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  1. Fulltext Diagnosis and management of mild cognitive impairment in the community: What is the role of primary care physician?
    Ambigga Devi SK, Suthahar A, Ramli AS, Ng KK, Radziah AR, Marymol K
    Malays Fam Physician, 2011;6(2-3):74-8.
    PMID: 25606229 MyJurnal
    Dementia is a large and growing problem in the ageing population but often not diagnosed in its earlier stages which is Mild Cognitive Impairment (MCI). MCI represents the phase between normal ageing and early dementia. About 12% of patients with MCI develop dementia per year, usually Alzheimer's disease. It is a diagnosis given to individuals who have cognitive impairments beyond that is expected for their age and education. However, this condition does not interfere significantly with daily activities as these individuals retain their critical thinking and reasoning skills. Nevertheless, due to its complexity and vague initial presentation, many cases of MCI can be missed. Therefore, it is imperative for primary care physicians to recognise these symptoms as opposed to normal ageing memory changes, and refer these patients to the memory clinic early to confirm the diagnosis. This paper illustrates a common primary care presentation of a patient with MCI. As there is no proven pharmacological treatment for MCI, the mainstay of management is to provide lifestyle intervention and long term support to these patients in the community. Primary care physicians should work as a team with the geriatrician, allied health personnel, support groups and caregivers in providing this care.
    Matched MeSH terms: Mild Cognitive Impairment*
  2. Fulltext Development and acceptance of a nutrition and lifestyle education booklet to improve mild cognitive impairment among elderly
    Sa’ida Munira Johari, Suzana Shahar, Roslee Rajikan, Safiyyah A. Aziz
    Jurnal Sains Kesihatan Malaysia, 2011;9(2):45-50.
    MyJurnal
    Mild cognitive impairment (MCI) is a common disorder among elderly and may worsen to dementia. The aim of this study is to develop a nutrition and lifestyle booklet to implement better lifestyle modification, as an effort to delay cognitive decline. A series of discussions with a research group comprising of dieticians, nutritionists, a geriatrician and a public health physician were conducted to ascertain the content of the booklet. There were seven guidelines in the booklet including; eat more fish, eat more foods rich in folic acid, eat more fruits and vegetables, exercise regularly, do activities to stimulate memory, stop smoking and alcohol drinking and stay cheerful and positive. Evaluation of acceptance for the booklet was carried out which comprised of assessment on content, graphic and design among elderly and health staff at health clinic in Cheras. The assessment involved 15 Malay elderly subjects aged 60 to 81 years (mean age 66.1 ±6.6 years), with 60.0% men and 40.0% women and 10 health staff aged 36.6 ± 12.0 years, with range of 27 to 58 years, consists of 20.0% men and 80.0% women also participated. Most of elderly subjects (80.0%, n = 12) indicated they understood information in the booklet. Meanwhile, 20.0% (n = 3) of elderly expressed they did not fully understand the content of the booklet in particular on sentence and terminology. All health staff (100.0%) understood the information in the booklet. This booklet was well accepted by elderly subjects and health staff, however adding more graphics, simplifying sentence structures and minimizing scientific terminologies to improve understanding were suggested. The booklet has the potential to increase the nutritional and health knowledge of elderly specifically with MCI. This would motivate them to adopt healthy eating and lifestyle, thus reducing cognitive decline and prevent dementia.
    Keywords: Cognitive, education, booklet, elderly, lifestyle
    Matched MeSH terms: Mild Cognitive Impairment
  3. Prevalence of gender disparities and predictors affecting the occurrence of mild cognitive impairment (MCI)
    Lee LK, Shahar S, Chin AV, Mohd Yusoff NA, Rajab N, Aziz SA
    Arch Gerontol Geriatr, 2012 Jan-Feb;54(1):185-91.
