Validity of the montreal cognitive assessment as a screen for mild cognitive impairment and dementia in African Americans.

PubMed

Goldstein, Felicia C; Ashley, Angela V; Miller, Eric; Alexeeva, Olga; Zanders, Lavezza; King, Veronique

2014-09-01

The validity of the Montreal Cognitive Assessment (MoCA) as a screen for mild cognitive impairment (MCI) and dementia was evaluated in African Americans attending an urban outpatient memory disorders clinic. Eighty one patients ≥50 years old were administered the MoCA and neuropsychological tests. Clinicians, blinded to the MoCA scores, reviewed the neuropsychological findings and reports of instrumental activities of daily living and they assigned a diagnosis of normal cognition (NC; N = 16), MCI (N = 38), or dementia (N = 27). The MoCA scores of the 3 groups were significantly different (NC > MCI > dementia). Using cutoff scores of ≤24 points for MCI and ≤22 points for dementia, the MoCA had .95 sensitivity and .63 specificity for MCI and .96 sensitivity and .88 specificity for dementia. The MoCA is a valid and cost-effective screen for cognitive impairment in African Americans but with a higher likelihood of falsely classifying persons with NC as having MCI. © The Author(s) 2014.

Screening cognitive impairment among institutionalized older Chinese men in Taiwan: a new minimum data set-based dementia screening tool is needed.

PubMed

Lin, Chu-Sheng; Lin, Ming-Hsien; Peng, Li-Ning; Chen, Liang-Kung; Hwang, Shinn-Jang; Lan, Chung-Fu

2011-01-01

Dementia screening is of great importance in various health settings for older people, long-term care facilities are no exception. The need for an effective dementia screening tool being culture sensitive is important. Minimum data set (MDS) is a population instrument for health care management in the world, which also covers dementia screening. The main purpose of this study was to evaluate the effectiveness of the MDS-based dementia screening tools among older Chinese men in the Veteran Home in Taiwan. Overall, 576 participants (mean age: 80.9±5.3 years, all males, 92.7% physically independent), 18.6% had cognitive impairment according to the mini-mental state examination (MMSE) (mean score: 26.7±3.9). However, the prevalence of cognitive impairment was 5.5% by MDS cognitive performance scale (CPS) and 18.9% by MDS cognition scale (MDS-COGS). The screening results of CPS and MDS-COGS were highly interrelated (γ=0.93, p<0.001), and MMSE scores were also significantly associated with CPS and MDS-COGS status (γ=-0.50, p<0.001 and γ=-0.52, p<0.001, respectively). Although the prevalence of cognitive impairment by MMSE and MDS-COGS are similar, the results are significantly inconsistent (p<0.001). In conclusion, both MDS-COGS and CPS were significantly correlated with MMSE scores, but significant inconsistence was noted between screening results of MMSE, CPS and MDS-COGS. Further study is needed to develop MDS-based dementia screening tools for older Chinese men in Taiwan. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Comparing Approaches to Optimize Cut-off Scores for Short Cognitive Screening Instruments in Mild Cognitive Impairment and Dementia

PubMed Central

O’Caoimh, Rónán; Gao, Yang; Svendovski, Anton; Gallagher, Paul; Eustace, Joseph; Molloy, D. William

2017-01-01

Background: Although required to improve the usability of cognitive screening instruments (CSIs), the use of cut-off scores is controversial yet poorly researched. Objective: To explore cut-off scores for two short CSIs: the Standardized Mini-Mental State Examination (SMMSE) and Quick Mild Cognitive Impairment (Qmci) screen, describing adjustments in scores for diagnosis (MCI or dementia), age (≤, >75 years), and education (<, ≥12 years), comparing two methods: the maximal accuracy approach, derived from receiver operating characteristic curves, and Youden’s Index. Methods: Pooled analysis of assessments from patients attending memory clinics in Canada between 1999–2010 : 766 with mild cognitive impairment (MCI) and 1,746 with dementia, and 875 normal controls. Results: The Qmci was more accurate than the SMMSE in differentiating controls from MCI or cognitive impairment (MCI and dementia). Employing the maximal accuracy approach, the optimal SMMSE cut-off for cognitive impairment was <28/30 (AUC 0.86, sensitivity 74%, specificity 88%) versus <63/100 for the Qmci (AUC 0.93, sensitivity 85%, specificity 85%). Using Youden’s Index, the optimal SMMSE cut-off remained <28/30 but fell slightly to <62/100 for the Qmci (sensitivity 83%, specificity 87%). The optimal cut-off for MCI was <29/30 for the SMMSE and <67/100 for the Qmci, irrespective of technique. The maximal accuracy approach generally produced higher Qmci cut-offs than Youden’s Index, both requiring adjustment for age and education. There were no clinically meaningful differences in SMMSE cut-off scores by age and education or method employed. Conclusion: Caution should be exercised selecting cut-offs as these differ by age, education, and method of derivation, with the extent of adjustment varying between CSIs. PMID:28222528

Screening for Sleep Problems in Early Intervention and Early Childhood Special Education: A Systematic Review of Screening and Assessment Instruments

ERIC Educational Resources Information Center

Bonuck, Karen A.; Hyden, Christel; Ury, Guenn; Barnett, Josephine; Ashkinaze, Hannah; Briggs, Rahil D.

2011-01-01

Behavioral insomnias of childhood (BIC) and sleep disordered breathing (SDB) disorders cause disrupted and/or inefficient sleep. Left untreated in early childhood, both conditions increase the risk of compromised development, particularly in the areas of behavior, cognition, and growth. This systematic review determined whether and how current…

Ethnicity and cognitive performance among older African Americans, Japanese Americans, and Caucasians: the role of education.

PubMed

Shadlen, M F; Larson, E B; Gibbons, L E; Rice, M M; McCormick, W C; Bowen, J; McCurry, S M; Graves, A B

2001-10-01

This cross-sectional analysis evaluated the association between ethnicity and cognitive performance and determined whether education modifies this association for nondemented older people (103 African Americans, 1,388 Japanese Americans, 2,306 Caucasians) in a study of dementia incidence. African Americans scored lower (median 89 out of 100) than Japanese Americans (93) and Caucasians (94) on the Cognitive Abilities Screening Instrument (CASI). Education affected CA

Testing the tests--an empirical evaluation of screening tests for the detection of cognitive impairment in aviators.

PubMed

Stokes, A F; Banich, M T; Elledge, V C

1991-08-01

The FAA has expressed concern that flight safety could be compromised by undetected cognitive impairment in pilots due to conditions such as substance abuse, mental illness, and neuropsychological problems. Interest has been shown in the possibility of adding a brief "mini-mental exam," or a simple automated test-battery to the standard flight medical to screen for such conditions. The research reported here involved the empirical evaluation of two "mini-mental exams," two paper-and-pencil test batteries, and a prototype version of an automated screening battery. Sensitivity, specificity, and positive predictive value were calculated for each sub-task in a discriminant study of 54 pilots and 62 individuals from a heterogeneous clinical population. Results suggest that the "mini-mental exams" are poor candidates for a screening test. The automated battery showed the best discrimination performance, in part because of the incorporation of dual-task tests of divided attention performance. These tests appear to be particularly sensitive to otherwise difficult-to-detect cognitive impairments of a mild or subtle nature. The use of an automated battery of tests as a screening instrument does appear to be feasible in principle, but the practical success of a screening program is heavily dependent upon the actual prevalence of cognitive impairment in the medical applicant population.

Cognitive Change Questionnaire as a method for cognitive impairment screening

PubMed Central

Damin, Antonio Eduardo; Nitrini, Ricardo; Brucki, Sonia Maria Dozzi

2015-01-01

The Cognitive Change Questionnaire (CCQ) was created as an effective measure of cognitive change that is easy to use and suitable for application in Brazil. Objective To evaluate whether the CCQ can accurately distinguish normal subjects from individuals with Mild Cognitive Impairment (MCI) and/or early stage dementia and to develop a briefer questionnaire, based on the original 22-item CCQ (CCQ22), that contains fewer questions. Methods A total of 123 individuals were evaluated: 42 healthy controls, 40 patients with MCI and 41 with mild dementia. The evaluation was performed using cognitive tests based on individual performance and on questionnaires administered to informants. The CCQ22 was created based on a selection of questions that experts deemed useful in screening for early stage dementia. Results The CCQ22 showed good accuracy for distinguishing between the groups. Statistical models selected the eight questions with the greatest power to discriminate between the groups. The AUC ROC corresponding to the final version of the 8-item CCQ (CCQ8), demonstrated good accuracy in differentiating between groups, good correlation with the final diagnosis (r=0.861) and adequate internal consistency (Cronbach's α=0.876). Conclusion The CCQ8 can be used to accurately differentiate between normal subjects and individuals with cognitive impairment, constituting a brief and appropriate instrument for cognitive screening. PMID:29213967

Spanish-language screening scales: A critical review.

PubMed

Torres-Castro, S; Mena-Montes, B; González-Ambrosio, G; Zubieta-Zavala, A; Torres-Carrillo, N M; Acosta-Castillo, G I; Espinel-Bermúdez, M C

2018-05-09

Dementia is a chronic, degenerative disease with a strong impact on families and health systems. The instruments currently in use for measuring cognitive impairment have different psychometric characteristics in terms of application time, cut-off point, reliability, and validity. The objective of this review is to describe the characteristics of the validated, Spanish-language versions of the Mini-Cog, Clock-Drawing Test, and Mini-Mental State Examination scales for cognitive impairment screening. We performed a three-stage literature search of articles published on Medline since 1953. We selected articles on validated, Spanish-language versions of the scales that included data on reliability, validity, sensitivity, and specificity. The 3 screening tools assessed in this article provide support for primary care professionals. Timely identification of mild cognitive impairment and dementia is crucial for the prognosis of these patients. Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

[Short evaluation of cognitive state in advanced stages of dementia: preliminary results of the Spanish validation of the Severe Mini-Mental State Examination].

PubMed

Buiza, Cristina; Navarro, Ana; Díaz-Orueta, Unai; González, Mari Feli; Alaba, Javier; Arriola, Enrique; Hernández, Carmen; Zulaica, Amaia; Yanguas, José Javier

2011-01-01

The cognitive assessment of patients with advanced dementia needs proper screening instruments that allow obtain information about the cognitive state and resources that these individuals still have. The present work conducts a Spanish validation study of the Severe Mini Mental State Examination (SMMSE). Forty-seven patients with advanced dementia (Mini-Cognitive Examination [MEC]<11) were evaluated with the Reisberg's Global Deterioration Scale, MEC, SMMSE and Severe Cognitive Impairment Profile scales. All test items were discriminative. The test showed high internal (α=0.88), test-retest (0.64 to 1.00, P<.01) and between observers reliabilities (0.69-1.00, p<0.01), both for scores total and for each item separately. Construct validity was tested through correlations between the instrument and MEC scores (r=0.59, P<0.01). Further information on the construct validity was obtained by dividing the sample into groups that scored above or below 5 points in the MEC and recalculating their correlations with SMMSE. The correlation between the scores in the SMMSE and MEC was significant in the MEC 0-5 group (r=0.55, P<.05), but not in the MEC>5 group. Additionally, differences in scores were found in the SMMSE, but not in the MEC, between the three GDS groups (5, 6 and 7) (H=11.1, P<.05). The SMMSE is an instrument for the assessment of advanced cognitive impairment which prevents the floor effect through an extension of lower measurement range relative to that of the MEC. From our results, this rapid screening tool and easy to administer, can be considered valid and reliable. Copyright © 2010 SEGG. Published by Elsevier Espana. All rights reserved.

Comparison of the Quick Mild Cognitive Impairment (Qmci) screen to the Montreal Cognitive Assessment (MoCA) in an Australian geriatrics clinic.

PubMed

Clarnette, Roger; O'Caoimh, Rónán; Antony, Deanna N; Svendrovski, Anton; Molloy, D William

2017-06-01

The Montreal Cognitive Assessment (MoCA) accurately differentiates mild cognitive impairment (MCI) from mild dementia and normal controls (NC). While the MoCA is validated in multiple clinical settings, few studies compare it with similar tests also designed to detect MCI. We sought to investigate how the shorter Quick Mild Cognitive Impairment (Qmci) screen compares with the MoCA. Consecutive referrals presenting with cognitive complaints to a teaching hospital geriatric clinic (Fremantle, Western Australia) underwent a comprehensive assessment and were classified as MCI (n = 72) or dementia (n = 109). NC (n = 41) were a sample of convenience. The Qmci and MoCA were scored by trained geriatricians, in random order, blind to the diagnosis. Median Qmci scores for NC, MCI and dementia were 69 (+/-19), 52.5 (+/-12) and 36 (+/-14), respectively, compared with 27 (+/-5), 22 (+/-4) and 15 (+/-7) for the MoCA. The Qmci more accurately identified cognitive impairment (MCI or dementia), area under the curve (AUC) 0.97, than the MoCA (AUC 0.92), p = 0.04. The Qmci was non-significantly more accurate in distinguishing MCI from controls (AUC 0.91 vs 0.84, respectively = 0.16). Both instruments had similar accuracy for differentiating MCI from dementia (AUC of 0.91 vs 0.88, p = 0.35). At the optimal cut-offs, calculated from receiver operating characteristic curves, the Qmci (≤57) had a sensitivity of 91% and specificity of 93% for cognitive impairment, compared with 87% sensitivity and 80% specificity for the MoCA (≤23). While both instruments are accurate in detecting MCI, the Qmci is shorter and arguably easier to complete, suggesting that it is a useful instrument in an Australian geriatric outpatient population. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

[Screening methods for mild cognitive impairment in primary care].

PubMed

Freire Pérez, Alberto

2017-06-01

Diagnosis of mild cognitive impairment (MCI) is always clinical and screening methods only indicate that the patient has a higher risk of this condition. In MCI, there is a slight decline in some cognitive abilities that does not affect activities of daily living and therefore does not produce social or occupational disability. The definitive diagnosis of MCI requires a considerable time investment that is very rarely possible to provide in primary care (PC) consultations. Hence the need for PC physicians to employ rapid and simple screening methods (brief cognitive assessment -BCA-) that allow objective identification of patients likely to have MCI in a few minutes. This article reviews the BCA tools that can truly be applied in less than 10 minutes. The phototest is a brief screening tool that is easy to use and interpret by physicians and is well accepted by patients. Consequently, it is one of the most useful tests in PC for screening of both MCI and dementia. In addition to BCA, instrumental activities of daily living scales should also be applied to differentiate MCI from dementia. Copyright © 2017 Sociedad Española de Geriatría y Gerontología. Publicado por Elsevier España, S.L.U. All rights reserved.

The Cross-Cultural Dementia Screening (CCD): A new neuropsychological screening instrument for dementia in elderly immigrants.

PubMed

Goudsmit, Miriam; Uysal-Bozkir, Özgül; Parlevliet, Juliette L; van Campen, Jos P C M; de Rooij, Sophia E; Schmand, Ben

2017-03-01

Currently, approximately 3.9% of the European population are non-EU citizens, and a large part of these people are from "non-Western" societies, such as Turkey and Morocco. For various reasons, the incidence of dementia in this group is expected to increase. However, cognitive testing is challenging due to language barriers and low education and/or illiteracy. The newly developed Cross-Cultural Dementia Screening (CCD) can be administered without an interpreter. It contains three subtests that assess memory, mental speed, and executive function. We hypothesized the CCD to be a culture-fair test that could discriminate between demented patients and cognitively healthy controls. To test this hypothesis, 54 patients who had probable dementia were recruited via memory clinics. Controls (N = 1625) were recruited via their general practitioners. All patients and controls were aged 55 years and older and of six different self-defined ethnicities (Dutch, Turkish, Moroccan-Arabic, Moroccan-Berber, Surinamese-Creole, and Surinamese-Hindustani). Exclusion criteria included current or previous conditions that affect cognitive functioning. There were performance differences between the ethnic groups, but these disappeared after correcting for age and education differences between the groups, which supports our central hypothesis that the CCD is a culture-fair test. Receiver-operating characteristic (ROC) and logistic regression analyses showed that the CCD has high predictive validity for dementia (sensitivity: 85%; specificity: 89%). The CCD is a sensitive and culture-fair neuropsychological instrument for dementia screening in low-educated immigrant populations.

A brief dementia screener suitable for use by non-specialists in resource poor settings—the cross-cultural derivation and validation of the brief Community Screening Instrument for Dementia

PubMed Central

Prince, M; Acosta, D; Ferri, C P; Guerra, M; Huang, Y; Jacob, K S; Llibre Rodriguez, J J; Salas, A; Sosa, A L; Williams, J D; Hall, K S

2011-01-01

Objective Brief screening tools for dementia for use by non-specialists in primary care have yet to be validated in non-western settings where cultural factors and limited education may complicate the task. We aimed to derive a brief version of cognitive and informant scales from the Community Screening Instrument for Dementia (CSI-D) and to carry out initial assessments of their likely validity. Methods We applied Mokken analysis to CSI-D cognitive and informant scale data from 15 022 participants in representative population-based surveys in Latin America, India and China, to identify a subset of items from each that conformed optimally to item response theory scaling principles. The validity coefficients of the resulting brief scales (area under ROC curve, optimal cutpoint, sensitivity, specificity and Youden's index) were estimated from data collected in a previous cross-cultural validation of the full CSI-D. Results Seven cognitive items (Loevinger H coefficient 0.64) and six informant items (Loevinger H coefficient 0.69) were selected with excellent hierarchical scaling properties. For the brief cognitive scale, AUROC varied between 0.88 and 0.97, for the brief informant scale between 0.92 and 1.00, and for the combined algorithm between 0.94 and 1.00. Optimal cutpoints did not vary between regions. Youden's index for the combined algorithm varied between 0.78 and 1.00 by region. Conclusion A brief version of the full CSI-D appears to share the favourable culture- and education-fair screening properties of the full assessment, despite considerable abbreviation. The feasibility and validity of the brief version still needs to be established in routine primary care. Copyright © 2010 John Wiley & Sons, Ltd. PMID:21845592

A brief dementia screener suitable for use by non-specialists in resource poor settings--the cross-cultural derivation and validation of the brief Community Screening Instrument for Dementia.

PubMed

Prince, M; Acosta, D; Ferri, C P; Guerra, M; Huang, Y; Jacob, K S; Llibre Rodriguez, J J; Salas, A; Sosa, A L; Williams, J D; Hall, K S

2011-09-01

Brief screening tools for dementia for use by non-specialists in primary care have yet to be validated in non-western settings where cultural factors and limited education may complicate the task. We aimed to derive a brief version of cognitive and informant scales from the Community Screening Instrument for Dementia (CSI-D) and to carry out initial assessments of their likely validity. We applied Mokken analysis to CSI-D cognitive and informant scale data from 15 022 participants in representative population-based surveys in Latin America, India and China, to identify a subset of items from each that conformed optimally to item response theory scaling principles. The validity coefficients of the resulting brief scales (area under ROC curve, optimal cutpoint, sensitivity, specificity and Youden's index) were estimated from data collected in a previous cross-cultural validation of the full CSI-D. Seven cognitive items (Loevinger H coefficient 0.64) and six informant items (Loevinger H coefficient 0.69) were selected with excellent hierarchical scaling properties. For the brief cognitive scale, AUROC varied between 0.88 and 0.97, for the brief informant scale between 0.92 and 1.00, and for the combined algorithm between 0.94 and 1.00. Optimal cutpoints did not vary between regions. Youden's index for the combined algorithm varied between 0.78 and 1.00 by region. A brief version of the full CSI-D appears to share the favourable culture- and education-fair screening properties of the full assessment, despite considerable abbreviation. The feasibility and validity of the brief version still needs to be established in routine primary care. Copyright © 2010 John Wiley & Sons, Ltd.

Trajectories of cognitive function in dementia-free subjects: Radiation Effects Research Foundation Adult Health Study.

PubMed

Yamada, Michiko; Landes, Reid D; Mimori, Yasuyo; Nagano, Yoshito; Sasaki, Hideo

2015-04-15

To investigate associations between age, sex, education, and birth cohort and global cognitive decline among a population that would most likely not progress to dementia. A total of 1538 dementia-free subjects aged 60 to 80years in 1992 were followed up through 2011 without dementia occurrence. We assessed cognitive function using the Cognitive Ability Screening Instrument (CASI). Using stepwise-like model selection procedure, we built mixed-effects models for initial cognition and longitudinal cognition. Initial CASI scores for younger age and more years of formal education were higher than those for older and less education. Sex did not show a significant effect. In the longitudinal analysis, cognitive decline became more rapid with increasing age. Sex and education did not modify the degree of deterioration with age. CASI scores were higher for younger cohorts and men due to differences in education levels. Among dementia-free subjects, age is an important predictor of cognitive function level and cognitive decline. Education level affects cognitive function level, but did not affect cognitive decline. The results have implications not only for elucidation of the aging process, but also for reference in dementia screening. Copyright © 2015 Elsevier B.V. All rights reserved.

Breast and colorectal cancer screening and associated correlates among Chinese older women.

PubMed

Leung, Doris Y P; Leung, Angela Y M; Chi, Iris

2012-01-01

To explore the participation rates for breast and colorectal cancer screening and identify associated correlates among elderly women. Logistic regressions were conducted using data collected in 2006 from 1,533 elderly women aged 60 years or above who had completed a screening instrument, the Minimum Data Set-Home Care, while applying for long-term care services at the first time in Hong Kong. The participation rates for breast and colorectal cancer screening among frail older Chinese women were 3.7% and 10.8% respectively. Cognitive status was inversely associated with the likelihood of participation in screening (breast: OR = 0.66, 95%CI = 0.47-0.94; colon: OR = 0.81, 95%CI = 0.66-0.99), as was educational level with the likelihood of participation in breast cancer screening (no formal education: OR = 0.20, 95%CI = 0.06-0.61, some primary education: OR = 0.31, 95%CI = 0.10-1.00). The delivery of cancer preventive health services to frail older women is less than ideal. Cognitive status and educational level were important factors in cancer screening behaviour. Tailor-made strategic promotion programmes targeting older women with low cognitive status and educational levels are needed to enhance awareness and acceptance within this vulnerable group.

Standards for Instrument Migration When Implementing Paper Patient-Reported Outcome Instruments Electronically: Recommendations from a Qualitative Synthesis of Cognitive Interview and Usability Studies.

PubMed

Muehlhausen, Willie; Byrom, Bill; Skerritt, Barbara; McCarthy, Marie; McDowell, Bryan; Sohn, Jeremy

2018-01-01

To synthesize the findings of cognitive interview and usability studies performed to assess the measurement equivalence of patient-reported outcome (PRO) instruments migrated from paper to electronic formats (ePRO), and make recommendations regarding future migration validation requirements and ePRO design best practice. We synthesized findings from all cognitive interview and usability studies performed by a contract research organization between 2012 and 2015: 53 studies comprising 68 unique instruments and 101 instrument evaluations. We summarized study findings to make recommendations for best practice and future validation requirements. Five studies (9%) identified minor findings during cognitive interview that may possibly affect instrument measurement properties. All findings could be addressed by application of ePRO best practice, such as eliminating scrolling, ensuring appropriate font size, ensuring suitable thickness of visual analogue scale lines, and providing suitable instructions. Similarly, regarding solution usability, 49 of the 53 studies (92%) recommended no changes in display clarity, navigation, operation, and completion without help. Reported usability findings could be eliminated by following good product design such as the size, location, and responsiveness of navigation buttons. With the benefit of accumulating evidence, it is possible to relax the need to routinely conduct cognitive interview and usability studies when implementing minor changes during instrument migration. Application of design best practice and selecting vendor solutions with good user interface and user experience properties that have been assessed in a representative group may enable many instrument migrations to be accepted without formal validation studies by instead conducting a structured expert screen review. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Cognitive screening tools for identification of dementia in illiterate and low-educated older adults, a systematic review and meta-analysis.

