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World-wide variations in tests of cognition and activities of daily living in participants of six international randomized controlled trials
BACKGROUND: Better understanding of worldwide variation in simple tests of cognition and global function in older adults would aid the delivery and interpretation of multi-national studies of the prevention of dementia and functional decline. METHOD: In six RCTs that measured cognition with the mini...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10368824/ https://www.ncbi.nlm.nih.gov/pubmed/37501909 http://dx.doi.org/10.1016/j.cccb.2023.100176 |
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author | Katsanos, Aristeidis H. Lee, Shun Fu Cukierman-Yaffe, Tali Sherlock, Laura Muniz-Terrera, Graciela Canavan, Michele Joundi, Raed Sharma, Mukul Shoamanesh, Ashkan Derix, Andrea Gerstein, Hertzel C. Yusuf, Salim O'Donnell, Martin J. Bosch, Jackie Whiteley, William N. |
author_facet | Katsanos, Aristeidis H. Lee, Shun Fu Cukierman-Yaffe, Tali Sherlock, Laura Muniz-Terrera, Graciela Canavan, Michele Joundi, Raed Sharma, Mukul Shoamanesh, Ashkan Derix, Andrea Gerstein, Hertzel C. Yusuf, Salim O'Donnell, Martin J. Bosch, Jackie Whiteley, William N. |
author_sort | Katsanos, Aristeidis H. |
collection | PubMed |
description | BACKGROUND: Better understanding of worldwide variation in simple tests of cognition and global function in older adults would aid the delivery and interpretation of multi-national studies of the prevention of dementia and functional decline. METHOD: In six RCTs that measured cognition with the mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), and activities of daily living (ADL) with the Standardised Assessment of Everyday Global Activities (SAGEA), we estimated average scores by global region with multilevel mixed-effects models. We estimated the proportion of participants with cognitive or functional impairment with previously defined thresholds (MMSE≤24 or MoCA≤25, SAGEA≥7), and with a country-standardised z-score threshold of cognitive or functional score of ≤-1. RESULTS: In 91,396 participants (mean age 66.6 years [SD 7.8], 31% females) from seven world regions, all global regions differed significantly in estimated cognitive function (z-score differences 0.11–0.45, p<0.001) after accounting for individual-level factors, centre and study. In different regions, the proportion of trial participants with MMSE≤24 or MoCA≤25 ranged from 23–36%; the proportion below a country-standardised z-score threshold of ≤1 ranged from 10–14%. The differences in prevalence of impaired IADL (SAGEA≥7) ranged from 2–6% and by country-standardised thresholds from 3–6%. CONCLUSIONS: Accounting for country-level factors reduced large differences between world regions in estimates of cognitive impairment. Measures of IADL were less variable across world regions, and could be used to better estimate dementia prevalence in large studies. |
format | Online Article Text |
id | pubmed-10368824 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-103688242023-07-27 World-wide variations in tests of cognition and activities of daily living in participants of six international randomized controlled trials Katsanos, Aristeidis H. Lee, Shun Fu Cukierman-Yaffe, Tali Sherlock, Laura Muniz-Terrera, Graciela Canavan, Michele Joundi, Raed Sharma, Mukul Shoamanesh, Ashkan Derix, Andrea Gerstein, Hertzel C. Yusuf, Salim O'Donnell, Martin J. Bosch, Jackie Whiteley, William N. Cereb Circ Cogn Behav Article BACKGROUND: Better understanding of worldwide variation in simple tests of cognition and global function in older adults would aid the delivery and interpretation of multi-national studies of the prevention of dementia and functional decline. METHOD: In six RCTs that measured cognition with the mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), and activities of daily living (ADL) with the Standardised Assessment of Everyday Global Activities (SAGEA), we estimated average scores by global region with multilevel mixed-effects models. We estimated the proportion of participants with cognitive or functional impairment with previously defined thresholds (MMSE≤24 or MoCA≤25, SAGEA≥7), and with a country-standardised z-score threshold of cognitive or functional score of ≤-1. RESULTS: In 91,396 participants (mean age 66.6 years [SD 7.8], 31% females) from seven world regions, all global regions differed significantly in estimated cognitive function (z-score differences 0.11–0.45, p<0.001) after accounting for individual-level factors, centre and study. In different regions, the proportion of trial participants with MMSE≤24 or MoCA≤25 ranged from 23–36%; the proportion below a country-standardised z-score threshold of ≤1 ranged from 10–14%. The differences in prevalence of impaired IADL (SAGEA≥7) ranged from 2–6% and by country-standardised thresholds from 3–6%. CONCLUSIONS: Accounting for country-level factors reduced large differences between world regions in estimates of cognitive impairment. Measures of IADL were less variable across world regions, and could be used to better estimate dementia prevalence in large studies. Elsevier 2023-07-06 /pmc/articles/PMC10368824/ /pubmed/37501909 http://dx.doi.org/10.1016/j.cccb.2023.100176 Text en © 2023 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Article Katsanos, Aristeidis H. Lee, Shun Fu Cukierman-Yaffe, Tali Sherlock, Laura Muniz-Terrera, Graciela Canavan, Michele Joundi, Raed Sharma, Mukul Shoamanesh, Ashkan Derix, Andrea Gerstein, Hertzel C. Yusuf, Salim O'Donnell, Martin J. Bosch, Jackie Whiteley, William N. World-wide variations in tests of cognition and activities of daily living in participants of six international randomized controlled trials |
title | World-wide variations in tests of cognition and activities of daily living in participants of six international randomized controlled trials |
title_full | World-wide variations in tests of cognition and activities of daily living in participants of six international randomized controlled trials |
title_fullStr | World-wide variations in tests of cognition and activities of daily living in participants of six international randomized controlled trials |
title_full_unstemmed | World-wide variations in tests of cognition and activities of daily living in participants of six international randomized controlled trials |
title_short | World-wide variations in tests of cognition and activities of daily living in participants of six international randomized controlled trials |
title_sort | world-wide variations in tests of cognition and activities of daily living in participants of six international randomized controlled trials |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10368824/ https://www.ncbi.nlm.nih.gov/pubmed/37501909 http://dx.doi.org/10.1016/j.cccb.2023.100176 |
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