- Email: [email protected]
HOW SHOULD WE ASSESS FUNCTIONAL PERFORMANCE IN INDIVIDUALS WITH MILD COGNITIVE IMPAIRMENT (MCI)?
P692
Poster Presentations: P3
4 Charles University in Prague, 2nd Faculty of Medicine and Motol University Hospital, Praha 5, Czech Republic; 5FNUSA - ICRC, Brno, Czech Republic; 6Charles University in Prague, 2nd Faculty of Medicine and Motol University Hospital, Prague 5, Czech Republic; 7International Research Center, Brno, Czech Republic, Brno, Czech Republic. Contact e-mail: [email protected]
Background: The olfactory identificationdysfunction in amnestic mild cognitive impairment (aMCI) which precedes mainly Alzheimer disease (AD) is well known and is considered to be caused by AD pathology. The presence of olfactory impairment in non amnestic MCI (naMCI) and patients with subjective memory complaint (SMC) is controversial. The aim of this study was to examine the degree of objective and subjective olfactory dysfunction in aMCI, naMCI and SMC. Methods: 92 patients with aMCI and 32 patients with naMCI, 28 SMC patients and 50 age matched healthy controls underwent a multiple choice olfactory identification test with 18 different odors developed in our memory clinic. Results: Both aMCI and naMCI patients showed impairment in olfactory identification test compared to both controls and SMC (p<0.01). There was no difference between aMCI and naMCI groups and between SMC and controls in olfactory identification. Conclusions: The olfactory identification impairment in naMCIand aMCI isindistinguishable. NaMCI often converts to Frontotemporal lobar degeneration, dementia with Lewy body or Vascular dementia and the olfactory deficit found in this study could be explained by the recently demonstrated olfactory impairment in these dementia subtypes. SMC patients do not have any significant olfactory discrimination impairment.
specific needs and be planned to reduce both the current impact of cognitive impairment as well as to slow the progress of the disease. P3-174
Renaud David1, Maja Yakhia2, Alexandra Konig3, Leah Friedman4, Philippe H. Robert5, 1CMRR, Nice, France; 2CMRR, Nice, France; 3CMRR, Nice, France; 4Stanford University, Palo Alto, California, United States; 5 H^opital de Cimiez, Lyon, France. Contact e-mail: [email protected] Background: Cognitive and behavioral disturbances in MCI subjects usually accelerate loss of autonomy for instrumental activities of daily living.Additionally, ageing mightbeassociated with changes in motor abilities. The main aim is to assess motor activity in MCI subjects carrying out short functional activity tasks using ambulatory actigraphy. Methods: 20 MCI subjects and 14 cognitively healthy subjects wore a chest actimeter and carried out a 30-minute standardized scenario comprising directed activities (eecution of motor tasks), semi-directed activities (execution of actiities if daily living) and undirected activities. Results: MCI subjects had significantly reduced motor activity while carrying out directed and semi-directed activities, compared to healthy subjects. The two subgroups did not differ on usual assessment scales for activities of daily liing (IADL). Conclusions: Motor activity assessment using actimetry might be an objective and more accuratetool, compared toclassical assessment questionnaires,for the detection of early motor changes during the evaluation of basic instrumental activities of daily livingin elderly non demented subjects with cognitive impairment. P3-175
P3-173
HOW SHOULD WE ASSESS FUNCTIONAL PERFORMANCE IN INDIVIDUALS WITH MILD COGNITIVE IMPAIRMENT (MCI)?