PubMed

Paddick, Stella-Maria; Gray, William K; McGuire, Jackie; Richardson, Jenny; Dotchin, Catherine; Walker, Richard W

2017-06-01

The majority of older adults with dementia live in low- and middle-income countries (LMICs). Illiteracy and low educational background are common in older LMIC populations, particularly in rural areas, and cognitive screening tools developed for this setting must reflect this. This study aimed to review published validation studies of cognitive screening tools for dementia in low-literacy settings in order to determine the most appropriate tools for use. A systematic search of major databases was conducted according to PRISMA guidelines. Validation studies of brief cognitive screening tests including illiterate participants or those with elementary education were eligible. Studies were quality assessed using the QUADAS-2 tool. Good or fair quality studies were included in a bivariate random-effects meta-analysis and a hierarchical summary receiver operating characteristic (HSROC) curve constructed. Forty-five eligible studies were quality assessed. A significant proportion utilized a case-control design, resulting in spectrum bias. The area under the ROC (AUROC) curve was 0.937 for community/low prevalence studies, 0.881 for clinic based/higher prevalence studies, and 0.869 for illiterate populations. For the Mini-Mental State Examination (MMSE) (and adaptations), the AUROC curve was 0.853. Numerous tools for assessment of cognitive impairment in low-literacy settings have been developed, and tools developed for use in high-income countries have also been validated in low-literacy settings. Most tools have been inadequately validated, with only MMSE, cognitive abilities screening instrument (CASI), Eurotest, and Fototest having more than one published good or fair quality study in an illiterate or low-literate setting. At present no screening test can be recommended.

Some performance effects of age and low blood alcohol levels on a computerized neuropsychological test.

DOT National Transportation Integrated Search

1995-02-01

COGSCREEN is a computerized test battery developed for the Federal Aviation Administration as an airman neuropsychological screening instrument for cognitive functioning. This study explored a multifaceted application of the sensitivity of the batter...

The Combined Utility of a Brief Functional Measure and Performance-Based Screening Test for Case Finding of Cognitive Impairment in Primary Healthcare.

PubMed

Chan, Qun Lin; Shaik, Muhammad Amin; Xu, Jing; Xu, Xin; Chen, Christopher Li-Hsian; Dong, YanHong

2016-04-01

Use of a total risk score (TRS) based on vascular and sociodemographic risk factors has been recommended to identify patients at risk of cognitive impairment. Moreover, combining screening tests has been reported to improve positive predictive values (PPV) for case finding of cognitive impairment. We investigated the utility of the conjunctive combination of the informant-based AD8 and the performance-based National Institute of Neurological Disorders and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute protocol for the detection of cognitive impairment, defined by a clinical dementia rating (CDR) score ≥0.5, in patients at risk of cognitive impairment (TRS ≥3). Participants were recruited from 2 primary healthcare centers in Singapore and received the AD8, Montreal Cognitive Assessment, Mini-Mental State Examination, CDR, and a formal neuropsychological test battery. The scores for NINDS-CSN 5-minute protocol were extracted from the Montreal Cognitive Assessment items. Area under the receiver operating characteristics curve analyses were conducted to determine the discriminant indices of the screening instruments, the conjunctive combination (ie, screened positive on both tests), and the compensatory combination (ie, screened positive in either of or both tests). A total of 309 participants were recruited of whom 78.7% (n = 243) had CDR = 0 and 21.3% (n = 66) had CDR ≥0.5. The conjunctive combination of AD8 and NINDS-CSN 5-minute protocol achieved excellent PPV and acceptable sensitivity (PPV 91.7%, sensitivity 73.3%). The conjunctive combination of the AD8 and NINDS-CSN 5-minute protocol is brief and accurate, and hence, suitable for case finding of cognitive impairment (CDR ≥0.5) in patients screened positive on the TRS in primary healthcare centers. Copyright © 2016. Published by Elsevier Inc.

The Telephone Interview for Cognitive Status: Creating a crosswalk with the Mini-Mental State Exam

PubMed Central

Fong, Tamara G.; Fearing, Michael A.; Jones, Richard N.; Shi, Peilin; Marcantonio, Edward R.; Rudolph, James L.; Yang, Frances M.; Kiely, Dan K.; Inouye, Sharon K.

2009-01-01

Background Brief cognitive screening measures are valuable tools for both research and clinical applications. The most widely used instrument, the Mini-Mental State Examination (MMSE) is limited in that it must be administered face-to-face, cannot be used in participants with visual or motor impairments, and is protected by copyright. Alternative screening instruments, such as the Telephone Interview for Cognitive Status (TICS) have been developed and may provide a valid alternative with comparable cut point scores to rate global cognitive function. Methods MMSE, TICS-30, and TICS-40 scores from 746 community dwelling elders who participated in the Aging, Demographics, and Memory Study (ADAMS) were analyzed with equipercentile equating, a statistical process of determining comparable scores based on percentile equivalents on different forms of an examination. Results Scores from the MMSE and the TICS-30 and TICS-40 corresponded well and clinically relevant cut point scores were determined; for example, an MMSE score of 23 is equivalent to 17 and 20 on the TICS-30 and TICS-40, respectively. Conclusions These findings provide scores that can be used to link TICS and MMSE scores directly. Clinically relevant and important MMSE cut points and the respective ADAMS TICS-30 and TICS-40 cut point scores have been included to identify the degree of cognitive impairment among respondents with any type of cognitive disorder. These results will help with the widespread application of the TICS in both research and clinical practice. PMID:19647495

Cross-cultural validation of instruments measuring health beliefs about colorectal cancer screening among Korean Americans.

PubMed

Lee, Shin-Young; Lee, Eunice E

2015-02-01

The purpose of this study was to report the instrument modification and validation processes to make existing health belief model scales culturally appropriate for Korean Americans (KAs) regarding colorectal cancer (CRC) screening utilization. Instrument translation, individual interviews using cognitive interviewing, and expert reviews were conducted during the instrument modification phase, and a pilot test and a cross-sectional survey were conducted during the instrument validation phase. Data analyses of the cross-sectional survey included internal consistency and construct validity using exploratory and confirmatory factor analysis. The main issues identified during the instrument modification phase were (a) cultural and linguistic translation issues and (b) newly developed items reflecting Korean cultural barriers. Cross-sectional survey analyses during the instrument validation phase revealed that all scales demonstrate good internal consistency reliability (Cronbach's alpha=.72~.88). Exploratory factor analysis showed that susceptibility and severity loaded on the same factor, which may indicate a threat variable. Items with low factor loadings in the confirmatory factor analysis may relate to (a) lack of knowledge about fecal occult blood testing and (b) multiple dimensions of the subscales. Methodological, sequential processes of instrument modification and validation, including translation, individual interviews, expert reviews, pilot testing and a cross-sectional survey, were provided in this study. The findings indicate that existing instruments need to be examined for CRC screening research involving KAs.

Cognitive assessment tools in Asia: a systematic review.

PubMed

Rosli, Roshaslina; Tan, Maw Pin; Gray, William Keith; Subramanian, Pathmawathi; Chin, Ai-Vyrn

2016-02-01

The prevalence of dementia is increasing in Asia than in any other continent. However, the applicability of the existing cognitive assessment tools is limited by differences in educational and cultural factors in this setting. We conducted a systematic review of published studies on cognitive assessments tools in Asia. We aimed to rationalize the results of available studies which evaluated the validity of cognitive tools for the detection of cognitive impairment and to identify the issues surrounding the available cognitive impairment screening tools in Asia. Five electronic databases (CINAHL, MEDLINE, Embase, Cochrane Library, and Science Direct) were searched using the keywords dementia Or Alzheimer Or cognitive impairment And screen Or measure Or test Or tool Or instrument Or assessment, and 2,381 articles were obtained. Thirty-eight articles, evaluating 28 tools in seven Asian languages, were included. Twenty-nine (76%) of the studies had been conducted in East Asia with only four studies conducted in South Asia and no study from northern, western, or central Asia or Indochina. Local language translations of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were assessed in 15 and six studies respectively. Only three tools (the Korean Dementia Screening Questionnaire, the Picture-based Memory Intelligence Scale, and the revised Hasegawa Dementia Screen) were derived de novo from Asian populations. These tools were assessed in five studies. Highly variable cut-offs were reported for the MMSE (17-29/30) and MoCA (21-26/30), with 13/19 (68%) of studies reporting educational bias. Few cognitive assessment tools have been validated in Asia, with no published validation studies for many Asian nations and languages. In addition, many available tools display educational bias. Future research should include concerted efforts to develop culturally appropriate tools with minimal educational bias.

Transcultural validation of the ALS-CBS Cognitive Section for the Brazilian population.

PubMed

Branco, Lucas M T; Zanao, Tamires; De Rezende, Thiago J; Casseb, Raphael F; Balthazar, Marcio F; Woolley, Susan C; França, Marcondes C

2017-02-01

Cognitive decline (CD) is common but often under-recognized in ALS due to the scarcity of adequate cognitive screening methods. In this scenario, the Amyotrophic Lateral Sclerosis Cognitive Behavioural Screen (ALS-CBS) is the most investigated instrument and presents high sensitivity to identify CD. Currently, there are no validated cognitive screening tools for ALS patients in the Brazilian population and little is known about the frequency of ALS related CD in the country. We assessed the accuracy of the Brazilian Portuguese version of ALS-CBS Cognitive Section (ALS-CBS-Br) for classifying the cognitive status of Brazilian patients compared to a standard neuropsychological battery, and estimated the prevalence of CD in the Brazilian ALS population. Among 73 initially recruited ALS patients, 49 were included. Twenty-four patients were excluded due to severe motor disability, FTD diagnosis or non-acceptance. Ten healthy controls were also included. Ten ALS patients (20%) were diagnosed with executive dysfunction (ALSci) based on the battery results. ALS-CBS-Br scores were significantly lower in the ALSci group (p < 0.001). The scale accuracy in detecting executive dysfunction was 0.906. Optimal cut-off score was 10/20 (specificity 0.872 and sensitivity 0.900). In conclusion, the ALS-CBS-Br may facilitate the recognition of CD in routine clinical care and complement future studies in our population.

Development and validation of a new cognitive screening test: The Hong Kong Brief Cognitive Test (HKBC).

PubMed

Chiu, Helen F K; Zhong, Bao-Liang; Leung, Tony; Li, S W; Chow, Paulina; Tsoh, Joshua; Yan, Connie; Xiang, Yu-Tao; Wong, Mike

2018-07-01

To develop and examine the validity of a new brief cognitive test with less educational bias for screening cognitive impairment. A new cognitive test, Hong Kong Brief Cognitive Test (HKBC), was developed based on review of the literature, as well as the views of an expert panel. Three groups of subjects aged 65 or above were recruited after written consent: normal older people recruited in elderly centres, people with mild NCD (neurocognitive disorder), and people with major NCD. The brief cognitive test, Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA), were administered to the subjects. The performance of HKBC in differentiating subjects with major NCD, mild NCD, and normal older people were compared with the clinical diagnosis, as well as the MMSE and MoCA scores. In total, 359 subjects were recruited, with 99 normal controls, 132 subjects with major NCD, and 128 with mild NCD. The mean MMSE, MoCA, and HKBC scores showed significant differences among the 3 groups of subjects. In the receiving operating characteristic curve analysis of the HKBC in differentiating normal subjects from those with cognitive impairment (mild NCD + major NCD), the area under the curve was 0.955 with an optimal cut-off score of 21/22. The performances of MMSE and MoCA in differentiating normal from cognitively impaired subjects are slightly inferior to the HKBC. The HKBC is a brief instrument useful for screening cognitive impairment in older adults and is also useful in populations with low educational level. Copyright © 2018 John Wiley & Sons, Ltd.

Validation of Montreal Cognitive Assessment and Discriminant Power of Montreal Cognitive Assessment Subtests in Patients With Mild Cognitive Impairment and Alzheimer Dementia in Turkish Population.

PubMed

Kaya, Yıldız; Aki, Ozlem Erden; Can, Ufuk Anik; Derle, Eda; Kibaroğlu, Seda; Barak, Anil

2014-06-01

Montreal Cognitive Assessment (MoCA) is a new cognitive tool developed for screening mild cognitive impairment (MCI). The authors examined validity of MoCA and discriminating power of subtests in a Turkish population comprising of 474 participants (246 healthy controls, 114 subjects with MCI and 114 subjects with dementia). The ANCOVAs showed that age and education had a main effect on MoCA scores. Cut scores were computed according to different education levels. The overall cut-off values for MCI and dementia were found to be lower compared to western studies. MoCA was found to have good internal consistency. The subtests most useful in discriminating MCI from healthy controls were recall, visuospatial and language, while in discriminating dementia from MCI were visuospatial, orientation and attention subtests. The results demonstrated that MoCA is a valid and reliable instrument in screening MCI, and compared with the MMSE, MoCA was proved to have superior sensitivity and specificity in detecting MCI. © The Author(s) 2014.

Validation of a short cognitive tool for the screening of dementia in elderly people with low educational level.

PubMed

De Yébenes, María Jesús García; Otero, Angel; Zunzunegui, María Victoria; Rodríguez-Laso, Angel; Sánchez-Sánchez, Fernando; Del Ser, Teodoro

2003-10-01

To validate the 'Prueba Cognitiva de Leganés' (PCL) as a screening tool for cognitive impairment in elderly people with little formal education. The PCL is a simple cognitive test with 32 items that includes two scores of orientation and memory and a global score of 0-32 points. It was applied to a population sample of 527 elderly people over 70 with low educational level, who were independently diagnosed by consensus between two neurologists as having normal cognitive function, age associated cognitive decline (AACD, IPA-OMS criteria) or dementia (DSM-IV criteria). Individuals with severe visual or hearing defects and those who rejected the exam were excluded from the study. The PCL was validated in a sample of 375 individuals: 300 normal, 42 with AACD and 33 with dementia. The sensitivity, specificity, accuracy and likelihood ratios, as well as the ROC curves for dementia and for AACD-dementia, were calculated. The confounding effect of sociodemographic variables was assessed by logistic regression analysis and convergent validity by partial correlations of the PCL with other cognitive tests. Inter-rater reliability was evaluated with the intraclass correlation coefficient. The PCL identified dementia (cut-off < or =22) and AACD-dementia (cut-off < or =26), with the following diagnostic parameters, respectively: sensitivity 93.9%-80%, specificity 94.7%-84.3%, positive likelihood ratio 17.8-5.1, negative likelihood ratio 0.06-0.24, and accuracy 94.6%-83.4%. The areas under the ROC curve were 0.985 (95% Confidence Intervals (CI) 0.967-0.995) and 0.904 (95% CI: 0.870-0.932) respectively. The intraclass correlation coefficient was 0.79 (0.74-0.83). The PCL is a simple instrument, which is both valid and reliable, for the screening of dementia in population samples of individuals with low educational level. This instrument could be useful in primary health care. Copyright 2003 John Wiley & Sons, Ltd.

Contributions of the Computer-Administered Neuropsychological Screen for Mild Cognitive Impairment (CANS-MCI) for the diagnosis of MCI in Brazil.

PubMed

Memória, Cláudia M; Yassuda, Mônica S; Nakano, Eduardo Y; Forlenza, Orestes V

2014-05-07

ABSTRACT Background: The Computer-Administered Neuropsychological Screen for Mild Cognitive Impairment (CANS-MCI) is a computer-based cognitive screening instrument that involves automated administration and scoring and immediate analyses of test sessions. The objective of this study was to translate and culturally adapt the Brazilian Portuguese version of the CANS-MCI (CANS-MCI-BR) and to evaluate its reliability and validity for the diagnostic screening of MCI and dementia due to Alzheimer's disease. Methods: The test was administered to 97 older adults (mean age 73.41 ± 5.27 years) with at least four years of formal education (mean education 12.23 ± 4.48 years). Participants were classified into three diagnostic groups according to global cognitive status (normal controls, n = 41; MCI, n = 35; AD, n = 21) based on clinical data and formal neuropsychological assessments. Results: The results indicated high internal consistency (Cronbach's α = 0.77) in the total sample. Three-month test-retest reliability correlations were significant and robust (0.875; p < 0.001). A moderate level of concurrent validity was attained relative to the screening test for MCI (MoCA test, r = 0.76, p < 0.001). Confirmatory factor analysis supported the three-factor model of the original test, i.e., memory, language/spatial fluency, and executive function/mental control. Goodness of fit indicators were strong (Bentler Comparative Fit Index = 0.96, Root Mean Square Error of Approximation = 0.09). Receiver operating characteristic curve analyses suggested high sensitivity and specificity (81% and 73% respectively) to screen for possible MCI cases. Conclusions: The CANS-MCI-BR maintains adequate psychometric characteristics that render it suitable to identify elderly adults with probable cognitive impairment to whom a more extensive evaluation by formal neuropsychological tests may be required.

Validation of the Dutch version of the quick mild cognitive impairment screen (Qmci-D).

PubMed

Bunt, Steven; O'Caoimh, Rónán; Krijnen, Wim P; Molloy, D William; Goodijk, Geert Pieter; van der Schans, Cees P; Hobbelen, Hans J S M

2015-10-02

Differentiating mild cognitive impairment (MCI) from dementia is important, as treatment options differ. There are few short (<5 min) but accurate screening tools that discriminate between MCI, normal cognition (NC) and dementia, in the Dutch language. The Quick Mild Cognitive Impairment (Qmci) screen is sensitive and specific in differentiating MCI from NC and mild dementia. Given this, we adapted the Qmci for use in Dutch-language countries and validated the Dutch version, the Qmci-D, against the Dutch translation of the Standardised Mini-Mental State Examination (SMMSE-D). The Qmci was translated into Dutch with a combined qualitative and quantitative approach. In all, 90 participants were recruited from a hospital geriatric clinic (25 with dementia, 30 with MCI, 35 with NC). The Qmci-D and SMMSE-D were administered sequentially but randomly by the same trained rater, blind to the diagnosis. The Qmci-D was more sensitive than the SMMSE-D in discriminating MCI from dementia, with a significant difference in the area under the curve (AUC), 0.73 compared to 0.60 (p = 0.024), respectively, and in discriminating dementia from NC, with an AUC of 0.95 compared to 0.89 (p = 0.006). Both screening instruments discriminated MCI from NC with an AUC of 0.86 (Qmci-D) and 0.84 (SMMSE-D). The Qmci-D shows similar,(good) accuracy as the SMMSE-D in separating NC from MCI; greater,(albeit fair), accuracy differentiating MCI from dementia, and significantly greater accuracy in separating dementia from NC. Given its brevity and ease of administration, the Qmci-D seems a useful cognitive screen in a Dutch population. Further study with a suitably powered sample against more sensitive screens is now required.

Evaluation and management of the elderly patient presenting with cognitive complaints.

PubMed

Hildreth, Kerry L; Church, Skotti

2015-03-01

Cognitive complaints are common in the geriatric population. Older adults should routinely be asked about any concerns about their memory or thinking, and any cognitive complaint from the patient or an informant should be evaluated rather than be attributed to aging. Several screening instruments are available to document objective impairments and guide further evaluation. Management goals for patients with cognitive impairment are focused on maintaining function and independence, providing caregiver support, and advance care planning. There are currently no treatments to effectively prevent or treat dementia. Increasing appreciation of the heterogeneity of Alzheimer disease may lead to novel treatment approaches. Copyright © 2015 Elsevier Inc. All rights reserved.

The Montreal Cognitive Assessment and the mini-mental state examination as screening instruments for cognitive impairment: item analyses and threshold scores.

PubMed

Damian, Anne M; Jacobson, Sandra A; Hentz, Joseph G; Belden, Christine M; Shill, Holly A; Sabbagh, Marwan N; Caviness, John N; Adler, Charles H

2011-01-01

To perform an item analysis of the Montreal Cognitive Assessment (MoCA) versus the Mini-Mental State Examination (MMSE) in the prediction of cognitive impairment, and to examine the characteristics of different MoCA threshold scores. 135 subjects enrolled in a longitudinal clinicopathologic study were administered the MoCA by a single physician and the MMSE by a trained research assistant. Subjects were classified as cognitively impaired or cognitively normal based on independent neuropsychological testing. 89 subjects were found to be cognitively normal, and 46 cognitively impaired (20 with dementia, 26 with mild cognitive impairment). The MoCA was superior in both sensitivity and specificity to the MMSE, although not all MoCA tasks were of equal predictive value. A MoCA threshold score of 26 had a sensitivity of 98% and a specificity of 52% in this population. In a population with a 20% prevalence of cognitive impairment, a threshold of 24 was optimal (negative predictive value 96%, positive predictive value 47%). This analysis suggests the potential for creating an abbreviated MoCA. For screening in primary care, the MoCA threshold of 26 appears optimal. For testing in a memory disorders clinic, a lower threshold has better predictive value. Copyright © 2011 S. Karger AG, Basel.

Vascular cognitive impairment, a cardiovascular complication.

PubMed

Frances, Adiukwu; Sandra, Ofori; Lucy, Ugbomah

2016-06-22

Over the past two decades, the term vascular cognitive impairment (VCI) has been used to refer to a spectrum of cognitive decline characterized by executive dysfunction, associated with vascular pathology. With 30% of stroke survivors showing cognitive impairments, it is regarded as the most common cause of cognitive impairment. This is a narrative review of available literature citing sources from PubMed, MEDLINE and Google Scholar. VCI has a high prevalence both before and after a stroke and is associated with great economic and caregiver burden. Despite this, there is no standardized diagnostic criteria for VCI. Hypertension has been identified as a risk factor for VCI and causes changes in cerebral vessel structure and function predisposing to lacuna infarcts and small vessel haemorrhages in the frontostriatal loop leading to executive dysfunction and other cognitive impairments. Current trials have shown promising results in the use of antihypertensive medications in the management of VCI and prevention of disease progression to vascular dementia. Prevention of VCI is necessary in light of the looming dementia pandemic. All patients with cardiovascular risk factors would therefore benefit from cognitive screening with screening instruments sensitive to executive dysfunction as well as prompt and adequate control of hypertension.

Vascular cognitive impairment, a cardiovascular complication

PubMed Central

Frances, Adiukwu; Sandra, Ofori; Lucy, Ugbomah

2016-01-01

Over the past two decades, the term vascular cognitive impairment (VCI) has been used to refer to a spectrum of cognitive decline characterized by executive dysfunction, associated with vascular pathology. With 30% of stroke survivors showing cognitive impairments, it is regarded as the most common cause of cognitive impairment. This is a narrative review of available literature citing sources from PubMed, MEDLINE and Google Scholar. VCI has a high prevalence both before and after a stroke and is associated with great economic and caregiver burden. Despite this, there is no standardized diagnostic criteria for VCI. Hypertension has been identified as a risk factor for VCI and causes changes in cerebral vessel structure and function predisposing to lacuna infarcts and small vessel haemorrhages in the frontostriatal loop leading to executive dysfunction and other cognitive impairments. Current trials have shown promising results in the use of antihypertensive medications in the management of VCI and prevention of disease progression to vascular dementia. Prevention of VCI is necessary in light of the looming dementia pandemic. All patients with cardiovascular risk factors would therefore benefit from cognitive screening with screening instruments sensitive to executive dysfunction as well as prompt and adequate control of hypertension. PMID:27354961

Screening for cognitive impairment in older individuals. Validation study of a computer-based test.

