Search results for ‘Subject term:"cognitive impairment"’ Sort:
Results 1 - 10 of 38
Single screening questions for cognitive impairment in older people: a systematic review
- Authors:
- HENDRY Kirsty, et al
- Journal article citation:
- Age and Ageing, 44(2), 2015, pp.322-326.
- Publisher:
- Oxford University Press
Background and objective: Single-item screening questions may be a practical first step in screening for cognitive problems in older people. A form of single-item cognitive assessment is proposed in the NHS England and Wales dementia strategy. The authors aim to provide a review and synthesis of the evidence regarding the performance of single-item tests for detection of cognitive impairment. Design: This review used Cochrane diagnostic test accuracy procedures. Two independent researchers searched for relevant papers across multiple, cross-disciplinary electronic databases using previously validated search strings. The index test was any single screening question for cognitive impairment, including factor analysis of multi-item tools. Reference standards included clinical diagnosis and multi-domain cognitive assessments. Results: From 884 titles, 11 studies were identified as eligible for inclusion. Four studies were graded low risk of bias and recruited a representative patient sample. Five papers described a single screening question for cognitive impairment with each using a different question. Sensitivity ranged from 26 to 96% and specificity from 45 to 100%. Six papers described the component analysis of multiple item tools with broadly worded single questions (‘decline in memory function’, ‘changes in ability to think and reason’ or ‘learning new things’) performing best. Conclusion: Informant-based, single-item screening questions show promise for detecting cognitive impairment. However, there was substantial heterogeneity in format and application of single-item screens, and several studies were of poor methodological quality. Currently, there is insufficient evidence to support routine screening using a single-item approach. (Edited publisher abstract)
Subjective memory complaints in an elderly sample: a cross-sectional study
- Authors:
- MINETT Thaís Soares Cianciarullo, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(1), January 2008, pp.49-54.
- Publisher:
- Wiley
Community based studies show that neurological or psychiatric symptoms are very frequent among the elderly population, with poor memory complaints being the most common. However, the relationship between poor memory complaints and objective memory performance is unclear. The authors designed this study to evaluate whether subjective memory complaints (SMC) are associated with objective cognitive performance or depression amongst the elderly Brazilian generation. A cross-sectional study was carried out in 114 patients who were 50+, with or without SMC having no obvious cognitive impairment at its baseline (this was screened by the Mini-Mental State Examination with cut-off values adapted according to the subjects' educational background). Subjects were assessed regarding memory difficulty complaints, demographic data and underwent a neuropsychological assessment made up of nine cognitive tests (Rey Auditory Verbal Learning Test, Visual Reproduction Test, Logic Memory - History A, Free and Cued Selective Reminding Test, Stroop Test, Digit Span, Digit Symbol, Trail Making Test, fluency tests: naming animals and fruits) and the Geriatric Depression Scale. Twenty-one percent of the subjects had subjective memory complaints. The scores in the cognitive assessment of subjects with SMC did not differ from the scores of subjects without SMC. However, patients with subjective memory complaints had lower scores in the fluency test - category animals and the Geriatric Depression Scale. These results support the finding from other cross-sectional studies showing that subjective memory complaints are associated with depressive symptoms rather than objective cognitive performance.
Do the ABCS 135 short cognitive screen and its subtests discriminate between normal cognition, mild cognitive impairment and dementia?
- Authors:
- STANDISH Timothy I. M., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(3), March 2007, pp.189-194.
- Publisher:
- Wiley
Cognitive screening instruments are either too long for routine clinical use or not sensitive to distinguish mild cognitive impairment (MCI) from normal cognition (NC) or dementia. The aim was to evaluate the sensitivity and specificity of the AB Cognitive Screen (ABCS) and its subtests with a view to improving its ability to differentiate between dementia, MCI and NC. The influence of age and education on sensitivity and specificity is also examined. Participants with dementia and MCI were recruited from those presenting to four specialty geriatric clinics in southern Ontario. Participants with NC were recruited from the family and friends of patients. A comprehensive geriatric assessment was done including ABCS, SMMSE and 15 point Geriatric Depression Scale. Analysis of variance and receiver operating characteristic (ROC) curves compared test scores. SMMSE scores were also analysed for comparison purposes. Three hundred and two participants had dementia, 166 had MCI and 174 had NC. ABCS total scores were significantly different between NC and MCI while SMMSE scores were not. Of individual ABCS subtests, verbal fluency and delayed recall were most sensitive to differences between NC and MCI. ROC curve analysis, which presents sensitivity and specificity, showed verbal fluency was better than delayed recall in distinguishing between NC and MCI, among participants 75 years of age or older. The AB Cognitive Screen (ABCS) can be administered in 3-5 min. The SMMSE and ABCS total and subtests significantly distinguished between dementia and MCI or NC. Verbal fluency and delayed recall were best at distinguishing between MCI and NC. The analysis illustrates how each subtest contributes to the sensitivity of the ABCS and suggests ways that sensitivity might be improved.
