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9 results

  • Methods for Improving Screening for Vascular Cognitive Impairment Using the Montreal Cognitive Assessment
  • Khush-Bakht Zaidi, Jill B. Rich, Kelly M. Sunderland, Malcolm A. Binns, Linda Truong, Paula M. McLaughlin, Bradley Pugh, Donna Kwan, Derek Beaton, Brian Levine, Demetrios J. Sahlas, Dariush Dowlatshahi, Ayman Hassan, Jennifer Mandzia, The ONDRI Investigators, Angela K. Troyer, Richard H. Swartz
  • Journal: Canadian Journal of Neurological Sciences / Volume 47 / Issue 6 / November 2020
  • Published online by Cambridge University Press: 11 June 2020, pp. 756-763
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    Background:

    Vascular cognitive impairment (VCI) post-stroke is frequent but may go undetected, which highlights the need to better screen cognitive functioning following a stroke.

    Aim:

    We examined the clinical utility of the Montreal Cognitive Assessment (MoCA) in detecting cognitive impairment against a gold-standard neuropsychological battery.

    Methods:

    We assessed cognitive status with a comprehensive battery of neuropsychological tests in 161 individuals who were at least 3-months post-stroke. We used receiver operating characteristic (ROC) curves to identify two cut points for the MoCA to maximize sensitivity and specificity at a minimum 90% threshold. We examined the utility of the Symbol Digit Modalities Test, a processing speed measure, to determine whether this additional metric would improve classification relative to the MoCA total score alone.

    Results:

    Using two cut points, 27% of participants scored ≤ 23 and were classified as high probability of cognitive impairment (sensitivity 92%), and 24% of participants scored ≥ 28 and were classified as low probability of cognitive impairment (specificity 91%). The remaining 48% of participants scored from 24 to 27 and were classified as indeterminate probability of cognitive impairment. The addition of a processing speed measure improved classification for the indeterminate group by correctly identifying 65% of these individuals, for an overall classification accuracy of 79%.

    Conclusions:

    The utility of the MoCA in detecting cognitive impairment post-stroke is improved when using a three-category approach. The addition of a processing speed measure provides a practical and efficient method to increase confidence in the determined outcome while minimally extending the screening routine for VCI.

  • The effects of weight loss on adipokines and markers of inflammation in dogs
  • Joseph J. Wakshlag, Angela M. Struble, Corri B. Levine, Jennifer J. Bushey, Dorothy P. Laflamme, Grace M. Long
  • Journal: British Journal of Nutrition / Volume 106 / Issue S1 / 12 October 2011
  • Published online by Cambridge University Press: 12 October 2011, pp. S11-S14
  • Print publication: 12 October 2011
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    Evidence suggests that adipose tissue-derived adipokines induce mild inflammation and may play a role in insulin resistance associated with diabetes. The present study was designed to examine a series of adipokines and markers of inflammation in dogs before and after a successful weight loss. The study included fasting serum samples from twenty-five dogs before and after a weight-loss programme. Serum C-reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1) were measured as indicators of chronic inflammation, while serum adipokines including total adiponectin, high-molecular-weight (HMW) adiponectin, resistin and leptin were also examined. Medians for CRP (before, 10·0 (interquartile range 5·4–15·0) μg/ml; after, 5·6 (interquartile range 3·8–7·0) μg/ml) and MCP-1 (before, 212 (interquartile range 157–288) ng/ml; after, 185 (interquartile range 143–215) ng/ml) decreased significantly after weight loss. Medians for resistin showed a mild, yet significant reduction (before, 67·1 (interquartile range 44·4–88·5) pg/ml; after, 60·5 (interquartile range 32·3–67·1) pg/ml), while leptin showed a dramatic decrease after weight loss (before, 18·9 (interquartile range 10·8–35·4) ng/ml; after, 6·6 (interquartile range 3·9–10·2) ng/ml). Serum total adiponectin and HMW adiponectin were unchanged on all analyses performed. These data suggest that weight loss can decrease chronic inflammation; however, the clinical implications of this decrease are not well elucidated in dogs. Surprisingly, there was no increase in total or HMW serum adiponectin after weight loss, as observed previously in human subjects. The lack of change in total and HMW adiponectin might explain why insulin resistance and type 2 diabetes are less prevalent in obese dogs when compared with humans and cats.