A Simple Physical Examination Predicts Cognitive Decline in Very Mild Dementia.

Background: Different exercises have different effects upon physical fitness and cognitive domains. In this context, physical fitness behaviors have been identified as a contributing factor to cognitive decline in patients with very mild dementia. The present study aimed to further determine baseline senior fitness behaviors in patients with very mild dementia and possible factors related to rapid cognitive decline.

Methods: This prospective cohort study was performed in a medical center in Taiwan, involving 132 patients with very mild dementia who were followed-up over 1 year. Assessments included the Senior Fitness Test (physical function), Mini-Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) Scale. Patients with a decline in MMSE of at least 2 points within 1 year were defined as having rapid cognitive decline.

Results: Age, sex, years of education, and baseline MMSE did not differ significantly between the groups (p > 0.05). At 1 year of follow-up, dietary habits and comorbidities did not differ between the rapid decline and not-rapid decline groups. At 1 year, performance on the right back scratch test was significantly better in the not-rapid decline group compared with the rapid decline group (-14 [-39-37.5] cm vs. -17 [-57-7] cm; p = 0.038). In a multiple regression analysis, the only factor that was significantly associated with rapid cognitive decline was the right back scratch test (p = 0.022).

Conclusions: Despite the similarity in the status of dementia, the right hand back scratch test appears to serve an important function in detecting cognitive decline in patients with very mild dementia.