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"ABSTRAKPada perempuan pascamenopause diperlukan marka biokimiawi dan klinis pada masa jendela terapeutik yang diharapkan dapat digunakan untuk menapis HKND yang berperan sangat penting dalam menghindari dampak demensia tipe alzheimer setelah terapi hormon. Penapisan HKND dapat dimanfaatkan juga untuk upaya terapeutik HKND pada perempuan pascamenopause dan mencegah perburukan ke dalam kondisi demensia tipe alzheimer. Dilakukan studi potong lintang pada 282 perempuan pascamenopause di Jakarta yang dibagi menjadi 2 kelompok, yaitu kelompok positif dengan HKND dan kelompok tanpa HKND. Pemeriksaan dilakukan pada sejumlah variabel seperti usia, lama menopause, keluhan vasomotor, IMT, kadar FSH, kadar LH, kadar leptin, kadar estradiol, dan status kognitif, kemudian dianalisis secara statistik. Diperoleh nilai FSH yang berhubungan bermakna dengan kejadian HKND p = 0,018 , serta variabel lain seperti nisbah FSH/estradiol p = 0,029 dan nisbah FSH/sOB-R p = 0,011 , sementara variabel lain tidak bermakna. Analisis multivariat menunjukkan nisbah FSH/estradiol adalah variabel yang paling berperan terhadap kejadian HKND, dengan nilai OR 1,15. Berdasarkan kurva ROC didapat nilai titik potong nisbah FSH/estradiol dalam memprediksi HKND adalah 1,94 dengan sensitivitas 66,5 dan spesifisitas 46,8 . Nisbah FSH/estradiol pada perempuan pascamenopause yang menderita HKND yang lebih tinggi secara bermakna dibandingkan dengan kelompok tanpa HKND dikaitkan dengan peran neuron KNDy terhadap peningkatan sekresi GnRH dan rendahnya neurosteroid estradiol di otak perempuan pascamenopause yang berisiko menderita HKND. Nilai nisbah FSH/estradiol > 1,94 dapat digunakan untuk penapis diagnostik HKND pada perempuan pascamenopause.

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ABSTRACTBiochemical and clinically important markers are needed in the window therapeutic period for postmenopausal women which are expected to be used as a screening methods for CIND as it is very important in avoiding the effect of dementia associated Alzheimer disease after hormone therapy. CIND screening was also useful for CIND treatment strategies in postmenopausal women and preventing postmenopausal women from impaired cognitive function due to dementia. A cross sectional study included 282 postmenopausal women in Jakarta was done, and subjects were further classified into two groups, with CIND and without CIND. Several related variables such as age, duration of menopause, vasomotor symptoms, BMI, FSH level, LH level, leptin level, estradiol level, and cognitive status, were assessed and analyzed statistically. The prevalence of CIND was significantly correlated with FSH level p 0.018 , along with ratio of FSH levels estradiol p 0.029 and ratio of FSH sOB R p 0.011 , while other variables were not. By multivariate analysis, FSH estradiol ratio of 1.15 was found as the most significant factor with probability of having CIND in postmenopausal women. Using the ROC curve, the ratio threshold of FSH estradiol to predict CIND was 1.94, with sensitivity 66.5 and specificity 46.8 . Level of FSH estradiol ratio in postmenopausal women with CIND was significantly higher than women without CIND, and is related to the role of KNDy neurons that induce the secretion of GnRH, and low level of neurosteroid estradiol in postmenopausal women rsquo s brain with risk of CIND. Ratio of FSH estradiol levels 1.94 could be used for screening methods of CIND in postmenopausal women."