    PMID: 21546098 DOI: 10.1016/j.archger.2011.03.015
    The aims were to investigate the prevalence of mild cognitive impairment (MCI) within gender disparities in Malaysian older adults, and to determine the predictors of MCI according to gender disparities. A community-based sample of urban, multiethnic dwelling elderly aged 60 years of age and above from Cheras, Kuala Lumpur was recruited. Prevalence of all-type MCI, amnestic-type MCI (am-MCI) and non-amnestic-type MCI (nam-MCI) was assessed using comprehensive neuropsychological batteries. The association between demography, socioeconomic status, lifestyle practices, and nutritional status and health risk factors with MCI were examined. Predictors of MCI occurrence between gender disparities were determined. The prevalence of all-type MCI, am-MCI and nam-MCI was 21.1%, 15.4% and 5.7%, respectively. Binary logistic regression indicated that hypercholesterolemia is the significant predictor for MCI in men after adjustment for age, ethnicity and total years of education. While, in women, MCI was best predicted by married status, without exercise practice, overweight and obesity. These results suggest that approximately one-fifth of the studied elderly people had MCI. Predictors for MCI are totally different between men and women. It is critical to identify those at higher risk for MCI in order to implement preventative measures to delay or reverse this abnormal condition.
    Matched MeSH terms: Mild Cognitive Impairment/epidemiology*
  4. Association between vitamin A, vitamin E and apolipoprotein E status with mild cognitive impairment among elderly people in low-cost residential areas
    Shahar S, Lee LK, Rajab N, Lim CL, Harun NA, Noh MF, et al.
    Nutr Neurosci, 2013 Jan;16(1):6-12.
    PMID: 23321337 DOI: 10.1179/1476830512Y.0000000013
    The influence of nutritional parameters and genetic susceptibility on poor cognitive impairment has been documented; however, the association between lipid-soluble vitamins with genetic susceptibility on mild cognitive impairment (MCI) has not yet been studied extensively.
    Matched MeSH terms: Mild Cognitive Impairment/genetics*; Mild Cognitive Impairment/epidemiology*
  5. The role of long chain omega-3 polyunsaturated fatty acids in reducing lipid peroxidation among elderly patients with mild cognitive impairment: a case-control study
    Lee LK, Shahar S, Rajab N, Yusoff NA, Jamal RA, Then SM
    J Nutr Biochem, 2013 May;24(5):803-8.
    PMID: 22898566 DOI: 10.1016/j.jnutbio.2012.04.014
    The present work explores the effect of dietary omega-3 polyunsaturated fatty acids (PUFAs) intake on lipid peroxidation among mild cognitive impairment (MCI) patients. The plasma lipid hydroperoxide (LPO) levels in 67 MCI patients were compared to those of 134 healthy elderly controls. Omega-3 PUFA intake was assessed using an interviewer-administered food frequency questionnaire. Apolipoprotein E genotyping was performed using polymerase chain reaction and restriction enzyme digestion. The association between various confounders and lipid peroxidation was evaluated using regression analysis. The influence of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) intake on LPO level was investigated. The results revealed that LPO levels were significantly higher in the MCI group than in the control group. Inverse correlations were found between DHA and EPA intake and LPO level among the MCI group. LPO levels decreased significantly with increasing DHA and EPA intake. In summary, the findings revealed that DHA and EPA can play a role in alleviating oxidative stress and reducing the risk of neurodegenerative diseases.
    Matched MeSH terms: Mild Cognitive Impairment/metabolism*
  6. Fulltext The impact of mild cognitive impairment on sexual activity
    Momtaz YA, Hamid TA, Ibrahim R
    Am J Alzheimers Dis Other Demen, 2013 Dec;28(8):759-62.
    PMID: 24085247 DOI: 10.1177/1533317513504612
    OBJECTIVE: The aim of this study was to identify the unique impact of mild cognitive impairment (MCI) on sexual activity among older adults.

    METHODS: Data for the study were drawn from a national survey entitled the "Determinants of Wellness among Older Malaysians: A Health Promotion Perspective" conducted in 2010.