PubMed

Green, R C; Green, J; Harrison, J M; Kutner, M H

1994-08-01

This study examined the validity of a computer-based cognitive test that was recently designed to screen the elderly for cognitive impairment. Criterion-related validity was examined by comparing test scores of impaired patients and normal control subjects. Construct-related validity was computed through correlations between computer-based subtests and related conventional neuropsychological subtests. University center for memory disorders. Fifty-two patients with mild cognitive impairment by strict clinical criteria and 50 unimpaired, age- and education-matched control subjects. Control subjects were rigorously screened by neurological, neuropsychological, imaging, and electrophysiological criteria to identify and exclude individuals with occult abnormalities. Using a cut-off total score of 126, this computer-based instrument had a sensitivity of 0.83 and a specificity of 0.96. Using a prevalence estimate of 10%, predictive values, positive and negative, were 0.70 and 0.96, respectively. Computer-based subtests correlated significantly with conventional neuropsychological tests measuring similar cognitive domains. Thirteen (17.8%) of 73 volunteers with normal medical histories were excluded from the control group, with unsuspected abnormalities on standard neuropsychological tests, electroencephalograms, or magnetic resonance imaging scans. Computer-based testing is a valid screening methodology for the detection of mild cognitive impairment in the elderly, although this particular test has important limitations. Broader applications of computer-based testing will require extensive population-based validation. Future studies should recognize that normal control subjects without a history of disease who are typically used in validation studies may have a high incidence of unsuspected abnormalities on neurodiagnostic studies.

Pediatric Sleep Disorders: Validation of the Sleep Disorders Inventory for Students

ERIC Educational Resources Information Center

Luginbuehl, Marsha; Bradley-Klug, Kathy L.; Ferron, John; Anderson, W. McDowell; Benbadis, Selim R.

2008-01-01

Approximately 20%-25% of the pediatric population will likely develop a sleep disorder sometime during childhood or adolescence. Studies have shown that untreated sleep disorders can negatively affect cognitive abilities, and academic and behavior performance. The Sleep Disorders Inventory for Students (SDIS) is a screening instrument designed to…

Performance on cognitive tests, instrumental activities of daily living and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro, Brazil

PubMed Central

Lima, Christina Martins Borges; Alves, Heloisa Veiga Dias; Mograbi, Daniel Correa; Pereira, Flávia Furtado; Fernandez, Jesus Landeira; Charchat-Fichman, Helenice

2017-01-01

Objective To describe the performance on basic cognitive tasks, instrumental activities of daily living, and depressive symptoms of a community-based sample of elderly adults in Rio de Janeiro (Brazil) who participated in multiple physical, social, and cognitive activities at government-run community centers. Methods A total of 264 educated older adults (> 60 years of age of both genders) were evaluated by the Brief Cognitive Screening Battery (BCSB), Lawton's and Pfeffer's activities of daily living indexes, and the Geriatric Depressive Scale (GDS). Results The mean age of the sample was 75.7 years. The participants had a mean of 9.3 years of formal education. With the exception of the Clock Drawing Test (CDT), mean scores on the cognitive tests were consistent with the values in the literature. Only 6.4% of the sample had some kind of dependence for activities of daily living. The results of the Geriatric Depression Scale (GDS-15) indicated mild symptoms of depression in 16.8% of the sample Conclusion This study provided important demographic, cognitive, and functional characteristics of a specific community-based sample of elderly adults in Rio de Janeiro, Brazil. PMID:29213494

Creating an Outcomes-Based Tool for Learning Barrier Assessment in an Outpatient Education Program.

ERIC Educational Resources Information Center

Hernandez, Teri L.; Rupnow, Jana M.; Currie, Kristi A.; Procious, James K.; Adams, Jenny

2003-01-01

An outcomes-based assessment instrument was devised to screen patients for learning problems that would impede patient education in cardiac rehabilitation. Criteria for seven barriers were established: hearing, language, cultural, religious, vision, cognitive, emotional). Points of data collection and a rationale for collection were identified.…

Screening for depression in people with epilepsy: comparative study among neurological disorders depression inventory for epilepsy (NDDI-E), hospital anxiety and depression scale depression subscale (HADS-D), and Beck depression inventory (BDI).

PubMed

de Oliveira, Guilherme Nogueira; Lessa, João Marcelo K; Gonçalves, Ana Paula; Portela, Eduardo Jardel; Sander, Josemir W; Teixeira, Antonio Lucio

2014-05-01

We aimed to assess and compare the psychometric properties of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), Hospital Anxiety and Depression Scale Depression Subscale (HADS-D), and Beck Depression Inventory (BDI) as screening instruments for depression and suicidality in people with epilepsy. One hundred twenty-six people (54% women) diagnosed with epilepsy were recruited and evaluated on their sociodemographic and clinical features. Depression and suicide risk were assessed with a structured psychiatric interview, the Mini International Neuropsychiatric Interview (MINI-Plus), and the performance of NDDI-E, HADS-D, and BDI was evaluated. The sensitivity and specificity of BDI for the diagnosis of depression was around 90%; HADS-D and NDDI-E have sensitivity higher than 80%, and specificity was greater than 75%. For identifying suicide risk, the NDDI-E sensitivity was 92.9%, and HADS-D sensitivity was 85.7%, and a reasonable specificity (68%) was observed for both instruments. All instruments showed a negative predictive value of over 90%. Comparisons of the areas under the ROC curve for these instruments were not significantly different regarding depression or moderate/severe risk of suicide. All three instruments evaluated have clinical utility in the screening of depression in people with epilepsy. Both NDDI-E and HADS-D are brief efficient screening instruments to identify depression in people with epilepsy. The BDI is a more robust instrument, but it takes longer to apply, which hampers its use by busy clinicians and by people with cognitive impairment. Copyright © 2014 Elsevier Inc. All rights reserved.

Development and community-based validation of the IDEA study Instrumental Activities of Daily Living (IDEA-IADL) questionnaire.

PubMed

Collingwood, Cecilia; Paddick, Stella-Maria; Kisoli, Aloyce; Dotchin, Catherine L; Gray, William K; Mbowe, Godfrey; Mkenda, Sarah; Urasa, Sarah; Mushi, Declare; Chaote, Paul; Walker, Richard W

2014-01-01

The dementia diagnosis gap in sub-Saharan Africa (SSA) is large, partly due to difficulties in assessing function, an essential step in diagnosis. As part of the Identification and Intervention for Dementia in Elderly Africans (IDEA) study, to develop, pilot, and validate an Instrumental Activities of Daily Living (IADL) questionnaire for use in a rural Tanzanian population to assist in the identification of people with dementia alongside cognitive screening. The questionnaire was developed at a workshop for rural primary healthcare workers, based on culturally appropriate roles and usual activities of elderly people in this community. It was piloted in 52 individuals under follow-up from a dementia prevalence study. Validation subsequently took place during a community dementia-screening programme. Construct validation against gold standard clinical dementia diagnosis using DSM-IV criteria was carried out on a stratified sample of the cohort and validity assessed using area under the receiver operating characteristic (AUROC) curve analysis. An 11-item questionnaire (IDEA-IADL) was developed after pilot testing. During formal validation on 130 community-dwelling elderly people who presented for screening, the AUROC curve was 0.896 for DSM-IV dementia when used in isolation and 0.937 when used in conjunction with the IDEA cognitive screen, previously validated in Tanzania. The internal consistency was 0.959. Performance on the IDEA-IADL was not biased with regard to age, gender or education level. The IDEA-IADL questionnaire appears to be a useful aid to dementia screening in this setting. Further validation in other healthcare settings in SSA is required.

Poor Performance on a Preoperative Cognitive Screening Test Predicts Postoperative Complications in Older Orthopedic Surgical Patients.

PubMed

Culley, Deborah J; Flaherty, Devon; Fahey, Margaret C; Rudolph, James L; Javedan, Houman; Huang, Chuan-Chin; Wright, John; Bader, Angela M; Hyman, Bradley T; Blacker, Deborah; Crosby, Gregory

2017-11-01

The American College of Surgeons and the American Geriatrics Society have suggested that preoperative cognitive screening should be performed in older surgical patients. We hypothesized that unrecognized cognitive impairment in patients without a history of dementia is a risk factor for development of postoperative complications. We enrolled 211 patients 65 yr of age or older without a diagnosis of dementia who were scheduled for an elective hip or knee replacement. Patients were cognitively screened preoperatively using the Mini-Cog and demographic, medical, functional, and emotional/social data were gathered using standard instruments or review of the medical record. Outcomes included discharge to place other than home (primary outcome), delirium, in-hospital medical complications, hospital length-of-stay, 30-day emergency room visits, and mortality. Data were analyzed using univariate and multivariate analyses. Fifty of 211 (24%) patients screened positive for probable cognitive impairment (Mini-Cog less than or equal to 2). On age-adjusted multivariate analysis, patients with a Mini-Cog score less than or equal to 2 were more likely to be discharged to a place other than home (67% vs. 34%; odds ratio = 3.88, 95% CI = 1.58 to 9.55), develop postoperative delirium (21% vs. 7%; odds ratio = 4.52, 95% CI = 1.30 to 15.68), and have a longer hospital length of stay (hazard ratio = 0.63, 95% CI = 0.42 to 0.95) compared to those with a Mini-Cog score greater than 2. Many older elective orthopedic surgical patients have probable cognitive impairment preoperatively. Such impairment is associated with development of delirium postoperatively, a longer hospital stay, and lower likelihood of going home upon hospital discharge.

Neuropsychological performance in patients with asymptomatic HIV-1 infection.

PubMed

Martínez-Banfi, Martha; Vélez, Jorge I; Perea, M Victoria; García, Ricardo; Puentes-Rozo, Pedro J; Mebarak Chams, Moises; Ladera, Valentina

2018-05-01

Human immunodeficiency virus (HIV-1) infection and acquired immunodeficiency syndrome (AIDS) lead to neurocognitive disorders; however, there is still much knowledge to be gained regarding HIV-associated neurocognitive disorders. The purpose of this study was to assess the cognitive performance, instrumental activities of daily living, depression, and anxiety in patients with asymptomatic HIV-1 infections compared with seronegative participants without neurocognitive impairment. We studied a sample consisted of 60 patients with asymptomatic HIV-1 infections and 60 seronegative participants without neurocognitive impairment from the city of Barranquilla, Colombia, with a mean age of 36.07 years. A protocol of neuropsychological and psychopathological tests was applied to the participants. The group of patients with asymptomatic HIV infections significantly underperformed on tasks that assessed global cognitive screening, attention span, learning, phonemic verbal fluency, auditory-verbal comprehension, information processing speed, cognitive flexibility, and motor skills compared to the group of seronegative participants. No significant differences were found in memory, visual confrontation naming, vocabulary, inhibition, and instrumental activities of daily living. Additionally, the patients with asymptomatic HIV-1 infection had a higher anxiety index than the seronegative participants, but no significant difference was found in depression. A correlation was found between depression and anxiety. In conclusion, the patients with asymptomatic HIV-1 infection had lower cognitive performances than the seronegative participants in the cognitive functions mentioned above and more anxiety but still performed the instrumental activities of daily living.

Application and validation of the barrow neurological institute screen for higher cerebral functions in a control population and in patient groups commonly seen in neurorehabilitation.

PubMed

Hofgren, Caisa; Esbjörnsson, Eva; Aniansson, Hans; Sunnerhagen, Katharina Stibrant

2007-09-01

To determine whether the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) can differentiate brain-dysfunctional patients from controls. A case-control study. A total of 92 controls and 120 patients from a neuro-rehabilitation clinic with a diagnosis of: right and left hemisphere stroke, traumatic brain injury, Parkinson's disease or anoxic brain damage. The BNIS has a maximum total score of 50 points, < 47 indicates cognitive dysfunction. Group comparisons and exploration of variables influencing the BNIS total score were made. A significant difference was found between the control group and the total patient group for the BNIS total score and for the subscales (p < 0.0005). Sensitivity was 88% and specificity 78%. Presence of disease and educational level had the greatest influence on the results of the BNIS. Patients with Parkinson's disease were shown to be the least cognitively affected and those with anoxic brain damage the most affected. The BNIS has potential value as a screening instrument for cognitive functions and is sufficiently sensitive to differentiate brain-dysfunctional patients from a control population. It appears to be applicable in a neurological rehabilitation setting, and can be used early in the process, giving a baseline cognitive functional level.

Frailty status as a predictor of three month cognitive and functional recovery following spinal surgery: a prospective pilot study.

PubMed

Rothrock, Robert J; Steinberger, Jeremy M; Badgery, Henry; Hecht, Andrew C; Cho, Samuel K; Caridi, John M; Deiner, Stacie

2018-05-21

Background Context As increasing numbers of elderly Americans undergo spinal surgery, it is important to identify which patients are at highest risk for poor cognitive and functional recovery. Frailty is a geriatric syndrome which has been closely linked to poor outcomes, and short form screening may be a helpful tool for preoperative identification of at risk patients. Purpose To conduct a pilot study on the usefulness of a short-form screening tool to identify elderly patients at increased risk for prolonged cognitive and functional recovery following elective spine surgery. Study Design/Setting Prospective, comparative cohort study. Patient Sample 100 patients over age 65 undergoing elective spinal surgery (cervical or lumbar) at a single, large academic medical center from 2013-2014. Outcome Measures FRAIL scale, Quality of Recovery Scale (PQRS), and Instrumental Activities (IADLs) scores. Methods Included patients were given the FRAIL scale and stratified as robust, pre-frail, or frail. Post-operative Quality of Recovery Scale (PQRS) and Instrumental Activities (IADLs) scores were also obtained. Patients were re-examined at 1 day, 3 days, 1 month, and 3 months after surgery for cognitive recovery at 3-months, and secondarily, functional recovery at 3-months. This study was funded in part by grants from the National Institute on Aging (K23-17-015, National Institutes of Health, Bethesda, Maryland, USA) and the American Federation for Aging Research (New York City, NY, USA). Results At 3-months, only 50% of frail patients had recovered to their cognitive baseline compared to 60.7% of pre-frail and 69.2% of robust patients (trend). At 3-months, 66.7% of frail patients had recovered to their functional baseline compared to 57% of pre-frail and 76.9% of robust patients (trend). Using multivariate regression modelling, at 3 months, frail patients were less likely to have recovered to their cognitive baseline compared to pre-frail and robust patients (OR 0.39, CI 0.131-1.161). Conclusions This pilot study demonstrates a trend towards poorer cognitive recovery 3-months following elective spinal surgery for frail patients. Frailty screening can help pre-operatively identify patients who may experience protracted cognitive and functional recovery. Copyright © 2018. Published by Elsevier Inc.

Screening for cognitive dysfunction in Huntington's disease with the clock drawing test.

PubMed

Terwindt, Paul W; Hubers, Anna A M; Giltay, Erik J; van der Mast, Rose C; van Duijn, Erik

2016-09-01

The aim of the study is to investigate the performance of the clock drawing test as a screening tool for cognitive impairment in Huntington's disease (HD) mutation carriers. The performance of the clock drawing test was assessed in 65 mutation carriers using the Shulman and the Freund scoring systems. The mini-mental state examination, the Symbol Digit Modalities Test, the Verbal Fluency Test, and the Stroop tests were used as comparisons for the evaluation of cognitive functioning. Correlations of the clock drawing test with various cognitive tests (convergent validity), neuropsychiatric characteristics (divergent validity) and clinical characteristics were analysed using the Spearman's rank correlation coefficient. Receiver-operator characteristic analyses were performed for the clock drawing test against both the mini-mental state examination and against a composite variable for executive cognitive functioning to assess optimal cut-off scores. Inter-rater reliability was high for both the Shulman and Freund scoring systems (ICC = 0.95 and ICC = 0.90 respectively). The clock drawing tests showed moderate to high correlations with the composite variable for executive cognitive functioning (mean ρ = 0.75) and weaker correlations with the mini-mental state examination (mean ρ = 0.62). Mean sensitivity of the clock drawing tests was 0.82 and mean specificity was 0.79, whereas the mean positive predictive value was 0.66 and the mean negative predictive value was 0.87. The clock drawing test is a suitable screening instrument for cognitive dysfunction in HD, because it was shown to be accurate, particularly so with respect to executive cognitive functioning, and is easy and quick to use. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Uncovering Common Sleep Disorders and Their Impacts on Occupational Performance.

PubMed

Judd, Sylvia R

2017-05-01

Sleep is an active process; the body undergoes restoration and regeneration. Adequate sleep is essential to health and cognitive function. Sleep is critical for cell repair, a healthy immune system, and hormonal regulation, and aids in the process of learning, memory, and emotion. Inadequate sleep can lead to multiple chronic health and mental conditions over time. The occupational health nurse can be instrumental in screening for two of the most common sleep disorders, insomnia and obstructive sleep apnea, by asking workers key questions and using simple screening tools.

Comparison of the montreal cognitive assessment and the mini-mental state examination as screening tests in hemodialysis patients without symptoms.

PubMed

Lee, Sun Hwa; Cho, AJin; Min, Yang-Ki; Lee, Young-Ki; Jung, San

2018-11-01

Cognitive impairment in end-stage renal disease patients is associated with an increased risk of mortality. We examined the cognitive function in hemodialysis (HD) patients and compared the Korean versions of the Montreal Cognitive Assessment (K-MoCA) and of the Mini-Mental State Examination (K-MMSE) to identify the better cognitive screening instrument in these patients. Thirty patients undergoing hemodialysis and 30 matched reference group of apparently healthy control were included. All subjects underwent the K-MoCA, K-MMSE and a neuropsychological test battery to measure attention, visuospatial function, language, memory and executive function. All cognitive data were converted to z-scores with appropriate age and education level prior to group comparisons. Cognitive performance 1.0 SD below the mean was defined as modest cognitve impairment while 1.5 below the mean was defined as severe cognitive impairment. Modest cognitive impairment in memory plus other cognitive domains was detected in 27 patients (90%) while severe cognitive impairment in memory plus other cognitive domains was detected in 23 (77%) patients. Total scores in the K-MoCA were significantly lower in HD patients than in the reference group. However, no significant group difference was found in the K-MMSE. The K-MMSE ROC AUC (95% confidence interval) was 0.72 (0.59-0.85) and K-MoCA ROC AUC was 0.77 (0.65-0.89). Cognitive impairment is common but under-diagnosed in this population. The K-MoCA seems to be more sensitive than the K-MMSE in HD patients.

The Hong Kong version of the Oxford Cognitive Screen (HK-OCS): validation study for Cantonese-speaking chronic stroke survivors.

PubMed

Kong, Anthony Pak-Hin; Lam, Pinky Hiu-Ping; Ho, Diana Wai-Lam; Lau, Johnny King; Humphreys, Glyn W; Riddoch, Jane; Weekes, Brendan

2016-09-01

This study reports the validation of the Hong Kong version of Oxford Cognitive Screen (HK-OCS). Seventy Cantonese-speaking healthy individuals participated to establish normative data and 46 chronic stroke survivors were assessed using the HK-OCS, Albert's Test of Visual Neglect, short test of gestural production, and Hong Kong version of the following assessments: Western Aphasia Battery, MMSE, MoCA, Modified Barthel Index, and Lawton Instrumental Activities of Daily Living scale. The validity of the HK-OCS was appraised by the difference between the two participant groups. Neurologically unimpaired individuals performed significantly better than stroke survivors on the HK-OCS. Positive and significant correlations found between cognitive subtests in the HK-OCS and related assessments indicated good concurrent validity. Excellent intra-rater and inter-rater reliabilities, fair test-retest reliability, and acceptable internal consistency suggested that the HK-OCS had good reliability. Specific HK-OCS subtests including semantics, episodic memory, number writing, and orientation were the best predictors of functional outcomes.

Development and community-based validation of the IDEA study Instrumental Activities of Daily Living (IDEA-IADL) questionnaire

PubMed Central

Collingwood, Cecilia; Paddick, Stella-Maria; Kisoli, Aloyce; Dotchin, Catherine L.; Gray, William K.; Mbowe, Godfrey; Mkenda, Sarah; Urasa, Sarah; Mushi, Declare; Chaote, Paul; Walker, Richard W.

2014-01-01

Background The dementia diagnosis gap in sub-Saharan Africa (SSA) is large, partly due to difficulties in assessing function, an essential step in diagnosis. Objectives As part of the Identification and Intervention for Dementia in Elderly Africans (IDEA) study, to develop, pilot, and validate an Instrumental Activities of Daily Living (IADL) questionnaire for use in a rural Tanzanian population to assist in the identification of people with dementia alongside cognitive screening. Design The questionnaire was developed at a workshop for rural primary healthcare workers, based on culturally appropriate roles and usual activities of elderly people in this community. It was piloted in 52 individuals under follow-up from a dementia prevalence study. Validation subsequently took place during a community dementia-screening programme. Construct validation against gold standard clinical dementia diagnosis using DSM-IV criteria was carried out on a stratified sample of the cohort and validity assessed using area under the receiver operating characteristic (AUROC) curve analysis. Results An 11-item questionnaire (IDEA-IADL) was developed after pilot testing. During formal validation on 130 community-dwelling elderly people who presented for screening, the AUROC curve was 0.896 for DSM-IV dementia when used in isolation and 0.937 when used in conjunction with the IDEA cognitive screen, previously validated in Tanzania. The internal consistency was 0.959. Performance on the IDEA-IADL was not biased with regard to age, gender or education level. Conclusions The IDEA-IADL questionnaire appears to be a useful aid to dementia screening in this setting. Further validation in other healthcare settings in SSA is required. PMID:25537940

Concurrent validity of Spanish-language versions of the Mini-Mental State Examination, Mental Status Questionnaire, Information-Memory-Concentration test, and Orientation-Memory-Concentration test: Alzheimer's disease patients and nondemented elderly comparison subjects.

PubMed

Taussig, I M; Mack, W J; Henderson, V W

1996-07-01

One-hundred fifty-eight elderly Spanish-speaking U.S. residents (81 patients diagnosed with Alzheimer's disease and 77 subjects without dementia) were tested with Spanish-language versions of four brief cognitive assessment instruments: the Mini-Mental State Examination (S-MMSE), the Mental Status Questionnaire (S-MSQ), the Information-Memory-Concentration test (S-IMC), and the Orientation-Memory-Concentration test (S-OMC). Within-group performances were highly correlated for all four instruments. All tests distinguished between the demented and nondemented groups, but best discrimination was achieved with the S-IMC, which correctly classified 98% of subjects. This version was also the best predictor of functional disability, as measured by impairments in instrumental activities of daily living. Within the normal comparison group, neither gender nor a subject's monolingual/bilingual status affected test performance. These four Spanish-language cognitive screening tasks may aid in the evaluation of dementia among Spanish-speaking patients.

Screening for cognitive and behavioural impairment in amyotrophic lateral sclerosis: Frequency of abnormality and effect on survival.

PubMed

Xu, Zhouwei; Alruwaili, Ashwag Rafea S; Henderson, Robert David; McCombe, Pamela Ann

2017-05-15

To screen for cognitive and behavioural impairment in people with amyotrophic lateral sclerosis (ALS) and controls with neuromuscular disease and to correlate these with clinical features. 108 people with ALS and 60 controls with other neuromuscular diseases were recruited and assessed with the Addenbrooke's cognitive examination-III (ACE-III), the frontal assessment battery (FAB), and the executive function component of the Edinburgh cognitive and behavioural ALS screen (ECAS). The Amyotrophic lateral sclerosis-Frontotemporal dementia questionnaire (ALS-FTD-Q) and the Motor Neuron Disease Behavioural instrument (MiND-B) were administered to the caregivers of people with ALS. The prevalence of abnormalities was determined and correlated with clinical features and survival. In 37 people with ALS, serial studies were performed. The frequencies of cognitive impairment based on the ACE-III and FAB were 30.0% and 14.0%, in ALS and 11.7% and 3.3% in controls, respectively. Age and years of education influence the results of the ACE-III and ECAS executive function. In ALS, the frequencies of behavioural impairment based on ALS-FTD-Q and MiND-B were 32.1% and 39.4%, respectively. There is significant correlation of ALS-FTD-Q and MiND-B with the ALSFRS-R score. ALS participants with cognitive impairment measured with ACE-III had significantly shorter survival time than those without. ALS participants with behavioural impairment measured with ALS-FTD-Q had worse prognosis than those without. No significant difference was found between the first two serial cognitive tests based on ACE-III and FAB by using generalized estimating equation. There is a greater frequency of cognitive impairment in people with ALS than in patients with other neuromuscular diseases. The cognitive and behavioural tests are potential biomarkers of the prognosis of ALS. The results of cognitive tests are stable over 6months and possibly longer. Copyright © 2017 Elsevier B.V. All rights reserved.

