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Claudia Kawas

Publications and source records attributed to Claudia Kawas.

7 recordsLinked to original sources
PubMed2007

Performance on MMSE sub-items and education level in presenilin-1 mutation carriers without dementia.

BACKGROUND: Spanish-language screening tests that are sensitive to the early cognitive changes of Alzheimer's disease (AD) are needed. Persons known to be at 50% risk for young-onset AD due to presenilin-1 (PSEN1) mutations provide the opportunity to assess which measures on the Mini-mental State Examination (MMSE) are most sensitive to these early changes. METHODS: We performed genetic and Spanish-language cognitive testing on 50 Mexican persons without dementia at risk for inheriting PSEN1 mutations. We then compared the performance on sub-items of the MMSE between PSEN1 mutation carriers (MCs) and non-carriers (NCs) using t-tests and Fisher's exact tests. Exploratory multiple logistic regression analyses were also performed. RESULTS: Twenty-nine persons were MCs and 21 NCs. NCs tended to achieve higher levels of education (p = 0.039) than did MCs. MCs tended to perform more poorly when spelling "MUNDO" backwards and on Orientation, particularly regarding the date. In multiple regression analyses the ability of backwards spelling to predict PSEN1 mutation status was reduced when education was included as an independent variable. CONCLUSION: Subjects in the earliest stage of PSEN1-related AD showed deficits on orientation to date and in divided attention when spelling backwards. It is unclear if educational level should be considered an associated feature or a con-founding variable in this population although it should be taken into account when considering performance on the MMSE task of divided attention. The relative lack of deficits on delayed recall of three words probably represents the insensitivity of this measure in early AD. This study supports the utility of autosomal dominant AD as a model of the more common sporadic form of the disorder.

Aged↗
PubMed2006

The A431E mutation in PSEN1 causing familial Alzheimer's disease originating in Jalisco State, Mexico: an additional fifteen families.

Nine families with autosomal dominant Alzheimer's disease (AD), all of whom had the Ala431Glu substitution in the PSEN1 gene and came from Jalisco State in Mexico, have been previously reported. As they shared highly polymorphic flanking dinucleotide marker alleles, this strongly suggests that this mutation arose from a common founder. In the current letter, we expand this observation by describing an additional 15 independent families with the Ala431Glu substitution in the PSEN1 gene and conclude that this mutation is not an uncommon cause of early-onset autosomal dominant AD in persons of Mexican origin.

Adult↗
PubMed2003

Prevalence and classification of mild cognitive impairment in the Cardiovascular Health Study Cognition Study: part 1.

OBJECTIVE: To examine the prevalence of mild cognitive impairment (MCI) and its diagnostic classification in the Cardiovascular Health Study (CHS) Cognition Study. DESIGN: The CHS Cognition Study is an ancillary study of the CHS that was conducted to determine the presence of MCI and dementia in the CHS cohort. SETTING: Multicenter population study. PATIENTS: We examined 3608 participants in the CHS who had undergone detailed neurological, neuropsychological, neuroradiological, and psychiatric testing to identify dementia and MCI. MAIN OUTCOME MEASURES: The prevalence of MCI was determined for the whole cohort, and specific subtypes of MCI were examined in detail only at the Pittsburgh, Pa, center (n = 927). Mild cognitive impairment was classified as either MCI amnestic-type or MCI multiple cognitive deficits-type. RESULTS: The overall prevalence of MCI was 19% (465 of 2470 participants); prevalence increased with age from 19% in participants younger than 75 years to 29% in those older than 85 years. The overall prevalence of MCI at the Pittsburgh center was 22% (130 of 599 participants); prevalence of the MCI amnesic-type was 6% and of the MCI multiple cognitive deficits-type was 16%. CONCLUSIONS: Twenty-two percent of the participants aged 75 years or older had MCI. Mild cognitive impairment is a heterogeneous syndrome, where the MCI amnestic-type is less frequent than the MCI multiple cognitive deficits-type. Most of the participants with MCI had comorbid conditions that may affect their cognitive functions.

Aged↗
PubMed2003

Risk factors for mild cognitive impairment in the Cardiovascular Health Study Cognition Study: part 2.