Patricia da Cunha Belchior1, Jade Chiu Wai Kwok2, Isabelle Gelinas1, Pedro Rosa-Neto3, 1McGill University, Montreal, Quebec, Canada; 2 CHUM - Notre-Dame Hospital, Montreal, Quebec, Canada; 3McGill University, Porto Alegre, Brazil. Contact e-mail: patricia.belchior@mcgill. ca Background: A number of studies have recently examined functional performance of individuals with MCI and found that these individuals face functional declines. Despite the relevant findings, the literature in this area has a number of limitations: 1) functional performance has been assessed using different types of measures (e.g., self report, informant report, questionnaire, performance-based activities), producing different estimates of functional abilities; 2) there is little consistency between studies on MCI criteria; 3) many studies do not indicate the MCI subtype, even though type directly impacts on functional performance, and 4) few studies have evaluated the performance-based (e.g., organization, initiation, planning, remembering, etc...) components affected. Thus, to date there is no consensus on how to assess functional performance in this population and clinicians are still left without much guidance in this area. The goal of our study is to develop an evidence-based guideline for the screening and assessment of functional performance in individuals with MCI. This presentation will focus on the analytical framework used for the development of the guideline and preliminary findings. Methods: The methodological approach used was adapted from the U.S. Preventive Service Task Force (USPSTF). The goal of the USPSTF is to take a more evidence-based approach to the development of clinical practice guidelines. It uses an analytic framework to guide the literature search for admissible evidence, including literature findings that are classified as overall good, fair or poor. The evidence is then translated into recommendations to the clinical community, and finally the proposed guidelines are tested out by the clinicians to make sure that they are understandable. Results: An analytical framework was developed and guided our critical review of the evidence currently available. The current evidence will be discussed in the presentation. Conclusions: Clearly, we need to identify the functional evaluations that will assist clinicians with the early identification of individuals with MCI. With better screening and assessment criteria, successful intervention programs can then be tailored to the individuals’
ACTIGRAPHIC MOTOR ACTIVITY IN MCI PATIENTS CARRYING OUT SHORT FUNCTIONAL ACTIVITY TASKS
VASCULAR MILD COGNITIVE IMPAIRMENT, FRAILTY SYNDROME, AND THEIR COMBINATION IN MEXICAN ELDERLY IN A MEMORY DISORDERS CLINIC
Sara Gloria Aguilar Navarro1, Alberto Mimenza Alvarado2, Sandra Juarez3, Carolina Bernal Lopez4, Alejandra Samudio Cruz2, Arturo Reyes5, Alberto Avila6, 1Insituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, D.F., Mexico; 2Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, D.F., Mexico; 3 Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, Mexico; 4Istituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, Mexico; 5Instituto Nacional de Ciencias Medicas y Nutricion Savador Zubiran, Mexico, D.F, Mexico; 6Insituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, Mexico. Contact e-mail: [email protected] Background: Studies have shown an association between physical frailty and cognitive function. These studies have also reported an association between aging, physical frailty and dementia. However, the relationship of vascular mild cognitive impairment(MCIv) and frailty is unknown. The aim of our study was to determine the factors associated with MCIv and frailty syndrome. Methods: Cross-sectional study. 140 subjects were evaluated by a geriatrician and a neurologist for diagnosis of dementia, mild cognitive impairment and frailty. Sociodemographic characteristics and risk factors were obtained. All patients with MCI underwent neuropsychological evaluation to confirm the vascular cognitive profile and all patients had a brain MRI. Frailty criteria developed by the cardiovascular Health Study, we considered to be characterized by limitations in 3 or more of the following 5 domains: mobility, strength, endurance, physical activity, and nutrition. We analyzed the difference between groups: MCI, Physical Frailty and both, we used X 2 and Kruskall Wallis test. Results: There were 97 (69.3%) females; 106 (75.7%) participants had less than 12 years of education. 