The COVID-19 social isolation period entailed changes in daily habits and routines, testing the adjustment abilities of the population to address unusual situations. Given that the activities of daily living require a normally functioning cognitive system, the study of cognitive-functional interaction under social isolation is relevant. The object of this work was to obtain information on the cognitive-functional impact of social isolation, analyze the changes induced in daily routines and habits, and assess the cognitive adjustment of the adult population to the isolation requirements. We carried out an online adult population survey, that combined multiple choice or binary questions following a Likert ordinal scale, performing a percentage analysis as well as a principal component analysis of the results. We surveyed 1095 subjects, 68% of which were residents of the Buenos Aires Metropolitan Area (AMBA), of an average age of 52.7 ± 12.8 years, and 15.6 ± 2.2 years of education. All age groups reported attention and memory impairment, more significant in lower age groups and women. The principal component analysis showed an associated correlation of the functional challenge brought about by social isolation on the executive system, with the negative impact on cognitive functions such as attention and memory. Social isolation significantly impacted on the attentional, mnesic and executive cognitive systems, ratifying the role of cognitive abilities in the generation of means and strategies to overcome unusual situations, and highlighting the importance of cognitive-functional interaction.

The increase in consultations for changes and/or cognitive complaints in the elderly, together with the current interest in epidemiological research in this context creates the need for screening tools for cognitive assessment to enable the detection of early deficits. Evidence shows its predictive value in the development of dementia disease. This study aims at displaying the results of a Cognitive Skills Questionnaire (CSQ) in a patient population with mild cognitive impairment (MCI) and Alzheimer’s disease (AD), both compared with a control group (CG) with no cognitive disorder and verifying its sensitivity and specificity in order to identify risk patients with cognitive disorder. Participants and Methods: A total of 208 participants were evaluated, out of which 60 had MCI, 46 had AD and a remaining group of 102 subjects who had no cognitive disorder. All participants were administrated the CSQ and a battery of neuropsychological proofs. We analysed the statistical data using ANOVA, Student’s t-test, Tuckey test, ROC curve and principal components analysis. A multiple regression analysis was carried out so as to single out those questions which better differentiated the studied groups. Results: The CSQ showed significant differences between the CG and both groups of patients (AD p> 0.01 and MCI p> 0.05). It was established a cut-off point of 17.5 in the CSQ total score with a sensitivity of 93% and a specificity of 91.3%. Conclusion: The CSQ could eventually allow us to identify patients with cognitive disorders and those others with a cognitive complaint greater than expected. Thus, this questionnaire could be a useful testing and counselling tool in health primary attention.

Subjective memory complaints is a symptom of cognitive impairment and dementia, but healthy aging people can also have memory complaints. A systematized questionnaire can help in differentiating both situations The objective of this presentation is to validate the Abbreviated Questionnaire of Mnesic Complaints (AQMC), elaborated starting from the Q.A.M. (Van Der Linden, 1989) in a Spanish speaking population. AQMC includes 15 questions about daily life situations that happen in the context of subjective memory complain to be answered in a Likert 4 level scale, in which a higher number implies higher frequency of the problem (0= never, 1= almost never; 2= often, 3= always) with maximal score of 45. The questions assess different memory subsystems (retrospective, semantic, episodic, prospective, short term, working memory) and some other cognitive functions: attention, learning capabilities, orientation. AQMC and a neurocognitive battery was administered to 222 subjects. Among which 71 had been diagnosed with MCI and 47 with Alzheimer Dementia (AD) at San Isidro Hospital (Patient group PG), and 104 were cognitively normal people (Control Group GC) recruited from personnel of Buenos Aires University and relatives of patients attending to San Isidro Hospital. We compared results of AD with CG; MCI with CG and AD with MCI. Anova, t student, and tuckey's test were used for data analisys. The AQMC obtained significant differences regarding both groups of patients compared with CG. CG vs. AD: 0.93 de specificity and 0.91 de sensibility, MCI vs CG 0.93 specificity and 0,65 sensibility (Graphics). No significant differences have been registered between MCI and the AD. A significant difference was registered between CG and PG in the frequency of answers 2 and 3 which measure the frequency of the apparition of the event.

Background: There is a close interaction between cognitive and functional performance in the normal brain. It increases in cases of brain disease, where a worse initial cognitive performance is associated with subsequent functional decline. Objective: To describe the cognitive and functional performance profile and their interaction in a population of patients with Vascular Dementia (VD). Methods: We studied 79 patients (Group 1, G1) with VD and 80 healthy subjects without brain disease (Group 2, G2). The following tests were administered to all the study population: ADAS Cog., Trail Making Test (TMT), Mini Mental State Examination (MMSE), Basic and instrumental activities of daily living (ADL, IADL), Disability Assessment for Dementia (DAD), and Gottfries-Brane-Steen Scale (GBS). Scores were statistically evaluated usingthe ANOVA Test, Spearman’s correlation matrix and Principal Component Analysis (PCA). Results: The average age of G1 was 72.6 + 7.1 and their literacy level was 8.05 + 4.76 years. The cognitive profile showed a significant global decline in the MMSE (19.9 + 3.77 points) and in the ADAS Cog (29.2 + 8.80 points). In this group, the cognitive functions most compromised were Memory, Orientation and Recognition and, to a lesser degree, Attention, Language and Praxis. The functional profile showed the greatest impairment in IADL. The PCA showed a correlation of ADAS with TMT and Katz Index, and of MMSE and DAD. Conclusions: The results highlight the interaction between complex functional performance and cognition, suggesting an impact of cognitive impairments linked to executive function on functional performance, of potential therapeutic significance.

