Research, looked at developing a new set of survey questions which effectively capture the living standards of older people. This report details the programme of cognitive testing which was undertaken to understand more about why the previous material deprivation question wording and items on the Family Resources Survey (FRS) do not work effectively for older people and to develop new questions for use on the FRS. This study was part of a wider programme of research on developing a robust question block on older people's material deprivation. Readers are recommended to also consult DWP Working paper 54, Measuring material deprivation among older people: Methodological study to revise the FRS questions (released at the same time), undertaken by Stephen McKay, Professor of Social Research at the University of Birmingham, which provides an outline of the overall programme of research and makes recommendations for the implementation of the new question block on the FRS.
Research, looked at developing a new set of survey questions which effectively capture the living standards of older people. This report details the programme of cognitive testing which was undertaken to understand more about why the previous material deprivation question wording and items on the Family Resources Survey (FRS) do not work effectively for older people and to develop new questions for use on the FRS. This study was part of a wider programme of research on developing a robust question block on older people's material deprivation. Readers are recommended to also consult DWP Working paper 54, Measuring material deprivation among older people: Methodological study to revise the FRS questions (released at the same time), undertaken by Stephen McKay, Professor of Social Research at the University of Birmingham, which provides an outline of the overall programme of research and makes recommendations for the implementation of the new question block on the FRS.
International Journal of Geriatric Psychiatry, 23(3), March 2008, pp.279-282.
Publisher:
Wiley
The discrepancy between results of diagnosing dementia with ICD-10 and DSM-IV has been shown by several studies. Our aim was to show that the two diagnostic systems are more or less alike if ICD-10 is interpreted in the way we believe is in the intention of the ICD-10 authors. Two hundred and seven patients consecutively referred patients and their caregivers were interviewed and the patients...
The discrepancy between results of diagnosing dementia with ICD-10 and DSM-IV has been shown by several studies. Our aim was to show that the two diagnostic systems are more or less alike if ICD-10 is interpreted in the way we believe is in the intention of the ICD-10 authors. Two hundred and seven patients consecutively referred patients and their caregivers were interviewed and the patients were clinically examined. Algorithms using criteria for the World health Organization's International classification of Diseases, 10th revision (ICD-10) and the American Psychiatric Association's, the fourth edition (DSM-IV) were followed to diagnose dementia. A diagnosis of dementia was made for 198 patients and there was 100% agreement (kappa = 1,0) between ICD-10 and DSM-IV diagnosis. In the ICD-10 criteria decline in other cognitive abilities such as abstraction, judgement, problem solving has been interpreted in a way that all the above executive functions must be impaired for diagnosing dementia. According to our interpretation these are meant to be examples of functions which may be compromised in demented patients. The results of our study demonstrate that this interpretation of ICD-10 has shown that the authors of ICD-10 and DSM-IV have succeeded in harmonising the two systems. However, the ICD-10 criteria are phrased in a way that leaves much to individual interpretation. WHO has to define the ICD criteria in such a way that there is uniformity in its interpretation.
International Journal of Geriatric Psychiatry, 21(11), November 2006, pp.1078-1085.
Publisher:
Wiley
There is a clear need for brief, but sensitive and specific, cognitive screening instruments as evidenced by the popularity of the Addenbrooke's Cognitive Examination (ACE). The authors aimed to validate an improved revision (the ACE-R) which incorporates five sub-domain scores (orientation/attention, memory, verbal fluency, language and visuo-spatial). Standard tests for evaluating dementia...