"ABSTRAKLatar Belakang: Hiperplasia adrenal kongenital HAK paling banyak disebabkan oleh defisiensi enzim 21-hidroksilase. Pajanan kortisol yang rendah dan androgen yang berlebihan pada masa prenatal dan/atau postnatal serta glukokortikoid berlebihan akibat terapi menyebabkan komplikasi medis dan psikososial. Anak HAK dapat mengalami masalah perilaku dan gangguan kognitif akibat penyakit atau terapi yang diberikan. Kondisi undertreatment dan overtreatment dapat memengaruhi perilaku dan kognitif. Identifikasi dini terhadap risiko masalah perilaku dan gangguan fungsi kognitif penting untuk intervensi klinis dan psikoedukasi terhadap anak.Tujuan: Mengetahui prevalens masalah perilaku dan gambaran fungsi kognitif anak HAK serta mengetahui risiko relatif terjadinya gangguan kognitif pada anak HAK yang memiliki masalah perilaku.Metode: Penelitian ini merupakan studi deskriptif-analitik dengan metode potong lintang, dilakukan di Rumah Sakit Cipto Mangunkusumo RSCM pada Januari ndash; Maret 2017. Pemeriksaan masalah perilaku menggunakan instrumen strengths and difficulties questionnaire SDQ , sedangkan pemeriksaan fungsi kognitif menggunakan instrumen the Wechsler Abbreviated Scale of Intelligence Scale WAIS untuk anak. Subyek pada penelitian ini adalah pasien HAK usia 4 ndash; 18 tahun. Analisis statistik dilakukan untuk mencari hubungan serta risiko relatif gangguan kognitif dengan masalah perilaku.Hasil: Penelitian dilakukan terhadap 20 subyek. Prevalens masalah perilaku sebesar 80 16/20 , dengan masalah terbanyak adalah masalah emosional 40 . Rerata IQ full scale adalah 96,5 20 . Terdapat 40 subyek dengan full scale IQ di bawah normal. Perbedaan bermakna secara statistik didapatkan antara rerata IQ full scale dengan hiperaktivitas

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ABSTRACTBackground Congenital adrenal hyperplasia CAH is most commonly caused by a 21 hydroxylase enzyme deficiency. Low and excessive androgen exposure during prenatal and or postnatal periods and excessive glucocorticoids from therapy leads to medical and psychosocial complications. Children of CAH can experience behavioural problems and cognitive impairment due to the disease or therapy. Undertreatment and overtreatment can affect behavior and cognitive. Early identification to the risk of behavioural problems and impaired cognitive function is important for clinical interventions and psychoeducationAim To identification the prevalence of behavioral problems and the cognitive function of children with CAH and to know the relative risk of cognitive impairment in children who have behavioural problems.Method This is a descriptive analytic study with cross sectional method, held at Cipto Mangunkusumo Hospital in January to March 2017. Examination of behavioral problems using strengths and difficulties questionnaire SDQ instrument, while examining cognitive function using the Wechsler Abbreviated Scale of Intelligence Scale WAIS for children. Subjects in this study were CAH patients aged 4 18 years. Statistical analysis was performed to find the relationship as well as the relative risk of cognitive impairment with behavioural problems.Result This study was conducted on 20 subjects. The prevalence of behavioural problems is 80 16 20 , with most problems being emotional problems 40 . The full scale IQ average is 96.5 20 . Forty percents of subjects have a full scale IQ under average. A statistically significant difference was found between mean full scale IQ and hyperactivity p "

"Latar Belakang: Pencapaian target glikemik pada pasien DM tipe2 yang masih rendah khususnya di Indonesia mengakibatkan berbagai komplikasi termasuk gangguan fungsi kognitif.. Padahal untuk menerapkan manajemen mandiri pada pasien DM, dibutuhkan fungsi kognitif yang kompleks. Pada berbagai penyakit kronis, fungsi kognitif khususnya domain memori yang buruk telah dihubungkan dengan ketidakpatuhan penggunaan obat. Meskipun demikian, belum ada studi yang mencari hubungan keduanya pada pasien DM tipe 2.Tujuan: Mengetahui hubungan gangguan fungsi kognitif dengan ketidakpatuhan penggunaan obat pada pasien DM tipe 2Metodologi: Desain studi ini adalah potong lintang terhadap 96 subjek penelitian dengan DM tipe 2 berusia >18 tahun di unit rawat jalan RSUD Tebet. Karakteristik demografi, parameter klinis, penilaian fungsi kognitif, dan kepatuhan penggunaan obat didokumentasikan secara lengkap. Penilaian fungsi kognitif menggunakan Montreal Cognitive Assessment versi Indonesia (MoCA-Ina). Penilaian kepatuhan penggunaan obat dinilai menggunakan penghitungan pil. Studi ini menggunakan analisis distribusi frekuensi dan proporsi, analisis bivariat dengan uji Chi-Square.Hasil: Terdapat 69,8% subjek penelitian dengan gangguan fungsi kognitif dengan faktor tingkat pendidikan sebagai faktor yang mempengaruhi. Analisa mendapatkan kejadian penurunan fungsi domain memori 96,9%;, eksekutif 78%, visuospasial 78%; atensi 30%; bahasa 26%; dan orientasi 4,2%. Ketidakpatuhan penggunaan obat didapatkan pada 26% subjek penelitian. Analisa bivariat tidak menunjukkan adanya hubungan antara gangguan fungsi kognitif dengan ketidakpatuhan penggunaan obat (OR 0,757 95% CI [0,280-2,051] p=0,58).Kesimpulan: Gangguan fungsi kognitif didapatkan pada 69,8% pasien DM tipe 2, dan ketidakpatuhan ditemukan pada 26% pasien. Tidak ada hubungan yang didapatkan antara gangguan fungsi kognitif dengan ketidakpatuhan penggunaan obat pada pasien DM tipe 2