Examining the Test of Memory Malingering Trial 1 and Word Memory Test Immediate Recognition as Screening Tools for Insufficient Effort

ERIC Educational Resources Information Center

Bauer, Lyndsey; O'Bryant, Sid E.; Lynch, Julie K.; McCaffrey, Robert J.; Fisher, Jerid M.

2007-01-01

Assessing effort level during neuropsychological evaluations is critical to support the accuracy of cognitive test scores. Many instruments are designed to measure effort, yet they are not routinely administered in neuropsychological assessments. The Test of Memory Malingering (TOMM) and the Word Memory Test (WMT) are commonly administered symptom…

Utility of TICS-M for the assessment of cognitive function in older adults.

PubMed

de Jager, Celeste A; Budge, Marc M; Clarke, Robert

2003-04-01

Routine screening of high-risk elderly people for early cognitive impairment is constrained by the limitations of currently available cognitive function tests. The Telephone Interview of Cognitive Status is a novel instrument for assessment of cognitive function that can be administered in person or by telephone. To evaluate the determinants and utility of TICS-M (13-item modified version) for assessment of cognitive function in healthy elderly people. The utility of TICS-M was compared with more widely used MMSE and CAMCOG in a cross-sectional survey of 120 older (62 to 89 years) UK adults. The TICS-M cognitive test scores (27.97, SD 4.15) were normally distributed in contrast with those for MMSE and CAMCOG that had a negatively skewed distribution. TICS-M scores were inversely correlated with age (r = -0.21) and with the NART fullscale IQ (r = -0.35), but were independent of years of education in this cohort. TICS-M was highly correlated with MMSE (r = 0.57) and with CAMCOG (r = 0.62) scores. The time required to complete the test is comparable to MMSE and substantially less than CAMCOG. The normal distribution of TICS-M test scores suggest that this test is less constrained by the ceiling effect which limits the utility of MMSE and CAMCOG test scores in detecting early cognitive impairment. TICS-M is an appropriate instrument to assess cognitive function in both research and in clinical practice. Copyright 2003 John Wiley & Sons, Ltd.

Issues in Geriatric Care: Alzheimer Disease.

PubMed

Kemle, Kathy; Ackermann, Richard J

2018-05-01

Alzheimer disease (AD) occurs in 8.8% of older US adults and is the sixth leading cause of death among older adults. Medicare annual wellness visits require screening for cognitive impairment but do not specify screening methods. Numerous screening instruments are available. If results are positive, evaluation with well-validated assessment tools is needed. If cognitive impairment is confirmed, laboratory tests and imaging studies should be obtained to rule out reversible etiologies. If patients meet diagnostic criteria for AD, clinicians should educate patients and families on the expected course and help them complete advance directives. Nutrition, behavioral issues, patient safety issues, and physical activity should be addressed. Physicians should screen for and manage concomitant depression. Troublesome behaviors should be managed with nonpharmacotherapeutic measures first. Pain should be considered as a possible cause of behavior. Antipsychotics should be reserved for select cases in which safety is an issue. Drugs for improving cognition can be prescribed but these typically result in short-term improvements and do not prevent disease progression. These drugs should be discontinued if adverse effects occur or when dementia worsens. Research on anti-amyloid and anti-tau protein drugs is promising but has not yet led to useful breakthroughs. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Instrument-mounted displays for reducing cognitive load during surgical navigation.

PubMed

Herrlich, Marc; Tavakol, Parnian; Black, David; Wenig, Dirk; Rieder, Christian; Malaka, Rainer; Kikinis, Ron

2017-09-01

Surgical navigation systems rely on a monitor placed in the operating room to relay information. Optimal monitor placement can be challenging in crowded rooms, and it is often not possible to place the monitor directly beside the situs. The operator must split attention between the navigation system and the situs. We present an approach for needle-based interventions to provide navigational feedback directly on the instrument and close to the situs by mounting a small display onto the needle. By mounting a small and lightweight smartwatch display directly onto the instrument, we are able to provide navigational guidance close to the situs and directly in the operator's field of view, thereby reducing the need to switch the focus of view between the situs and the navigation system. We devise a specific variant of the established crosshair metaphor suitable for the very limited screen space. We conduct an empirical user study comparing our approach to using a monitor and a combination of both. Results from the empirical user study show significant benefits for cognitive load, user preference, and general usability for the instrument-mounted display, while achieving the same level of performance in terms of time and accuracy compared to using a monitor. We successfully demonstrate the feasibility of our approach and potential benefits. With ongoing technological advancements, instrument-mounted displays might complement standard monitor setups for surgical navigation in order to lower cognitive demands and for improved usability of such systems.

Clinical, Functional, and Biological Correlates of Cognitive Dimensions in Major Depressive Disorder – Rationale, Design, and Characteristics of the Cognitive Function and Mood Study (CoFaM-Study)

PubMed Central

Baune, Bernhard T.; Air, Tracy

2016-01-01

Cross-sectional and longitudinal studies exploring clinical, functional, and biological correlates of major depressive disorder are frequent. In this type of research, depression is most commonly defined as a categorical diagnosis based on studies using diagnostic instruments. Given the phenotypic and biological heterogeneity of depression, we chose to focus the phenotypic assessments on three cognitive dimensions of depression including (a) cognitive performance, (b) emotion processing, and (c) social cognitive functioning. Hence, the overall aim of the study is to investigate the long-term clinical course of these cognitive dimensions in depression and its functional (psychosocial) correlates. We also aim to identify biological “genomic” correlates of these three cognitive dimensions of depression. To address the above overall aim, we created the Cognition and Mood Study (CoFaMS) with the key objective to investigate the clinical, functional, and biological correlates of cognitive dimensions of depression by employing a prospective study design and including a healthy control group. The study commenced in April 2015, including patients with a primary diagnosis of a major depressive episode of major depressive disorder or bipolar disorder according to DSM-IV-TR criteria. The assessments cover the three cognitive dimensions of depression (cognitive performance, emotion processing, and social cognition), cognitive function screening instrument, plus functional scales to assess general, work place, and psychosocial function, depression symptom scales, and clinical course of illness. Blood is collected for comprehensive genomic discovery analyses of biological correlates of cognitive dimensions of depression. The CoFaM-Study represents an innovative approach focusing on cognitive dimensions of depression and its functional and biological “genomic” correlates. The CoFaMS team welcomes collaborations with both national and international researchers. PMID:27616997

Clinical, Functional, and Biological Correlates of Cognitive Dimensions in Major Depressive Disorder - Rationale, Design, and Characteristics of the Cognitive Function and Mood Study (CoFaM-Study).

PubMed

Baune, Bernhard T; Air, Tracy

2016-01-01

Cross-sectional and longitudinal studies exploring clinical, functional, and biological correlates of major depressive disorder are frequent. In this type of research, depression is most commonly defined as a categorical diagnosis based on studies using diagnostic instruments. Given the phenotypic and biological heterogeneity of depression, we chose to focus the phenotypic assessments on three cognitive dimensions of depression including (a) cognitive performance, (b) emotion processing, and (c) social cognitive functioning. Hence, the overall aim of the study is to investigate the long-term clinical course of these cognitive dimensions in depression and its functional (psychosocial) correlates. We also aim to identify biological "genomic" correlates of these three cognitive dimensions of depression. To address the above overall aim, we created the Cognition and Mood Study (CoFaMS) with the key objective to investigate the clinical, functional, and biological correlates of cognitive dimensions of depression by employing a prospective study design and including a healthy control group. The study commenced in April 2015, including patients with a primary diagnosis of a major depressive episode of major depressive disorder or bipolar disorder according to DSM-IV-TR criteria. The assessments cover the three cognitive dimensions of depression (cognitive performance, emotion processing, and social cognition), cognitive function screening instrument, plus functional scales to assess general, work place, and psychosocial function, depression symptom scales, and clinical course of illness. Blood is collected for comprehensive genomic discovery analyses of biological correlates of cognitive dimensions of depression. The CoFaM-Study represents an innovative approach focusing on cognitive dimensions of depression and its functional and biological "genomic" correlates. The CoFaMS team welcomes collaborations with both national and international researchers.

Development of a video-simulation instrument for assessing cognition in older adults.

PubMed

Ip, Edward H; Barnard, Ryan; Marshall, Sarah A; Lu, Lingyi; Sink, Kaycee; Wilson, Valerie; Chamberlain, Dana; Rapp, Stephen R

2017-12-06

Commonly used methods to assess cognition, such as direct observation, self-report, or neuropsychological testing, have significant limitations. Therefore, a novel tablet computer-based video simulation was created with the goal of being valid, reliable, and easy to administer. The design and implementation of the SIMBAC (Simulation-Based Assessment of Cognition) instrument is described in detail, as well as informatics "lessons learned" during development. The software emulates 5 common instrumental activities of daily living (IADLs) and scores participants' performance. The modules were chosen by a panel of geriatricians based on relevance to daily functioning and ability to be modeled electronically, and included facial recognition, pairing faces with the correct names, filling a pillbox, using an automated teller machine (ATM), and automatic renewal of a prescription using a telephone. Software development included three phases 1) a period of initial design and testing (alpha version), 2) pilot study with 10 cognitively normal and 10 cognitively impaired adults over the age of 60 (beta version), and 3) larger validation study with 162 older adults of mixed cognitive status (release version). Results of the pilot study are discussed in the context of refining the instrument; full results of the validation study are reported in a separate article. In both studies, SIMBAC reliably differentiated controls from persons with cognitive impairment, and performance was highly correlated with Mini Mental Status Examination (MMSE) score. Several informatics challenges emerged during software development, which are broadly relevant to the design and use of electronic assessment tools. Solutions to these issues, such as protection of subject privacy and safeguarding against data loss, are discussed in depth. Collection of fine-grained data (highly detailed information such as time spent reading directions and the number of taps on screen) is also considered. SIMBAC provides clinicians direct insight into whether subjects can successfully perform selected cognitively intensive activities essential for independent living and advances the field of cognitive assessment. Insight gained from the development process could inform other researchers who seek to develop software tools in health care.

Cross-validation of a dementia screening test in a heterogeneous population.

PubMed

Ritchie, K A; Hallerman, E F

1989-09-01

Recognition of the increasing importance of early dementia screening for both research and clinical purposes has led to the development of numerous screening instruments. The most promising of these are based on neuropsychological measures which are able to focus on very specific cognitive functions. Of these tests the Iowa screening test is of particular interest to researchers and clinicians working with heterogenous populations or wishing to make cross-cultural comparisons as it is relatively culture-fair and does not assume literacy. A preliminary study of the performance of the Iowa in an Israeli sample of diverse ethnic origins and low education level suggests it to be a very sensitive measure even in such groups. The study also demonstrates the inadvisability of adopting item weights derived by multivariate statistical techniques from another population.

Measurement of Functional Cognition and Complex Everyday Activities in Older Adults with Mild Cognitive Impairment and Mild Dementia: Validity of the Large Allen's Cognitive Level Screen.

PubMed

Wesson, Jacqueline; Clemson, Lindy; Crawford, John D; Kochan, Nicole A; Brodaty, Henry; Reppermund, Simone

2017-05-01

To explore the validity of the Large Allen's Cognitive Level Screen-5 (LACLS-5) as a performance-based measure of functional cognition, representing an ability to perform complex everyday activities in older adults with mild cognitive impairment (MCI) and mild dementia living in the community. Using cross-sectional data from the Sydney Memory and Ageing Study, 160 community-dwelling older adults with normal cognition (CN; N = 87), MCI (N = 43), or dementia (N = 30) were studied. Functional cognition (LACLS-5), complex everyday activities (Disability Assessment for Dementia [DAD]), Assessment of Motor and Process Skills [AMPS]), and neuropsychological measures were used. Participants with dementia performed worse than CN on all clinical measures, and MCI participants were intermediate. Correlational analyses showed that LACLS-5 was most strongly related to AMPS Process scores, DAD instrumental activities of daily living subscale, Mini-Mental State Exam, Block Design, Logical Memory, and Trail Making Test B. Multiple regression analysis indicated that both cognitive (Block Design) and functional measures (AMPS Process score) and sex predicted LACLS-5 performance. Finally, LACLS-5 was able to adequately discriminate between CN and dementia and between MCI and dementia but was unable to reliably distinguish between CN and MCI. Construct validity, including convergent and discriminative validity, was supported. LACLS-5 is a valid performance-based measure for evaluating functional cognition. Discriminativevalidity is acceptable for identifying mild dementia but requires further refinement for detecting MCI. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Relationships between socio-clinico-demographic factors and global cognitive function in the oldest old living in the Tokyo Metropolitan area: Reanalysis of the Tokyo Oldest Old Survey on Total Health (TOOTH).

PubMed

Eguchi, Yoko; Tasato, Kumiko; Nakajima, Shinichiro; Noda, Yoshihiro; Tsugawa, Sakiko; Shinagawa, Shunichiro; Niimura, Hidehito; Hirose, Nobuyoshi; Arai, Yasumichi; Mimura, Masaru

2018-03-07

Despite a steady increase in life expectancy, a few studies have investigated cross-sectional correlates and longitudinal predictors of cognitive function, a core domain of the successful aging, among socio-clinico-demographic factors in the oldest-old exclusively. The aims of this study were to examine socio-clinico-demographic characteristics associated with global cognition and its changes in the oldest-old. We reanalyzed a dataset of cognitively preserved community-dwelling subjects aged 85 years and older in the Tokyo Oldest Old Survey on Total Health, a 6-year longitudinal observational study. This study consisted of (1) baseline cross-sectional analyses examining correlates of global cognition (n = 248) among socio-clinico-demographic factors and (2) longitudinal analyses examining baseline predictors for changes of global cognition in 3-year follow-up (n = 195). The Mini-Mental State Examination was used as a screening test to assess global cognition. At baseline, higher weights were related to higher cognitive function in the oldest-old. The baseline predictors of global cognitive decline in 3-year follow-up were higher global cognition, shorter education period, and lower sociocultural activities and lower instrumental activity of daily living, in this order. The present study suggests that it is crucial to attain higher education during early life and avoid leanness or obesity, participate in sociocultural cognitive activities during late life, and maintain instrumental activity of daily living to preserve optimal cognitive function in the oldest-old, which will facilitate developing prevention strategies for cognitive decline and promoting successful aging in this increasing population. Copyright © 2018 John Wiley & Sons, Ltd.

A prediction model for cognitive performance in health ageing using diffusion tensor imaging with graph theory.

PubMed

Yun, Ruijuan; Lin, Chung-Chih; Wu, Shuicai; Huang, Chu-Chung; Lin, Ching-Po; Chao, Yi-Ping

2013-01-01

In this study, we employed diffusion tensor imaging (DTI) to construct brain structural network and then derive the connection matrices from 96 healthy elderly subjects. The correlation analysis between these topological properties of network based on graph theory and the Cognitive Abilities Screening Instrument (CASI) index were processed to extract the significant network characteristics. These characteristics were then integrated to estimate the models by various machine-learning algorithms to predict user's cognitive performance. From the results, linear regression model and Gaussian processes model showed presented better abilities with lower mean absolute errors of 5.8120 and 6.25 to predict the cognitive performance respectively. Moreover, these extracted topological properties of brain structural network derived from DTI also could be regarded as the bio-signatures for further evaluation of brain degeneration in healthy aged and early diagnosis of mild cognitive impairment (MCI).

Use of spoken and written Japanese did not protect Japanese-American men from cognitive decline in late life.

PubMed

Crane, Paul K; Gruhl, Jonathan C; Erosheva, Elena A; Gibbons, Laura E; McCurry, Susan M; Rhoads, Kristoffer; Nguyen, Viet; Arani, Keerthi; Masaki, Kamal; White, Lon

2010-11-01

Spoken bilingualism may be associated with cognitive reserve. Mastering a complicated written language may be associated with additional reserve. We sought to determine if midlife use of spoken and written Japanese was associated with lower rates of late life cognitive decline. Participants were second-generation Japanese-American men from the Hawaiian island of Oahu, born 1900-1919, free of dementia in 1991, and categorized based on midlife self-reported use of spoken and written Japanese (total n included in primary analysis = 2,520). Cognitive functioning was measured with the Cognitive Abilities Screening Instrument scored using item response theory. We used mixed effects models, controlling for age, income, education, smoking status, apolipoprotein E e4 alleles, and number of study visits. Rates of cognitive decline were not related to use of spoken or written Japanese. This finding was consistent across numerous sensitivity analyses. We did not find evidence to support the hypothesis that multilingualism is associated with cognitive reserve.

Use of Spoken and Written Japanese Did Not Protect Japanese-American Men From Cognitive Decline in Late Life

PubMed Central

Gruhl, Jonathan C.; Erosheva, Elena A.; Gibbons, Laura E.; McCurry, Susan M.; Rhoads, Kristoffer; Nguyen, Viet; Arani, Keerthi; Masaki, Kamal; White, Lon

2010-01-01

Objectives. Spoken bilingualism may be associated with cognitive reserve. Mastering a complicated written language may be associated with additional reserve. We sought to determine if midlife use of spoken and written Japanese was associated with lower rates of late life cognitive decline. Methods. Participants were second-generation Japanese-American men from the Hawaiian island of Oahu, born 1900–1919, free of dementia in 1991, and categorized based on midlife self-reported use of spoken and written Japanese (total n included in primary analysis = 2,520). Cognitive functioning was measured with the Cognitive Abilities Screening Instrument scored using item response theory. We used mixed effects models, controlling for age, income, education, smoking status, apolipoprotein E e4 alleles, and number of study visits. Results. Rates of cognitive decline were not related to use of spoken or written Japanese. This finding was consistent across numerous sensitivity analyses. Discussion. We did not find evidence to support the hypothesis that multilingualism is associated with cognitive reserve. PMID:20639282

Development and validation of a parent-report measure for detection of cognitive delay in infancy.

PubMed

Schafer, Graham; Genesoni, Lucia; Boden, Greg; Doll, Helen; Jones, Rosamond A K; Gray, Ron; Adams, Eleri; Jefferson, Ros

2014-12-01

To develop a brief, parent-completed instrument (ERIC - Early Report by Infant Caregivers) for detection of cognitive delay in 10- to 24-month-olds born preterm, or of low birthweight, or with perinatal complications, and to establish ERIC's diagnostic properties. Scores for ERIC were collected from the parents of 317 children meeting ≥inclusion criterion (birthweight <1500 g, gestational age <34 completed weeks, 5 min Apgar score <7, or presence of hypoxic-ischaemic encephalopathy) and no exclusion criteria. Children were assessed using a criterion score of below 80 on the Bayley Scales of Infant and Toddler Development-III cognitive scale. Items were retained according to their individual associations with delay. Sensitivity, specificity, and positive and negative predictive values were estimated and a truncated ERIC was developed for use in children <14 months old. ERIC correctly detected developmental delay in 17 out of 18 children in the sample, with 94.4% sensitivity, 76.9% specificity, 19.8% positive predictive value, 99.6% negative predictive value, 4.09 likelihood ratio positive, and 0.07 likelihood ratio negative. ERIC has potential value as a quickly administered diagnostic instrument for the absence of early cognitive delay in 10- to 24-month-old preterm infants and as a screen for cognitive delay. © 2014 Mac Keith Press.

Developing an oropharyngeal cancer (OPC) knowledge and behaviors survey.

PubMed

Dodd, Virginia J; Riley Iii, Joseph L; Logan, Henrietta L

2012-09-01

To use the community participation research model to (1) develop a survey assessing knowledge about mouth and throat cancer and (2) field test and establish test-retest reliability with newly developed instrument. Cognitive interviews with primarily rural African American adults to assess their perception and interpretation of survey items. Test-retest reliability was established with a racially diverse rural population. Test-retest reliabilities ranged from .79 to .40 for screening awareness and .74 to .19 for knowledge. Coefficients increased for composite scores. Community participation methodology provided a culturally appropriate survey instrument that demonstrated acceptable levels of reliability.

Developing Dementia Prevention Trials: Baseline Report of the Home-Based Assessment Study

PubMed Central

Sano, Mary; Egelko, Susan; Donohue, Michael; Ferris, Steven; Kaye, Jeffrey; Hayes, Tamara L.; Mundt, James C.; Sun, C.K.; Paparello, Silvia; Aisen, Paul S.

2014-01-01

This report describes the baseline experience of the multi-center, Home Based Assessment (HBA) study, designed to develop methods for dementia prevention trials using novel technologies for test administration and data collection. Non-demented individuals ≥ 75 years old were recruited and evaluated in-person using established clinical trial outcomes of cognition and function, and randomized to one of 3 assessment methodologies: 1) mail-in questionnaire/live telephone interviews (MIP); 2) automated telephone with interactive voice recognition (IVR); and 3) internet-based computer Kiosk (KIO). Brief versions of cognitive and non-cognitive outcomes, were adapted to each methodology and administered at baseline and repeatedly over a 4-year period. “Efficiency” measures assessed the time from screening to baseline, and staff time required for each methodology. 713 individuals signed consent and were screened; 640 met eligibility and were randomized to one of 3 assessment arms and 581 completed baseline. Drop out, time from screening to baseline and total staff time were highest among those assigned to KIO. However efficiency measures were driven by non-recurring start-up activities suggesting that differences may be mitigated over a long trial. Performance among HBA instruments collected via different technologies will be compared to established outcomes over this 4 year study. PMID:23151596

Japanese-English language equivalence of the Cognitive Abilities Screening Instrument among Japanese-Americans.

PubMed

Gibbons, Laura E; McCurry, Susan; Rhoads, Kristoffer; Masaki, Kamal; White, Lon; Borenstein, Amy R; Larson, Eric B; Crane, Paul K

2009-02-01

The Cognitive Abilities Screening Instrument (CASI) was designed for use in cross-cultural studies of Japanese and Japanese-American elderly in Japan and the U.S.A. The measurement equivalence in Japanese and English had not been confirmed in prior studies. We analyzed the 40 CASI items for differential item functioning (DIF) related to test language, as well as self-reported proficiency with written Japanese, age, and educational attainment in two large epidemiologic studies of Japanese-American elderly: the Kame Project (n=1708) and the Honolulu-Asia Aging Study (HAAS; n = 3148). DIF was present if the demographic groups differed in the probability of success on an item, after controlling for their underlying cognitive functioning ability. While seven CASI items had DIF related to language of testing in Kame (registration of one item; recall of one item; similes; judgment; repeating a phrase; reading and performing a command; and following a three-step instruction), the impact of DIF on participants' scores was minimal. Mean scores for Japanese and English speakers in Kame changed by <0.1 SD after accounting for DIF related to test language. In HAAS, insufficient numbers of participants were tested in Japanese to assess DIF related to test language. In both studies, DIF related to written Japanese proficiency, age, and educational attainment had minimal impact. To the extent that DIF could be assessed, the CASI appeared to meet the goal of measuring cognitive function equivalently in Japanese and English. Stratified data collection would be needed to confirm this conclusion. DIF assessment should be used in other studies with multiple language groups to confirm that measures function equivalently or, if not, form scores that account for DIF.

The WERCAP Screen and the WERC Stress Screen: psychometrics of self-rated instruments for assessing bipolar and psychotic disorder risk and perceived stress burden.