There is a clear need for brief, but sensitive and specific, cognitive screening instruments as evidenced by the popularity of the Addenbrooke's Cognitive Examination (ACE). The authors aimed to validate an improved revision (the ACE-R) which incorporates five sub-domain scores (orientation/attention, memory, verbal fluency, language and visuo-spatial). Standard tests for evaluating dementia screening tests were applied. A total of 241 subjects participated in this study (Alzheimer's disease = 67, frontotemporal dementia = 55, dementia of Lewy Bodies = 20; mild cognitive impairment-MCI = 36; controls = 63). Reliability of the ACE-R was very good. Correlation with the Clinical Dementia Scale was significant. Two cut-offs were defined (88: sensitivity = 0.94, specificity = 0.89; 82: sensitivity = 0.84, specificity = 1.0). Likelihood ratios of dementia were generated for scores between 88 and 82: at a cut-off of 82 the likelihood of dementia is 100:1. A comparison of individual age and education matched groups of MCI, AD and controls placed the MCI group performance between controls and AD and revealed MCI patients to be impaired in areas other than memory (attention/orientation, verbal fluency and language). The ACE-R accomplishes standards of a valid dementia screening test, sensitive to early cognitive dysfunction.
Aging and Mental Health, 10(6), November 2006, pp.648-655.
Publisher:
Taylor and Francis
Hong Kong Chinese adults. Ninety-six participants with normal cognitive functioning and 33 participants with dementia were recruited. All participants were involved in the investigation of internal consistency and construct validity. One sub-sample from each group was selected for test-retest reliability and inter-rater reliability respectively. The ASP-CV demonstrated excellent inter-rater...
The Adult Sensory Profile (ASP) evaluates the sensory experiences of adults in the categories of auditory, visual, taste/smell, touch, movement, and activity level. It generates four sensory processing patterns including low registration, sensation seeking, sensory sensitivity, and sensation avoiding. This study examined the psychometric properties of the Chinese version of ASP (ASP-CV) for older Hong Kong Chinese adults. Ninety-six participants with normal cognitive functioning and 33 participants with dementia were recruited. All participants were involved in the investigation of internal consistency and construct validity. One sub-sample from each group was selected for test-retest reliability and inter-rater reliability respectively. The ASP-CV demonstrated excellent inter-rater reliability and test-retest reliability, and satisfactory internal consistency. The construct validity of ASP-CV was supported by the known-groups method, in which participants with dementia differed significantly from their healthy counterparts in the patterns of ‘low registration’, ‘sensory sensitivity’, and ‘sensation avoiding’. In conclusion, ASP-CV is reliable and valid to measure sensory processing functions of older Hong Kong Chinese people. Further studies are suggested to examine the factor structure of and the equivalence of self-report and proxy report of ASP-CV.
Subject terms:
Chinese people, dementia, diagnostic tests, evaluation;
Dementia: the International Journal of Social Research and Practice, 5(2), May 2006, pp.213-222.
Publisher:
Sage
The purpose of this American study was to develop a screening test of driving knowledge for use with dementia patients and other older drivers. Seventy-five drivers with dementia and 80 non-demented elderly drivers completed a 39-item questionnaire concerning the rules-of-the-road and a Mini-Mental State Examination (MMSE). Using item analysis, 15 items were selected for a screening test...
The purpose of this American study was to develop a screening test of driving knowledge for use with dementia patients and other older drivers. Seventy-five drivers with dementia and 80 non-demented elderly drivers completed a 39-item questionnaire concerning the rules-of-the-road and a Mini-Mental State Examination (MMSE). Using item analysis, 15 items were selected for a screening test. The internal consistency reliability of the test was 0.74, while that of all 39 questions was 0.79. Patient and control means on the test differed significantly. MMSE scores accounted for only 16 percent of the variance in driving knowledge scores in the dementia patients. Results suggest that it is possible to develop a knowledge-based driving instrument that can successfully be administered to patients with diagnoses of mild to moderate dementia. Drivers with dementia demonstrated significantly poorer knowledge of driving regulations than the control group. However, the final score on the driving instrument was not well predicted by the MMSE, suggesting that direct assessment of driving knowledge is important to driving assessment.
International Journal of Geriatric Psychiatry, 16(3), March 2001, pp.288-292.
Publisher:
Wiley
Dementia is a degenerating illness and the lack of a reliable measure of self-report in particular presents difficulties for research. Often in the later stages of dementia behavioural measurement is the only tool available for the evaluation of treatment techniques. This paper describes and evaluates a short observational tool suitable for clinical assessment purposes.
