Comparing the Efficacy of Two Cognitive Screening Tools in Identifying Gray and White Matter Brain Damage among Older Adults

Paula Andreatta Maduro; Manoel Pereira Guimarães; Mateus de Sousa Rodrigues; Ana Paula Pereira Rolim Coimbra Pinto; Américo Alves da Mota Junior; Alaine Souza Lima Rocha; Juliana Magalhães Duarte Matoso; Bruno Bavaresco Gambassi; Paulo Adriano Schwingel

doi:10.1155/2024/5527225

Comparing the Efficacy of Two Cognitive Screening Tools in Identifying Gray and White Matter Brain Damage among Older Adults

J Aging Res. 2024 Apr 23:2024:5527225. doi: 10.1155/2024/5527225. eCollection 2024.

Authors

Paula Andreatta Maduro^{1

2

3}, Manoel Pereira Guimarães², Mateus de Sousa Rodrigues^{2

3}, Ana Paula Pereira Rolim Coimbra Pinto³, Américo Alves da Mota Junior^{2

3}, Alaine Souza Lima Rocha^{1

2

4}, Juliana Magalhães Duarte Matoso^{2

5}, Bruno Bavaresco Gambassi^{2

6}, Paulo Adriano Schwingel^{1

2}

Affiliations

¹ Post-Graduation Program in Health Sciences (PPGCS), University of Pernambuco (UPE), Recife, PE 50100-130, Brazil.
² Human Performance Research Laboratory (LAPEDH), UPE, Petrolina, PE 56328-900, Brazil.
³ University Hospital of the Federal University of Vale do São Francisco (HU-UNIVASF), Brazilian Hospital Services Company (EBSERH), Petrolina, PE 56304-205, Brazil.
⁴ Department of Physical Therapy, Federal University of Ceará (UFC), Fortaleza, CE 60430-450, Brazil.
⁵ Department of Clinical Medicine, Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ 20551-030, Brazil.
⁶ Post-Graduation Program in Management of Health Programs and Services (PPGGPSS), CEUMA University (UNICEUMA), São Luís, MA 65075-120, Brazil.

Abstract

Background: Ageing is associated with structural changes in brain regions and functional decline in cognitive domains. Noninvasive tools for identifying structural damage in the brains of older adults are relevant for early treatment.

Aims: This study aims to evaluate and compare the accuracy of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA©) in identifying gray and white matter brain damage in older individuals with varying degrees of cognitive impairment.

Methods: Ninety older adults (62 women) with an average age of 69 ± 7 years were enrolled and categorized as having no cognitive impairment (NCI), mild cognitive impairment (MCI), or moderate cognitive impairment (MoCI). Magnetic resonance imaging (MRI) was utilized to assess the number, volume, and distribution of brain damage. The Fazekas and Scheltens scales were applied to the brain MRIs, and inferential statistics were employed to compare variables among the groups.

Results: Cognitive impairment was observed in 56.7% of the participants (95% confidence interval (CI): 46.4-66.4%), with thirty-six older adults (40%) classified as MCI and 15 (17%) as MoCI. Cognitive impairment and medial temporal lobe (MTL) atrophy were found to be associated (p=0.001), exhibiting higher mean volume scales of the MTL atrophied area in the MoCI group (p < 0.001). The MMSE accurately revealed MTL atrophy based on the Scheltens (p < 0.05) and Fazekas (p < 0.05) scales. At the same time, the MoCA accurately identified periventricular white matter (PWM) abnormalities according to the Fazekas scale (p < 0.05).

Conclusions: The MMSE and MoCA screening tools effectively identified gray and white matter brain damage in older adults with varying degrees of cognitive impairment. Lower MMSE scores are associated with MTL atrophy and lesions, and lower MoCA scores are related to PWM lesions. The concurrent use of MMSE and MoCA is recommended for assessing structural changes in distinct brain regions.