42 (30%) was Pre-Frail, 22 (15.7%) Frail y 14 subjects (10%) con ambos criteria’s. Increasing age was associated with cognitive impairment (MCI and frailty (p¼.020). MCI was significantly associated with a lower education level (p¼.036). The presence of vascular risk factors (n¼140) ranged from 66.4% (hypertension) to 14.3% (diabetes). Subjective memory complaints were significantly associated with cognitive impairment (p¼.001). Except for the use of the telephone (p¼.225) and the television (p¼.08), impairment in all domains of instrumental activities of daily
Poster Presentations: P3
4 Charles University in Prague, 2nd Faculty of Medicine and Motol University Hospital, Praha 5, Czech Republic; 5FNUSA - ICRC, Brno, Czech Republic; 6Charles University in Prague, 2nd Faculty of Medicine and Motol University Hospital, Prague 5, Czech Republic; 7International Research Center, Brno, Czech Republic, Brno, Czech Republic. Contact e-mail: [email protected]
Background: The olfactory identificationdysfunction in amnestic mild cognitive impairment (aMCI) which precedes mainly Alzheimer disease (AD) is well known and is considered to be caused by AD pathology. The presence of olfactory impairment in non amnestic MCI (naMCI) and patients with subjective memory complaint (SMC) is controversial. The aim of this study was to examine the degree of objective and subjective olfactory dysfunction in aMCI, naMCI and SMC. Methods: 92 patients with aMCI and 32 patients with naMCI, 28 SMC patients and 50 age matched healthy controls underwent a multiple choice olfactory identification test with 18 different odors developed in our memory clinic. Results: Both aMCI and naMCI patients showed impairment in olfactory identification test compared to both controls and SMC (p<0.01). There was no difference between aMCI and naMCI groups and between SMC and controls in olfactory identification. Conclusions: The olfactory identification impairment in naMCIand aMCI isindistinguishable. NaMCI often converts to Frontotemporal lobar degeneration, dementia with Lewy body or Vascular dementia and the olfactory deficit found in this study could be explained by the recently demonstrated olfactory impairment in these dementia subtypes. SMC patients do not have any significant olfactory discrimination impairment.
specific needs and be planned to reduce both the current impact of cognitive impairment as well as to slow the progress of the disease. P3-174
Renaud David1, Maja Yakhia2, Alexandra Konig3, Leah Friedman4, Philippe H. Robert5, 1CMRR, Nice, France; 2CMRR, Nice, France; 3CMRR, Nice, France; 4Stanford University, Palo Alto, California, United States; 5 H^opital de Cimiez, Lyon, France. Contact e-mail: [email protected] Background: Cognitive and behavioral disturbances in MCI subjects usually accelerate loss of autonomy for instrumental activities of daily living.Additionally, ageing mightbeassociated with changes in motor abilities. The main aim is to assess motor activity in MCI subjects carrying out short functional activity tasks using ambulatory actigraphy. Methods: 20 MCI subjects and 14 cognitively healthy subjects wore a chest actimeter and carried out a 30-minute standardized scenario comprising directed activities (eecution of motor tasks), semi-directed activities (execution of actiities if daily living) and undirected activities. Results: MCI subjects had significantly reduced motor activity while carrying out directed and semi-directed activities, compared to healthy subjects. The two subgroups did not differ on usual assessment scales for activities of daily liing (IADL). Conclusions: Motor activity assessment using actimetry might be an objective and more accuratetool, compared toclassical assessment questionnaires,for the detection of early motor changes during the evaluation of basic instrumental activities of daily livingin elderly non demented subjects with cognitive impairment. P3-175
P3-173
HOW SHOULD WE ASSESS FUNCTIONAL PERFORMANCE IN INDIVIDUALS WITH MILD COGNITIVE IMPAIRMENT (MCI)?