Dementia is a degenerating illness and the lack of a reliable measure of self-report in particular presents difficulties for research. Often in the later stages of dementia behavioural measurement is the only tool available for the evaluation of treatment techniques. This paper describes and evaluates a short observational tool suitable for clinical assessment purposes.
Objectives: Using a sample of dementia caregivers, this study compared the diagnostic utility of the various short versions of the Zarit Burden Interview (ZBI) with the original scale to identify the most optimal one. The study then established externally validated cutoffs for the various ZBI versions using probable depression cases as a reference standard. Methods: Caregivers (N = 394; 236 males
(Edited publisher abstract)
Objectives: Using a sample of dementia caregivers, this study compared the diagnostic utility of the various short versions of the Zarit Burden Interview (ZBI) with the original scale to identify the most optimal one. The study then established externally validated cutoffs for the various ZBI versions using probable depression cases as a reference standard. Methods: Caregivers (N = 394; 236 males; Agemean = 56 years) were administered the ZBI and a self-report depression measure. Participants who exceeded the cutoff for the latter were identified as probable depression cases. For each of the ZBI versions, a receiver operating characteristic (ROC) curve was plotted against probable depression cases. The area under these ROC curves between the short versions and the original were then compared using a non-parametric approach. Results: Compared to the original ZBI, the AUROC were similar for the 6-item, 7-item, and two 12-item versions, but significantly worse for the other short variants. The sensitivity and specificity of the cutoffs for all ZBI versions ranged from 77.3% to 85.2% and 60.1% to 79.8%, respectively. Conclusions: The original ZBI had good utility in identifying probable depression in caregivers, while the 6-item variant can be a useful alternative when short versions are preferred.
(Edited publisher abstract)
This discussion paper summarises the findings of a study examining guidelines for health professionals on the eye health care of people with dementia. The study also reviewed assessment processes, tests and techniques that are used for sight testing in people with dementia. After summarising the findings, the paper suggests ways of meeting the vision and eye health care needs of people...
This discussion paper summarises the findings of a study examining guidelines for health professionals on the eye health care of people with dementia. The study also reviewed assessment processes, tests and techniques that are used for sight testing in people with dementia. After summarising the findings, the paper suggests ways of meeting the vision and eye health care needs of people with dementia and sight loss in a more tailored manner. It also makes seven recommendations for action.
Subject terms:
visual impairment, dementia, diagnostic tests, health care, health professionals;
International Journal of Geriatric Psychiatry, 25(6), June 2010, pp.562-568.
Publisher:
Wiley
This research compare the performance of patients with mild-moderate Alzheimer's disease (AD) and vascular dementia (VaD) on tests of executive functioning and working memory. Seventy six patients with AD and forty six with VaD were recruited from a memory clinic, at the Belfast City Hospital, along with twenty eight dementia free control group participants. They underwent tests of working memory
This research compare the performance of patients with mild-moderate Alzheimer's disease (AD) and vascular dementia (VaD) on tests of executive functioning and working memory. Seventy six patients with AD and forty six with VaD were recruited from a memory clinic, at the Belfast City Hospital, along with twenty eight dementia free control group participants. They underwent tests of working memory from the Cognitive Drug Research battery, pen and paper tests of executive function, and a test of verbal fluency. All patients had a CT brain scan testing for white matter change or ischaemia. Findings showed that the AD and VaD groups were extensively impaired on all measures of working memory and executive functioning compared to the control group, with no significant differences between the AD and VaD groups on any measure. Results confirmed the pattern of impairment in executive functioning and working memory was mostly equivalent in both patient groups. Small correlations were seen between the mini-mental state examination and the neurocognitive scores in both patient groups and the pattern of correlations was also very similar in both patient groups. The authors conclude that this study showed considerable executive functioning and working memory impairments in patients with mild-moderate AD and VaD, but no significant differences between the two groups.
Subject terms:
memory, Alzheimers disease, communication skills, dementia, diagnostic tests;