity for dementia or MCI. Full article
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10 pages, 1050 KiB  
Article
“Mmm, Smells like Coffee!”: How a Brief Odor Identification Test Could Help to Identify People with Mild Cognitive Impairment and Dementia
by Wolfgang Trapp, Andreas Heid, Susanne Röder, Franziska Wimmer and Göran Hajak
Brain Sci. 2023, 13(7), 1052; https://doi.org/10.3390/brainsci13071052 - 10 Jul 2023
Cited by 2 | Viewed by 1901
Abstract
(1) Background: Dementia and mild cognitive impairment (MCI) are still underdiagnosed in the general population. Impaired odor identification has been identified as an early marker of MCI and dementia. We aimed to compare the additional diagnostic value of two odor identification tests to [...] Read more.
(1) Background: Dementia and mild cognitive impairment (MCI) are still underdiagnosed in the general population. Impaired odor identification has been identified as an early marker of MCI and dementia. We aimed to compare the additional diagnostic value of two odor identification tests to a cognitive screening test in detecting MCI or dementia. (2) Methods: The Sniffin’ Sticks odor identification test (SS-OIT), a brief odor identification test (B-OIT) requiring the identification of coffee scent, and the Mini-Mental State Exam (MMSE) were administered to a consecutive series of 174 patients (93 with dementia, 42 with mild cognitive impairment, and 39 without cognitive impairment) referred for neuropsychological testing. (3) Results: Both participants with dementia and with MCI exhibited impairments in odor identification. The SS-OIT and the B-OIT were substantially correlated. Complementing MMSE scores with the SS-OIT or the B-OIT similarly improved the diagnostic accuracy of individuals with dementia and MCI. (4) Conclusions: People with suspected dementia or MCI may already benefit from brief odor identification tests. Although these tests require little additional time, they can notably increase sensitivity for dementia or MCI. Full article
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13 pages, 1789 KiB  
Article
Immersive Virtual Reality Reaction Time Test and Relationship with the Risk of Falling in Parkinson’s Disease
by Pablo Campo-Prieto, José Mª Cancela-Carral and Gustavo Rodríguez-Fuentes
Sensors 2023, 23(9), 4529; https://doi.org/10.3390/s23094529 - 6 May 2023
Cited by 12 | Viewed by 4620
Abstract
Immersive virtual reality (IVR) uses customized and advanced software and hardware to create a digital 3D reality in which all of the user’s senses are stimulated with computer-generated sensations and feedback. This technology is a promising tool that has already proven useful in [...] Read more.
Immersive virtual reality (IVR) uses customized and advanced software and hardware to create a digital 3D reality in which all of the user’s senses are stimulated with computer-generated sensations and feedback. This technology is a promising tool that has already proven useful in Parkinson’s disease (PD). The risk of falls is very high in people with PD, and reaction times and processing speed may be markers of postural instability and functionality, cognitive impairment and disease progression. An exploratory study was conducted to explore the feasibility of reaction time tests performed in IVR as predictors of falls. A total of 26 volunteers (79.2% male; 69.73 ± 6.32 years) diagnosed with PD (1.54 ± 0.90 H&Y stage; 26.92 ± 2.64 MMSE) took part in the study. IVR intervention was feasible, with no adverse effects (no Simulator Sickness Questionnaire symptoms). IVR reaction times were related (Spearman’s rho) to functionality (timed up and go test (TUG) (rho = 0.537, p = 0.005); TUG-Cognitive (rho = 0.576, p = 0.020); cognitive impairment mini mental state exam (MMSE) (rho = −0.576, p = 0.002)) and the years of the patients (rho = 0.399, p = 0.043) but not with the first PD symptom or disease stage. IVR test is a complementary assessment tool that may contribute to preventing falls in the proposed sample. Additionally, based on the relationship between TUG and reaction times, a cut-off time is suggested that would be effective at predicting the risk of suffering a fall in PD patients using a simple and quick IVR test. Full article
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16 pages, 3082 KiB  
Article
The Effect of Alpha Neurofeedback Training on Cognitive Performance in Healthy Adults
by Rab Nawaz, Humaira Nisar, Vooi Voon Yap and Chi-Yi Tsai
Mathematics 2022, 10(7), 1095; https://doi.org/10.3390/math10071095 - 29 Mar 2022
Cited by 20 | Viewed by 5886
Abstract
This study investigates the effect of long-term alpha neurofeedback training (NFT) in healthy adults using music stimuli. The optimal protocol for future research is presented in this study. The data from 40 healthy participants, divided into two groups (NFT group and Control group), [...] Read more.
