Oscar H Del Brutto1, Robertino M Mera2, Mauricio Zambrano3, Francisco Soriano3, Julio Lama4. 1. School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador; Department of Neurology, Hospital-Clínica Kennedy, Guayaquil, Ecuador. Electronic address: oscardelbrutto@hotmail.com. 2. Gastroenterology Department, Vanderbilt University, Nashville, TN, United States. 3. Community Center, The Atahualpa Project, Atahualpa, Ecuador. 4. Department of Imaging, Hospital-Clínica Kennedy, Guayaquil, Ecuador.
Abstract
BACKGROUND/ OBJECTIVE: Increasing numbers of individuals with cognitive impairment are posing economic threads to the developing world. Proper assessment of this condition may be complicated by illiteracy and cross-cultural factors. We conducted a population-based study in elders living in rural Ecuador to evaluate whether the MoCA associated with structural brain damage in less-educated populations. METHODS: Atahualpa residents aged ≥60 years were identified during a door-to-door survey and invited to undergo MRI for grading GCA. Using a multivariate generalized linear model, we evaluated whether MoCA scores correlates with GCA, after adjusting for demographics, education, cardiovascular health (CVH) status, depression and edentulism. RESULTS: Out of 311 eligible persons, 241 (78%) were enrolled. Mean age was 69.2±7.5 years, 141 (59%) were women, 199 (83%) had primary school education, 175 (73%) had poor CVH status, 30 (12%) had symptoms of depression and 104 (43%) had edentulism. Average MoCA scores were 18.5±4.7 points. GCA was mild in 108, moderate in 95, and severe in 26 persons. Total and most domain-specific MoCA scores were significantly worse in persons with moderate to severe GCA. In the multivariate model, mean MoCA score was associated with GCA severity (β=2.38, SE=1.07, p=0.027). CONCLUSIONS: MoCA scores associate with severity of GCA after adjusting for potential confounders, and may be used as reliable estimates of structural brain damage. However, a lower cut-off than that recommended for developed countries, would be better for recognizing cognitive impairment in less educated populations.
BACKGROUND/ OBJECTIVE: Increasing numbers of individuals with cognitive impairment are posing economic threads to the developing world. Proper assessment of this condition may be complicated by illiteracy and cross-cultural factors. We conducted a population-based study in elders living in rural Ecuador to evaluate whether the MoCA associated with structural brain damage in less-educated populations. METHODS: Atahualpa residents aged ≥60 years were identified during a door-to-door survey and invited to undergo MRI for grading GCA. Using a multivariate generalized linear model, we evaluated whether MoCA scores correlates with GCA, after adjusting for demographics, education, cardiovascular health (CVH) status, depression and edentulism. RESULTS: Out of 311 eligible persons, 241 (78%) were enrolled. Mean age was 69.2±7.5 years, 141 (59%) were women, 199 (83%) had primary school education, 175 (73%) had poor CVH status, 30 (12%) had symptoms of depression and 104 (43%) had edentulism. Average MoCA scores were 18.5±4.7 points. GCA was mild in 108, moderate in 95, and severe in 26 persons. Total and most domain-specific MoCA scores were significantly worse in persons with moderate to severe GCA. In the multivariate model, mean MoCA score was associated with GCA severity (β=2.38, SE=1.07, p=0.027). CONCLUSIONS: MoCA scores associate with severity of GCA after adjusting for potential confounders, and may be used as reliable estimates of structural brain damage. However, a lower cut-off than that recommended for developed countries, would be better for recognizing cognitive impairment in less educated populations.
Authors: Heidi C Rossetti; Emily E Smith; Linda S Hynan; Laura H Lacritz; C Munro Cullum; Aaron Van Wright; Myron F Weiner Journal: Arch Clin Neuropsychol Date: 2019-08-28 Impact factor: 2.813
Authors: Oscar H Del Brutto; Naoum P Issa; Perla Salgado; Victor J Del Brutto; Mauricio Zambrano; Julio Lama; Héctor H García Journal: Am J Trop Med Hyg Date: 2016-11-14 Impact factor: 2.345
Authors: Oscar H Del Brutto; Robertino M Mera; Mark J Sedler; Jadry A Gruen; Kelsie J Phelan; Elizabeth H Cusick; Mauricio Zambrano; David L Brown Journal: High Blood Press Cardiovasc Prev Date: 2015-05-19