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Background: Poor glycemic control in Type 2 Diabetes Mellitus patients, especially in Indonesia, results in a variety of complications including a cognitive impairment. In fact, to implement self-management in DM patients, intact cognitive function is necessary. In a variety of chronic diseases, cognitive impairment, especially the memory domain has been associated with medication nonadherence. Nonetheless, no studies have looked for the relationship between the two in type 2 DM patients

Objective: This study aims to determine the relationship of cognitive impairment with medication nonadherence in type 2 DM patients.

Methodology: The design of this study was cross-sectional with 96 study subjects with type 2 DM, > 18 years old in the outpatient unit at RSUD Tebet. Demographic characteristics, clinical parameters, cognitive function assessment, and medication adherence use were fully documented. Cognitive function assessed with the Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina). Medication adherence was assessed using pill count. This study uses the analysis of frequency and proportions distribution, and bivariate analysis with the Chi-Square test.

Results: There were 69.8% of the research subjects with cognitive impairment with education level as an associated factor. Analysis of the occurrence of impairment of the function of memory domain 96.9%; executive 78%, visuospatial 78%; attention 30%; language 26%; and 4.2% orientation. Oraal medication nonadherence was found in 26% of the study subjects. Bivariate analysis did not show an association between cognitive impairment and medication nonadherence (OR 0.757 95% CI [0.280-2.051] p=0.58).

Conclusion: Cognitive impairment was found in 69.8% Type 2 DM patients, and medication nonadherence was found in 26% patients. Cognitive impairment was not associated with medication nonadherence in type 2 DM patients"

"Latar belakang. Kognitif merupakan proses sejumlah fungsi kompleks dari berbagai sirkuit di otak. Diabetes mellitus tipe 2 merupakan salah satu faktor risiko gangguan kognitif melalui mekanisme vaskuler dan non-vaskuler. Berbagai studi menunjukkan hubungan antara diabetes dengan risiko terjadinya demensia. Tujuan penelitian ini adalah untuk melihat gambaran fungsi kognitif pada penyandang OM tipe 2 . Metode. Penelitian ini adalah penelitian potong lintang dengan populasi penyandang OM tipe 2 berusia - 50 tahun yang berobat di Puskesmas Tebet dan Pasar Minggu Jakarta yang memenuhi kriteria inklusi. Semua subyek dilakukan anamnesis, pemeriksaan fisik umum dan neurologis serta pencatatan kadar gula darah puasa dalam 2 tahun terakhir. Kemudian dilakukan pemeriksaan fungsi kognitif untuk menilai atensi, bahasa, memori, praxis, fungsi eksekutif dan kecepatan psikomotor. Kriteria gangguan kognitif ringan tanpa demensia (CIND) adalah bila ditemukan satu atau lebih skor kognitif di bawah < 1.5 standard deviasi nilai normatif. Data dianalisis menggunakan tes chi- square, Fisher's exact dan Mann Whitney memakai program SPSS versi 11.5 hasil. Pada penelitian ini didapatkan % pasien DM tipe 2, rentang usia antara 50-75 tahun (rerata 59.5 ± 5.53 tahun), terdiri dari 55 (57.3%) wanita. Sebanyak 84 (87.5%) subyek memenuhi kriteria CIND. Rana kognitif yang paling terganggu adalah fungsi eksekutif (77 .1% ). Sebagai hasil tambahan, didapatkan hubungan bermakna antara gangguan fungsi kognitif dengan tingkat pendidikan (p=0.007; OR:6.69; IK.95% 1.48;34.34). Subyek berusia - 60 tahun memiliki kecenderungan terjadi gangguan atensi(p=0.023) dan immediate memory (p=0.039). Subyek dengan durasi DM - 5 tahun cenderung memiliki gangguan pada immediate memory (p=0.002). Subyek dengan kriteria pengendalian GOP buruk berhubungan bermakna dengan gangguan fungsi eksekutif (p=0.006). Subyek dengan riwayat hipertensi memiliki kecenderungan terjadi gangguan atensi (p=0.0035). Kesimpulan. Gangguan kognitif umum ditemukan pada penyandang OM tipe 2 terutama gangguan fungsi eksekutif. Pasien DM tipe 2 dengan tingkat pendidikan rendah mempunyai kecenderungan memiliki gangguan fungsi kognitif (CIND). Faktor usia lanjut, lama OM, pengendalian GOP dan hipertensi berhubungan dengan gangguan pada rana kognitif spesifik.