This study investigates the effect of long-term alpha neurofeedback training (NFT) in healthy adults using music stimuli. The optimal protocol for future research is presented in this study. The data from 40 healthy participants, divided into two groups (NFT group and Control group), were analyzed in the current study. We found a significantly enhanced alpha rhythm after training in the NFT group which was not observed in the control group. The immediate subsequent effects were greater in more than 80% of the sessions from the initial recordings. Stroop task and behavioral questionnaires, mini-mental state exam (MMSE), and perceived stress scale (PSS) did not reveal any training-specific changes. Within-training session effects were significant from the baseline and were more pronounced at the beginning of the session as compared to the end of the session. It is also observed that a shorter session length with multiple sessions may be more effective than a long and continuous run of a single session. Full article
(This article belongs to the Special Issue From Brain Science to Artificial Intelligence)
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9 pages, 276 KiB  
Communication
Feasibility of a Small Group Otago Exercise Program for Older Adults Living with Dementia
by Julie D. Ries and Martha Carroll
Geriatrics 2022, 7(2), 23; https://doi.org/10.3390/geriatrics7020023 - 24 Feb 2022
Cited by 8 | Viewed by 4318
Abstract
Older adults with dementia experience more frequent and injurious falls than their cognitively-intact peers; however, there are no evidence-based fall-prevention programs (EBFPP) for this population. The Otago Exercise Program (OEP) is an EBFPP for older adults that has not been well-studied in people [...] Read more.
Older adults with dementia experience more frequent and injurious falls than their cognitively-intact peers; however, there are no evidence-based fall-prevention programs (EBFPP) for this population. The Otago Exercise Program (OEP) is an EBFPP for older adults that has not been well-studied in people with dementia. We sought to explore the feasibility of group delivery of OEP in an adult day health center (ADHC) for people with dementia. We collected demographic data, Functional Assessment Staging Tool (FAST), and Mini Mental State Exam (MMSE) scores for seven participants with dementia. Pre- and post-test data included: Timed-Up-and-Go (TUG), 30-Second Chair-Stand (30s-CST), Four-Stage-Balance-Test (4-SBT), and Berg Balance Scale (BBS). We implemented a supervised group OEP, 3x/week × 8 weeks. Most participants required 1:1 supervision for optimal challenge and participation. Five participants completed the program. All had moderately severe to severe dementia based upon FAST; MMSE scores ranged from mild to severe cognitive impairment. Four of five participants crossed the threshold from higher to lower fall risk in at least one outcome (TUG, 30s-CST, 4-SBT, or BBS), and four of five participants improved by >Minimal Detectible Change (MDC90) score in at least one outcome. The group delivery format of OEP required significant staff oversight for optimal participation, making the program unsustainable. Full article
(This article belongs to the Special Issue New Trends in Cognitive Ageing and Mild Cognitive Impairment)
10 pages, 7958 KiB  
Article
Vitamin D and Folate as Predictors of MMSE in Alzheimer’s Disease: A Machine Learning Analysis
by Giuseppe Murdaca, Sara Banchero, Alessandro Tonacci, Alessio Nencioni, Fiammetta Monacelli and Sebastiano Gangemi
Diagnostics 2021, 11(6), 940; https://doi.org/10.3390/diagnostics11060940 - 24 May 2021
Cited by 29 | Viewed by 3762
Abstract
Vitamin D (VD) and micronutrients, including folic acid, are able to modulate both the innate and the adaptive immune responses. Low VD and folic acid levels appear to promote cognitive decline as in Alzheimer’s disease (AD). A machine learning approach was applied to [...] Read more.
