Background: The burden of Alzheimer's disease and related dementias (AD/ADRD) in Costa Rica is expected to become one of the highest in the region. Early detection will help optimize resources and improve primary care interventions. The Montreal Cognitive Assessment (MoCA) has shown good sensitivity for detecting mild cognitive impairment (MCI), but specificity varies depending on the population. This motivated the analysis of different cutoffs to minimize false-positive classifications in a Costa Rican sample for its use in clinical settings.
Methods: Data was analyzed from 516 memory clinic outpatients (148 cognitively normal, 260 MCI, 108 mild AD/ADRD; mean age 66.3 ± 10.8 years) who underwent complete neurological and neuropsychological assessment and were diagnosed by consensus. Optimal MoCA cutoff scores were identified using a multiple cutoff approach.
Results: Overall, a cutoff score of ≥ 23 showed better accuracy to distinguish between normal cognition (NC) and MCI (sensitivity 73%, specificity 83%). When analyzed by educational levels, a cutoff score of ≥ 21 showed better accuracy for ≤ 6 years (sensitivity 80%, specificity 76%), ≥23 for 7-12 years (sensitivity 86%, specificity 76%) and ≥ 24 for > 12 years (sensitivity 70%, specificity 85%). For distinguishing MCI from mild AD/ADRD, the optimal overall cutoff score was ≥ 15 (sensitivity 66%, specificity 85%). When stratified by years of education, cutoff scores of ≥ 14 showed better accuracy for ≤ 6 years (sensitivity 70%, specificity 88%), ≥15 for 7-12 years (sensitivity 46%, specificity 95%) and ≥ 17 for > 12 years (sensitivity 67%, specificity 93%).
Conclusions: A MoCA cutoff score of ≥ 23 in the Costa Rican population showed better diagnostic accuracy for detecting MCI and may reduce the false positive rate. Our findings may be helpful for primary care clinical settings and further referral criteria.
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http://dx.doi.org/10.1080/13803395.2024.2411355 | DOI Listing |
Lipids Health Dis
January 2025
Department of Urology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road Jinan, Shandong, 250012, People's Republic of China.
Background: An association exists between obesity and reduced testosterone levels in males. The propose of this research is to reveal the correlation between 15 indices linked to obesity and lipid levels with the concentration of serum testosterone, and incidence of testosterone deficiency (TD) among adult American men.
Methods: The study utilized information gathered from the National Health and Nutrition Examination Survey (NHANES) carried out from 2011 to 2016.
Adv Rheumatol
January 2025
Division of Rheumatology, Department of Internal Medicine, Kocaeli University Faculty of Medicine, İzmit, Kocaeli, 41380, Turkey.
Background: The clinical manifestations and course of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) exhibits considerable heterogeneity. In this study, we aimed to explore radiographic progression over a defined period, employing the Warrick score as a semi-quantitative measure in early RA-ILD, and to assess the associated risk factors for progression.
Methods: RA-ILD patients underwent consecutive Warrick scoring based on initial high-resolution computed tomography (HRCT) at diagnosis and the first follow-up.
Eur Arch Otorhinolaryngol
January 2025
ENT institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, 83 FenYang Road, Shanghai, 200031, China.
Background: Vocal fold leukoplakia (VFL), a precancerous lesion of the larynx, is characterized by white plaques on the vocal fold mucous membrane. Currently, there are no reliable biomarkers to predict the recurrence and malignant transformation of VFL. Considering chondroitin sulfate proteoglycan 4 (CSPG4) as a biomarker for malignant tumors such as laryngeal squamous cell carcinoma (LSCC), we conducted this cohort study to evaluate the prognostic influence of CSPG4 expression on VFL patients.
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January 2025
Division of Critical Care Medicine, Department of Emergency Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si, Gyeonggi-do, Republic of Korea.
The optimal duration of on-scene cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) patients remains uncertain. Determining this critical time period requires outweighing the potential risks associated with intra-arrest transport while minimizing delays in accessing definitive hospital-based treatments. This study evaluated the association between on-scene CPR duration and 30-day neurologically favorable survival based on the transport time interval (TTI) in patients with OHCA.
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January 2025
Department of Radiology, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People's Hospital, Yancheng, China.
We intended to investigate the potential of several transitional zone (TZ) volume-related variables for the detection of clinically significant prostate cancer (csPCa) among lesions scored as Prostate Imaging Reporting and Data System (PI-RADS) category 3. Between September 2018 and August 2023, patients who underwent mpMRI examination and scored as PI-RADS 3 were queried from our institution. The diagnostic performances of prostate-specific antigen density (PSAD), TZ-adjusted PSAD (TZPSAD), and TZ-ratio (TZ volume/whole gland prostate volume) were analyzed.
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