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Background. Cognitive function is the process of several complex functions of various circuits in the brain. Type 2 diabetes is one of the risk factors which may cause cognitive function impairment through vascular and non-vascular mechanisms. Many studies show that there is a positive correlation between diabetes mellitus and the risk of dementia. The aim of this study was to describe the cognitive function of people with type 2 diabetes before any dementia manifestation occurred. Methods. This was an cross sectional study which included all type 2 diabetes patients who fulfilled the inclusion criteria. Medical history, physical and neurology examination were performed, fasting blood glucose levels of all the patients in the last 2 years were also collected. The patient's cognitive function was examined using neurophsycology test of CERAD, digit span, trail making B and finger tapping test Criteria of mild cognitive impairment without dementia (CIND) were confirmed if one or more cognitive scores were < 1.5 SD below normative value. The data were analyzed using chi-square, Fisher' exact and Mann Whitney test with SPSS for Windows version 11.5. Result. There were found 96 subjects with type 2 diabetes, 55 (57.3%) subjects were female, range of age was 50-75 years old (mean 59.5 years old SD 5.53). Eighty four (87.5%) subjects fulfilled the CIND criteria. The most affected cognitive domain was executive function (77.1%). In addition, a significant correlation was found between the cognitive impairment and the level of education (p=0.007;0R 6.69; Cl95% 1.48;34.34). Subjects with advanced aged or prior hypertension tended to have attention decicit; subjects with poor control of blood glucose had a significant correlation with executive dysfunction ; Subjects - 60 years-old and with diabetes more than 5 years tended to have immediate memory impairment (p<0.05). Conclusion. Cognitive impairment without dementia is commonly encountered in people with type 2 diabetes particularly in the domain of executive function. Type 2 diabetes patients with lower levels of education are more likely to have a cognitive impairment. There is a correlation between advanced age, duration of diabetes, control of blood glucose and hypertension with specific cognitive domain impairment."

"Type 2 diabetes mellitus (T2DM) is strongly associated with lower performance on multiple domains of cognitive function and with structural abnormalities of the brain. With the growing epidemic of diabetes and aging population, neural complications of diabetes are expected to rise and becoming a challenge for future health implications. Understanding pathophysiology, factors associated with this complication, manifestation of cognitive impairment and various metabolic and neuroradiologic markers suggestive of this pathologic condition is crucial for proper management of this potentially debilitating complication of T2DM. This review will discuss briefly important aspects of cognitive impairment in T2DM."