Vitamin D (VD) and micronutrients, including folic acid, are able to modulate both the innate and the adaptive immune responses. Low VD and folic acid levels appear to promote cognitive decline as in Alzheimer’s disease (AD). A machine learning approach was applied to analyze the impact of various compounds, drawn from the blood of AD patients, including VD and folic acid levels, on the Mini-Mental State Exam (MMSE) in a cohort of 108 patients with AD. The first analysis was aimed at predicting the MMSE at recruitment, whereas a second investigation sought to predict the MMSE after a 4 year follow-up. The simultaneous presence of low levels of VD and folic acid allow to predict MMSE, suggestive of poorer cognitive function. Such results suggest that the low levels of VD and folic acid could be associated with more severe cases of cognitive impairment in AD. It could be hypothesized that simultaneous supplementation of VD and folic acid could slow down the progression of cerebral degeneration at least in a subset of AD individuals. Full article
(This article belongs to the Special Issue Diagnosis and Management of Alzheimer's Disease)
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12 pages, 248 KiB  
Article
Effects of Dog-Assisted Therapies on Cognitive Mnemonic Capabilities in People Affected by Alzheimer’s Disease
by Fausto Quintavalla, Simona Cao, Diana Spinelli, Paolo Caffarra, Fiammetta M. Rossi, Giuseppina Basini and Alberto Sabbioni
Animals 2021, 11(5), 1366; https://doi.org/10.3390/ani11051366 - 11 May 2021
Cited by 14 | Viewed by 6548
Abstract
Alzheimer’s disease (AD) is the most common cause of dementia in humans and, currently, a valid treatment is lacking. Our goal is to demonstrate the importance and benefits of the relationship with companion animals (considered as co-therapists), intended as a means of facilitating [...] Read more.
Alzheimer’s disease (AD) is the most common cause of dementia in humans and, currently, a valid treatment is lacking. Our goal is to demonstrate the importance and benefits of the relationship with companion animals (considered as co-therapists), intended as a means of facilitating social relations and promoting evident wellbeing in AD patients. The study involved 30 randomly chosen patients with Alzheimer’s disease (group T) and three dogs. The group participated in a total of 24 animal-assisted interventions (AAIs) sessions over a span of 12 weeks, using the Mini-Mental State Examination (MMSE), Wellness and Cognitive Ability Questionnaire (Brief Assessment Cognition or BAC), and Alzheimer’s Disease Assessment Scale (ADAS) as assessment tests. A second group (group C), consisting of 10 people with AD, was enrolled as control group and underwent the same assessment tests but did not benefit from the presence of the dogs. Tests were carried out at time T0 (before starting sessions), T1 (end of sessions), and T2 (two months after last session). People belonging to group T achieved an overall improvement in their perceived state of wellbeing, even on a cognitive and mnemonic plane. However, two months after the end of the sessions, the test results in people suffering from AD decreased towards the baseline (T0). The study shows how such progress can be achieved through activities based on the relationship with an animal, as long as the animal is a steady presence in the life of the patient receiving the intervention. Dogs involved in other dog-assisted therapies have been found suitable also for assisting patients with AD. Full article
(This article belongs to the Special Issue Advanced Research in Animal Communication)
12 pages, 329 KiB  
Article
Air Pollution Is Associated with Poor Cognitive Function in Taiwanese Adults
by Meng-Chieh Chen, Chen-Feng Wang, Bo-Cheng Lai, Sun-Wung Hsieh, Szu-Chia Chen, Chih-Hsing Hung and Chao-Hung Kuo
Int. J. Environ. Res. Public Health 2021, 18(1), 316; https://doi.org/10.3390/ijerph18010316 - 4 Jan 2021
Cited by 28 | Viewed by 3928
Abstract
The issue of air pollution is gaining increasing attention worldwide, and mounting evidence has shown an association between air pollution and cognitive decline. The aim of this study was to investigate the relationships between air pollutants and cognitive impairment using the Mini-Mental State [...] Read more.
