S Kant

Abstract

Introduction: Dementia is a major public health challenge that is becoming more common with growing age. It involves progressive and often remorseless decline in cognition, functions, behavior and care needs. The Assessment of dementia greatly relies on collateral as well as patient-derived information. The use of various cognitive tests assumes great importance during the process of diagnostic investigation. In this research we attempt to assess the practical usage of various cognitive scales. Materials and Methods: In this study, we studied the data of 233 patients in the neurology OPD. The following cognitive scales like Montreal Cognitive Assessment (MoCA), Addenbrooke’s Cognitive Examination (ACE), Hachinski Ischemic Score (HIS), and Everyday Abilities Scale for India (EASI) were performed on the above selected data of patient. Results: 228 (97.85) % of patients were found to have cognitive impairment when screened with MoCA. However, 230 (98.7%) of patients screened with EASI had a disability score. The patients with a HIS score of more than 7 was (64) 27.9%. Whereas, ACE indicated all patients had score below 83 (100%). The sensitivity of MoCA, ACE, and EASI score was 72.69% and 72.29%, 71.74% respectively with a specificity of 50 and 100, 0.0% respectively for the above scores, whereas the sensitivity and specificity of HIS was 49.50% and 10.61. Conclusion: MoCA, ACE, and EASI tools have good capability to detect most patients with cognitive impairments. They are sensitive to predict probable cases of dementia, therefore can be used as an efficient diagnostic tool in quick screening of cognitive impairment. Keywords: Montreal Cognitive Assessment (MoCA), Addenbrooke’s Cognitive Examination (ACE), Hachinski Ischemic Score (HIS), Everyday Abilities Scale for India (EASI), and dementia.

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Aim: The occurrence of diabetes mellitus (DM) is in increasing trend worldwide predominantly in South East Asian countries comprising India. Also, there is strong evidences that, DM upsurges the risk of cognitive impairment and dementia. Hence our main aim behind this study was to divulge the relationship between DM and mild cognitive impairment (MCI). Materials and Methods: A retrospective cohort study was conducted by reviewing and analyzing the medical records of DM who had been consulted at the neurology out-patient department during a period of 2015 - 2016. The cognitive impairment in DM patients were assessed by using Addenbrooke’s Cognitive Examination (ACE) and Montreal Cognitive Assessment (MoCA). Statistical Analysis: The data was analyzed using Statistical Package for Social Sciences (SPSS) version 19 software. If the p-value < 0> Results: The prevalence of cognitive impairment in DM patient is seemingly high with both scores i.e. 96.31% with MoCA and 99.85% with ACE-R. The variables like sex and age groups were not statistically significant with MoCA scores. The MoCA score & ACE-R score showed a negative association with education levels. The MoCA scores of different items i.e. visuo-excutive, naming, attention, language, abstraction and orientation were highly statistically significant at 0.01% level, between the DM patients who had cognitive impairment and DM patients with normal score, except memory which score zero in all patients. Conclusion: The prevalence of cognitive impairment in DM patients is very high. The, elder age, low education attainment, and unskilled occupation were also the potential identified risk factors for cognitive impairment. Keywords: Diabetes, Dementia, MoCA, Cognitive impairment, Low education etc.

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Introduction: Alzheimer’s disease (AD) is a common cognitive function disorder commonly reported in old ages. Our aim was to understand the sociodemographic factors associated with AD. Material and Methods:In a retrospective study, we screened database at our private memory clinic to include the adult patients > 45 years of age who were screened with Montreal Cognitive Assessment (MoCA) test for AD. MoCA score of diagnosis of AD. Results:In 2412 patients included in analysis, 91.9% patients were diagnosed with AD. Overall mean age of the participants was 53.5±6.8 years and 63.2% were males. Among sociodemographic factors, compared to patients without AD, those with AD were younger (p=0.006), females (plesser occurrence of AD (p=0.001). No difference by dietary pattern was evident (p=0.976). Conclusion:In an urban memory clinic setting, AD is observed in young and female patients who have lower level of education and are involved in unskilled occupation. Greater number of family members also predisposes to AD. These findings need further confirmation in a prospective and long duration follow up. Keywords:Alzheimer’s disease, Sociodemographic, Cognitive dysfunction, India, Memory.

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