Montreal cognitive assessment moca â”cognitive screen
Cognitive dysfunction was defined using z-score values and predictive values were calculated. Composite scores were created for comparison of cognitive domains and test results were analyzed using Spearman's correlation and linear regression. We evaluated the Montreal Cognitive Assessment (MoCA) for suitability in assessing cognitive performance in HD patients in comparison to the commonly used Mini-Mental State Examination (MMSE) and a detailed neuropsychological test battery, used as gold standard.Ĥ3 HD patients and 42 healthy controls with an average age of 58 years, were assessed with the MoCA, the MMSE and a detailed neuropsychological test battery, covering the domains of memory, attention, language, visuospatial and executive functions. 8 Department of Neurology, RWTH Aachen University Hospital, Aachen, Germany Jülich Aachen Research Alliance (JARA) - Translational Brain Medicine, Aachen and Jülich, Germany Institute of Neuroscience and Medicine (INM-4), Research Center Jülich GmbH, Jülich, Germany.Ĭhronic kidney disease (CKD) patients undergoing hemodialysis (HD) therapy have an increased risk of developing cognitive impairment and dementia, which are known relevant factors in disease prognosis and therapeutic success, but still lack adequate screening in clinical routine.7 Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany Bayer Pharma AG, Global Drug Development, Kidney Diseases Research, Wuppertal, Germany.6 Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany Department of Internal Medicine, Dresden-Friedreichstadt Hospital, Dresden, Germany.5 Division of Nephrology and Clinical Immunology, RWTH Aachen University, Aachen, Germany.4 Dialysis Center Aachen, Dialysis Center, Aachen, Germany.3 Department of Internal Medicine, St.-Antonius-Hospital Eschweiler, Eschweiler, Germany.2 KfH Curatorship for Dialysis and Kidney Transplant e.V., KfH-Nephrology Center, Stolberg, Germany.1 Department of Neurology, RWTH Aachen University Hospital, Aachen, Germany Jülich Aachen Research Alliance (JARA) - Translational Brain Medicine, Aachen and Jülich, Germany.In this study we show a relationship between elevated levels of plasma mtDNA and lower performance on the MoCA, greater exhaustion, and slower walk, suggesting mtDNA may have a role as a novel biomarker in assessing pathogenic inflammation associated with cognitive dysfunction and some components of frailty in PLWH. Neither plasma nor urine mtDNA levels were correlated with IL-6 level, -0.05 (p=0.55) and 0.09 (p=0.29), respectively. Serum IL-6 levels were associated with frailty status (p=0.018) but not with low MoCA score (p=0.89 by JT). Higher plasma mtDNA level was associated with slow walk (p=0.007) and exhaustion (p=0.04), but not weight loss (p=0.62), grip strength (p=0.06), low physical activity (p=0.71) or composite frailty score (p=0.98). Plasma mtDNA level was higher in those with low MoCA score (p=0.028) by t-test. Age was not related to MoCA score (=-0.1, p=0.19), but was associated with frailty status by Jonckheere-Terpstra (JT) test (p=0.008).
Levels of plasma and urine mtDNA (Spearman correlation rho, =0.05, p=0.54) were unrelated. Geometric mean mtDNA level in plasma was 221 copies/l (geometric SD: 2) and 2.4x108 copies/gram of urine creatinine (geometric SD: 4) in urine. The majority (93%) had HIV-1 viral load <200 copies/mL and median CD4 count was 582 cells/uL (IQR 402-795).
Median time living with HIV was 25 years (IQR 22-29). Half identified as Black, 29% as White, and 21% as other. There were 164 participants mean age 61 (SD: 6) range 54-87 years. Plasma and urine cell-free mtDNA were measured by qPCR detection of mitochondrial NADH dehydrogenase-1. Participants completed a psychosocial questionnaire, biomedical visit, cognitive assessment (Montreal Cognitive Assessment, MoCA) and frailty testing by Fried criteria. We analyzed cross-sectional data from PLWH over age 55 at a single urban medical center.
We hypothesized that in older PLWH, plasma mtDNA would be associated with lower cognitive performance, frailty, and higher serum IL-6 level. Mitochondrial DNA (mtDNA), released from dying cells, is a biomarker of inflammation, a mediator of immune activation and has been detected at elevated levels in the plasma of PLWH. Older PLWH experience more comorbidities and geriatric syndromes, including cognitive impairment and frailty. MITOCHONDRIAL DNA, COGNITIVE FUNCTION, AND FRAILTY IN OLDER ADULTS WITH HIVĬarrie Johnston1, Michelle Rice1, Heather Derry1, Chelsie Burchett1, Eugenia Siegler1, Mary Choi1, Marshall Glesby1ġWeill Cornell Medicine, New York, NY, USA