The issue of air pollution is gaining increasing attention worldwide, and mounting evidence has shown an association between air pollution and cognitive decline. The aim of this study was to investigate the relationships between air pollutants and cognitive impairment using the Mini-Mental State Exam (MMSE) and its sub-domains. In this study, we used data from the Taiwan Biobank combined with detailed daily data on air pollution. Cognitive function was assessed using the MMSE and its five subgroups of cognitive functioning. After multivariable linear regression analysis, a high level of particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5), low ozone (O3), high carbon monoxide (CO), high sulfur dioxide (SO2), high nitric oxide (NO), high nitrogen dioxide (NO2), and high nitrogen oxide (NOx) were significantly associated with low total MMSE scores. Further, high SO2 and low O3 were significantly associated with low MMSE G1 scores. Low O3, high CO, high SO2, high NO2, and high NOx were significantly associated with low MMSE G4 scores, and high PM2.5, high particulate matter with an aerodynamic diameter of ≤10 μm (PM10), high SO2, high NO2, and high NOx were significantly associated with low MMSE G5 scores. Our results showed that exposure to different air pollutants may lead to general cognitive decline and impairment of specific domains of cognitive functioning, and O3 may be a protective factor. These findings may be helpful in the development of policies regarding the regulation of air pollution. Full article
12 pages, 539 KiB  
Article
Cognitive Impairment, Chronic Kidney Disease, and 1-Year Mortality in Older Patients Discharged from Acute Care Hospital
by Mirko Di Rosa, Sonia D’Alia, Francesco Guarasci, Luca Soraci, Elisa Pierpaoli, Federica Lenci, Maddalena Ricci, Graziano Onder, Stefano Volpato, Carmelinda Ruggiero, Antonio Cherubini, Andrea Corsonello and Fabrizia Lattanzio
J. Clin. Med. 2020, 9(7), 2202; https://doi.org/10.3390/jcm9072202 - 12 Jul 2020
Cited by 8 | Viewed by 3057
Abstract
The prognostic interaction between chronic kidney disease (CKD) and cognitive impairment is still to be elucidated. We investigated the potential interaction of overall cognitive impairment or defective constructional praxis and CKD in predicting 1-year mortality among 646 older patients discharged from hospital. The [...] Read more.
The prognostic interaction between chronic kidney disease (CKD) and cognitive impairment is still to be elucidated. We investigated the potential interaction of overall cognitive impairment or defective constructional praxis and CKD in predicting 1-year mortality among 646 older patients discharged from hospital. The estimated glomerular filtration rate (eGFR) was calculated using the Berlin Initiative Study (BIS) equation. Cognitive impairment was assessed by the Mini Mental State Exam (MMSE) and defective constructional praxis was ascertained by the inherent MMSE item. The study outcome was 1-year mortality. Statistical analysis was carried out using Cox regression. After adjusting for potential confounders, the co-occurrence of eGFR <30 and overall cognitive impairment (Hazard Ratio (HR) = 3.12, 95% Confidence Interval (CI) = 1.26–7.77) and defective constructional praxis (HR = 2.50, 95% CI = 1.08–5.77) were associated with the outcome. No significant prognostic interaction of eGFR < 30 with either overall cognitive impairment (HR = 1.99, 95% CI = 0.38–10.3) or constructional apraxia (HR = 1.68, 95% CI = 0.33–8.50) was detectable, while only cognitive deficits were found significantly associated with the outcome in the interaction models (HR = 3.12, 95% CI = 1.45–6.71 for overall cognitive impairment and HR = 2.16, 95% CI = 1.05–4.45 for constructional apraxia). Overall cognitive impairment and defective constructional praxis may be associated with increased risk of 1-year mortality among older hospitalized patients with severe CKD. However, no significant prognostic interaction between CKD and cognitive impairment could be observed. Full article
(This article belongs to the Special Issue Management of the Progression and Complications of CKD)
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16 pages, 4503 KiB  
Article
Classification of Alzheimer’s Disease with and without Imagery Using Gradient Boosted Machines and ResNet-50
by Lawrence V. Fulton, Diane Dolezel, Jordan Harrop, Yan Yan and Christopher P. Fulton
Brain Sci. 2019, 9(9), 212; https://doi.org/10.3390/brainsci9090212 - 22 Aug 2019
Cited by 125 | Viewed by 13731
Abstract
Background. Alzheimer’s is a disease for which there is no cure. Diagnosing Alzheimer’s disease (AD) early facilitates family planning and cost control. The purpose of this study is to predict the presence of AD using socio-demographic, clinical, and magnetic resonance imaging (MRI) data. [...] Read more.