Measuring psychological well-being in cognitively impaired persons
- Authors:
- BURGENER Sandy C., TWIGG Prudence, POPOVICH Ann
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 4(4), November 2005, pp.463-485.
- Publisher:
- Sage
An objective measure of psychological well-being (a previously understudied outcome for persons with dementia) was developed and tested as part of a longitudinal study (n= 96 participant pairs; n= 73 pairs remaining at 18 months). The reliability and validity of the Psychological Well-being in Cognitively Impaired Persons (PWB-CIP) scale was examined as a measure of one dimension of quality of life (QoL) as persons progress in the disease. The original 16-item PWB-CIP Likert-type scale required only five to 10 minutes to complete and was reduced to 11 items following factor analysis. Cronbach's alpha for the total scale was .79 at baseline and .82 at 18 months. Two subscales were identified: positive affect/interaction and negative affect/interaction. One item ('involved in a single activity for > five minutes') loaded on a different subscale at baseline (early disease stages) compared to 18 months (reflecting disease progression). The internal consistency of the two subscales remained acceptable across the two measurement intervals. Controlling for mental status, the PWB-CIP's construct validity was supported through significant relationships with depression, personal characteristics (personality), and the behavioral competence QoL dimensions at baseline and at 18 months. Because both rural (55%) and urban populations were sampled and the PWB-CIP was used across care settings, the findings support the PWB-CIP as a psychometrically sound measure of psychological well-being for diverse populations of persons with dementia.
Comparison of the sensitivity of three instruments for the detection of cognitive decline in elderly living at home
- Authors:
- LITTLE A., et al
- Journal article citation:
- British Journal of Psychiatry, 150, June 1987, pp.808-814.
- Publisher:
- Cambridge University Press
-
Embodiment in tests of cognitive functioning: a study of an interpreter-mediated dementia evaluation
- Authors:
- MAJLESI Ali Reza, PLEJERT Charlotta
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 17(2), 2018, pp.138-163.
- Publisher:
- Sage
This study explores how manners of mediation, and the use of embodiment in interpreter-mediated conversation have an impact on tests of cognitive functioning in a dementia evaluation. By a detailed analysis of video recordings, we show how participants - an occupational therapist, an interpreter, and a patient - use embodied practices to make the tasks of a test of cognitive functioning intelligible, and how participants collaboratively put the instructions of the tasks into practice. We demonstrate that both instructions and instructed actions - and the whole procedure of accomplishing the tasks - are shaped co-operatively by embodied practices of all three participants involved in the test situation. Consequently, the accomplishment of the tasks should be viewed as the outcome of a collaborative achievement of instructed actions, rather than an individual product. The result of the study calls attention to issues concerning interpretations of, and the reliability of interpreter-mediated tests and their bearings for diagnostic procedures in dementia evaluations. (Edited publisher abstract)
Subjective cognitive complaints, neuropsychological performance, affective and behavioural symptoms in non-demented patients
- Authors:
- GALLASSI Roberto, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(1), January 2008, pp.95-101.
- Publisher:
- Wiley
Subjective cognitive complaints (SCC) have been previously investigated to establish whether they are risk factors for dementia, but no clear-cut conclusions have emerged. In this study non-demented patients with SCC were studied and the neuropsychological findings, affective and behavioural aspects and parameters with the highest correct classifications in discriminating patients who had only SCC but no objective clinical and neuropsychological impairment, i.e. no cognitive impairment (NCI) patients and those with objective neuropsychological deficits, namely patients with mild cognitive (MCI) were analyzed Consecutive non-demented outpatients with SCC were enrolled of over 9 months and examined using neuropsychological tests and scales for depression, anxiety and behaviour. Clinical criteria and neuropsychological test results were used to classify patients into groups of NCI, MCI and subtypes of MCI. Ninety-two patients with SCC were included; 49 of them had objective deficits (MCI patients), whereas 43 were without any clinical and cognitive impairment (NCI patients). These patients had lower age, higher education and better general cognitive indices than MCI patients who had higher caregiver distress, depression and irritability. The combination of a battery for mental deterioration and for behavioural memory assessment were the most discriminative in differentiating the two groups. An objective cognitive impairment, reaching the criteria for a MCI diagnosis, was present in almost half of patients having SCC. MCI patients have more behavioural disturbances than NCI subjects. SCC should not be underestimated and appropriate neuropsychological assessment is required to reassure subjects with normal results and to identify patients with MCI.