"Latar belakang: Gangguan Kognitif adalah salah satu manifestasi dari NPSLE. Pasien LES dengan gangguan kognitif telah dilaporkan memiliki dampak yang besar pada kualitas hidup dan berpengaruh besar pada peran sosial pasien LES. Tujuan: Mengetahui prevalensi gangguan kognitif pada pasien LES dan hubungan gangguan kognitif dengan kualitas hidup pada pasien LES. Metode: Penelitian ini merupakan studi potong lintang pada pasien LES di poliklinik rawat jalan Rumah Sakit Cipto Mangunkusumo, Jakarta. Data yang dikumpulkan adalah karakteristik pasien, hasil tes MoCA-Ina, LupusQol, dan HADS. Data karakteristik pasien meliputi usia, jenis kelamin, penyakit komorbid, aktivitas penyakit, penggunaan kortikosteroid dan imunosupresan lainnya, serta durasi penyakit. Analisis dilakukan dengan menggunakan uji T independen jika data terdistribusi normal, jika data tidak terdistribusi normal maka dilakukan uji statistik dengan menggunakan Uji Mann Whitney. Analisis multivariat regresi linier dilakukan untuk menilai pengaruh variabel perancu terhadap hubungan gangguan kognitif dengan kualitas hidup. Nilai p yang dianggap signifikan adalah <0,05. Hasil: Dari 116 subjek, 112 (96,6%) adalah perempuan, dengan usia rerata (SB) 34,41 (10,15) tahun, memiliki tingkat pendidikan perguruan tinggi sebanyak 45 (38,8%). Durasi penyakit median (RIK) adalah 52 (16,75 - 109,5) bulan, dan yang memiliki komorbid sebanyak 41 (35,3%). Aktivitas penyakit berdasarkan penilaian Mex-SLEDAI adalah 2,75 (0-6), dengan keterlibatan organ terbanyak adalah mukokutaneus (90,5%) dan muskuloskeletal (91,4%). Sebagian besar pasien menggunakan kortikosteroid, sedangkan yang tidak menggunakan hanya 12 (10,3%) dan hidroksiklorokuin adalah penggunaan tertinggi sebesar 79 (68,1%). Depresi dan ansietas berdasarkan kuesioner HADS masing-masing 24 dan 44 subjek. Prevalensi gangguan kognitif pada pasien LES adalah 57,8%. Berdasarkan analisis bivariat dengan uji Mann Whitney, ditemukan bahwa kualitas hidup, yang dinilai dengan kuesioner LupusQoL, tidak berhubungan dengan gangguan kognitif. (p-value = 0,750). Kesimpulan: Lebih dari separuh subjek mengalami gangguan kognitif. Tidak ada hubungan antara gangguan kognitif dan kualitas hidup pada pasien LES.

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Background: Cognitive Impairment is one of the manifestations of NPSLE. SLE patients with cognitive impairment have been reported to have a major impact on quality of life and a major effect on the social role of SLE patients.

Objective: This study aimed to find out prevalence of cognitive impairment in SLE patients and the relationship between cognitive impairment and quality of life in SLE patients.

Method: This was a cross-sectional study of SLE patients from outpatient clinic Cipto Mangunkusumo Hospital, Jakarta. Data collected were patient characteristics, MoCA-Ina, LupusQol, and HADS test results. Data on patient characteristics included age, gender, comorbid diseases, disease activity, use of corticosteroids and other immunosuppressants, and duration of disease. The analysis was carried out using the independent T test if the data was normally distributed, if the data was not normally distributed then a statistical test was carried out using the Mann Whitney Test. Linear regression multivariate analysis was performed to assess the effect of confounding variables on the relationship between cognitive impairment and quality of life. The p value that was considered significant was <0.05.

Result: Of the 116 subjects, 112 (96.6%) were female, with a mean age of 34.41 (10.15) years, had tertiary level of educations at 45(38.8%). The duration of illness was 52 (16.75-109.5) months with 41 (35.3%) had comorbidities. Their disease activity based on Mex-SLEDAI assessment was 2.75 (0-6), with the most organ involvement of the participants were mucocutaneous (90.5%) and musculoskeletal (91.4%). Most of the patients were using corticosteroid as their therapy, while those who did not use was only 12 (10.3%) and hydroxychloroquine was the highest usage among the participants 79 (68.1%). Depression and anxiety were assessed with HADS questionnaire were 24 and 44, respectively. The prevalence of cognitive impairment in SLE patients was 57.8%. Based on bivariate analysis with the Mann Whitney test, it was found that the quality of life, which was assessed by the Lupus QoL questionnaire, there was no relationship between cognitive impairment and quality of life in SLE patients (p-value= 0.750).

Conclusion: More than half of the subjects experienced cognitive impairment. There was no significant relationship between cognitive impairment and quality of life in SLE patients."

