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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...

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Autores principales: 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.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
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.
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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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