Background: Several papers describe functional changes in the aging population, and its relevance in early detection.Objectives: In order to count on a tool to evaluate the performance in the use of new technologies we have designed a new protocol - Complex Functional Study (CFS)-that quantifies performance and functional changes related to previous states.Our objectives are to study the aging population with this lately developed tool.Methods: We evaluated 350 healthy subjects grouped according to age and instruction levels. We administered a General Cognitive Screening and the CFS. We used ANOVA Test, and Regression Analysis and Principal Components.Results: Our finding verifies that the 15.75% registered functional loss and the 2.8%, registered changes in performance. The differences in the averages were higher at the age range 80-90. The measure of change proved to have less impact in groups with higher instruction level. A greater functional loss has been registered in older participants with less instruction level.Conclusions: This study enables the use of the CFS as a tool of clinical interest for the detection of incipient impairment in daily living complex functional skills.The results obtained verify a good performance in those skills in most of the studied population. On the other hand, this study has also a psycho-social perspective insofar as it fosters significant learning processes. In this way it will be possible to implement strategies to develop social awareness about the learning capacity in the elderly to impact in the social net and on their wellbeing.

BACKGROUND:The Memory Impairment Screen (MIS-A) is a validated test to detect Alzheimer's Disease (AD) and other dementias. We have modified this test to suit a Spanish speaking population and added a new component, delayed recall (MIS-D).OBJECTIVES:1) To test a Spanish version of MIS-A and MIS-D. 2) To assess the discriminative validity of MIS-D as a screening tool for the amnestic variant of Mild Cognitive Impairment (aMCI).METHODS:A case-control study of a cohort of 739 aged 65 years old and over, of whom 436 were healthy controls and 303 had a diagnosis of aMCI. The MCI group was patients from the Geriatric Unit for the Elderly at the Italian Hospital of Buenos Aires staffed by geriatricians.MEASUREMENTS:ANOVA test and test t de Student mean comparison. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NVP) were estimated for MIS-D and MIS-A.RESULTS:Normative values for MIS-A and MIS-D were obtained from the control population. Both age and education significantly affected these values (p<0.0001). The cut-off for MIS-A should be 7.5 and for MIS-D, 5.5. Comparison between control population and aMCI population using ROC curve gave a result of 5.5 in MIS-D, with 97% specificity and 76% sensitivity.CONCLUSION:MIS-D was positively predictive of Amci. An extension of the sample in other health care contexts would enable us to verify its clinical validity for other populations.

Background: Cognitive impairment becomes more common with ageing and may benefit from intervention. In a Spanish speaking population, detection of cognitive impairment by a general practitioner in Primary Care can be a problem, as many of the standard tests target English speaking populations. The Memory Impairment Screen (MIS-A) is a validated test using English words to detect Alzheimer’s Disease (AD) and other dementias. We have modified this test to suit a Spanish speaking population and added a new component, delayed recall. We have called our new test the Memory Impairment Screen with Delayed Recall (MIS-D). Objectives: 1) To test a Spanish version of MIS-A and MIS-D. 2) To assess the discriminative validity of MIS-D as a screening tool for the amnestic variant of Mild Cognitive Impairment (aMCI) in a group of Spanish speaking people aged 65 years old and over. Methods: A case-control study of a cohort of 739 native Spanish speaking residents of Buenos Aires aged 65 years old and over, of whom 436 were healthy controls and 303 had a diagnosis of aMCI. Measurements: Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NVP) were estimated for MIS-D and MIS-A. Results: Normative values for MIS-A and MIS-D were obtained from the control population. Both age and education significantly affected these values (p < 0.0001). Control participants showed significant differences for both modalities, MIS-A and MIS-D. The cut-off for MIS-A should be 7.5 and for MIS-D, 5.5. Comparison between control population and aMCI population using ROC curve gave a result of 5.5 in MIS-D, with 97% specificity and 76% sensitivity. Conclusion: MIS-D was positively predictive of aMCI, with 97% specificity and 76% sensitivity in a sample of Spanish speaking patients aged 65 years old and over in Buenos Aires.