The Weigl Colour-Form Sorting Test: a quick and easily administered bedside screen for dementia and executive dysfunction
- Authors:
- HOBSON Peter, MEARA Jolyon, TAYLOR Carolyn
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(9), September 2007, pp.909-915.
- Publisher:
- Wiley
Screening for cognitive impairment in hospital and the community requires a valid, reliable, concise, well tolerated, easily administered instrument. In this investigation, we have studied a non-verbal cognitive screening instrument; Weigl's Colour-Form Sorting Test (WCFT), to determine its utility as a brief cognitive screen in a community based sample of stroke survivors, Parkinson's disease (PD) patients and age/sex matched controls. A total of 236 subjects consented to participate in this investigation, consisting of 105 stroke survivors, 40 PD and 91 control subjects. The sensitivity and specificity of the WCFT to detect significant cognitive impairment was based upon psychiatric interview, cognitive assessment and application of DSMIV criteria. The optimal cut-point of the WCFT to detect cases of cognitive impairment was 2/4 in all of the groups in this investigation. The sensitivity and specificity of the WCFT at the cut point of 2 in the stroke survivors was 77.8% and 78.3, in the PD patients, it was 78.6% and 85.5% and, in the control group 83.3% and 94.1% respectively. The diagnostic accuracy of the WCFT as calculated by the area under the receiver operating curve was greater than 0.70 in all subject groups, which suggests that it has acceptable psychometric properties to discriminate between case and non-cases of cognitive impairment. The WCFT was able to demonstrate good sensitivity and specificity, at detecting cognitive impairments in all of the subjects. This instrument will prove to be a useful adjunct to existing cognitive screens in clinical practice, due to its excellent psychometric properties, and lack of dependency on language skills.
Depression among older people with cognitive impairment: prevalence and detection
- Authors:
- McCABE Marita P., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(7), July 2006, pp.633-644.
- Publisher:
- Wiley
Past research has demonstrated that there is a high level of depression among older people, particularly for those with cognitive impairment and those in residential care. The current study was designed to determine the prevalence of depression among older people in hostels with cognitive impairment using a structured diagnostic interview. A further aim was to determine an appropriate screening instrument to detect depression within this population. It was also designed to evaluate the extent to which depression among these older people had previously been detected. Five commonly used depression scales were administered and compared to the results of the diagnostic interview. The results demonstrated that 38.9% of older people were diagnosed with depression, but that only 50% of these people had been previously diagnosed with this disorder. All scales showed some level of validity to detect depression. The implications of these findings for our understanding of depression among older people with cognitive impairment are discussed.
The need for a consensus in the use of assessment tools for Alzheimer's disease: the Feasibility Study (assessment tools for dementia in Alzheimer Centres across Europe), a European Alzheimer's Disease Consortium's (EADC) survey
- Authors:
- DIAZ Santiago Paulino Ramirez, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(8), August 2005, pp.744-748.
- Publisher:
- Wiley
To aims of this study were to ensure that all Alzheimer centres across Europe are capable of using a similar method of data collection. Information about the patient assessment tools used by each participating centre was obtained and normal clinical practice in each EADC centre was documented by collecting data from routine new patient consultation. Twenty new consecutive patients with objective memory impairment were recruited in each Alzheimer centre over 6 months. Each patient consultation was carried out according to routine clinical practice. Patient data were recorded using the anonymous patient protocol (demographic, diagnosis, MMSE score, patient assessment scales, and most prominent behavioural problem). Information about neuropsychological assessment tools used in each centre was take to account to harmonise research practice for future multicentre collaboration. Seven hundred and four patients from 36 memory clinics in 13 countries across Europe participated in the study. Five hundred and fifty-five patients had a clinical diagnosis of dementia The most common type of cognitive decline was Alzheimer's disease followed by mild cognitive impairment and vascular dementia. CDR, GDS Reisberg, and ADL/IADL were used widely (40-50%). The NPI, geriatric depression scale and ADL (Katz, 1963) were only used in 20% of the centres. The study verifies large differences in the tools use in the EADC centres to evaluate patients with dementia across Europe. The authors conclude there is a need for a consensus in the use of assessment tools for dementia in Alzheimer's centres in Europe.