    RESULTS: According to the Mini-Mental State Examination education-adjusted cutoff points, 15.6% of the 1046 respondents were identified as having MCI. Older adults with MCI had a significantly lower level of sexual activity than the healthy cognitive group (chi-square = 50.20, P < .001, 32.5% vs 62.3%). The results of 3-step hierarchical logistic regression model revealed that MCI is significantly associated with decreased sexual activity in community-dwelling older adults, over and beyond demographic factors, and age-related medical conditions affecting sexual activity (odds ratio 0.33, P < .001, 95% confidence interval 0.23-0.49).

    CONCLUSION: Findings from the present study support the significant role of cognitive functioning to perform sexual activity in later life.

    Matched MeSH terms: Mild Cognitive Impairment/physiopathology*
  7. Behavioural and psychological symptoms of dementia, cognitive impairment and caregiver burden in patients with dementia
    Rosdinom R, Zarina MZ, Zanariah MS, Marhani M, Suzaily W
    Prev Med, 2013;57 Suppl:S67-9.
    PMID: 23313789 DOI: 10.1016/j.ypmed.2012.12.025
    OBJECTIVE: This study aims to determine the relationships between behavioural and psychological symptoms of dementia (BPSD), cognitive impairment and burden of care of patients with dementia.
    METHOD: A cross-sectional, non-randomised study of 65 elderly patients with dementia and their caregivers was conducted over a 3-month period in January 2007 at the memory clinics of Universiti Kebangsaan Malaysia Medical Centre and Hospital Kuala Lumpur. Patients' cognitive functions were assessed with the Mini Mental State Examination (MMSE). Caregivers were interviewed to determine the severity of BPSD and caregiver burden (CB) using the Neuropsychiatric Inventory (NPI) Questionnaire and Zarit Burden Interview (BI) respectively.
    RESULTS: Cognitive impairment did not contribute significantly to CB. Multiple linear regression analysis showed that high BPSD scores contributed 0.27 more in BI score, female patients contributed 0.37 less in BI score and caregivers with higher educational level contribute 0.5 more in BI score.
    CONCLUSION: Patients' BPSD and male gender, but not cognitive impairment, were associated with CB. Even though CB was experienced more among caregivers with better education, all caregivers should be screened to ensure their general well-being.
    KEYWORDS: BPSD; Caregiver burden; Cognitive impairment
    Study site: Memory clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) and Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
    Matched MeSH terms: Mild Cognitive Impairment/psychology*
  8. Is the Bahasa Malaysia version of the Montreal Cognitive Assessment (MoCA-BM) a better instrument than the Malay version of the Mini Mental State Examination (M-MMSE) in screening for mild cognitive impairment (MCI) in the elderly?
    Razali R, Jean-Li L, Jaffar A, Ahmad M, Shah SA, Ibrahim N, et al.
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S70-5.
    PMID: 24314103 DOI: 10.1016/j.comppsych.2013.04.010
    Mild Cognitive Impairment (MCI) is a known precursor to Alzheimer disease, yet there is a lack of validated screening instruments for its detection among the Malaysian elderly.
    Matched MeSH terms: Mild Cognitive Impairment/diagnosis*; Mild Cognitive Impairment/epidemiology
  9. Dietary repletion with ω3 fatty acid or with COX inhibition reverses cognitive effects in F3 ω3 fatty-acid-deficient mice
    Hafandi A, Begg DP, Premaratna SD, Sinclair AJ, Jois M, Weisinger RS
    Comp. Med., 2014 Apr;64(2):106-9.