PubMed

Mamah, Daniel; Owoso, Akinkunle; Sheffield, Julia M; Bayer, Chelsea

2014-10-01

Identification of individuals in the prodromal phase of bipolar disorder and schizophrenia facilitates early intervention and promises an improved prognosis. There are no current assessment tools for clinical risk symptoms of bipolar disorder, and psychosis-risk assessment generally involves semi-structured interviews, which are time consuming and rater dependent. We present psychometric data on two novel quantitative questionnaires: the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen for assessing bipolar and psychotic disorder risk traits, and the accompanying WERC Stress Screen for assessing individual and total psychosocial stressor severities. Prevalence rates of the WERCAP Screen were evaluated among 171 community youth (aged 13-24 years); internal consistency was assessed and k-means cluster analysis was used to identify symptom groups. In 33 participants, test-retest reliability coefficients were assessed, and ROC curve analysis was used to determine the validity of the psychosis section of the WERCAP Screen (pWERCAP) against the Structured Interview of Psychosis-Risk Symptoms (SIPS). Correlations of the pWERCAP, the affectivity section of the WERCAP Screen (aWERCAP) and the WERC Stress Screen were examined to determine the relatedness of scores with cognition and clinical measures. Cluster analysis identified three groups of participants: a normative (47%), a psychosis-affectivity (18%) and an affectivity only (35%) group. Internal consistency of the aWERCAP and pWERCAP resulted in alphas of 0.87 and 0.92, and test-retest reliabilities resulted in intraclass correlation coefficients of 0.76 and 0.86 respectively. ROC curve analysis showed the optimal cut-point on the pWERCAP as a score of >30 (sensitivity: 0.89; specificity: 1.0). There was a significant negative correlation between aWERCAP scores and total cognition (R=-0.42), and between pWERCAP scores and sensorimotor processing speed. Total stress scores correlated significantly with scores on the aWERCAP (R=0.88), pWERCAP (R=0.62) and total cognition (R=-0.44). Our results show that the WERCAP Screen and the WERC Stress Screen are easy to administer and derived scores are related to cognitive and clinical traits. This suggests that their use could have particular benefits for epidemiologic studies and in busy clinical settings. Longitudinal studies would be required to evaluate clinical outcomes with high questionnaire scores. Copyright © 2014 Elsevier Inc. All rights reserved.

Brain activation patterns elicited by the 'Faces Symbol Test' -- a pilot fMRI study.

PubMed

Grabner, Rh; Popotnig, F; Ropele, S; Neuper, C; Gorani, F; Petrovic, K; Ebner, F; Strasser-Fuchs, S; Fazekas, F; Enzinger, C

2008-04-01

The Faces Symbol Test (FST) has recently been proposed as a brief and patient-friendly screening instrument for the assessment of cognitive dysfunction in patients with multiple sclerosis (MS). However, in contrast to well-established MS screening tests such as the Paced Auditory Serial Addition Test, the neural correlates of the FST have not been investigated so far. In the present study, we developed a functional MRI (fMRI) version of the FST to provide first data on brain regions and networks involved in this test. A sample of 19 healthy participants completed a version of the FST adapted for fMRI, requiring matching of faces and symbols in a multiple choice test and two further experimental conditions drawing on cognitive subcomponents (face matching and symbol matching). Imaging data showed a differential involvement of a fronto-parieto-occipital network in the three conditions. The most demanding FST condition elicited brain activation patterns related with sustained attention and executive control. These results suggest that the FST recruits brain networks critical for higher-order cognitive functions often impaired in MS patients.

Bilingualism and Cognitive Reserve: A Critical Overview and a Plea for Methodological Innovations

PubMed Central

Calvo, Noelia; García, Adolfo M.; Manoiloff, Laura; Ibáñez, Agustín

2016-01-01

The decline of cognitive skills throughout healthy or pathological aging can be slowed down by experiences which foster cognitive reserve (CR). Recently, some studies on Alzheimer's disease have suggested that CR may be enhanced by life-long bilingualism. However, the evidence is inconsistent and largely based on retrospective approaches featuring several methodological weaknesses. Some studies demonstrated at least 4 years of delay in dementia symptoms, while others did not find such an effect. Moreover, various methodological aspects vary from study to study. The present paper addresses contradictory findings, identifies possible lurking variables, and outlines methodological alternatives thereof. First, we characterize possible confounding factors that may have influenced extant results. Our focus is on the criteria to establish bilingualism, differences in sample design, the instruments used to examine cognitive skills, and the role of variables known to modulate life-long cognition. Second, we propose that these limitations could be largely circumvented through experimental approaches. Proficiency in the non-native language can be successfully assessed by combining subjective and objective measures; confounding variables which have been distinctively associated with certain bilingual groups (e.g., alcoholism, sleep disorders) can be targeted through relevant instruments; and cognitive status might be better tapped via robust cognitive screenings and executive batteries. Moreover, future research should incorporate tasks yielding predictable patterns of contrastive performance between bilinguals and monolinguals. Crucially, these include instruments which reveal bilingual disadvantages in vocabulary, null effects in working memory, and advantages in inhibitory control and other executive functions. Finally, paradigms tapping proactive interference (which assess the disruptive effect of long-term memory on newly learned information) could also offer useful data, since this phenomenon seems to be better managed by bilinguals and it becomes conspicuous in early stages of dementia. Such considerations may shed light not just on the relationship between bilingualism and CR, but also on more general mechanisms of cognitive compensation. PMID:26793100

Bilingualism and Cognitive Reserve: A Critical Overview and a Plea for Methodological Innovations.

PubMed

Calvo, Noelia; García, Adolfo M; Manoiloff, Laura; Ibáñez, Agustín

2015-01-01

The decline of cognitive skills throughout healthy or pathological aging can be slowed down by experiences which foster cognitive reserve (CR). Recently, some studies on Alzheimer's disease have suggested that CR may be enhanced by life-long bilingualism. However, the evidence is inconsistent and largely based on retrospective approaches featuring several methodological weaknesses. Some studies demonstrated at least 4 years of delay in dementia symptoms, while others did not find such an effect. Moreover, various methodological aspects vary from study to study. The present paper addresses contradictory findings, identifies possible lurking variables, and outlines methodological alternatives thereof. First, we characterize possible confounding factors that may have influenced extant results. Our focus is on the criteria to establish bilingualism, differences in sample design, the instruments used to examine cognitive skills, and the role of variables known to modulate life-long cognition. Second, we propose that these limitations could be largely circumvented through experimental approaches. Proficiency in the non-native language can be successfully assessed by combining subjective and objective measures; confounding variables which have been distinctively associated with certain bilingual groups (e.g., alcoholism, sleep disorders) can be targeted through relevant instruments; and cognitive status might be better tapped via robust cognitive screenings and executive batteries. Moreover, future research should incorporate tasks yielding predictable patterns of contrastive performance between bilinguals and monolinguals. Crucially, these include instruments which reveal bilingual disadvantages in vocabulary, null effects in working memory, and advantages in inhibitory control and other executive functions. Finally, paradigms tapping proactive interference (which assess the disruptive effect of long-term memory on newly learned information) could also offer useful data, since this phenomenon seems to be better managed by bilinguals and it becomes conspicuous in early stages of dementia. Such considerations may shed light not just on the relationship between bilingualism and CR, but also on more general mechanisms of cognitive compensation.

Relationship of CogScreen-AE to flight simulator performance and pilot age.

PubMed

Taylor, J L; O'Hara, R; Mumenthaler, M S; Yesavage, J A

2000-04-01

We report on the relationship between CogScreen-Aeromedical Edition (AE) factor scores and flight simulator performance in aircraft pilots aged 50-69. Some 100 licensed, civilian aviators (average age 58+/-5.3 yr) performed aviation tasks in a Frasca model 141 flight simulator and the CogScreen-AE battery. The aviation performance indices were: a) staying on course; b) dialing in communication frequencies; c) avoiding conflicting traffic; d) monitoring cockpit instruments; e) executing the approach; and f) a summary score, which was the mean of these scores. The CogScreen predictors were based on a factor structure reported by Kay (11), which comprised 28 CogScreen scores. Through principal components analysis of Kay's nine factors, we reduced the number of predictors to five composite CogScreen scores: Speed/Working Memory (WM), Visual Associative Memory, Motor Coordination, Tracking, and Attribute Identification. Speed/WM scores had the highest correlation with the flight summary score, Spearman r(rho) = 0.57. A stepwise-forward multiple regression analysis indicated that four CogScreen variables could explain 45% of the variance in flight summary scores. Significant predictors, in order of entry, were: Speed/WM, Visual Associative Memory, Motor Coordination, and Tracking (p<0.05). Pilot age was found to significantly improve prediction beyond that which could be predicted by the four cognitive variables. In addition, there was some evidence for specific ability relationships between certain flight component scores and CogScreen scores, such as approach performance and tracking errors. These data support the validity of CogScreen-AE as a cognitive battery that taps skills relevant to piloting.

A validation study of the Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) in Chinese older adults in Hong Kong.

PubMed

Yeung, P Y; Wong, L L; Chan, C C; Leung, Jess L M; Yung, C Y

2014-12-01

To validate the Hong Kong version of Montreal Cognitive Assessment (HK-MoCA) in identification of mild cognitive impairment and dementia in Chinese older adults. Cross-sectional study. Cognition clinic and memory clinic of a public hospital in Hong Kong. A total of 272 participants (dementia, n=130; mild cognitive impairment, n=93; normal controls, n=49) aged 60 years or above were assessed using HK-MoCA. The HK-MoCA scores were validated against expert diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed) criteria for dementia and Petersen's criteria for mild cognitive impairment. Statistical analysis was performed using receiver operating characteristic curve and regression analyses. Additionally, comparison was made with the Cantonese version of Mini-Mental State Examination and Global Deterioration Scale. The optimal cutoff score for the HK-MoCA to differentiate cognitive impaired persons (mild cognitive impairment and dementia) from normal controls was 21/22 after adjustment of education level, giving a sensitivity of 0.928, specificity of 0.735, and area under the curve of 0.920. Moreover, the cutoff to detect mild cognitive impairment was 21/22 with a sensitivity of 0.828, specificity of 0.735, and area under the curve of 0.847. Score of the Cantonese version of the Mini-Mental State Examination to detect mild cognitive impairment was 26/27 with a sensitivity of 0.785, specificity of 0.816, and area under the curve of 0.857. At the optimal cutoff of 18/19, HK-MoCA identified dementia from controls with a sensitivity of 0.923, specificity of 0.918, and area under the curve of 0.971. The HK-MoCA is a useful cognitive screening instrument for use in Chinese older adults in Hong Kong. A score of less than 22 should prompt further diagnostic assessment. It has comparable sensitivity with the Cantonese version of Mini-Mental State Examination for detection of mild cognitive impairment. It is brief and feasible to conduct in the clinical setting, and can be completed in less than 15 minutes. Thus, HK-MoCA provides an attractive alternative screening instrument to Mini-Mental State Examination which has ceiling effect (ie may fail to detect mild/moderate cognitive impairment in people with high education level or premorbid intelligence) and needs to be purchased due to copyright issues.

Cognitive deficits in problematic drinkers with and without mild to borderline intellectual disability.

PubMed

van Duijvenbode, Neomi; Didden, Robert; VanDerNagel, Joanne El; Korzilius, Hubert Plm; Engels, Rutger Cme

2018-03-01

We examined cognitive deficits in problematic drinkers with and without mild to borderline intellectual disability (MBID). Problematic drinkers were expected to show a significantly lower estimated performance IQ (PIQ), but not a lower estimated verbal IQ (VIQ), compared to light drinkers. Participants ( N = 474) were divided into four groups based on IQ and severity of alcohol use-related problems. IQ was estimated using (a short form of) the Wechsler Adult Intelligence Scale third edition. Severity of alcohol use-related problems was assessed using the Alcohol Use Disorder Identification Test. Overall, there were no significant differences between light and problematic drinkers on estimated VIQ. Within the group without MBID, estimated PIQ was significantly lower. Estimated PIQ was not lower in problematic drinkers with MBID compared to light drinkers with MBID. The results are indicative of cognitive deficits in problematic drinkers without MBID. Screening for cognitive deficits with additional instruments is advised.

The Symbol Digit Modalities Test is an effective cognitive screen in pediatric onset multiple sclerosis (MS).

PubMed

Charvet, Leigh E; Beekman, Rachel; Amadiume, Nneka; Belman, Anita L; Krupp, Lauren B

2014-06-15

To evaluate the Symbol Digit Modalities Test (SDMT) as a tool for identifying pediatric-onset MS patients at risk for cognitive impairment. The SDMT is a brief measure of cognitive processing speed that is often used in adult MS patients. Approximately one-third of pediatric-onset MS patients have cognitive impairment and there is a need for an effective screening instrument. Seventy (70) consecutive outpatients with pediatric-onset MS underwent clinical evaluations including the SDMT and were compared to those with other pediatric neurological diagnoses (OND, n=40) and healthy controls (HC, n=32). A subset of the MS group and all healthy controls completed neuropsychological evaluation within one year of SDMT administration. The MS group performed worse on the SDMT compared to the HC group (p=0.02). Thirty-seven percent (37%) of the MS, 20% of the OND, and 9% of HC groups scored in the impaired range. For MS participants who underwent neuropsychological testing (n=31), the SDMT showed 77% sensitivity and 81% specificity for detecting neuropsychological impairment when administered within one year and reached 100% sensitivity when the interval was under two months (n=17). Overall, older age and increased disability predicted poorer SDMT performance (age r=-0.26, p=0.03) and the Expanded Disability Status Scale score or EDSS (r=-0.47, p<0.001), while a history of optic neuritis predicted better performance (p=0.04). Optical coherence tomography measures were not related to SDMT performance. In this preliminary study, the SDMT was an effective brief screen for detecting cognitive impairment in pediatric-onset MS. Copyright © 2014 Elsevier B.V. All rights reserved.

Using the Oxford Cognitive Screen to Detect Cognitive Impairment in Stroke Patients: A Comparison with the Mini-Mental State Examination.

PubMed

Mancuso, Mauro; Demeyere, Nele; Abbruzzese, Laura; Damora, Alessio; Varalta, Valentina; Pirrotta, Fabio; Antonucci, Gabriella; Matano, Alessandro; Caputo, Marina; Caruso, Maria Giovanna; Pontiggia, Giovanna Teresa; Coccia, Michela; Ciancarelli, Irene; Zoccolotti, Pierluigi

2018-01-01

The Oxford Cognitive Screen (OCS) was recently developed with the aim of describing the cognitive deficits after stroke. The scale consists of 10 tasks encompassing five cognitive domains: attention and executive function, language, memory, number processing, and praxis. OCS was devised to be inclusive and un-confounded by aphasia and neglect. As such, it may have a greater potential to be informative on stroke cognitive deficits of widely used instruments, such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment, which were originally devised for demented patients. The present study compared the OCS with the MMSE with regards to their ability to detect cognitive impairments post-stroke. We further aimed to examine performance on the OCS as a function of subtypes of cerebral infarction and clinical severity. 325 first stroke patients were consecutively enrolled in the study over a 9-month period. The OCS and MMSE, as well as the Bamford classification and NIHSS, were given according to standard procedures. About a third of patients (35.3%) had a performance lower than the cutoff (<22) on the MMSE, whereas 91.6% were impaired in at least one OCS domain, indicating higher incidences of impairment for the OCS. More than 80% of patients showed an impairment in two or more cognitive domains of the OCS. Using the MMSE as a standard of clinical practice, the comparative sensitivity of OCS was 100%. Out of the 208 patients with normal MMSE performance 180 showed impaired performance in at least one domain of the OCS. The discrepancy between OCS and MMSE was particularly strong for patients with milder strokes. As for subtypes of cerebral infarction, fewer patients demonstrated widespread impairments in the OCS in the Posterior Circulation Infarcts category than in the other categories. Overall, the results showed a much higher incidence of cognitive impairment with the OCS than with the MMSE and demonstrated no false negatives for OCS vs MMSE. It is concluded that OCS is a sensitive screen tool for cognitive deficits after stroke. In particular, the OCS detects high incidences of stroke-specific cognitive impairments, not detected by the MMSE, demonstrating the importance of cognitive profiling.

Cognitive abilities screening instrument-short form, mini-mental state examination and functional activities questionnaire in the illiterate elderly.

PubMed

Rezende, Gabriela Pravatta; Cecato, Juliana; Martinelli, José Eduardo

2013-01-01

Dementia prevalence is increasing in developing countries due to population aging. Brief tests for assessing cognition and activities of daily living are very useful for the diagnosis of dementia by the clinician. Low education, particularly illiteracy, is a hindrance to the diagnosis of dementia in several regions of the world. To compare the Brazilian version of the Cognitive Abilities Screening Instrument-Short Form (CASI-S) with the Mini-Mental State Examination (MMSE) and Pfeffer Functional Activities Questionnaire (PFAQ) for the diagnosis of dementia in illiterate elderly. A cross-sectional study with illiterate elderly of both genders seen at the outpatient clinics of the Institute of Gerontology and Geriatrics Jundiaí, São Paulo state was performed. Spearman's correlation coefficient was used to correlate CASI-S, MMSE and PFAQ scores. The sample comprised 29 elderly over 57 years old whose mean scores on the CASI-S (scores ranging from 3 to 23) and the MMSE (scores ranging from 2 to 23) were 11.69 and 12.83, respectively. There was a strong significant correlation between the CASI-S and MMSE (r=0.75, p<0.001) and a moderate correlation coefficient that was significant and negative between the PFAQ and CASI-S (r= -0.53 p=0.003),similar to that between the MMSE and PFAQ (r= -0.41 p=0.025). The Brazilian version of the CASI-S demonstrates ease of application and correction in the illiterate elderly, and warrants further studies regarding its applicability for the diagnosis of dementia in populations with a heterogeneous educational background.

Rapid and Accurate Behavioral Health Diagnostic Screening: Initial Validation Study of a Web-Based, Self-Report Tool (the SAGE-SR)

PubMed Central

Purcell, Susan E; Rhea, Karen; Maier, Philip; First, Michael; Zweede, Lisa; Sinisterra, Manuela; Nunn, M Brad; Austin, Marie-Paule; Brodey, Inger S

2018-01-01

Background The Structured Clinical Interview for DSM (SCID) is considered the gold standard assessment for accurate, reliable psychiatric diagnoses; however, because of its length, complexity, and training required, the SCID is rarely used outside of research. Objective This paper aims to describe the development and initial validation of a Web-based, self-report screening instrument (the Screening Assessment for Guiding Evaluation-Self-Report, SAGE-SR) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the SCID-5-Clinician Version (CV) intended to make accurate, broad-based behavioral health diagnostic screening more accessible within clinical care. Methods First, study staff drafted approximately 1200 self-report items representing individual granular symptoms in the diagnostic criteria for the 8 primary SCID-CV modules. An expert panel iteratively reviewed, critiqued, and revised items. The resulting items were iteratively administered and revised through 3 rounds of cognitive interviewing with community mental health center participants. In the first 2 rounds, the SCID was also administered to participants to directly compare their Likert self-report and SCID responses. A second expert panel evaluated the final pool of items from cognitive interviewing and criteria in the DSM-5 to construct the SAGE-SR, a computerized adaptive instrument that uses branching logic from a screener section to administer appropriate follow-up questions to refine the differential diagnoses. The SAGE-SR was administered to healthy controls and outpatient mental health clinic clients to assess test duration and test-retest reliability. Cutoff scores for screening into follow-up diagnostic sections and criteria for inclusion of diagnoses in the differential diagnosis were evaluated. Results The expert panel reduced the initial 1200 test items to 664 items that panel members agreed collectively represented the SCID items from the 8 targeted modules and DSM criteria for the covered diagnoses. These 664 items were iteratively submitted to 3 rounds of cognitive interviewing with 50 community mental health center participants; the expert panel reviewed session summaries and agreed on a final set of 661 clear and concise self-report items representing the desired criteria in the DSM-5. The SAGE-SR constructed from this item pool took an average of 14 min to complete in a nonclinical sample versus 24 min in a clinical sample. Responses to individual items can be combined to generate DSM criteria endorsements and differential diagnoses, as well as provide indices of individual symptom severity. Preliminary measures of test-retest reliability in a small, nonclinical sample were promising, with good to excellent reliability for screener items in 11 of 13 diagnostic screening modules (intraclass correlation coefficient [ICC] or kappa coefficients ranging from .60 to .90), with mania achieving fair test-retest reliability (ICC=.50) and other substance use endorsed too infrequently for analysis. Conclusions The SAGE-SR is a computerized adaptive self-report instrument designed to provide rigorous differential diagnostic information to clinicians. PMID:29572204

Risk Propensity and Health Risk Behaviors in U.S. Army Soldiers with and without Psychological Disturbances across the Deployment Cycle

DTIC Science & Technology

2012-02-09

screening instruments, participants were categorized with respect to PTSD and probable TBI. Results suggest that Soldiers engage in more alcohol use and...a longitudinal study will provide stronger evidence to our understanding of the relationships between deployment and adverse health outcomes...and alcohol use, and cost-benefit analysis tasks. The results of this study showed that cognitive regulation was predictive of rational decision

First evaluation of the Behavioral Addiction Indoor Tanning Screener (BAITS) in a nationwide representative sample.

PubMed

Diehl, K; Görig, T; Breitbart, E W; Greinert, R; Hillhouse, J J; Stapleton, J L; Schneider, S

2018-01-01

Evidence suggests that indoor tanning may have addictive properties. However, many instruments for measuring indoor tanning addiction show poor validity and reliability. Recently, a new instrument, the Behavioral Addiction Indoor Tanning Screener (BAITS), has been developed. To test the validity and reliability of the BAITS by using a multimethod approach. We used data from the first wave of the National Cancer Aid Monitoring on Sunbed Use, which included a cognitive pretest (August 2015) and a Germany-wide representative survey (October to December 2015). In the cognitive pretest 10 users of tanning beds were interviewed and 3000 individuals aged 14-45 years were included in the representative survey. Potential symptoms of indoor tanning addiction were measured using the BAITS, a brief screening survey with seven items (answer categories: yes vs. no). Criterion validity was assessed by comparing the results of BAITS with usage parameters. Additionally, we tested internal consistency and construct validity. A total of 19·7% of current and 1·8% of former indoor tanning users were screened positive for symptoms of a potential indoor tanning addiction. We found significant associations between usage parameters and the BAITS (criterion validity). Internal consistency (reliability) was good (Kuder-Richardson-20, 0·854). The BAITS was shown to be a homogeneous construct (construct validity). Compared with other short instruments measuring symptoms of a potential indoor tanning addiction, the BAITS seems to be a valid and reliable tool. With its short length and the binary items the BAITS is easy to use in large surveys. © 2017 British Association of Dermatologists.

Clock Drawing as a Screen for Impaired Driving in Aging and Dementia: Is It Worth the Time?

PubMed Central

Manning, Kevin J.; Davis, Jennifer D.; Papandonatos, George D.; Ott, Brian R.

2014-01-01

Clock drawing is recommended by medical and transportation authorities as a screening test for unsafe drivers. The objective of the present study was to assess the usefulness of different clock drawing systems as screening measures of driving performance in 122 healthy and cognitively impaired older drivers. Clock drawing was measured using four different scoring systems. Driving outcomes included global ratings of safety and the error rate on a standardized on-road test. Findings revealed that clock drawing was significantly correlated with the driving score on the road test for each of the scoring systems. However, receiver operator curve analyses showed limited clinical utility for clock drawing as a screening instrument for impaired on-road driving performance with the area under the curve ranging from 0.53 to 0.61. Results from this study indicate that clock drawing has limited utility as a solitary screening measure of on-road driving, even when considering a variety of scoring approaches. PMID:24296110

Clock drawing as a screen for impaired driving in aging and dementia: is it worth the time?

