Correlation between the Montreal Cognitive Assessment-Indonesian Version (Moca-INA) and the Mini-Mental State Examination (MMSE) in Elderly

BACKGROUND: As the rapid growth of the elderly population and the increased prevalence of Alezheimer’s Disease and related disorders, there is an increasing need for effective cognitive screening. The Mini Mental State Examination (MMSE) is the most frequently used screening test of cognitive impairment because of its convenience. The Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) has been validated and recently been used as a cognitive screening tool.OBJECTIVES: The aim of this study was to compare the MMSE and MoCA-INA scores and to determine the correlation between the MMSE and MoCA-INA scores in elderly.MATERIAL AND METHODS: This was a cross-sectional study including 83 elderly subjects from November 2016 until June 2017. We performed MMSE and MoCA-INA for assessment of cognitive function and the time between each test was at least 30 minutes.RESULTS: The study included 83 subjects which were consisted of 46 (55.4%) males and 37 (44.6%) females. The mean age was 69.19 ± 4.23 ranging from 65 to 79 years old. The average MMSE scores was 24.96 ± 3.38 (range 14 to 30). The average MoCA-INA scores was 21.06 ± 4.56 (range 5 to 30). The Pearson correlation coefficient between the scores was 0.71 (p<0.005). There were no significant differences of both scores based on history of hypertension, diabetes mellitus and previous stroke, but there was a significant difference in MMSE scores based on level of education.CONCLUSION: The MoCA-INA score showed a good correlation with the MMSE score. Both tests showed comparable results but MoCA-INA showed lower average with wider range of scores

Effect of fatigue on cognitive performance in neurology residents of faculty of medicine Universitas Sumatera Utara

Background: Fatigue is a general term used to describe an overall feeling of tiredness. It is one of the most common complaints of people seen in primary health care. Several previous studies have evaluated the effects of fatigue on cognitive function in various clinical and population settings and yielded different results. This study aimed to investigate the effect of fatigue on cognitive performance in neurology residents of Faculty of Medicine of Universitas Sumatera UtaraMethods: This was a crosssectional study involving all of the neurology residents of faculty of medicine universitas Sumatera Utara who fulfilled the inclusion criteria. This study was conducted on November until December 2020. Fatigue was assessed using fatigue severity scale and cognitive performance was assessed using Stroop test. The data was analyse using regression linear testResults: Total subject in this study was 42 subjects consisted of 26 female and 16 male with mean age of 32.02±3.45 years. The mean of FSS score was 33.71±7.41 and the mean of Stroop test score was 46.37±9.16 second. Using regression linear test we found fatigue affect cognitive function with p=0.002; R=0.470 and R2=0.221 and after stratification analysis based on sex of the subjects found that fatigue affect cognitive function in female subjects with p=0.013; R=0.482 and R2=0.232. According to age of the subject, fatigue affect cognitive function in subject >30 years old with p=0.001; R=0.635; R2=0.403Conclusions: There is significant effect of fatigue on cognitive performance. Particularly in women and age >30 years old

Correlation between IgG Anti-Toxoplasmosis Gondii Antibodies and Cognitive Function in Human Immunodeficiency Virus-Acquired Immunodeficiency Syndrome (HIV-AIDS) Patients with Cerebral Toxoplasmosis

Background: Patients with HIV-AIDS are at increased risk for both opportunistic infections, such as cerebral toxoplasmosis, and cognitive impairment. IgG anti-Toxoplasmosis gondii (T.gondii) is a marker for latent infection. However, its role in cognition in HIV patients remains unclear. The study aims to determine the correlation between Ig-G anti-T.gondii and each domain cognitive function in HIV patients with cerebral toxoplasmosis. Method: This was a cross-sectional study involving 110 HIV patients with cerebral toxoplasmosis who met the inclusion and exclusion criteria. We assessed cognitive function using Montreal Cognitive Assessment Indonesian Version (MoCA-INA) and measured the IgG anti-T.Gondii using the ELISA method. The Spearman correlation test was used to determine the correlation between Ig-G anti-T.gondii with each cognitive domain. Results: There was a significant correlation between IgG anti-T.gondii and cognitive function. (p = 0.004, r = -0.275). There was also significant relation between IgG anti-T.gondii with attention (p = 0.046, r =-0.19), abstraction (p = 0.036, r = -0.2), and delayed recall (p = 0.047, r =-0.19). But there was no significant relation between Ig-G anti-T.gondii with visuospatial (p = 0.171), naming (p = 0.521), language (p = 0.810), and orientation (p = 0.11) Conclusion: Lower Level Of IgG Anti-Toxoplasmosis Gondii Antibodies Is Associated With Worse Cognitive Function In Human Immunodeficiency Virus-Acquired Immunodeficiency Syndrome (HIV-AIDS) Patients with Cerebral Toxoplasmosi

Association between mid upper arm and calf circumferences and cognitive function in elderly

Background: Nutritional status has been associated with cognitive function in elderly. Several anthropometric measurement, including mid upper arm circumference and calf circumference are recognized as effective means to assess nutritional status, as they have good correlation with body mass index. This study aimed to identify the association between MUAC, CC and cognitive function in elderly population.Methods: This cross sectional study involved 71 elderly subjects aged more than 60 years old. We recruited subjects from Medan Helvetia district because it has the largest aging population in Medan, North Sumatera, Indonesia. The Cognitif function was assessed using montreal cognitive assessment test Indonesian version (MoCA-INA) and visual cognitive assessment test. To examine the association between MUAC, CC and cognitive function using Kruskal Wallis test and Fisher Exact.Results: There were 42 females and 29 males. The mean age was 68.68±6.35 years. The mean MUAC was 24.3±3.25 cm and CC was 31.5±2.45 cm. There was no association between MUAC and MoCA-INA (p=0.215) and VCAT (p=0.062). There was an association between CC and MoCA-INA (p=0.040) and VCAT (p=0.019).Conclusions: There was an association between calf circumference and cognitive function while mid upper arm circumference was not. Compared to BMI, calf circumference can predict sarcopenia in the elderly. Elderly with functional impairment and impaired mobility may show a decrease in calf circumference. Sarcopenia is often associated with brain atrophy in the elderly