    PMID: 24674584
    Dietary deficiency of ω3 fatty acid during development leads to impaired cognitive function. However, the effects of multiple generations of ω3 fatty-acid deficiency on cognitive impairment remain unclear. In addition, we sought to test the hypothesis that the cognitive impairments of ω3 fatty-acid-deficient mice are mediated through the arachidonic acid-cyclooxygenase (COX) pathway. To address these issues, C57BL/6J mice were bred for 3 generations and fed diets either deficient (DEF) or sufficient (SUF) in ω3 fatty acids. At postnatal day 21, the F3 offspring remained on the dam's diet or were switched to the opposite diet, creating 4 groups. In addition, 2 groups that remained on the dam's diet were treated with a COX inhibitor. At 19 wk of age, spatial-recognition memory was tested on a Y-maze. Results showed that 16 wk of SUF diet reversed the cognitive impairment of F3 DEF mice. However, 16 wk of ω3 fatty-acid-deficient diet impaired the cognitive performance of the F3 SUF mice, which did not differ from that of the F3 DEF mice. These findings suggest that the cognitive deficits after multigenerational maintenance on ω3 fatty-acid-deficient diet are not any greater than are those after deficiency during a single generation. In addition, treatment with a COX inhibitor prevented spatial-recognition deficits in F3 DEF mice. Therefore, cognitive impairment due to dietary ω3 fatty-acid deficiency appears to be mediated by the arachidonic acid-COX pathway and can be prevented by 16 wk of dietary repletion with ω3 fatty acids or COX inhibition.
    Matched MeSH terms: Mild Cognitive Impairment/drug therapy*; Mild Cognitive Impairment/etiology; Mild Cognitive Impairment/genetics
  10. Fulltext Development of clinical pathway for Mild Cognitive Impairment and Dementia to quantify cost of age-related cognitive disorders in Malaysia
    Syed Mohamed Aljunid, Namaitijiang Maimaiti, Zafar Ahmed, Amrizal Muhammad Nur, Norashidah Mohamed Nor, Normazwana Ismail, et al.
    Malaysian Journal of Public Health Medicine, 2014;14(3):0-0.
    MyJurnal
    As the Malaysian population ages, the burden of age-related cognitive disorders such as dementia and Alzheimer’s disease will increase concomitantly. This is one of the sub-study under a research project titled by quantify the cost of age-related cognitive impairment in Malaysia, which was undertaken to develop a clinical pathway for Mild Cognitive Impairment (MCI) and Dementia. The clinical pathway (CP) will be used to support the costing studies of MCI and Dementia. An expert group discussion (EGD) was conducted among selected experts from six (6) government hospitals from different states of Malaysia, Ministry of Health, and United Nations University, International Institute for Global Health, UKM and UPM. The expert group includes psychiatrist specialists and public health medicine specialists. A total of 15 participants took part in the EGD. The group was presented with the different approach in managing MCI and Dementia. Finally, the group came to the consensus agreement on the most appropriate and efficient ways of managing the two conditions. In the EGD, an operational definition for MCI and Dementia was agreed upon and a pathway was developed for the usual practice in the Malaysian health system. A typical case used, as a reference is a 60-year-old patient referred to a memory clinic with complaint of “forgetfulness”. After three outpatient visits in the clinic, the diagnosis of MCI and Dementia could be clinically established. The clinical pathways covered all active clinical and non-clinical management of the patient over a period of one year. The experts identified the additional resources required to manage these patients for the whole spectrum of lifetime based on the expected life expectancy. The Clinical pathway (CP) for MCI and Dementia was successfully developed in EGD with strong support from practitioners in the health system. The findings will help the researchers to identify all-important clinical activities and interventions that will be included in the costing study.
    Matched MeSH terms: Mild Cognitive Impairment
  11. Small longitudinal study of serum anticholinergic activity and cognitive change in community-dwelling older adults
    Kashyap M, Mulsant BH, Tannenbaum C
    Am J Geriatr Psychiatry, 2015 Mar;23(3):326-9.
    PMID: 25450763 DOI: 10.1016/j.jagp.2014.09.009
    The discriminative ability of serum anticholinergic activity (SAA) to differentiate between older individuals with stable versus deteriorating cognition remains undetermined. We examined the relationship between SAA changes, the presence or absence of a mild neurocognitive disorder, age and anticholinergic medication over a one-year time period.