PubMed

Manning, Kevin J; Davis, Jennifer D; Papandonatos, George D; Ott, Brian R

2014-02-01

Clock drawing is recommended by medical and transportation authorities as a screening test for unsafe drivers. The objective of the present study was to assess the usefulness of different clock drawing systems as screening measures of driving performance in 122 healthy and cognitively impaired older drivers. Clock drawing was measured using four different scoring systems. Driving outcomes included global ratings of safety and the error rate on a standardized on-road test. Findings revealed that clock drawing was significantly correlated with the driving score on the road test for each of the scoring systems. However, receiver operator curve analyses showed limited clinical utility for clock drawing as a screening instrument for impaired on-road driving performance with the area under the curve ranging from 0.53 to 0.61. Results from this study indicate that clock drawing has limited utility as a solitary screening measure of on-road driving, even when considering a variety of scoring approaches.

The CERAD Neuropsychological Battery in Patients with Frontotemporal Lobar Degeneration

PubMed Central

Haanpää, Ramona M.; Suhonen, Noora-Maria; Hartikainen, Päivi; Koivisto, Anne M.; Moilanen, Virpi; Herukka, Sanna-Kaisa; Hänninen, Tuomo; Remes, Anne M.

2015-01-01

Background/Aims The diagnosis of frontotemporal lobar degeneration (FTLD) is based on neuropsychological examination in addition to clinical symptoms and brain imaging. There is no simple, validated, cognitive tool available in screening for FTLD. The Consortium to Establish a Registry for Alzheimer's Disease neuropsychological battery (CERAD-NB) was originally devised to identify the early cognitive changes related to Alzheimer's disease (AD). Our aim was to investigate the utility of the CERAD-NB in FTLD. Methods Patients with FTLD (n = 95) and AD (n = 90) were assessed with the CERAD-NB, Trail Making Test parts A and B and single-letter Phonemic Fluency. Results FTLD patients were more severely impaired in the Verbal Fluency subtest in the CERAD-NB and Trail Making Test part A compared to AD patients. In addition, AD patients were more impaired in memory subtests compared to FTLD patients. Conclusion The CERAD-NB may be a useful tool in screening for FTLD. Impaired performance in Verbal Fluency with moderately well-preserved Delayed Recall and Memory Tests may help in identifying patients with probable FTLD and discriminating FTLD from AD. Adding the Trail Making Test to the battery might enhance its value as a screening instrument for FTLD. PMID:25999981

Psychometric characteristics of the Rivermead Behavioural Memory Test (RBMT) as an early detection instrument for dementia and mild cognitive impairment in Brazil.

PubMed

Yassuda, Mônica Sanches; Flaks, Mariana Kneese; Viola, Luciane Fátima; Pereira, Fernanda Speggiorin; Memória, Claudia Maia; Nunes, Paula Villela; Forlenza, Orestes Vicente

2010-09-01

The Rivermead Behavioural Memory Test (RBMT) assesses everyday memory by means of tasks which mimic daily challenges. The objective was to examine the validity of the Brazilian version of the RBMT to detect cognitive decline. 195 older adults were diagnosed as normal controls (NC) or with mild cognitive impairment (MCI) or Alzheimer's disease (AD) by a multidisciplinary team, after participants completed clinical and neuropsychological protocols. Cronbach's alpha was high for the total sample for the RBMT profile (PS) and screening scores (SS) (PS = 0.91, SS = 0.87) and for the AD group (PS = 0.84, SS = 0.85), and moderate for the MCI (PS = 0.62, SS = 0.55) and NC (PS = 0.62, SS = 0.60) groups. RBMT total scores, Appointment, Pictures, Immediate and Delayed Story, Immediate and Delayed Route, Delayed Message and Date contributed to differentiate NC from MCI. ROC curve analyses indicated high accuracy to differentiate NC from AD patients, and, moderate accuracy to differentiate NC from MCI. The Brazilian version of the RBMT seems to be an appropriate instrument to identify memory decline in Brazilian older adults.

Changes in cognition and behaviour in amyotrophic lateral sclerosis: nature of impairment and implications for assessment.

PubMed

Goldstein, Laura H; Abrahams, Sharon

2013-04-01

Increased awareness of cognitive and behavioural change in amyotrophic lateral sclerosis has been driven by various clinic-based and population-based studies. A frontotemporal syndrome occurs in a substantial proportion of patients, a subgroup of whom present with frontotemporal dementia. Deficits are characterised by executive and working-memory impairments, extending to changes in language and social cognition. Behaviour and social cognition abnormalities are closely similar to those reported in behavioural variant frontotemporal dementia, implying a clinical spectrum linking amyotrophic lateral sclerosis and frontotemporal dementia. Cognitive impairment should be considered in clinical management, but few specialist assessment resources are available, and thus the cognitive status of most patients is unknown. Standard assessment procedures are not appropriate to detect dysfunction due to progressive physical disability; techniques that better measure the problems encountered by this group of patients are needed to further establish disease effects. Screening instruments are needed that are validated specifically for amyotrophic lateral sclerosis, encompass the heterogeneity of impairment, and accommodate physical disability. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Koori Growing Old Well Study: investigating aging and dementia in urban Aboriginal Australians.

PubMed

Radford, Kylie; Mack, Holly A; Robertson, Hamish; Draper, Brian; Chalkley, Simon; Daylight, Gail; Cumming, Robert; Bennett, Hayley; Jackson Pulver, Lisa; Broe, Gerald A

2014-06-01

Dementia is an emerging health priority in Australian Aboriginal communities, but substantial gaps remain in our understanding of this issue, particularly for the large urban section of the population. In remote Aboriginal communities, high prevalence rates of dementia at relatively young ages have been reported. The current study is investigating aging, cognitive decline, and dementia in older urban/regional Aboriginal Australians. We partnered with five Aboriginal communities across the eastern Australian state of New South Wales, to undertake a census of all Aboriginal men and women aged 60 years and over residing in these communities. This was followed by a survey of the health, well-being, and life history of all consenting participants. Participants were also screened using three cognitive instruments. Those scoring below designated cut-offs, and a 20% random sample of those scoring above (i.e. "normal" range), completed a contact person interview (with a nominated family member) and medical assessment (blind to initial screening results), which formed the basis of "gold standard" clinical consensus determinations of cognitive impairment and dementia. This paper details our protocol for a population-based study in collaboration with local Aboriginal community organizations. The study will provide the first available prevalence rates for dementia and cognitive impairment in a representative sample of urban Aboriginal people, across city and rural communities, where the majority of Aboriginal Australians live. It will also contribute to improved assessment of dementia and cognitive impairment and to the understanding of social determinants of successful aging, of international significance.

Psychological predictors of participation in screening for cognitive impairment among community-dwelling older adults.

PubMed

Harada, Kazuhiro; Lee, Sangyoon; Shimada, Hiroyuki; Lee, Sungchul; Bae, Seongryu; Anan, Yuya; Harada, Kenji; Suzuki, Takao

2017-08-01

Detecting cognitive impairment in the earlier stages is important for preventing or delaying dementia. To develop intervention strategies that promote screening for cognitive impairment, it is essential to identify the modifiable predictors for participation in screening. The present study examined whether participation in screening for cognitive impairment was predicted by the constructs of the health belief model, dementia worry and behavioral intentions to undergo screening among older adults. The study used a prospective design. After a baseline questionnaire survey, participation in screening for cognitive impairment was followed for 6 months (n = 10 023). Participation in the screening, constructs of the health belief model (perceived susceptibility to dementia, perceived severity of dementia, perceived benefits of screening, perceived barriers to screening), dementia worry, behavioral intentions and demographic factors were measured. A path analysis showed that the behavioral intention to undergo screening (path coefficient = 0.29) directly predicted participation in screening for cognitive impairment, whereas other psychological and demographic factors did not directly predict participation. The behavioral intention was explained by the perceived benefits of screening (path coefficient = 0.51), perceived barriers to screening (path coefficient = -0.19) and perceived susceptibility to dementia (path coefficient = 0.16). Participation in screening for cognitive impairment was positively predicted by higher behavioral intention to undergo screening. In turn, this behavioral intention was mainly predicted by the perceived benefits of screening among older adults. These findings suggest that emphasizing the perceived benefits and encouraging behavioral intentions might promote participation in screening for cognitive impairment. Geriatr Gerontol Int 2017; 17: 1197-1204. © 2016 Japan Geriatrics Society.

Validation of the Identification and Intervention for Dementia in Elderly Africans (IDEA) cognitive screen in Nigeria and Tanzania.

PubMed

Paddick, Stella-Maria; Gray, William K; Ogunjimi, Luqman; Lwezuala, Bingileki; Olakehinde, Olaide; Kisoli, Aloyce; Kissima, John; Mbowe, Godfrey; Mkenda, Sarah; Dotchin, Catherine L; Walker, Richard W; Mushi, Declare; Collingwood, Cecilia; Ogunniyi, Adesola

2015-04-25

We have previously described the development of the Identification and Intervention for Dementia in Elderly Africans (IDEA) cognitive screen for use in populations with low levels of formal education. The IDEA cognitive screen was developed and field-tested in an elderly, community-based population in rural Tanzania with a relatively high prevalence of cognitive impairment. The aim of this study was to validate the IDEA cognitive screen as an assessment of major cognitive impairment in hospital settings in Nigeria and Tanzania. In Nigeria, 121 consecutive elderly medical clinic outpatients reviewed at the University College Hospital, Ibadan were screened using the IDEA cognitive screen. In Tanzania, 97 consecutive inpatients admitted to Mawenzi Regional Hospital (MRH), Moshi, and 108 consecutive medical clinic outpatients attending the geriatric medicine clinic at MRH were screened. Inter-rater reliability was assessed in Tanzanian outpatients attending St Joseph's Hospital in Moshi using three raters. A diagnosis of dementia or delirium (DSM-IV criteria) was classified as major cognitive impairment and was provided independently by a physician blinded to the results of the screening assessment. The area under the receiver operating characteristic (AUROC) curve in Nigerian outpatients, Tanzanian outpatients and Tanzanian inpatients was 0.990, 0.919 and 0.917 respectively. Inter-rater reliability was good (intra-class correlation coefficient 0.742 to 0.791). In regression models, the cognitive screen did not appear to be educationally biased. The IDEA cognitive screen performed well in these populations and should prove useful in screening for dementia and delirium in other areas of sub-Saharan Africa.

Sensitivity and specificity of the Beck Depression Inventory in cardiologic inpatients: how useful is the conventional cut-off score?

PubMed

Forkmann, Thomas; Vehren, Thomas; Boecker, Maren; Norra, Christine; Wirtz, Markus; Gauggel, Siegfried

2009-10-01

The Beck Depression Inventory (BDI) is widely used for depression screening in various patient populations. However, there are still insufficient data about its sensitivity and specificity in nonpsychiatric patients. Furthermore, some research suggests that somatic BDI items heighten its sum score artificially in physically ill patients. The aim of the present study was to validate the conventional BDI cut-off score by examination of its sensitivity and specificity in a mixed sample of cardiac inpatients and compare it to a modified "cognitive-emotional" BDI (BDI(c/e)) after exclusion of somatic items. A total of 126 cardiologic inpatients were assessed. Receiver operating characteristic curves (ROC) were calculated for total BDI (BDI(t)) and BDI(c/e). Screening performance of cut-off scores was evaluated using the Youden Index (Y). With the application of the conventional BDI cut-off score, ROC analysis revealed a moderate overall screening performance with Y=52.6 and an area under the curve (AUC) of 0.83. In contrast, Y improved to 57.5 at a cut-off score of >9, but screening performance was still not optimal. BDI(c/e) showed also a moderate screening performance (AUC=.82); Y was maximized at a cut-off score of >8 (Y=0.53.5). Again, no cut-off score provided optimal screening performance. The BDI cannot be recommended as a formal screening instrument in cardiac inpatients since no cut-off score for either BDI(t) or BDI(c/e) combined both sufficiently high sensitivity and specificity. However, the shorter BDI(c/e) could be used as alternative to BDI(t) which may be confounded in physically ill patients. Generally, researchers should consider using alternative screening instruments (e.g., the Hospital Anxiety and Depression Scale) instead.

Cognitive abilities screening instrument-short form, mini-mental state examination and functional activities questionnaire in the illiterate elderly

PubMed Central

Rezende, Gabriela Pravatta; Cecato, Juliana; Martinelli, José Eduardo

2013-01-01

Dementia prevalence is increasing in developing countries due to population aging. Brief tests for assessing cognition and activities of daily living are very useful for the diagnosis of dementia by the clinician. Low education, particularly illiteracy, is a hindrance to the diagnosis of dementia in several regions of the world. OBJECTIVES To compare the Brazilian version of the Cognitive Abilities Screening Instrument-Short Form (CASI-S) with the Mini-Mental State Examination (MMSE) and Pfeffer Functional Activities Questionnaire (PFAQ) for the diagnosis of dementia in illiterate elderly. METHODS A cross-sectional study with illiterate elderly of both genders seen at the outpatient clinics of the Institute of Gerontology and Geriatrics Jundiaí, São Paulo state was performed. Spearman's correlation coefficient was used to correlate CASI-S, MMSE and PFAQ scores. RESULTS The sample comprised 29 elderly over 57 years old whose mean scores on the CASI-S (scores ranging from 3 to 23) and the MMSE (scores ranging from 2 to 23) were 11.69 and 12.83, respectively. There was a strong significant correlation between the CASI-S and MMSE (r=0.75, p<0.001) and a moderate correlation coefficient that was significant and negative between the PFAQ and CASI-S (r= –0.53 p=0.003),similar to that between the MMSE and PFAQ (r= –0.41 p=0.025). CONCLUSION The Brazilian version of the CASI-S demonstrates ease of application and correction in the illiterate elderly, and warrants further studies regarding its applicability for the diagnosis of dementia in populations with a heterogeneous educational background. PMID:29213866

Normative data for the Clock Drawing Test for French-Quebec mid- and older aged healthy adults.

PubMed

Turcotte, Valérie; Gagnon, Marie-Eve; Joubert, Sven; Rouleau, Isabelle; Gagnon, Jean-François; Escudier, Frédérique; Koski, Lisa; Potvin, Olivier; Macoir, Joël; Hudon, Carol

2018-05-09

The Clock Drawing Test (CDT) is frequently used to screen for cognitive impairment, however, normative data for Rouleau et al.'s scoring system are scarce. The present study aims to provide norms for Rouleau et al.'s scoring system that are tailored to Quebec French-speaking mid- and older aged healthy adults. Six researchers from various research centers across the Province of Quebec (Canada) sent anonymous data for 593 (391 women) healthy community-dwelling volunteers (age range: 43-93 years; education range: 5-23 years) who completed the CDT 'drawing on command' version. This command version (setting the clock hands to 11:10, without a pre-drawn circle) was administrated as part of a more extensive neuropsychological assessment, or along with cognitive screening instruments. Each drawn clock was scored according to the quantitative criteria set by Rouleau et al.'s scoring system. CDT scores were significantly correlated with age (r(592) = -.132, p = .001) and years of education (r(592) = .116, p = .005), but not with sex (r(592) = .065, p = .112). Since data were skewed towards higher test scores, the percentiles method was used for analysis. Percentile ranks stratified by age and education are presented. These normative data for Rouleau et al.'s scoring system will contribute towards adequately screening for cognitive decline in Quebec French-speaking healthy adults, by also taking into account individual characteristics such as age and education.

Cognitive Screening Tests Versus Comprehensive Neuropsychological Test Batteries: A National Academy of Neuropsychology Education Paper†.

PubMed

Roebuck-Spencer, Tresa M; Glen, Tannahill; Puente, Antonio E; Denney, Robert L; Ruff, Ronald M; Hostetter, Gayle; Bianchini, Kevin J

2017-06-01

The American Medical Association Current Procedural Panel developed a new billing code making behavioral health screening a reimbursable healthcare service. The use of computerized testing as a means for cognitive screening and brief cognitive testing is increasing at a rapid rate. The purpose of this education paper is to provide information to clinicians, healthcare administrators, and policy developers about the purpose, strengths, and limitations of cognitive screening tests versus comprehensive neuropsychological evaluations. Screening tests are generally brief and narrow in scope, they can be administered during a routine clinical visit, and they can be helpful for identifying individuals in need of more comprehensive assessment. Some screening tests can also be helpful for monitoring treatment outcomes. Comprehensive neuropsychological assessments are multidimensional in nature and used for purposes such as identifying primary and secondary diagnoses, determining the nature  and severity of a person's cognitive difficulties, determining functional limitations, and planning treatment and rehabilitation. Cognitive screening tests are expected to play an increasingly important role in identifying individuals with cognitive impairment and in determining which individuals should be referred for further neuropsychological assessment. However, limitations of existing cognitive screening tests are present and cognitive screening tests should not be used as a replacement for comprehensive neuropsychological testing. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Sensitivity and Specificity of a Five-Minute Cognitive Screening Test in Patients With Heart Failure.

PubMed

Cameron, Janette D; Gallagher, Robyn; Pressler, Susan J; McLennan, Skye N; Ski, Chantal F; Tofler, Geoffrey; Thompson, David R

2016-02-01

Cognitive impairment occurs in up to 80% of patients with heart failure (HF). The National Institute for Neurological Disorders and Stroke (NINDS) and the Canadian Stroke Network (CSN) recommend a 5-minute cognitive screening protocol that has yet to be psychometrically evaluated in HF populations. The aim of this study was to conduct a secondary analysis of the sensitivity and specificity of the NINDS-CSN brief cognitive screening protocol in HF patients. The Montreal Cognitive Assessment (MoCA) was administered to 221 HF patients. The NINDS-CSN screen comprises 3 MoCA items, with lower scores indicating poorer cognitive function. Receiver operator characteristic (ROC) curves were constructed, determining the sensitivity, specificity and appropriate cutoff scores of the NINDS-CSN screen. In an HF population aged 76 ± 12 years, 136 (62%) were characterized with cognitive impairment (MoCA <26). Scores on the NINDS-CSN screen ranged from 3-11. The area under the receiver operating characteristic curve indicated good accuracy in screening for cognitive impairment (0.88; P < .01; 95% CI 0.83-0.92). A cutoff score of ≤9 provided 89% sensitivity and 71% specificity. The NINDS-CSN protocol offers clinicians a feasible telephone method to screen for cognitive impairment in patients with HF. Future studies should include a neuropsychologic battery to more comprehensively examine the diagnostic accuracy of brief cognitive screening protocols. Copyright © 2016 Elsevier Inc. All rights reserved.

Misclassification due to age grouping in measures of child development.

PubMed

Veldhuizen, Scott; Rodriguez, Christine; Wade, Terrance J; Cairney, John

2015-03-01

Screens for developmental delay generally provide a set of norms for different age groups. Development varies continuously with age, however, and applying a single criterion for an age range will inevitably produce misclassifications. In this report, we estimate the resulting error rate for one example: the cognitive subscale of the Bayley Scales of Infant and Toddler Development (BSID-III). Data come from a general population sample of 594 children (305 male) aged 1 month to 42.5 months who received the BSID-III as part of a validation study. We used regression models to estimate the mean and variance of the cognitive subscale as a function of age. We then used these results to generate a dataset of one million simulated participants and compared their status before and after division into age groups. Finally, we applied broader age bands used in two other instruments and explored likely validity limitations when different instruments are compared. When BSID-III age groups are used, 15% of cases are missed and 15% of apparent cases are false positives. Wider age groups produced error rates from 27% to 46%. Comparison of different age groups suggests that sensitivity in validation studies would be limited, under certain assumptions, to 70% or less. The use of age groups produces a large number of misclassifications. Although affected children will usually be close to the threshold, this may lead to misreferrals. Results may help to explain the poor measured agreement of development screens. Scoring methods that treat child age as continuous would improve instrument accuracy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Lower Limb Function in Elderly Korean Adults Is Related to Cognitive Function.

PubMed

Kim, A-Sol; Ko, Hae-Jin

2018-05-01

Patients with cognitive impairment have decreased lower limb function. Therefore, we aimed to investigate the relationship between lower limb function and cognitive disorders to determine whether lower limb function can be screened to identify cognitive decline. Using Korean National Health Insurance Service-National Sample Cohort database data, we assessed the cognitive and lower limb functioning of 66-year-olds who underwent national health screening between 2010 and 2014. Cognitive function was assessed via a questionnaire. Timed Up-and-Go (TUG) and one-leg-standing (OLS) tests were performed to evaluate lower limb function. Associations between cognitive and lower limb functions were analyzed, and optimal cut-off points for these tests to screen for cognitive decline, were determined. Cognitive function was significantly correlated with TUG interval ( r = 0.414, p < 0.001) and OLS duration ( r = −0.237, p < 0.001). Optimal cut-off points for screening cognitive disorders were >11 s and ≤12 s for TUG interval and OLS duration, respectively. Among 66-year-olds who underwent national health screening, a significant correlation between lower limb and cognitive function was demonstrated. The TUG and OLS tests are useful screening tools for cognitive disorders in elderly patients. A large-scale prospective cohort study should be conducted to investigate the causal relationship between cognitive and lower limb function.

Rapid and Accurate Behavioral Health Diagnostic Screening: Initial Validation Study of a Web-Based, Self-Report Tool (the SAGE-SR).

PubMed

Brodey, Benjamin; Purcell, Susan E; Rhea, Karen; Maier, Philip; First, Michael; Zweede, Lisa; Sinisterra, Manuela; Nunn, M Brad; Austin, Marie-Paule; Brodey, Inger S

2018-03-23

The Structured Clinical Interview for DSM (SCID) is considered the gold standard assessment for accurate, reliable psychiatric diagnoses; however, because of its length, complexity, and training required, the SCID is rarely used outside of research. This paper aims to describe the development and initial validation of a Web-based, self-report screening instrument (the Screening Assessment for Guiding Evaluation-Self-Report, SAGE-SR) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the SCID-5-Clinician Version (CV) intended to make accurate, broad-based behavioral health diagnostic screening more accessible within clinical care. First, study staff drafted approximately 1200 self-report items representing individual granular symptoms in the diagnostic criteria for the 8 primary SCID-CV modules. An expert panel iteratively reviewed, critiqued, and revised items. The resulting items were iteratively administered and revised through 3 rounds of cognitive interviewing with community mental health center participants. In the first 2 rounds, the SCID was also administered to participants to directly compare their Likert self-report and SCID responses. A second expert panel evaluated the final pool of items from cognitive interviewing and criteria in the DSM-5 to construct the SAGE-SR, a computerized adaptive instrument that uses branching logic from a screener section to administer appropriate follow-up questions to refine the differential diagnoses. The SAGE-SR was administered to healthy controls and outpatient mental health clinic clients to assess test duration and test-retest reliability. Cutoff scores for screening into follow-up diagnostic sections and criteria for inclusion of diagnoses in the differential diagnosis were evaluated. The expert panel reduced the initial 1200 test items to 664 items that panel members agreed collectively represented the SCID items from the 8 targeted modules and DSM criteria for the covered diagnoses. These 664 items were iteratively submitted to 3 rounds of cognitive interviewing with 50 community mental health center participants; the expert panel reviewed session summaries and agreed on a final set of 661 clear and concise self-report items representing the desired criteria in the DSM-5. The SAGE-SR constructed from this item pool took an average of 14 min to complete in a nonclinical sample versus 24 min in a clinical sample. Responses to individual items can be combined to generate DSM criteria endorsements and differential diagnoses, as well as provide indices of individual symptom severity. Preliminary measures of test-retest reliability in a small, nonclinical sample were promising, with good to excellent reliability for screener items in 11 of 13 diagnostic screening modules (intraclass correlation coefficient [ICC] or kappa coefficients ranging from .60 to .90), with mania achieving fair test-retest reliability (ICC=.50) and other substance use endorsed too infrequently for analysis. The SAGE-SR is a computerized adaptive self-report instrument designed to provide rigorous differential diagnostic information to clinicians. ©Benjamin Brodey, Susan E Purcell, Karen Rhea, Philip Maier, Michael First, Lisa Zweede, Manuela Sinisterra, M Brad Nunn, Marie-Paule Austin, Inger S Brodey. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.03.2018.