Correlation between Lymphocyte CD4 Count, Treatment Duration, Opportunistic Infection and Cognitive Function in Human Immunodeficiency Virus-Acquired Immunodeficiency Syndrome (HIV-AIDS) Patients

BACKGROUND: Human immunodeficiency virus (HIV) infection is an epidemic worldwide, despite the marked benefits of antiretroviral therapy (ARV) in reducing severe HIV-associated dementia. A milder form of neurocognitive disorders are still prevalent and remain a challenge.AIM: This study aimed to determine the correlation between plasma cluster of differentiation 4 (CD4) lymphocyte, duration of ARV treatment, opportunistic infections, and cognitive function in HIV-AIDS patients.METHODS: A cross-sectional study involving 85 HIV-AIDS patients was conducted at Adam Malik General Hospital Medan, Indonesia. All subjects were subjected to physical, neurologic examination and Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) to assess cognitive function and measurement of lymphocyte CD4 counts.RESULTS: Out of the 85 subjects evaluated, the proportion concerning sexes include 52 males (61.2 %) and 33 females (38.8%). The mean age was 38.53 ± 9.77 years old. There was a significant correlation between CD4 lymphocyte counts and MoCA-INA score (r = 0.271, p = 0.012), but there was no significant correlation between duration of ARV treatment and MoCA-INA score. There was also no difference in MoCA-INA score based on the presence of opportunistic infection.CONCLUSION: Lymphocyte CD4 count was independently correlated with cognitive function in HIV-AIDS patients

Cognitive Function and Blood Pressure Examination in Padang Bulan Selayang II Subdistrict

Hypertension is one of the main health problems in Indonesia, which if not controlled will result in health, psychological, social and economic burdens. A common clinical consequence of hypertension is impaired cognitive function, namely dementia and senility, which can be examined through the Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina). The service program which is carried out by the Faculty of Medicine, Universitas Sumatera Utara (FK USU) is an examination of cognitive function and blood pressure in Padang Bulan Selayang II region. Examinations are carried out in accordance with the 2017 World Alzheimer Month and are followed by lay seminars on dementia, brain gym exercises (gerak latih otak/GLO) as well as brain teasers. The activity involved 26 participants from integrated development post (pos pembinaan terpadu/Posbindu) with a mean systolic blood pressure (TDS) 131.54 + 18.70 mmHg, mean diastolic blood pressure (TDD) 83.85 + 8.98 mmHg, mean mean arterial pressure 99, 69 + 9.47 mmHg and a mean MoCA-Ina score of22 + 5.03. Blood pressure monitoring, education of community awareness and cognitive stimulation at regular intervals are expected to prevent and reduce the incidence of hypertension, dementia and senility

Awareness, attitudes, and beliefs of dementia in Indonesia

INTRODUCTION: Tackling dementia stigma is a policy priority. In Indonesia, we have little insight into the general public's knowledge and attitudes about dementia. METHODS: Cross-sectional study of 4430 Indonesian adults recruited from Jakarta and North Sumatra, Indonesia. Measures included dementia knowledge and attitudes. RESULTS: A total of 86.3% (n = 3,803) of adults had not heard of the terms dementia or Alzheimer's disease, and commonly viewed dementia as a normal part of aging. Being older, incorrect knowledge about etiology, not having heard of the terms dementia and/or Alzheimer's disease, having less than primary education, and being from North Sumatra were associated with more negative attitudes (p-values < 0.05). DISCUSSION: Misconceptions and lack of awareness about dementia are common in Indonesia. Attitudes tended not to be negative, but our research highlights factors associated with dementia attitudes. Future research should use this information to better tailor and target potential anti-stigma strategies. Highlights: Most Indonesians had not heard of the terms dementia and/or Alzheimer's disease and thought it was caused by normal aging. The majority of participants held mixed or positive attitudes towards dementia. A series of demographic factors alongside poor awareness were associated with negative attitudes towards dementia

The dementia severity rating scale: a potential community screening tool for dementia in low- and middle-income countries

Background The Dementia Severity Rating Scale (DSRS) is an informant report, dementia staging tool that is quick to administer and has previous been shown to differentiate between people with dementia and healthy controls. However, it is not clear how accurate the tool is screening against diagnostic criteria in middle-income settings. Methods Embedded within the STRiDE programme, older adults (aged ≥65 years) and their informants were randomly recruited from four sites across Indonesia and South Africa. All informants were asked to complete DSRS. We report the tool’s psychometric properties and accuracy against the 10/66 short diagnostic algorithm. Results Between September and December 2021, data was collected from 2110 older adults in Indonesia and 408 in South Africa. Overall, the DSRS scores significantly differed between those with and without dementia, as identified on the 10/66 short algorithm (p 2 on the DSRS had the greatest agreement with the 10/66 short algorithm and had excellent discriminative properties in both Indonesia (Area Under Curve (AUC) = .75, 95% CIs = .72–.77) and South Africa (AUC = .82, 95% CIs = .76–.88). Conclusions The DSRS has potential as a screening tool for dementia in middle-income countries, with high sensitivity and specificity against a standardized diagnostic algorithm