    Matched MeSH terms: Mild Cognitive Impairment/blood*; Mild Cognitive Impairment/diagnosis*
  12. Quality of life in people with cognitive impairment: nursing homes versus home care
    Nikmat AW, Al-Mashoor SH, Hashim NA
    Int Psychogeriatr, 2015 May;27(5):815-24.
    PMID: 25497589 DOI: 10.1017/S1041610214002609
    The evaluation of quality of life (QoL) among older adults has become increasingly important, and living arrangements play a pivotal role in determining the QoL of people with cognitive impairment (PWCI). Although informal care (home-based) is favored, transition to formal care (residential care) often becomes necessary, especially in the later stages of cognitive impairment. The primary objective was to compare the QoL of PWCI in the community and nursing homes. Additionally, factors differentiate the QoL of PWCI in these two settings were identified.
    Matched MeSH terms: Mild Cognitive Impairment/psychology*; Mild Cognitive Impairment/therapy
  13. Intellectual and physical activities, but not social activities, are associated with better global cognition: a multi-site evaluation of the cognition and lifestyle activity study for seniors in Asia (CLASSA)
    Lam LC, Ong PA, Dikot Y, Sofiatin Y, Wang H, Zhao M, et al.
    Age Ageing, 2015 Sep;44(5):835-40.
    PMID: 26271049 DOI: 10.1093/ageing/afv099
    population ageing will lead to a leap in the dementia population in Asia. However, information about potentials for low-cost and low-risk interventions is limited.
    Matched MeSH terms: Mild Cognitive Impairment/diagnosis; Mild Cognitive Impairment/epidemiology; Mild Cognitive Impairment/prevention & control*; Mild Cognitive Impairment/psychology
  14. Fulltext Mild cognitive impairment and its management in older people
    Eshkoor SA, Hamid TA, Mun CY, Ng CK
    Clin Interv Aging, 2015;10:687-93.
    PMID: 25914527 DOI: 10.2147/CIA.S73922
    Mild cognitive impairment (MCI) is a common condition in the elderly. It is characterized by deterioration of memory, attention, and cognitive function that is beyond what is expected based on age and educational level. MCI does not interfere significantly with individuals' daily activities. It can act as a transitional level of evolving dementia with a range of conversion of 10%-15% per year. Thus, it is crucial to protect older people against MCI and developing dementia. The preventive interventions and appropriate treatments should improve cognitive performance, and retard or prevent progressive deficits. The avoidance of toxins, reduction of stress, prevention of somatic diseases, implementation of mental and physical exercises, as well as the use of dietary compounds like antioxidants and supplements can be protective against MCI. The modification of risk factors such as stopping smoking, as well as the treatment of deficiency in vitamins and hormones by correcting behaviors and lifestyle, can prevent cognitive decline in the elderly. The progressive increase in the growth rate of the elderly population can enhance the rate of MCI all over the world. There is no exact cure for MCI and dementia; therefore, further studies are needed in the future to determine causes of MCI and risk factors of progression from MCI to dementia. This will help to find better ways for prevention and treatment of cognitive impairment worldwide.
    Matched MeSH terms: Mild Cognitive Impairment/diagnosis; Mild Cognitive Impairment/prevention & control*; Mild Cognitive Impairment/therapy
  15. Fulltext An Exploratory Factor Analysis of a Brief Self-Report Scale to Detect Neurocognitive Impairment Among Participants Enrolled in Methadone Maintenance Therapy
    Copenhaver M, Shrestha R, Wickersham JA, Weikum D, Altice FL
    J Subst Abuse Treat, 2016 Apr;63:61-5.
