Cognitive parameters. Broadly, a person’s cognition refers to the underlying brain processes that make it possible for them to think, remember and learn. Cognition can be divided in to sub divisions which fall in to the categories below: Perception Attention Language Memory Problem solving Reasoning Executive functioning The DOREMI intervention aims to target individuals with mild impairments in these cognitive processes. Mild cognitive impairment is characterised by impairments in any cognitive domain which are greater than expected for the individual’s age and education level, but that are not severe enough to warrant a diagnosis of a dementia [12] (see section 6.1.3 for further discussion of cognitive decline). Although cognition declines with age, the brain retains the ability to learn and can restore depleted cognitive functions (this is known as brain plasticity [13-15]. The fact that the brain retains this plasticity and flexibility in later life provides support for cognitive training interventions as proposed in DOREMI in order to delay or reverse cognitive impairments. In order to evaluate the success of a cognitive intervention, it is necessary to take a number of cognitive assessments or parameters before and after the intervention. In their report of a computerised brain plasticity training program, Xxxxxx et al. [13] suggest that in addition to evaluating general cognitive functioning (with the MMSE for example), it is important to evaluate directly trained functions targeted by the intervention. DOREMI participants will be subjected to a cognitive test battery at baseline, during the pre-intervention screening phase, and again at post intervention follow-up. Selected cognitive tests cover a range of cognitive domains which will be trained during the intervention. In order to give a further insight of some specific cognitive functions, the following set of tools (shown in Table 2) has been suggested and adopted in the DOREMI protocol:
Cognitive parameters. Cognitive functions are the skills that allow us to correctly interpret and manage information: they are memory, attention, perception, language, problem solving, orientation in space and time. MMSE Score. The maximum score is 30 and it takes about 5-10 minutes to administer. Table score: Orientation (10 points) Registration (3 points) Attention and Calculation (5 points) Recall (3 points) Language and Praxis (9 points) A person's MMSE score can be affected by their level of education. This is because for highly educated people the questions may be too easy and for poorly educated people some may be too difficult. This means that a highly educated person with mild dementia may score in the normal range, whereas a poorly educated person with no problems in cognition may score in the dementia range. The same goes for the question of age (Table 20). Schooling (in years) 0-4 5-7 8-12 13-17 Age 65-69 +0.4 -1.1 -2.0 -2.8 70-74 +0.7 -0.7 -1.6 -2.3 75-79 -0.9 -0.3 -1.0 -1.7 80-84 +1.5 +0.4 -0.3 -0.9 85-89 +2.2 +1.4 +0.8 +0.3 Table 20. MMSE score modulation respect to age and scholarization time.
