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Nationally Informed Recommendations on Approaching the Detection, Assessment, and Management of Mild Cognitive Impairment.

ABSTRACT: Prior to the usual clinical symptoms of dementia, there can be subtle changes in cognitive function that differ from the normal age-related cognitive decline, which has been termed mild cognitive impairment (MCI). The increase in the numbers of individuals with possible MCI presenting to health care professionals, notably, General Practitioners (GPs), is going to rise dramatically in the coming years. With ever increasing demands on GPs, it is therefore timely to provide information that can be accessed by health care professionals to assist them in making appropriate diagnoses and to provide the most relevant, evidence-based treatment options. We have provided a comprehensive list of recommendations that aim to address key aspects of MCI in primary care. Specifically, these relate to detection and diagnosis; sharing the diagnosis, monitoring, and follow up; practical interventions to potentially delay progression; and personalizing care-planning, engagement, and patient motivation for the long term.

SUBMITTER: Woodward M

PROVIDER: S-EPMC9535556 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Nationally Informed Recommendations on Approaching the Detection, Assessment, and Management of Mild Cognitive Impairment.

Woodward Michael M Brodaty Henry H McCabe Maree M Masters Colin L CL Naismith Sharon L SL Morris Philip P Rowe Christopher C CC Walker Peter P Yates Mark M

Journal of Alzheimer's disease : JAD 20220101 3

Prior to the usual clinical symptoms of dementia, there can be subtle changes in cognitive function that differ from the normal age-related cognitive decline, which has been termed mild cognitive impairment (MCI). The increase in the numbers of individuals with possible MCI presenting to health care professionals, notably, General Practitioners (GPs), is going to rise dramatically in the coming years. With ever increasing demands on GPs, it is therefore timely to provide information that can be ...[more]

PMID: 35964184

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Project description:The Optimal electrode configuration of Electroencephalograms (EEG) systems for mild cognitive impairment (MCI) detection and monitoring in non-clinical settings, i.e. number of electrodes and the positions of the electrodes, remains to be explored. In the current study, we explored the optimization of electrode configuration for MCI detection. We used a 32-channel EEG device to record the data of 21 MCI patients and 20 cognitively normal elderly (NC) undergoing working memory (WM) tasks. Based on the differential value (MCI group vs. NC group) from the Power Spectral Density (PSD) value of each electrode in θ and α frequency band during WM coding stage, six different electrode configurations were obtained: (1) four electrodes in the occipital lobe (OCL4); (2) three electrodes in the prefrontal lobe (PRL3); (3) four electrodes in the parietal lobe (PLL4), (4) eight electrodes in occipital combined parietal lobe (OPL8), (5) seven electrodes in occipital combined prefrontal lobe (OPL7); and (6) seven electrodes in parietal combined prefrontal lobe (PPL7). A multi-parameter combination-assisted binary logistic regression model was established to distinguish two groups. Receiver operating characteristic (ROC) curves were used to evaluate the MCI diagnostic power of each electrode configuration. The area under curve (AUC) of the ROC of electrode configurations OCL4, PRL3, PLL4, OPL8, OPL7 and PPL7 were 0.765, 0.683, 0.729, 0.83, 0.788, and 0.769, respectively. And the sensitivity of six electrode configurations were 0.962, 0.794, 0.873, 0.943, 0.859, and 0.938, respectively. Among these six configurations, OCL4, i.e. PO3, PO4, PO8, and PO7, had the highest sensitivity 96.2%, which meant that relying solely on these four electrodes of the occipital lobe had the potential to serve as an objective tool for preliminary screening of MCI. The abnormal brain rhythm characteristics of the frontal, parietal, and occipital lobes in the memory encoding stage of MCI provide a new perspective for MCI-WM impairment, which has the potential to be a novel biomarker for the early detection of pathological age-related cognitive decline. Further, a potential four-electrode configuration may be used for a novel detecting and monitoring EEG system of MCI in non-clinical settings.

Project description:ObjectiveSocial connections and participation are essential for individuals with mild cognitive impairment (MCI) to prevent the progression of cognitive decline and enhance their overall well-being. However, existing research has primarily focused on environmental barriers, overlooking personal factors and the interconnected nature of these barriers. Moreover, there is a lack of understanding regarding social connections and participation challenges specific to people with MCI in low- and middle-income countries. Therefore, this study aimed to explore the barriers that hinder social connections and participation among people with MCI in China and investigate opportunities to design appropriate supportive interventions.MethodsThirty-one people with MCI (13 males and 18 females; mean age = 82.74 years, SD = 7.69; mean MoCA score = 21.26, SD = 2.44) and 13 caregivers were recruited to attend focus groups. In addition, 10 therapists were interviewed using a semi-structured interview guide. Focus groups and interviews were audio-recorded, transcribed, and analyzed using a framework analysis approach.ResultsWe found that the ability to build social connections among people with MCI is affected by mobility challenges, intensive grandparenting responsibilities, availability of suitable activities, and feelings of exclusion in a closed-minded community environment. Personal reasons, such as lower social efficacy, inability to find suitable social activities, and intensive family responsibilities, discourage people with MCI from social participation. The digital literacy of people with MCI depends on their motivation to learn and use digital tools; people with MCI who live in a community have a higher digital literacy than those living in care centers. The motivation to achieve digital literacy is affected by perceived benefits, costs of technology use, and social influence.ConclusionMultidimensional initiatives are needed to address barriers to social connections, participation, and technology adoption among individuals with MCI. This includes organizing and engaging in social activities, promoting awareness and education on the importance of social participation, and exploring technology-based interventions to improve memory and storytelling abilities. These efforts can create a supportive environment and empower individuals with MCI to participate actively in social interactions, enhancing their overall well-being.

Dataset Information

Nationally Informed Recommendations on Approaching the Detection, Assessment, and Management of Mild Cognitive Impairment.

Publications

Nationally Informed Recommendations on Approaching the Detection, Assessment, and Management of Mild Cognitive Impairment.

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