Background. Alzheimer’s is a disease for which there is no cure. Diagnosing Alzheimer’s disease (AD) early facilitates family planning and cost control. The purpose of this study is to predict the presence of AD using socio-demographic, clinical, and magnetic resonance imaging (MRI) data. Early detection of AD enables family planning and may reduce costs by delaying long-term care. Accurate, non-imagery methods also reduce patient costs. The Open Access Series of Imaging Studies (OASIS-1) cross-sectional MRI data were analyzed. A gradient boosted machine (GBM) predicted the presence of AD as a function of gender, age, education, socioeconomic status (SES), and a mini-mental state exam (MMSE). A residual network with 50 layers (ResNet-50) predicted the clinical dementia rating (CDR) presence and severity from MRI’s (multi-class classification). The GBM achieved a mean 91.3% prediction accuracy (10-fold stratified cross validation) for dichotomous CDR using socio-demographic and MMSE variables. MMSE was the most important feature. ResNet-50 using image generation techniques based on an 80% training set resulted in 98.99% three class prediction accuracy on 4139 images (20% validation set) at Epoch 133 and nearly perfect multi-class predication accuracy on the training set (99.34%). Machine learning methods classify AD with high accuracy. GBM models may help provide initial detection based on non-imagery analysis, while ResNet-50 network models might help identify AD patients automatically prior to provider review. Full article
(This article belongs to the Section Neurotechnology and Neuroimaging)
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18 pages, 1798 KiB  
Article
Randomized Trial of Marine n-3 Polyunsaturated Fatty Acids for the Prevention of Cerebral Small Vessel Disease and Inflammation in Aging (PUFA Trial): Rationale, Design and Baseline Results
by Gene L. Bowman, Lisa C. Silbert, Hiroko H. Dodge, David Lahna, Kirsten Hagen, Charles F. Murchison, Diane Howieson, Jeffrey Kaye, Joseph F. Quinn and Lynne Shinto
Nutrients 2019, 11(4), 735; https://doi.org/10.3390/nu11040735 - 29 Mar 2019
Cited by 21 | Viewed by 5653
Abstract
Vascular risk factors for age-related cognitive decline are significant, and their management may ultimately prove the most successful strategy for reducing risk and sustaining cognitive health. This randomized, double-blinded, placebo-controlled trial with parallel group allocation to either marine n-3 polyunsaturated fatty acids (n-3 [...] Read more.
Vascular risk factors for age-related cognitive decline are significant, and their management may ultimately prove the most successful strategy for reducing risk and sustaining cognitive health. This randomized, double-blinded, placebo-controlled trial with parallel group allocation to either marine n-3 polyunsaturated fatty acids (n-3 PUFA) or soybean oil placebo assesses the effects on the total volume of accumulation in cerebral white matter hyperintensities (WMH), a potentially modifiable neurovascular component of age-related cognitive decline. Total WMH accumulation over 3 years is the primary endpoint. The safety and efficacy of n-3 PUFA is evaluated in older adults with significant WMH and suboptimum plasma n-3 PUFA as inclusion criteria. One hundred and two non-demented older adults were enrolled with a mean age of 81.1 (±4.4) years, WMH of 19.4 (±16.1) cm3, and a plasma n-3 PUFA of 86.64 (±29.21) µg/mL. 61% were female, 28% were apolipoprotein E epsilon 4 carriers, and the mean mini-mental state exam (MMSE) was 27.9 (±1.7). This trial provides an initial evaluation of n-3 PUFA effects on WMH, a reproducible and valid risk biomarker for cognitive decline, as well as on inflammatory biomarkers thought to play a role in WMH accumulation. We present the baseline results and operational experience of enriching a study population on advanced age, blood n-3 PUFA, and magnetic resonance imaging (MRI) derived WMH with biomarker outcomes (WMH, inflammation markers) in a dementia prevention paradigm. Full article
(This article belongs to the Special Issue Lifestyle Strategies in Cognitive Decline: Focus on Nutrition)
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16 pages, 263 KiB  
Article
Prospective Associations of Erythrocyte Composition and Dietary Intake of n-3 and n-6 PUFA with Measures of Cognitive Function
by Sherman J. Bigornia, Tammy M. Scott, William S. Harris and Katherine L. Tucker
Nutrients 2018, 10(9), 1253; https://doi.org/10.3390/nu10091253 - 6 Sep 2018
Cited by 24 | Viewed by 5067
Abstract
Polyunsaturated fatty acid (PUFA) consumption is recommended as part of a healthy diet, but evidence of the impact of individual species and biological concentrations on cognitive function is limited. We examined prospective associations of PUFA erythrocyte composition and dietary intake with measures of [...] Read more.
