Mild cognitive impairment : improved identification and a novel cognitive intervention.
Notice bibliographique
Résumé
The prevention and treatment of cognitive impairment in the elderly has assumed increasing importance given the ageing population. Mild Cognitive Impairment (MCI) is considered as a transitional state between healthy ageing and dementia. The primary aim of the current study was to develop a cognitive intervention for MCI that encourages participation in a variety of complex and novel cognitive activities, and to examine its efficacy. Furthermore, these cognitive activities were developed to influence multiple brain networks, particularly the default mode network (DMN). A secondary aim was to assess the diagnostic utility of a number of screening measures in discriminating MCI. In the Cognitive Screening Study, 609 individuals (age range 65-97 years old) were evaluated using brief cognitive tests, including the Montreal Cognitive Assessment (MoCA), Rey Complex Figure Test (RCFT; copy and 3-min recall), and Trail Making Test-Part A (TMT-A). After the initial evaluation, 222 were excluded, the remaining were classified as Probable MCI (n = 75), Possible MCI (n = 72) and Probable Healthy Control (HC; n = 240). A portion of these individuals were followed-up with detailed cognitive assessment, and their performance on the detailed assessment determined which cognitive group they were assigned to. As a result, 17 individuals were classified as Confirmed MCI, 91 as Possible MCI, and 226 as Probable HC. The diagnostic utility of each individual screening measure was examined using the standard receiver operating characteristic curve (ROC). Multivariate logistic regression analysis was conducted to investigate whether combinations of the screening instruments improved the detection of MCI. Simultaneous discriminations among the three cognitive classes were examined using three-dimensional ROC. The results revealed that both MoCA and RCFT (copy and 3-min recall) demonstrated good discrimination of MCI, however, the combination of the two tests showed even better discriminatory power. Thirteen MCI participants were included in the Cognitive Enrichment Study, these individuals were randomly allocated to either the intervention (n = 6) or waitlist group (n = 7). Those in the intervention group received the 4-month-long Cognitive Enrichment Programme. Although the neuropsychological results were generally non-significant, we found a significant pre-post-effect on a measure of long-term memory retrieval. Furthermore, this study also used functional magnetic resonance imaging (fMRI) to examine the effect of enrichment on the DMN in MCI. DMN activity and connectivity were recorded pre- and post-enrichment. An increase in resting-state DMN connectivity was found in intervention participants, while the waitlist group showed a reduced connectivity. The changes in DMN connectivity were associated with an improvement on tests of executive function. However, there were no enrichment-related changes in DMN activation and deactivation. In conclusion, these results suggest some beneficial effects of cognitive enrichment on cognitive abilities, as well as DMN connectivity. Results from the current study, however, should be interpreted with caution because of the small sample size. Further larger trials are needed to confirm the preliminary findings of this study.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,002 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».