"Latar belakang. Kognitif merupakan proses berpikir akibat aktivitas sejumlah fungsi kompleks dari berbagai sirkuit di otak. Adanya gangguan kognitif menunjukkan terjadinya gangguan fungsi otak. MCI ( Mild Cognitive Impairment ) merupakan gangguan kognitif ringan yang sudah terjadi pada kelompok lanjut usia nondemensia. Berbagai studi menunjukkan gambaran dan prevalensi MCI pada lanjut usia nondemensia. Tujuan penelitian ini adalah untuk melihat gambaran fungsi kognitif dan prevalensi MCI pada kelompok lanjut usia nondemensia .Metode. Penelitian ini menggunakan cara potong lintang dengan populasi semua lanjut usia nondemensia di Puskesmas Tebet dan Pasar Minggu yang memenuhi kriteria inklusi. Semua subyek dilakukan anamnesis, pemeriksaan fisik umum dan neurologis , Dilakukan pemeriksaan fungsi kognitif dengan menggunakan CERAD dan Trail Making Test - B. Diagnosis MCI menggunakan kriteria dari Petersen RC. Data diolah dengan menggunakan tes chi-square, Fisher's Exact dan memakai program SPSS versi 12Hasil. Pada penelitian ini didapatkan 300 lanjut usia (> 60 tahun) nondemensia, rentang usia antara 60-76 tahun (rerata 63,5 ± 4,1 tahun) dengan kelompok usia terbesar 60 - 65 tahun (75,0%) , terdiri dari 177 (59%) wanita dan 123 (41%) pria. Sebanyak 269 subyek (89,6%) memenuhi kriteria MCI. Subkelas MCIa 22 kasus (7,3%), MClsdnm 81 kasus (27%) dan MCImd 166 kasus (55,3%). Gangguan kognitif terbanyak pada MCIa adalah Memori Rekognisi (81,8%) , pada MClsdnm adalah Fungsi Eksekutif (100%) dan pada MCImd adalah Fungsi Eksekutif (89,1%) beserta Memori Rekognisi (64,5%). Didapatkan hubungan bermakna antara MCIa dengan DM ( p = 0,038 ; OR 0,10 ; IK 95% 0,01;0,88 ) dan MCImd dengan pendidikan rendah ( SD dan SLP) (p = 0,000 ; OR 5,32 ; IK95% 2,12;13,31 ) dan DM (p = 0,008 ; OR 0,26 ; IK95% 0,10;0,70 ).Kesimpulan. Prevalensi MCI pada lanjut usia nondemensia ( > 60 tahun ) ditemukan sebesar 89,6% .Rana kognitif yang paling banyak terganggu adalah Memori Rekognisi dan Fungsi Eksekutif . Faktor risiko terbanyak adalah pendidikan rendah dan DM

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Background. Cognitive function is the process of several complex functions of various circuits in the brain. Mild Cognitive Impairment (MCI) is a transition state between normal and probable dementia. The aim of this study was to describe the cognitive impairment profile and the prevalence of MCI in non demented elder

Methods. This was an analytical cross sectional study which included all non demented elder patients who fulfilled the inclusion criteria. Medical history, physical and neurology examination were performed.. The patient's cognitive function was examined using neurophsycology test of CERAD and Trail Making Test-B. Diagnostic criteria of mild cognitive impairment were confirmed by using criteria from Petersen RC (< 1.5 SD below normative value ). The data were analyzed using chi-square, Fisher' exact and using SPSS for Windows ver. 12.

Result. There were found 300 non demented elder ( age > 60 years old ), 177 (59%) subjects were female and 123 (41%) were male , range of age was 60-76 years old (mean 63,5 ± 4,1 years old ) with largest age group were 60-65 years old ( 75,0%). There were 269 (89,6%) subjects fulfilled the MCI criteria with MCIa 22 (7,3%) , MClsdnm 81 (27%) and MCImd 166 (55,3%) . The most affected cognitive domain in MCIa was Recognition Memory ( 81,8%) in MClsdnm was Executive Function (100%) and in MCImd were Recognition Memory (64,5%) together with Executive Function (89,1%) . In addition, a significant correlation was found between the MCIa and DM ( p=0.038;OR 0,10; CI95% 0,01;0,88) and between MCImd with poor education (p=0.000;OR 5,32; C195% 2,12;13,31) and DM (p=0.008;OR 0,26; CI95% 0,10;0,70.

Conclusion. Prevalence of MCI in non demented elder (> 60 years old ) 89,6% . The most affective cognitive domains were Recognition and Executive Function . The most risk factors were poor education and DM"