Polyunsaturated fatty acid (PUFA) consumption is recommended as part of a healthy diet, but evidence of the impact of individual species and biological concentrations on cognitive function is limited. We examined prospective associations of PUFA erythrocyte composition and dietary intake with measures of cognitive function among participants of the Boston Puerto Rican Health Study (aged 57 years). Erythrocyte and dietary PUFA composition were ascertained at baseline and associated with 2-year scores on the Mini-Mental State Exam (MMSE) (n = 1032) and cognitive domain patterns derived from a battery of tests (n = 865), as well as with incidence of cognitive impairment. Erythrocyte and dietary n-3 PUFA were not significantly associated with MMSE score. However, total erythrocyte and dietary n-3 very-long-chain fatty acids (VLCFA), and intake of individual species, were associated with better executive function (P-trend < 0.05, for all). There was evidence that greater erythrocyte n-6 eicosadienoic acid concentration was associated with lower MMSE and executive function scores (P-trend = 0.02). Only erythrocyte arachidonic acid (ARA) concentration predicted cognitive impairment (Odds Ratio = 1.26; P = 0.01). Among Puerto Rican adults, we found that n-3 VLCFA consumption may beneficially impact executive function. Further, these findings provide some evidence that n-6 metabolism favoring greater ARA tissue incorporation, but not necessarily dietary intake, could increase the risk of cognitive impairment. Full article
14 pages, 249 KiB  
Article
General Cognitive Impairment as a Risk Factor for Motor Vehicle Collision Involvement: A Prospective Population-Based Study
by Carrie Huisingh, Cynthia Owsley, Virginia G. Wadley, Emily B. Levitan, Marguerite R. Irvin, Paul MacLennan and Gerald McGwin Jr.
Geriatrics 2018, 3(1), 11; https://doi.org/10.3390/geriatrics3010011 - 6 Mar 2018
Cited by 2 | Viewed by 4757
Abstract
This study examined whether cognitive impairment and decline as assessed by a brief mental status screening test is associated with future crash risk in a cohort of older drivers. A three-year prospective study was conducted in a population-based sample of 2000 licensed drivers, [...] Read more.
This study examined whether cognitive impairment and decline as assessed by a brief mental status screening test is associated with future crash risk in a cohort of older drivers. A three-year prospective study was conducted in a population-based sample of 2000 licensed drivers, aged 70 years and older. At the baseline visit, cognitive impairment was defined as <24 on the Mini Mental State Exam (MMSE). Decline was defined as those with a one-year change in MMSE scores in the lowest quartile (largest decrease). Motor vehicle collision involvement was obtained from the Alabama Department of Public Safety. Poisson regression was used to calculate crude and adjusted rate ratios (RR). There were 278 crashes during the follow-up period. Rates of crash involvement were higher for those with cognitive impairment (crude RR = 2.33) compared to those without impairment at baseline; adjustment for potential confounders namely age and visual processing speed attenuated this relationship (adjusted RR = 1.26, 95% confidence interval (CI) 0.65–2.44). Drivers who experienced a pronounced decline in estimated MMSE scores in one year were 1.64 (95% CI 1.04–2.57) times more likely to have a future at-fault crash, as compared to those whose scores did not decline. Evaluation of MMSE over time may provide important insight in an older driver’s future risk of at-fault crash involvement. Full article
(This article belongs to the Special Issue Aging and Driving)
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