OBJECTIVE: To examine the risk factors for mild cognitive impairment (MCI) in a longitudinal population study-the Cardiovascular Health Study Cognition Study. DESIGN: We examined the factors that in the period 1991 through 1994 predicted the development of MCI in all participants of the Cardiovascular Health Study Cognition Study. Further examination was conducted in the Pittsburgh, Pa, cohort (n = 927), where participants with MCI were classified as having either the MCI amnestic-type or the MCI multiple cognitive deficits-type. SETTING: Multicenter population study. PATIENTS: This study includes all participants of the Cardiovascular Health Study Cognition Study (n = 3608) who had a magnetic resonance imaging (MRI) scan of the brain between 1991 and 1994, and detailed neuropsychological, neurological, and medical evaluations to identify the presence of MCI or dementia in the period 1998 to 1999. The mean time between the closest clinical examination to the MRI and the diagnostic evaluation for cognitive disorders was 5.8 years for the Cardiovascular Health Study Cognition Study cohort and 6.0 years for the Pittsburgh cohort. MAIN OUTCOME MEASURES: Risk factors for MCI at the time of the MRI were identified using logistic regression, controlling for age, race, educational level, baseline Modified Mini-Mental State Examination and Digit Symbol Test scores, measurements of depression, MRI findings (atrophy, ventricular volume, white matter lesions, and infarcts), the presence of the apolipoprotein E (APOE) epsilon4 allele, hypertension, diabetes mellitus, and heart disease. RESULTS: Mild cognitive impairment (n = 577) was associated with race (African American), low educational level, low Modified Mini-Mental State Examination and Digit Symbol Test scores, cortical atrophy, MRI-identified infarcts, and measurements of depression. The MCI amnestic-type was associated with MRI-identified infarcts, the presence of the APOE epsilon4 allele, and low Modified Mini-Mental State Examination scores. The MCI multiple cognitive deficits-type was associated with low Modified Mini-Mental State Examination and Digit Symbol Test scores. CONCLUSIONS: The development of MCI is associated with measurements of cognition and depression, racial and constitutional factors, and cerebrovascular disease. Early cognitive deficits seem to be a common denominator for the 2 forms of MCI; the presence of cerebrovascular disease and the APOE epsilon4 allele is associated with the amnestic type of MCI.

Aged↗
PubMed2002

Survival following a diagnosis of Alzheimer disease.

CONTEXT: Survival following a diagnosis of Alzheimer disease (AD) is important information for health planners, caregivers, patients, and their families. OBJECTIVES: To estimate the duration of survival following a diagnosis of AD and to determine the effect of AD on life span. DESIGN, SETTING, AND PARTICIPANTS: Follow-up of participants of the Baltimore Longitudinal Study of Aging who were older than 55 years (January 1, 1985-September 30, 1999). MAIN OUTCOME MEASURES: Survival duration. RESULTS: The median survival time following a diagnosis of AD depended strongly on the patient's age at diagnosis. The median survival times ranged from 8.3 years for persons diagnosed as having AD at age 65 years to 3.4 years for persons diagnosed as having AD at age 90 years. There were no significant differences between men and women in survival after having a diagnosis of AD. Diagnoses of AD at ages 65 and 90 years were associated with approximately a 67% and 39% reduction in median life span, respectively. CONCLUSIONS: The effect of a diagnosis of AD on life span depends crucially on the age of the person when AD is diagnosed. Caregivers, patients, and their families could plan on a median life span as long as 7 to 10 years for patients whose conditions are diagnosed when they are in their 60s and early 70s, to only about 3 years or less for patients whose conditions are diagnosed when they are in their 90s.

Age Factors↗
PubMedDate not supplied

Computerized neuropsychiatric assessment of geriatric subjects by content analysis of brief samples of their speech.

The life expectancy of people living in the United States is increasing. Are very elderly individuals compromised mentally and physically in comparison to much younger persons? The purpose of this study was to test the efficacy of a computerized program applicable to the content analysis of 5-minute speech samples obtained from a group of individuals 90 years of age and older and to compare the results with those previously obtained in younger people with respect to their mental capacities in terms of a set of diverse neuropsychiatric dimensions. After obtaining informed consent from 26 elderly people, recorded verbal samples were elicited from each individual in response to purposely ambiguous instructions to talk for 5 minutes about any interesting or dramatic personal life experiences. The transcripts of their speech samples were digitized on a computer diskette and processed on the computer program. The computer program compared the scores obtained on each verbal sample with norms obtained on 15 previously validated content-analysis scales from individuals ranging in age from 5 to 80. The norms on these content-analysis scales are different for children (aged 5-10) and adults (aged 11-80). The computerized content-analysis scores obtained from this elderly cohort reveal plausible deviations from the norms for younger people.

Adolescent↗