    PMID: 26879859 DOI: 10.1016/j.jsat.2016.01.002
    The present study examines the factor structure of the existing Neuropsychological Impairment Scale (NIS) through the use of exploratory factor analysis (EFA). The NIS is a brief, self-report measure originally designed to assess neurocognitive impairment (NCI) by having patients rate a range of items that may influence cognitive functioning. Stabilized patients on methadone maintenance therapy (MMT; N=339) in New Haven, CT who reported drug- or sex-related HIV risk behaviors in the past 6 months were administered the full 95-item NIS. An EFA was then conducted using principal axis factoring and orthogonal varimax rotation. The EFA resulted in retaining 57 items, with a 9-factor solution that explained 54.8% of the overall variance. The revised 9-factor measure--now referred to as the Brief Inventory of Neuro-cognitive Impairment (BINI)--showed a diverse set of factors with excellent to good reliability (i.e., F1 α=0.97 to F9 α=0.73). This EFA suggests the potential utility of using the BINI in the context of addiction treatment. Further research should examine the utility of this tool within other clinical care settings.
    Matched MeSH terms: Mild Cognitive Impairment/diagnosis*; Mild Cognitive Impairment/etiology
  16. The burden of HIV-associated neurocognitive disorder (HAND) in the Asia-Pacific region and recommendations for screening
    Ian E, Gwen CL, Soo CT, Melissa C, Chun-Kai H, Eosu K, et al.
    Asian J Psychiatr, 2016 Aug;22:182-9.
    PMID: 26617385 DOI: 10.1016/j.ajp.2015.10.009
    HIV-associated neurocognitive disorder incurs a significant burden on HIV patients in Asia-Pacific countries; however, the incidence is difficult to estimate due to a lack of local epidemiological data. The impact of neurocognitive impairment in HIV patients is often underestimated due to a lack of education and awareness, and there are consequently gaps in the provision of screening and diagnosis to enable earlier intervention to limit neurocognitive impairment.
    Matched MeSH terms: Mild Cognitive Impairment/diagnosis*; Mild Cognitive Impairment/etiology*; Mild Cognitive Impairment/therapy
  17. Fulltext A Review of Risk Factors for Cognitive Impairment in Stroke Survivors
    Mohd Zulkifly MF, Ghazali SE, Che Din N, Singh DK, Subramaniam P
    ScientificWorldJournal, 2016;2016:3456943.
    PMID: 27340686 DOI: 10.1155/2016/3456943
    In this review, we aimed to identify the risk factors that may influence cognitive impairment among stroke survivors, namely, demographic, clinical, psychological, and physical determinants. A search from Medline, Scopus, and ISI Web of Science databases was conducted for papers published from year 2004 to 2015 related to risk factors of cognitive impairment among adult stroke survivors. A total of 1931 articles were retrieved, but only 27 articles met the criteria and were reviewed. In more than half of the articles it was found that demographical variables that include age, education level, and history of stroke were significant risk factors of cognitive impairment among stroke survivors. The review also indicated that diabetes mellitus, hypertension, types of stroke and affected region of brain, and stroke characteristics (e.g., size and location of infarctions) were clinical determinants that affected cognitive status. In addition, the presence of emotional disturbances mainly depressive symptoms showed significant effects on cognition. Independent relationships between cognition and functional impairment were also identified as determinants in a few studies. This review provided information on the possible risk factors of cognitive impairment in stroke survivors. This information may be beneficial in the prevention and management strategy of cognitive impairments among stroke survivors.
    Matched MeSH terms: Mild Cognitive Impairment/etiology*
  18. Fulltext Development of TUA-WELLNESS screening tool for screening risk of mild cognitive impairment among community-dwelling older adults
    Vanoh D, Shahar S, Rosdinom R, Din NC, Yahya HM, Omar A
    Clin Interv Aging, 2016;11:579-87.
    PMID: 27274208 DOI: 10.2147/CIA.S102925
    BACKGROUND AND AIM:
    Focus on screening for cognitive impairment has to be given particular importance because of the rising older adult population. Thus, this study aimed to develop and assess a brief screening tool consisting of ten items that can be self-administered by community dwelling older adults (TUA-WELLNESS).