Midlife C-reactive protein and risk of cognitive decline: a 31-year follow-up.

PubMed

Laurin, Danielle; David Curb, J; Masaki, Kamal H; White, Lon R; Launer, Lenore J

2009-11-01

There is evidence for a relationship between raised inflammatory markers, including high sensitivity C-reactive protein (hs-CRP), measured late in life, and an increased risk of cognitive decline and dementia. This study evaluates the association of midlife hs-CRP concentrations with late-life longitudinal trends in cognitive function. Data are from the Honolulu-Asia Aging Study (HAAS), a longitudinal community-based study of Japanese American men. hs-CRP levels were measured on average 25 years before cognitive testing began in 1991. Subjects were followed from up to three follow-up examinations (mean of 6.1 years). At each exam, cognitive function was measured with the Cognitive Abilities Screening Instrument (CASI). This analysis includes a sub-sample of 691 subjects dementia-free in 1991. With incident dementia cases included, those with the highest quartile of hs-CRP had significantly more cognitive decline than those in the lowest quartile, after adjustment for baseline CASI score, demographic and cardiovascular risk factors. When cases were removed, there was no difference in cognitive decline by CRP quartile. This relationship was not modified by the presence of apolipoprotein E varepsilon4. These findings suggest that inflammatory mechanisms during midlife may reflect underlying processes contributing to dementia-related cognitive decline late in life.

Web-based cognitive rehabilitation for survivors of adult cancer: A randomised controlled trial.

PubMed

Mihuta, Mary E; Green, Heather J; Shum, David H K

2018-04-01

Cognitive dysfunction associated with cancer is frequently reported and can reduce quality of life. This study evaluated a Web-based cognitive rehabilitation therapy program (eReCog) in cancer survivors compared with a waitlist control group. Adult cancer survivors with self-reported cognitive symptoms who had completed primary treatment at least 6 months prior were recruited. Participants completed telephone screening and were randomly allocated to the 4-week online intervention or waitlist. Primary outcome was perceived cognitive impairment assessed with the Functional Assessment of Cancer Therapy-Cognitive Function version 3. Secondary outcomes were additional measures of subjective cognitive functioning, objective cognitive functioning, and psychosocial variables. Seventy-six women were allocated to the intervention (n = 40) or waitlist (n = 36). A significant interaction was found on the instrumental activities of daily living measure of self-reported prospective memory whereby the intervention group reported a greater reduction in prospective memory failures than the waitlist group. Interaction trends were noted on perceived cognitive impairments (P = .089) and executive functioning (P = .074). No significant interactions were observed on other measures of objective cognitive functioning or psychosocial variables. The Web-based intervention shows promise for improving self-reported cognitive functioning in adult cancer survivors. Further research is warranted to better understand the mechanisms by which the intervention might contribute to improved self-reported cognition. Copyright © 2017 John Wiley & Sons, Ltd.

[The Amsterdam Dementia Screening Test in cognitively healthy and clinical samples. An update of normative data].

PubMed

van Toutert, Meta; Diesfeldt, Han; Hoek, Dirk

2016-10-01

The six tests in the Amsterdam Dementia Screening Test (ADST) examine the cognitive domains of episodic memory (delayed picture recognition, word learning), orientation, category fluency (animals and occupations), constructional ability (figure copying) and executive function (alternating sequences). New normative data were collected in a sample of 102 elderly volunteers (aged 65-94), including subjects with medical or other health conditions, except dementia or frank cognitive impairment (MMSE > 24). Included subjects were independent in complex instrumental activities of daily living.Fluency, not the other tests, needed adjustment for age and education. A deficit score (0-1) was computed for each test. Summation (range 0-6) proved useful in differentiating patients with dementia (N = 741) from normal elderly (N = 102).Positive and negative predictive power across a range of summed deficit scores and base rates are displayed in Bayesian probability tables.In the normal elderly, delayed recall for eight words was tested and adjusted for initial recall. A recognition test mixed the target words with eight distractors. Delayed recognition was adjusted for immediate and delayed recall.The ADST and the normative data in this paper help the clinical neuropsychologist to make decisions concerning the presence or absence of neurocognitive disorder in individual elderly examinees.

Developing dementia prevention trials: baseline report of the Home-Based Assessment study.

PubMed

Sano, Mary; Egelko, Susan; Donohue, Michael; Ferris, Steven; Kaye, Jeffrey; Hayes, Tamara L; Mundt, James C; Sun, Chung-Kai; Paparello, Silvia; Aisen, Paul S

2013-01-01

This report describes the baseline experience of the multicenter, Home-Based Assessment study, designed to develop methods for dementia prevention trials using novel technologies for test administration and data collection. Nondemented individuals of 75 years of age or more were recruited and evaluated in-person using established clinical trial outcomes of cognition and function, and randomized to one of 3 assessment methodologies: (1) mail-in questionnaire/live telephone interviews [mail-in/phone (MIP)]; (2) automated telephone with interactive voice recognition; and (3) internet-based computer Kiosk. Brief versions of cognitive and noncognitive outcomes were adapted to each methodology and administered at baseline and repeatedly over a 4-year period. "Efficiency" measures assessed the time from screening to baseline, and staff time required for each methodology. A total of 713 individuals signed consent and were screened; 640 met eligibility and were randomized to one of 3 assessment arms; and 581 completed baseline. Dropout, time from screening to baseline, and total staff time were highest among those assigned to internet-based computer Kiosk. However, efficiency measures were driven by nonrecurring start-up activities suggesting that differences may be mitigated over a long trial. Performance among Home-Based Assessment instruments collected through different technologies will be compared with established outcomes over this 4-year study.

Validation of the Arabic Rowland Universal Dementia Assessment Scale (A-RUDAS) in elderly with mild and moderate dementia.

PubMed

Chaaya, M; Phung, T K T; El Asmar, K; Atweh, S; Ghusn, H; Khoury, R M; Prince, M; Nielsen, T R; Waldemar, G

2016-08-01

Validated screening tests for dementia in Arabic are lacking. Given the low levels of education among elderly in the Middle East and North Africa region, the commonly used screening instrument, the Mini Mental State Examination, is not best suited. Alternatively, the Rowland Universal Dementia Assessment Scale (RUDAS) was especially designed to minimize the effects of cultural learning and education. The aim of this study was to validate the RUDAS in the Arabic language (A-RUDAS), evaluate its ability to screen for mild and moderate dementia, and assess the effect of education, sex, age, depression, and recruitment site on its performance. A-RUDAS was administered to 232 elderly aged ≥65 years recruited from the communities, community-based primary care clinics, and hospital-based specialist clinics. Of these, 136 had normal cognition, and 96 had dementia. Clinicians diagnosed dementia according to the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) criteria. Interviewers, blind to the cognitive status of participants, administered A-RUDAS. The psychometric properties of A-RUDAS were examined for three cutoffs. At the cutoff of ≤22, A-RUDAS exhibited good sensitivity (83%) and specificity (85%) with an area under the receiver operating characteristic curve of 83.95%. Adjusting for age, sex, education, depression, and recruitment site, A-RUDAS score demonstrated a high level of accuracy in screening for mild and moderate dementia against DSM-IV diagnosis. The A-RUDAS is proposed for dementia screening in clinical practice and in research in Arabic-speaking populations with an optimal cutoff of ≤22.

Prevalence of dementia in Al Kharga District, New Valley Governorate, Egypt.

PubMed

El Tallawy, Hamdy N; Farghly, Wafaa M A; Shehata, Ghaydaa A; Rageh, Tarek A; Hakeem, Nabil Abdel; Abo-Elfetoh, Noha; Hegazy, Ahmed M; Rayan, Ibraheem; El-Moselhy, Essam A

2012-01-01

With aging, there is a parallel increase in the prevalence of dementia worldwide. The aim of this work is to determine the prevalence of dementia among the population of Al Kharga District, New Valley, Egypt. Screening of all subjects aged ≥50 years (n = 8,173 out of 62,583 inhabitants) was done through a door-to-door survey by 3 neurologists, using a short standardized Arabic screening test and a modified Mini-Mental State Examination. Suspected cases were subjected to full clinical examination, psychometric assessment using the Cognitive Abilities Screening Instrument, Instrumental Activities of Daily Living Scale, Geriatric Depression Scale, Hachinski Ischemic Score, DSM-IV-TR diagnostic criteria, neuroimaging, and laboratory investigations, when indicated. The prevalence rate of dementia was 2.26% for the population aged ≥50 years. It increased steeply with age to a maximum of 18.48% for those aged ≥80 years. Alzheimer's disease (51.2%) was the most common subtype, followed by vascular dementia (28.7%), dementia due to general medical conditions (12.8%), and lastly dementia due to multiple etiologies (7.3%). Mild dementia was the commonest (53.7%). Dementia is prevalent in Egypt as elsewhere. Detection through a door-to-door survey is the best method in developing countries for early detection of mild cases. Copyright © 2012 S. Karger AG, Basel.

Validation of the Telephone Interview of Cognitive Status and Telephone Montreal Cognitive Assessment Against Detailed Cognitive Testing and Clinical Diagnosis of Mild Cognitive Impairment After Stroke.

PubMed

Zietemann, Vera; Kopczak, Anna; Müller, Claudia; Wollenweber, Frank Arne; Dichgans, Martin

2017-11-01

Assessment of cognitive status poststroke is recommended by guidelines but follow-up can often not be done in person. The Telephone Interview of Cognitive Status (TICS) and the Telephone Montreal Cognitive Assessment (T-MoCA) are considered useful screening instruments. Yet, evidence to define optimal cut-offs for mild cognitive impairment (MCI) after stroke is limited. We studied 105 patients enrolled in the prospective DEDEMAS study (Determinants of Dementia After Stroke; NCT01334749). Follow-up visits at 6, 12, 36, and 60 months included comprehensive neuropsychological testing and the Clinical Dementia Rating scale, both of which served as reference standards. The original TICS and T-MoCA were obtained in 2 separate telephone interviews each separated from the personal visits by 1 week (1 before and 1 after the visit) with the order of interviews (TICS versus T-MoCA) alternating between subjects. Area under the receiver-operating characteristic curves was determined. Ninety-six patients completed both the face-to-face visits and the 2 interviews. Area under the receiver-operating characteristic curves ranged between 0.76 and 0.83 for TICS and between 0.73 and 0.94 for T-MoCA depending on MCI definition. For multidomain MCI defined by multiple-tests definition derived from comprehensive neuropsychological testing optimal sensitivities and specificities were achieved at cut-offs <36 (TICS) and <18 (T-MoCA). Validity was lower using single-test definition, and cut-offs were higher compared with multiple-test definitions. Using Clinical Dementia Rating as the reference, optimal cut-offs for MCI were <36 (TICS) and approximately 19 (T-MoCA). Both the TICS and T-MoCA are valid screening tools poststroke, particularly for multidomain MCI using multiple-test definition. © 2017 American Heart Association, Inc.

The mini-cog: a cognitive 'vital signs' measure for dementia screening in multi-lingual elderly.

PubMed

Borson, S; Scanlan, J; Brush, M; Vitaliano, P; Dokmak, A

2000-11-01

The Mini-Cog, a composite of three-item recall and clock drawing, was developed as a brief test for discriminating demented from non-demented persons in a community sample of culturally, linguistically, and educationally heterogeneous older adults. All 129 who met criteria for probable dementia based on informant interviews and 120 with no history of cognitive decline were included; 124 were non-English speakers. Sensitivity, specificity, and diagnostic value of the Mini-Cog were compared with those of the Mini-Mental State Exam (MMSE) and Cognitive Abilities Screening Instrument (CASI). The Mini-Cog had the highest sensitivity (99%) and correctly classified the greatest percentage (96%) of subjects. Moreover, its diagnostic value was not influenced by education or language, while that of the CASI was adversely influenced by low education, and both education and language compromised the diagnostic value of the MMSE. Administration time for the Mini-Cog was 3 minutes vs 7 minutes for the MMSE. The Mini-Cog required minimal language interpretation and training to administer, and no test forms of scoring modifications were needed to compensate for the extensive linguistic and educational heterogeneity of the sample. Validation in clinical and population-based samples is warranted, as its brevity and ease of administration suggest that the Mini-Cog might be readily incorporated into general practice and senior care settings as a routine 'cognitive vital signs' measure. Copyright 2000 John Wiley & Sons, Ltd.

Validation of the Patient Health Questionnaire-9 (PHQ-9) For Depression Screening in Adults with Epilepsy

PubMed Central

Rathore, Jaivir S.; Jehi, Lara E.; Fan, Youran; Patel, Sima I.; Foldvary-Schaefer, Nancy; Ramirez, Maya J.; Busch, Robyn M.; Obuchowski, Nancy A.; Tesar, George E.

2015-01-01

Objective Assess accuracy and operating characteristics of the Patient Health Questionnaire-9 (PHQ-9) for depression-screening in adults with epilepsy. Methods Tertiary epilepsy center patients served as the study population with 237 agreeing to structured interview using the Mini-International Neuropsychiatric Interview (MINI), a “gold standard” instrument developed for rapid diagnosis of neuropsychiatric disorders, including major depressive disorder (MDD); 172 also completed the PHQ-9, and 127 completed both the PHQ-9 and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) within two days of the MINI. Sensitivity, specificity, positive & negative predictive values & areas under the ROC curves for each instrument were determined. Cut-points of 10 for the PHQ-9 and 15 for the NDDI-E were used and ratings at or above the cut-points were considered screen-positive. The PHQ-9 was divided into cognitive/affective (PHQ-9/CA) and somatic (PHQ-9/S) subscales to determine comparative depression-screening accuracy. Results The calculated areas under the ROC curves for the PHQ-9 (n=172) and the PHQ-9/CA and PHQ-9/S sub-scales were 0.914, 0.924, and 0.846, respectively, with the PHQ-9 more accurate than the PHQ-9/S (p=0.002) but no different than the PHQ-9/CA (p=0.378). At cut-points of 10 and 15, respectively, the PHQ-9 had higher sensitivity (0.92 vs 0.87), but lower specificity (0.74 vs 0.89) than the NDDI-E. The areas under the ROC curves of the PHQ-9 and the NDDI-E showed similar accuracy (n=127; 0.930 vs 0.934; p=0.864). Significance The PHQ-9 is an efficient & non-proprietary depression screening instrument with excellent accuracy validated for use in adult epilepsy patients as well as multiple other medical populations. PMID:25064739

Tracking Cognitive Decline in Amnestic Mild Cognitive Impairment and Early-Stage Alzheimer Dementia: Mini-Mental State Examination versus Neuropsychological Battery.

PubMed

Kim, Joonho; Na, Han Kyu; Byun, Justin; Shin, Jiwon; Kim, Sungsoo; Lee, Byung Hwa; Na, Duk L

2017-01-01

Although the Mini-Mental State Examination (MMSE), Clinical Dementia Rating-Sum of Boxes (CDR-SOB), and neuropsychological batteries are widely used for evaluating cognitive function, it remains elusive which instrument best reflects the longitudinal disease progression in amnestic mild cognitive impairment (aMCI) and probable Alzheimer disease (AD). We investigated whether changes in these three instruments over time correlate with loss of cortical gray matter volume (cGMV). We retrospectively investigated 204 patients (aMCI, n = 114; AD, n = 90) who had undergone MMSE, CDR-SOB, the dementia version of the Seoul Neuropsychological Screening Battery (SNSB-D), and 3-dimensional T1-weighted magnetic resonance images at least twice. We investigated the partial correlation between annual decline in test scores and percent change of cGMV. In aMCI patients, changes in the SNSB-D total score (r = 0.340, p < 0.001) and CDR-SOB (r = 0.222, p = 0.020), but not MMSE, showed a correlation with cGMV loss, with the SNSB-D total score showing the strongest correlation. In AD patients, decline in all three test scores correlated significantly with cGMV loss, with MMSE exhibiting the strongest correlation (r = 0.464, p < 0.001). In aMCI patients, neuropsychological battery, though time-consuming, was the most adequate tool in tracking disease progression. In AD patients, however, MMSE may be the most effective longitudinal monitoring tool when considering cost-effectiveness. © 2017 S. Karger AG, Basel.

Screening for cognitive impairment in the elderly.

PubMed Central

Bush, C.; Kozak, J.; Elmslie, T.

1997-01-01

OBJECTIVE: To evaluate the extent and type of screening for cognitive impairment primary care physicians use for their elderly patients, to identify perceived barriers to screening, and to explore whether physicians would be willing to use the clock drawing test as a cognitive screening tool. DESIGN: Mailed questionnaire. SETTING: Primary care practices in the Ottawa-Carleton region. PARTICIPANTS: Family physicians and general practitioners culled from the Yellow Pages and Canadian Medical Directory; 368 of 568 questionnaires were returned for a response rate of 70%. Six respondents had fewer than 30 patients weekly and two responded too late to be included in the analysis; 360 cases were included in the analysis. MAIN OUTCOME MEASURES: Responses to 10 questions on cognitive screening and five on demographics and the nature of respondents' practices. RESULTS: About 80% of respondents reported doing at least one mental status examination during the past year. Only 24% routinely screened patients, although 82% believed screening was needed. Major barriers to cognitive screening were lack of time, risk of offending patients, and possible negative consequences of follow up. Clock drawing was perceived as an acceptable method of screening, if it were proven effective. CONCLUSIONS: Most primary care physicians believe cognitive screening is needed, but few routinely screen their elderly patients. Lack of time is the most important perceived barrier to screening. Primary care physicians are receptive to using the clock drawing test, and, because it is not time-consuming, are less likely to consider lack of time a barrier to testing. The clock test might help bridge the gap between perceived need for screening and actual screening. PMID:9356757

Cognitive assessment: A challenge for occupational therapists in Brazil

PubMed Central

Conti, Juliana

2017-01-01

Cognitive impairment is a common dysfunction after neurological injury. Cognitive assessment tools can help the therapist understand how impairments are affecting functional status and quality of life. Objective The aim of the study was to identify instruments for cognitive assessment that Occupational Therapists (OT) can use in clinical practice. Methods The instruments published in English and Portuguese between 1999 and 2016 were systematically reviewed. Results The search identified 17 specific instruments for OT not validated in Brazilian Portuguese, 10 non-specific instruments for OT not validated in Brazilian Portuguese, and 25 instruments validated for Portuguese, only one of which was specific for OT (Lowenstein Occupational Therapy Cognitive Assessment). Conclusion There are few assessment cognitive tools validated for use in the Brazilian culture and language. The majority of the instruments appear not to be validated for use by OT in clinical practice. PMID:29213503

Three screening methods for cognitive dysfunction using the Mini-Mental State Examination and Korean Dementia Screening Questionnaire.

PubMed

Choi, Seong Hye; Park, Moon Ho

2016-02-01

To screen for and determine cognitive dysfunction, cognitive tests and/or informant reports are commonly used. However, these cognitive tests and informant reports are not always available. The present study investigated three screening methods using the Mini-Mental State Examination (MMSE) as the cognitive test, and the Korean dementia screening questionnaire (KDSQ) as the informant report. Participants were recruited from the Korea Clinical Research Center for Dementia of South Korea, and included 2861 patients with Alzheimer's disease (dementia), 3519 patients with mild cognitive impairment and 1375 controls with no cognitive dysfunction. Three screening methods were tested: (i) MMSE alone (MMSE(cut-off) ); (ii) a conventional combination of MMSE and KDSQ (MMSE+KDSQ(cut-off) ); and (iii) a decision tree with MMSE and KDSQ (MMSE+KDSQ(decision tree) ). For discriminating any cognitive dysfunction from controls, MMSE+KDSQ(cut-off) had the highest area under the receiver operating characteristic curve (0.784). For discriminating dementia from controls, MMSE+KDSQ(cut-off) had the highest area under the receiver operating characteristic curve (0.899). For discriminating mild cognitive impairment from controls, MMSE(cut-off) had the highest area under the receiver operating characteristic curve (0.683). MMSE+KDSQ(decision tree) showed the highest sensitivity for all discriminations. For overall classification accuracy, MMSE+KDSQ(decision tree) had the highest value (70.0%). These three methods had different advantageous properties for screening and staging cognitive dysfunction. As there might be different availability across clinical settings, these three methods can be selected and used according to situational needs. © 2015 Japan Geriatrics Society.

A Comparison of Screening Instruments: Predictive Validity of the BESS and BSC

ERIC Educational Resources Information Center

King, Kathleen R.; Reschly, Amy L.

2014-01-01

The purpose of this study was to evaluate and compare two behavior screening instruments--the Behavioral and Emotional Screening System and the Behavior Screening Checklist. The sample consisted of 492 elementary school children from the southeastern United States. The psychometric properties of the screening instruments were evaluated in terms of…

Functional decline in the elderly with MCI: Cultural adaptation of the ADCS-ADL scale.

PubMed

Cintra, Fabiana Carla Matos da Cunha; Cintra, Marco Túlio Gualberto; Nicolato, Rodrigo; Bertola, Laiss; Ávila, Rafaela Teixeira; Malloy-Diniz, Leandro Fernandes; Moraes, Edgar Nunes; Bicalho, Maria Aparecida Camargos

2017-07-01

Translate, transcultural adaptation and application to Brazilian Portuguese of the Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) scale as a cognitive screening instrument. We applied the back translation added with pretest and bilingual methods. The sample was composed by 95 elderly individuals and their caregivers. Thirty-two (32) participants were diagnosed as mild cognitive impairment (MCI) patients, 33 as Alzheimer's disease (AD) patients and 30 were considered as cognitively normal individuals. There were only little changes on the scale. The Cronbach alpha coefficient was 0.89. The scores were 72.9 for control group, followed by MCI (65.1) and by AD (55.9), with a p-value < 0.001. The ROC curve value was 0.89. We considered a cut point of 72 and we observed a sensibility of 86.2%, specificity of 70%, positive predictive value of 86.2%, negative predictive value of 70%, positive likelihood ratio of 2.9 and negative likelihood ratio of 0.2. ADCS-ADL scale presents satisfactory psychometric properties to discriminate between MCI, AD and normal cognition.