In order to count on a sistematized tool to evaluate the performance in complex abilities related to new technologies (such as Cell Phones, Computers, ATMs, Microwave ovens, Remote controls), we have designed a new protocol - Extended Functional Study (EFS)- that quantifies the level of performance and the functional changes related to a previous state. The objectives are to study a functional profile of daily living complex activities of a healthy aged population. Also to study the level of change and/or functional loss according of age, gender, instruction level and type of task. We evaluated 352 healthy subjects which were grouped according to two instruction levels and three ranges of age. The whole population was evaluated with a General Cognitive Screening (Adas Cog) MMSS, ADL, IADL and EFS. We established a cut point of 26 for the MMSS and normal performance in ADL and IADL. We used Anova Test, and Regression Analysis and Principal Components. The ANOVA showed a significant difference concerning: a) Measure of change by Age Group (F value 86.45, Pr (>F) <0.001), b) Measure of change by Instruction Level (F value 146.5, Pr(>F)<0.001), c) Measure of loss by Age Group ( F value 9.759, Pr (>F) 0.001 ). Equally significant was the comparison between measure of loss by Age and Instruction Group (both intersected). The differences in the averages are bigger at the age range 80-90. It has been shown as well that the measure of change has less impact in groups with higher instruction level. The analysis of the main components showed more incidence of time and use of the TV variable in the loss score. Our finding verifies that: 1. the complex functions undergo changes and/or losses in the aging process. 2. There is variability among tasks, and 3. There is a relationship between time and frequency of use. This study enables the use of the EFS as a tool of clinical interest for the detection of incipient impairment in the daily living complex functional activities, as it puts in evidence the losses and/or functional changes which are expected in the normal aging process.

Las pruebas de fluencia verbal semántica (FS) y fonológica (FF) son útiles herramientas clínicas y constituyen un posible marcador temprano de enfermedad de Alzheimer (EA). Se muestran los perfiles característicos y los datos normativos según variables edad, género e instrucción de FS (animales y frutas) en tiempo extendido y de FF en una vasta población de sujetos sanos. Fueron evaluados 891 sujetos de ambos géneros, con edades de 20 a 97 años, hispanohablantes alfabetizados residentes en Buenos Aires, que cumplieron con los criterios de inclusión. El diseño de la muestra fue estratificado considerando género, años de instrucción (10,60 ± 4,56) y edad (64,05 ± 13,44). Se administró una batería neuropsicológica que incluyó MMSE (28,63 ± 1,21), Memory Impairment Screening, ADAS Cog. y Trail Making Test. Se realizaron un análisis ANOVA, test t de Student, de comparación t de Bonferroni, t de Dunnet y correlación de Pearson. Se verifica el efecto de edad e instrucción en FS en 60 y 90” y FF, registrándose un descenso en forma de hipérbole, con disminución de ejemplares a medida que aumenta la edad. En el segundo minuto se registra producción categorial (animales) en el 99,9% de la muestra. La categoría frutas muestra un comportamiento diferenciado (masculino y femenino) en contraposición a la categoría animales, con una Pr > F igual a 0,02. Los resultados aportan hallazgos acerca de la organización del sistema lexical y su desarrollo en el adulto. La prueba con tiempo extendido constituye un parámetro válido de utilidad clínica. Tests on Semantic (FS) and Fonological (FF) Oral Fluency have proved to be useful clinical tools and are early measuring ways to detect Alzheimer‘s Disease (AD). Characteristic profile and normative data are shown depending upon age, gender and educational level both from FS (animals and fruits) and FF in a wide population of healthy subjects. 891 male and female subjects were evaluated (ages 20 to 97). They are educated Spanish-speaking residents of Buenos Aires that fulfilled inclusion criteria. The design of the sample was stratified considerig gender, years of instruction (10.60 ± 4.56) and age (64.05 ± 13.44). The neuropsychologic tools administrated included was: MMSE (28.63 ± 1.21) Memory Impairment Screening, ADAS Cog. and Trail Making Test. Also an ANOVA analysis, test t of Student, comparative t of Bonferroni, t of Dunnet, and Pearson correlative. The effect of age and instruction is proved in FS in 60 and 90” and FF observing an hyperbolic fall with a decrease of sujects as the age increases. In the second minute is registered a category production (animals) in the 99,9% of the sample. Category of fruits shows a differenciated behavior (male and female) against category of animals, with a Pr > F of 0.02. Results throw light over organization of lexical system and its development in adults. The test with extended time is a valid parameter of clinical utility.

Cognitive impairment is very prevalent in the elderly and an important target for medical intervention. Accurately identification of this vulnerable group is a critical step for implementing interventions. However, identification in primary care setting by general practitioner can be cumbersome. To improve discrimination in the detecting aMCI, we developed the Memory Impairment Screen Deferred (MISD). This test is based on the MIS (a 4-minute, four-item delayed free and cued recall memory)with the addition of a delayed recall after 30 min. With this modification, the MISD would be able to accurately evaluate patient's encoding capabilities which will optimize the detection of aMCI. Prospective community based cohort study comprising 838 patients aged 65 and older. Measurements: Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NVP) were calculated for the MISD and conventional MIS. For detection of aMCI, the MISD had higher sensitivity(0.82 vs 0.55), and NVP (0.88 vs 0.75) when compared with the MIS. Specificity (0.85 vs 0.90),PPV (0.80 vs 0.80), did not differ significantly. The area under the ROC curve for the MISD was 0.91, compared with 0.79 for the MIS.