Patricia da Cunha Belchior1, Jade Chiu Wai Kwok2, Isabelle Gelinas1, Pedro Rosa-Neto3, 1McGill University, Montreal, Quebec, Canada; 2 CHUM - Notre-Dame Hospital, Montreal, Quebec, Canada; 3McGill University, Porto Alegre, Brazil. Contact e-mail: patricia.belchior@mcgill. ca Background: A number of studies have recently examined functional performance of individuals with MCI and found that these individuals face functional declines. Despite the relevant findings, the literature in this area has a number of limitations: 1) functional performance has been assessed using different types of measures (e.g., self report, informant report, questionnaire, performance-based activities), producing different estimates of functional abilities; 2) there is little consistency between studies on MCI criteria; 3) many studies do not indicate the MCI subtype, even though type directly impacts on functional performance, and 4) few studies have evaluated the performance-based (e.g., organization, initiation, planning, remembering, etc...) components affected. Thus, to date there is no consensus on how to assess functional performance in this population and clinicians are still left without much guidance in this area. The goal of our study is to develop an evidence-based guideline for the screening and assessment of functional performance in individuals with MCI. This presentation will focus on the analytical framework used for the development of the guideline and preliminary findings. Methods: The methodological approach used was adapted from the U.S. Preventive Service Task Force (USPSTF). The goal of the USPSTF is to take a more evidence-based approach to the development of clinical practice guidelines. It uses an analytic framework to guide the literature search for admissible evidence, including literature findings that are classified as overall good, fair or poor. The evidence is then translated into recommendations to the clinical community, and finally the proposed guidelines are tested out by the clinicians to make sure that they are understandable. Results: An analytical framework was developed and guided our critical review of the evidence currently available. The current evidence will be discussed in the presentation. Conclusions: Clearly, we need to identify the functional evaluations that will assist clinicians with the early identification of individuals with MCI. With better screening and assessment criteria, successful intervention programs can then be tailored to the individuals’
ACTIGRAPHIC MOTOR ACTIVITY IN MCI PATIENTS CARRYING OUT SHORT FUNCTIONAL ACTIVITY TASKS
VASCULAR MILD COGNITIVE IMPAIRMENT, FRAILTY SYNDROME, AND THEIR COMBINATION IN MEXICAN ELDERLY IN A MEMORY DISORDERS CLINIC
Sara Gloria Aguilar Navarro1, Alberto Mimenza Alvarado2, Sandra Juarez3, Carolina Bernal Lopez4, Alejandra Samudio Cruz2, Arturo Reyes5, Alberto Avila6, 1Insituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, D.F., Mexico; 2Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, D.F., Mexico; 3 Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, Mexico; 4Istituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, Mexico; 5Instituto Nacional de Ciencias Medicas y Nutricion Savador Zubiran, Mexico, D.F, Mexico; 6Insituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico, Mexico. Contact e-mail: [email protected] Background: Studies have shown an association between physical frailty and cognitive function. These studies have also reported an association between aging, physical frailty and dementia. However, the relationship of vascular mild cognitive impairment(MCIv) and frailty is unknown. The aim of our study was to determine the factors associated with MCIv and frailty syndrome. Methods: Cross-sectional study. 140 subjects were evaluated by a geriatrician and a neurologist for diagnosis of dementia, mild cognitive impairment and frailty. Sociodemographic characteristics and risk factors were obtained. All patients with MCI underwent neuropsychological evaluation to confirm the vascular cognitive profile and all patients had a brain MRI. Frailty criteria developed by the cardiovascular Health Study, we considered to be characterized by limitations in 3 or more of the following 5 domains: mobility, strength, endurance, physical activity, and nutrition. We analyzed the difference between groups: MCI, Physical Frailty and both, we used X 2 and Kruskall Wallis test. Results: There were 97 (69.3%) females; 106 (75.7%) participants had less than 12 years of education. 42 (30%) was Pre-Frail, 22 (15.7%) Frail y 14 subjects (10%) con ambos criteria’s. Increasing age was associated with cognitive impairment (MCI and frailty (p¼.020). MCI was significantly associated with a lower education level (p¼.036). The presence of vascular risk factors (n¼140) ranged from 66.4% (hypertension) to 14.3% (diabetes). Subjective memory complaints were significantly associated with cognitive impairment (p¼.001). Except for the use of the telephone (p¼.225) and the television (p¼.08), impairment in all domains of instrumental activities of daily