    METHODOLOGY:
    A total of 1,993 noninstitutionalized respondents aged 60 years and above were selected for this study. The dependent variable was mild cognitive impairment (MCI) assessed using neuropsychological test batteries. The items for the screening tool comprised a wide range of factors that were chosen mainly from the analysis of ordinal logistic regression (OLR) and based on past literature. A suitable cut-off point was developed using receiver operating characteristic analysis.
    RESULTS: A total of ten items were included in the screening tool. From the ten items, eight were found to be significant by ordinal logistic regression and the remaining two items were part of the tool because they showed strong association with cognitive impairment in previous studies. The area under curve (AUC), sensitivity, and specificity for cut-off 11 were 0.84%, 83.3%, and 73.4%, respectively.
    CONCLUSION: TUA-WELLNESS screening tool has been used to screen for major risk factors of MCI among Malaysian older adults. This tool is only suitable for basic MCI risk screening purpose and should not be used for diagnostic purpose.
    KEYWORDS: TUA-WELLNESS; mild cognitive impairment; screening; sensitivity; specificity
    Matched MeSH terms: Mild Cognitive Impairment/diagnosis*
  19. Fulltext Protocol of a feasibility study for cognitive assessment of an ageing cohort within the Southeast Asia Community Observatory (SEACO), Malaysia
    Mohan D, Stephan BC, Allotey P, Jagger C, Pearce M, Siervo M, et al.
    BMJ Open, 2017 01 19;7(1):e013635.
    PMID: 28104710 DOI: 10.1136/bmjopen-2016-013635
    INTRODUCTION: There is a growing proportion of population aged 65 years and older in low-income and middle-income countries. In Malaysia, this proportion is predicted to increase from 5.1% in 2010 to more than 15.4% by 2050. Cognitive ageing and dementia are global health priorities. However, risk factors and disease associations in a multiethnic, middle-income country like Malaysia may not be consistent with those reported in other world regions. Knowing the burden of cognitive impairment and its risk factors in Malaysia is necessary for the development of management strategies and would provide valuable information for other transitional economies.

    METHODS AND ANALYSIS: This is a community-based feasibility study focused on the assessment of cognition, embedded in the longitudinal study of health and demographic surveillance site of the South East Asia Community Observatory (SEACO), in Malaysia. In total, 200 adults aged ≥50 years are selected for an in-depth health and cognitive assessment including the Mini Mental State Examination, the Montreal Cognitive Assessment, blood pressure, anthropometry, gait speed, hand grip strength, Depression Anxiety Stress Score and dried blood spots.

    DISCUSSION AND CONCLUSIONS: The results will inform the feasibility, response rates and operational challenges for establishing an ageing study focused on cognitive function in similar middle-income country settings. Knowing the burden of cognitive impairment and dementia and risk factors for disease will inform local health priorities and management, and place these within the context of increasing life expectancy.

    ETHICS AND DISSEMINATION: The study protocol is approved by the Monash University Human Research Ethics Committee. Informed consent is obtained from all the participants. The project's analysed data and findings will be made available through publications and conference presentations and a data sharing archive. Reports on key findings will be made available as community briefs on the SEACO website.

    Matched MeSH terms: Mild Cognitive Impairment/diagnosis*; Mild Cognitive Impairment/ethnology
  20. Fulltext Cognitive impairment and depressive symptoms coexisting in an elderly man
    Masiran R, Pang NT
    BMJ Case Rep, 2017 Feb 08;2017.
    PMID: 28179386 DOI: 10.1136/bcr-2016-218267
    We report a case of a man aged 67 years presenting with recent depressive symptoms and paranoid ideations in addition to 1-year cognitive impairment. He has vascular risk factors and family history of memory loss. An episode of depression 2 decades ago resolved spontaneously but was followed by occupational decline. On mental state examination, he denied having depressed mood, hallucinations or delusions, but there were prominent word-finding difficulties and impaired attention and concentration.
    Matched MeSH terms: Mild Cognitive Impairment/diagnosis*
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