A Valid and Reliable Instrument for Cognitive Complexity Rating Assignment of Chemistry Exam Items

ERIC Educational Resources Information Center

Knaus, Karen; Murphy, Kristen; Blecking, Anja; Holme, Thomas

2011-01-01

The design and use of a valid and reliable instrument for the assignment of cognitive complexity ratings to chemistry exam items is described in this paper. Use of such an instrument provides a simple method to quantify the cognitive demands of chemistry exam items. Instrument validity was established in two different ways: statistically…

Cognitive-behavioral screening reveals prevalent impairment in a large multicenter ALS cohort

PubMed Central

Factor-Litvak, Pam; Goetz, Raymond; Lomen-Hoerth, Catherine; Nagy, Peter L.; Hupf, Jonathan; Singleton, Jessica; Woolley, Susan; Andrews, Howard; Heitzman, Daragh; Bedlack, Richard S.; Katz, Jonathan S.; Barohn, Richard J.; Sorenson, Eric J.; Oskarsson, Björn; Fernandes Filho, J. Americo M.; Kasarskis, Edward J.; Mozaffar, Tahseen; Rollins, Yvonne D.; Nations, Sharon P.; Swenson, Andrea J.; Koczon-Jaremko, Boguslawa A.; Mitsumoto, Hiroshi

2016-01-01

Objectives: To characterize the prevalence of cognitive and behavioral symptoms using a cognitive/behavioral screening battery in a large prospective multicenter study of amyotrophic lateral sclerosis (ALS). Methods: Two hundred seventy-four patients with ALS completed 2 validated cognitive screening tests and 2 validated behavioral interviews with accompanying caregivers. We examined the associations between cognitive and behavioral performance, demographic and clinical data, and C9orf72 mutation data. Results: Based on the ALS Cognitive Behavioral Screen cognitive score, 6.5% of the sample scored below the cutoff score for frontotemporal lobar dementia, 54.2% scored in a range consistent with ALS with mild cognitive impairment, and 39.2% scored in the normal range. The ALS Cognitive Behavioral Screen behavioral subscale identified 16.5% of the sample scoring below the dementia cutoff score, with an additional 14.1% scoring in the ALS behavioral impairment range, and 69.4% scoring in the normal range. Conclusions: This investigation revealed high levels of cognitive and behavioral impairment in patients with ALS within 18 months of symptom onset, comparable to prior investigations. This investigation illustrates the successful use and scientific value of adding a cognitive-behavioral screening tool in studies of motor neuron diseases, to provide neurologists with an efficient method to measure these common deficits and to understand how they relate to key clinical variables, when extensive neuropsychological examinations are unavailable. These tools, developed specifically for patients with motor impairment, may be particularly useful in patient populations with multiple sclerosis and Parkinson disease, who are known to have comorbid cognitive decline. PMID:26802094

Cognitive-behavioral screening reveals prevalent impairment in a large multicenter ALS cohort.

PubMed

Murphy, Jennifer; Factor-Litvak, Pam; Goetz, Raymond; Lomen-Hoerth, Catherine; Nagy, Peter L; Hupf, Jonathan; Singleton, Jessica; Woolley, Susan; Andrews, Howard; Heitzman, Daragh; Bedlack, Richard S; Katz, Jonathan S; Barohn, Richard J; Sorenson, Eric J; Oskarsson, Björn; Fernandes Filho, J Americo M; Kasarskis, Edward J; Mozaffar, Tahseen; Rollins, Yvonne D; Nations, Sharon P; Swenson, Andrea J; Koczon-Jaremko, Boguslawa A; Mitsumoto, Hiroshi

2016-03-01

To characterize the prevalence of cognitive and behavioral symptoms using a cognitive/behavioral screening battery in a large prospective multicenter study of amyotrophic lateral sclerosis (ALS). Two hundred seventy-four patients with ALS completed 2 validated cognitive screening tests and 2 validated behavioral interviews with accompanying caregivers. We examined the associations between cognitive and behavioral performance, demographic and clinical data, and C9orf72 mutation data. Based on the ALS Cognitive Behavioral Screen cognitive score, 6.5% of the sample scored below the cutoff score for frontotemporal lobar dementia, 54.2% scored in a range consistent with ALS with mild cognitive impairment, and 39.2% scored in the normal range. The ALS Cognitive Behavioral Screen behavioral subscale identified 16.5% of the sample scoring below the dementia cutoff score, with an additional 14.1% scoring in the ALS behavioral impairment range, and 69.4% scoring in the normal range. This investigation revealed high levels of cognitive and behavioral impairment in patients with ALS within 18 months of symptom onset, comparable to prior investigations. This investigation illustrates the successful use and scientific value of adding a cognitive-behavioral screening tool in studies of motor neuron diseases, to provide neurologists with an efficient method to measure these common deficits and to understand how they relate to key clinical variables, when extensive neuropsychological examinations are unavailable. These tools, developed specifically for patients with motor impairment, may be particularly useful in patient populations with multiple sclerosis and Parkinson disease, who are known to have comorbid cognitive decline. © 2016 American Academy of Neurology.

Validity of the Montreal Cognitive Assessment Screener in Adolescents and Young Adults With and Without Congenital Heart Disease.

PubMed

Pike, Nancy A; Poulsen, Marie K; Woo, Mary A

Cognitive deficits are common, long-term sequelae in children and adolescents with congenital heart disease (CHD) who have undergone surgical palliation. However, there is a lack of a validated brief cognitive screening tool appropriate for the outpatient setting for adolescents with CHD. One candidate instrument is the Montreal Cognitive Assessment (MoCA) questionnaire. The purpose of the research was to validate scores from the MoCA against the General Memory Index (GMI) of the Wide Range Assessment of Memory and Learning, 2nd Edition (WRAML2), a widely accepted measure of cognition/memory, in adolescents and young adults with CHD. We administered the MoCA and the WRAML2 to 156 adolescents and young adults ages 14-21 (80 youth with CHD and 76 healthy controls who were gender and age matched). Spearman's rank order correlations were used to assess concurrent validity. To assess construct validity, the Mann-Whitney U test was used to compare differences in scores in youth with CHD and the healthy control group. Receiver operating characteristic curves were created and area under the curve, sensitivity, specificity, positive predictive value, and negative predictive value were also calculated. The MoCA median scores in the CHD versus healthy controls were (23, range 15-29 vs. 28, range 22-30; p < .001), respectively. With the screening cutoff scores at <26 points for the MoCA and 85 for GMI (<1 SD, M = 100, SD = 15), the CHD versus healthy control groups showed sensitivity of .96 and specificity of .67 versus sensitivity of .75 and specificity of .90, respectively, in the detection of cognitive deficits. A cutoff score of 26 on the MoCA was optimal in the CHD group; a cutoff of 25 had similar properties except for a lower negative predictive value. The area under the receiver operating characteristic curve (95% CI) for the MoCA was 0.84 (95% CI [0.75, 0.93], p < .001) and 0.84 (95% CI [0.62, 1.00], p = .02) for the CHD and controls, respectively. Scores on the MoCA were valid for screening to detect cognitive deficits in adolescents and young adults aged 14-21 with CHD when a cutoff score of 26 is used to differentiate youth with and without significant cognitive impairment. Future studies are needed in other adolescent disease groups with known cognitive deficits and healthy populations to explore the generalizability of validity of MoCA scores in adolescents and young adults.

Validation of the modified telephone interview for cognitive status (TICS-m) in Hebrew.

PubMed

Beeri, Michal Schnaider; Werner, Perla; Davidson, Michael; Schmidler, James; Silverman, Jeremy

2003-05-01

The validity of the Hebrew version of the Telephone Interview for Cognitive Status-Modified (TICS-m) for Mild Cognitive Impairment (MCI), for dementia, and for cognitive impairment (either MCI or dementia) was investigated. Of the 10 059 who took part of the Israel Ischemic Heart Disease Cohort, 1902 of the 2901 survivors in 1999 had TICS-m interviews. Those with a score of 27 or below and a random sample with a score of 28 or 29 were invited to have a physician's examination for the diagnosis of dementia. The analysis was performed on the 576 who agreed. Based on physician's diagnosis, 269 were diagnosed as suffering from dementia, 128 as suffering from MCI, and 179 were diagnosed with no cognitive impairment. The TICS-m Hebrew version's internal consistency was very high (Cronbach's alpha = 0.98) and showed a strong convergent validity with the MMSE (r = 0.82; p < 0.0005). The sensitivity was 100% for each of the conditions. Finally, after controlling for age, education and hearing impairment, TICS-m was a strong predictor of dementia, MCI and cognitive impairment. At a cut-off of 27/50 the Hebrew version of the TICS-m is a useful screening instrument to identify subjects suffering from mild cognitive impairment, dementia and cognitive impairment (MCI or dementia). Copyright 2003 John Wiley & Sons, Ltd.

Montreal Cognitive Assessment for screening mild cognitive impairment: variations in test performance and scores by education in Singapore.

PubMed

Ng, Tze Pin; Feng, Lei; Lim, Wee Shiong; Chong, Mei Sian; Lee, Tih Shih; Yap, Keng Bee; Tsoi, Tung; Liew, Tau Ming; Gao, Qi; Collinson, Simon; Kandiah, Nagaendran; Yap, Philip

2015-01-01

The Montreal Cognitive Assessment (MoCA) was developed as a screening instrument for mild cognitive impairment (MCI). We evaluated the MoCA's test performance by educational groups among older Singaporean Chinese adults. The MoCA and Mini-Mental State Examination (MMSE) were evaluated in two independent studies (clinic-based sample and community-based sample) of MCI and normal cognition (NC) controls, using receiver operating characteristic curve analyses: area under the curve (AUC), sensitivity (Sn), and specificity (Sp). The MoCA modestly discriminated MCI from NC in both study samples (AUC = 0.63 and 0.65): Sn = 0.64 and Sp = 0.36 at a cut-off of 28/29 in the clinic-based sample, and Sn = 0.65 and Sp = 0.55 at a cut-off of 22/23 in the community-based sample. The MoCA's test performance was least satisfactory in the highest (>6 years) education group: AUC = 0.50 (p = 0.98), Sn = 0.54, and Sp = 0.51 at a cut-off of 27/28. Overall, the MoCA's test performance was not better than that of the MMSE. In multivariate analyses controlling for age and gender, MCI diagnosis was associated with a <1-point decrement in MoCA score (η(2) = 0.010), but lower (1-6 years) and no education was associated with a 3- to 5-point decrement (η(2) = 0.115 and η(2) = 0.162, respectively). The MoCA's ability to discriminate MCI from NC was modest in this Chinese population, because it was far more sensitive to the effect of education than MCI diagnosis. © 2015 S. Karger AG, Basel.

Impact of obstructive sleep apnea syndrome on cognition in early postmenopausal women.

PubMed

Lal, Chitra; DiBartolo, Michelle M; Kumbhare, Suchit; Strange, Charlie; Joseph, Jane E

2016-05-01

Obstructive sleep apnea syndrome (OSAS) has a higher prevalence in postmenopausal women who are not on hormone replacement therapy (HRT), as compared to premenopausal women. Cognitive impairment (CI) is associated with OSAS and the early postmenopausal state. We hypothesized that compared to postmenopausal women at low risk for OSAS, postmenopausal women at high risk for OSAS would report worse cognitive function. Early postmenopausal women not on HRT between the ages of 45 and 60 years, within 5 years of natural menopause, were enrolled. Participants completed a REDCap survey which collected information on demographics and risk factors, Berlin questionnaire to screen subjects for OSAS risk, and the Mail-In Cognitive Function Screening Instrument (MCFSI) score which was used to assess CI. Of 381 respondents, 127 were omitted due to missing/duplicate data or not meeting inclusion criteria. One hundred fifty-four women were classified as high risk for OSAS (OSAS+), and 100 were classified as low risk for OSAS (OSAS-). OSAS- women reported lifetime smoking, lifetime drinking, and recreational drug use more often than OSAS+ women, while OSAS+ women reported a depression diagnosis more often. The mean MCFSI score in the OSAS+ group was significantly higher (worse cognition) than in the OSAS- group after controlling for covariates (5.59, 95 % CI 5.08-6.11 vs. 4.29, 95 % CI 3.64-4.93, p < 0.05). Early postmenopausal women at high risk for OSAS report more CI than those at low risk for OSAS. Future studies should identify biomarkers of this CI and define the degree of reversibility of CI with OSAS treatment.

Cognition and competency restoration: using the RBANS to predict length of stay for patients deemed incompetent to stand trial.

PubMed

Toofanian Ross, Parnian; Padula, Claudia B; Nitch, Stephen R; Kinney, Dominique I

2015-01-01

Intact cognition is a foundational component of one's ability to be competent to stand trial. Given the cost of assessing and treating incompetence, it is recommended that clinicians develop efficient methods to identify individuals who are most likely to require intensive competence-related treatment interventions. This study sought to ascertain whether a brief cognitive screening instrument, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), could predict the length of stay required to restore trial competency among 288 forensic psychiatric inpatients undergoing competency restoration treatment. Results indicated that incompetent defendants who were older or demonstrated poorer overall RBANS performance required longer hospitalizations to be deemed restored to trial competence. Interestingly, incompetent defendants scoring in the 51-60 range on the RBANS Total Scale Index were almost three times more likely to require hospitalization beyond the average length of stay. Findings support the use of the RBANS to identify individuals early in the treatment process who may require and benefit from intensive restoration treatment.

Measurement tools of resource use and quality of life in clinical trials for dementia or cognitive impairment interventions: protocol for a scoping review.

PubMed

Yang, Fan; Dawes, Piers; Leroi, Iracema; Gannon, Brenda

2017-01-26

Dementia and cognitive impairment could severely impact patients' life and bring heavy burden to patients, caregivers and societies. Some interventions are suggested for the older patients with these conditions to help them live well, but economic evaluation is needed to assess the cost-effectiveness of these interventions. Trial-based economic evaluation is an ideal method; however, little is known about the tools used to collect data of resource use and quality of life alongside the trials. Therefore, the aim of this review is to identify and describe the resource use and quality of life instruments in clinical trials of interventions for older patients with dementia or cognitive impairment. We will perform a search in main electronic databases (Ovid MEDLINE, PsycINFO, EMBASE, CINAHL, Cochrane Databases of Systematic Reviews, Web of Science and Scopus) using the key terms or their synonyms: older, dementia, cognitive impairment, cost, quality of life, intervention and tools. After removing duplicates, two independent reviewers will screen each entry for eligibility, initially by title and abstract, then by full-text. A hand search of the references of included articles and general search, e.g. Google Scholar, will also be conducted to identify potential relevant studies. All disagreements will be resolved by discussion or consultation with a third reviewer if necessary. Data analysis will be completed and reported in a narrative review. This review will identify the instruments used in clinical trials to collect resource use and quality of life data for dementia or cognitive impairment interventions. This will help to guide the study design of future trial-based economic evaluation of these interventions. PROSPERO CRD42016038495.

Radiation Effects on Cognitive Function Among Atomic Bomb Survivors Exposed at or After Adolescence.

PubMed

Yamada, Michiko; Landes, Reid D; Mimori, Yasuyo; Nagano, Yoshito; Sasaki, Hideo

2016-06-01

The objective of this study was to investigate radiation effects on longitudinal pre-dementia cognitive decline among participants who developed dementia as well as on those who did not develop dementia during follow-up. Measuring cognitive function with the Cognitive Abilities Screening Instrument approximately every 2 years, we followed 1844 atomic bomb survivors participating in the Adult Health Study of the Radiation Effects Research Foundation from 1992 to 2011. Participants were adolescents or older when exposed to between 0 and 4 Gy. Approximately 15% and 40% of participants were exposed to ≥1 Gy and <5 mGy, respectively. At study start, participants were dementia-free and between 60 and 80 years old. Three-quarters of the participants returned after baseline, averaging 8.4 years of follow-up. During follow-up, 313 developed dementia. We used cognitive scores before dementia onset for analysis and a mixed-effects model to estimate radiation effects on longitudinal change of cognition, adjusting for dementia occurrence, age, sex, and education. Cognition level was significantly associated with age, education, and dementia occurrence but not with radiation dose or sex. Cognitive decline accelerated with increasing age, especially among participants who developed dementia. Neither radiation nor education was significantly associated with the degree of deterioration with age. Radiation did not modify the different cognitive decline by dementia occurrence. Radiation did not significantly affect cognition among atomic bomb survivors exposed at or after adolescence. Copyright © 2016 Elsevier Inc. All rights reserved.

The Need for Screening, Assessment, and Treatment for Cognitive Dysfunction in Multiple Sclerosis

PubMed Central

Benedict, Ralph H.B.; Gromisch, Elizabeth S.; DeLuca, John

2012-01-01

Cognitive dysfunction is observed in about half of people with multiple sclerosis (MS), and MS health-care professionals face the challenge of screening, assessing, and treating patients for cognitive problems. Considering the inconsistent or limited empirical evidence to assist in this task, a multidisciplinary consensus conference of MS experts, sponsored by the Consortium of Multiple Sclerosis Centers (CMSC), was held on September 24, 2010, to address these issues. Key articles from the literature on these topics were distributed prior to the meeting, and CMSC member professionals were surveyed on clinical practices related to screening, assessment, and treatment for cognitive problems. The purpose of the meeting was threefold: 1) to achieve a multidisciplinary perspective on practices for screening, monitoring, evaluating, and treating MS patients for cognitive problems; 2) to propose consensus candidate measures for screening and/or monitoring for cognitive problems in MS that neurologists or nurses might administer on a regular basis; and 3) to propose consensus treatment approaches from a multidisciplinary perspective. This article summarizes the conclusions of the conference participants and provides preliminary suggestions for screening and brief assessment. PMID:24453735

Italian version of the Parkinson Neuropsychometric Dementia Assessment (PANDA): a useful instrument to detect cognitive impairments in Parkinson's Disease.

PubMed

Pignatti, Riccardo; Bertella, Laura; Scarpina, Federica; Mauro, Alessandro; Portolani, Elisa; Calabrese, Pasquale

2014-01-01

Parkinson's disease (PD) is frequently characterized by cognitive and affective dysfunctions. The "Parkinson Neuropsychometric Dementia Assessment" (PANDA) is a screening tool designed for the early detection of mild cognitive impairment as well as dementia in PD. The PANDA is already validated in German and in French. The aim of the present work was to provide normative data for the Italian-speaking population, Swiss regions included; moreover, the effectiveness of the PANDA compared to the Mini Mental State Examination (MMSE) was tested. One-hundred and eleven PD patients with and without cognitive impairment and one-hundred and three matched healthy subjects participated at this study; all patients underwent an extensive neuropsychological evaluation. A PANDA total score of 13 appeared to be the most fitting cut-off with a sensitivity of 96.6% and a specificity of 82.2%; with the MMSE, the same value of sensitivity but with a specificity of 72,4% was reached only by adopting a cut-off of 28. Moreover, a PANDA range of 13-17 appeared to be suggestive for possible cognitive disturbance. The present work provides evidence for the effectiveness of the PANDA in evaluating cognitive deficits also in PD Italian-speaking patients, even when their pathological degree is still initial or very mild.

Diarrhea-predominant irritable bowel syndrome: creation of an electronic version of a patient-reported outcome instrument by conversion from a pen-and-paper version and evaluation of their equivalence.

PubMed

Delgado-Herrera, Leticia; Banderas, Benjamin; Ojo, Oluwafunke; Kothari, Ritesh; Zeiher, Bernhardt

2017-01-01

Subjects with diarrhea-predominant irritable bowel syndrome (IBS-D) experience abdominal cramping, bloating, pressure, and pain. Due to an absence of clinical biomarkers for IBS-D severity, evaluation of clinical therapy benefits depends on valid and reliable symptom assessments. A patient-reported outcome (PRO) instrument has been developed, comprising of two questionnaires - the IBS-D Daily Symptom Diary and IBS-D Symptom Event Log - suitable for clinical trials and real-world settings. This program aimed to support instrument conversion from pen-and-paper to electronic format. Digital technology (Android/iOS) and a traditional mode of administration study in the target population were used to migrate or convert the validated PRO IBS-D pen-and-paper measure to an electronic format. Equivalence interviews, conducted in three waves, each had three parts: 1) conceptual equivalence testing between formats, 2) electronic-version report-history cognitive debriefing, and 3) electronic version usability evaluation. After each inter-view wave, preliminary analyses were conducted and modifications made to the electronic version, before the next wave. Final revisions were based on a full analysis of equivalence interviews. The final analysis evaluated subjects' ability to read, understand, and provide meaningful responses to the instruments across both formats. Responses were classified according to conceptual equivalence between formats and mobile-format usability assessed with a questionnaire and open-ended probes. Equivalence interviews (n=25) demonstrated conceptual equivalence between formats. Mobile-application cognitive debriefing showed some subjects experienced difficulty with font/screen visibility and understanding or reading some report-history charts and summary screens. To address difficulties, minor revisions/modifications were made and landscape orientation and zoom-in/zoom-out features incorporated. This study indicates that the two administration modes are conceptually equivalent. Since both formats are conceptually equivalent, both are psychometrically reliable, as established in the pen-and-paper version. Subjects found both mobile applications (Android/iOS) offered many advantages over the paper version, such as real-time assessment of their experience.

A new early cognitive screening measure to detect cognitive side-effects of electroconvulsive therapy?

PubMed

Martin, Donel M; Katalinic, Natalie; Ingram, Anna; Schweitzer, Isaac; Smith, Deidre J; Hadzi-Pavlovic, Dusan; Loo, Colleen K

2013-12-01

Cognitive side-effects from electroconvulsive therapy (ECT) can be distressing for patients and early detection may have an important role in guiding treatment decisions over the ECT course. This prospective study examined the utility of an early cognitive screening battery for predicting cognitive side-effects which develop later in the ECT course. The screening battery, together with the Mini Mental Status Examination (MMSE), was administered to 123 patients at baseline and after 3 ECT treatments. A more detailed cognitive battery was administered at baseline, after six treatments (post ECT 6) and after the last ECT treatment (post treatment) to assess cognitive side-effects across several domains: global cognition, anterograde memory, executive function, speed and concentration, and retrograde memory. Multivariate analyses examined the predictive utility of change on items from the screening battery for later cognitive changes at post ECT 6 and post treatment. Results showed that changes on a combination of items from the screening battery were predictive of later cognitive changes at post treatment, particularly for anterograde memory (p < 0.01), after controlling for patient and treatment factors. Change on the MMSE predicted cognitive changes at post ECT 6 but not at post treatment. A scoring method for the new screening battery was tested for discriminative ability in a sub-sample of patients. This study provides preliminary evidence that a simple and easy-to-administer measure may potentially be used to help guide clinical treatment decisions to optimise efficacy and cognitive outcomes. Further development of this measure and validation in a more representative ECT clinical population is required. Copyright © 2013 Elsevier Ltd. All rights reserved.

Specific cognitive functions and depressive symptoms as predictors of activities of daily living in older adults with heterogeneous cognitive backgrounds

PubMed Central

de Paula, Jonas J.; Diniz, Breno S.; Bicalho, Maria A.; Albuquerque, Maicon Rodrigues; Nicolato, Rodrigo; de Moraes, Edgar N.; Romano-Silva, Marco A.; Malloy-Diniz, Leandro F.

2015-01-01

Cognitive functioning influences activities of daily living (ADL). However, studies reporting the association between ADL and neuropsychological performance show inconsistent results regarding what specific cognitive domains are related to each specific functional domains. Additionally, whether depressive symptoms are associated with a worse functional performance in older adults is still under explored. We investigated if specific cognitive domains and depressive symptoms would affect different aspects of ADL. Participants were 274 older adults (96 normal aging participants, 85 patients with mild cognitive impairment, and 93 patients probable with mild Alzheimer’s disease dementia) with low formal education (∼4 years). Measures of ADL included three complexity levels: Self-care, Instrumental-Domestic, and Instrumental-Complex. The specific cognitive functions were evaluated through a factorial strategy resulting in four cognitive domains: Executive Functions, Language/Semantic Memory, Episodic Memory, and Visuospatial Abilities. The Geriatric Depression Scale measured depressive symptoms. Multiple linear regression analysis showed executive functions and episodic memory as significant predictors of Instrumental-Domestic ADL, and executive functions, episodic memory and language/semantic memory as predictors of Instrumental-Complex ADL (22 and 28% of explained variance, respectively). Ordinal regression analysis showed the influence of specific cognitive functions and depressive symptoms on each one of the instrumental ADL. We observed a heterogeneous pattern of association with explained variance ranging from 22 to 38%. Different instrumental ADL had specific cognitive predictors and depressive symptoms were predictive of ADL involving social contact. Our results suggest a specific pattern of influence depending on the specific instrumental daily living activity. PMID:26257644

Physician Awareness of Developmental Screening and Referral in the State of Kuwait.

PubMed

Hix-Small, Hollie; Alkherainej, Khaled

In the State of Kuwait, family physicians and pediatricians are responsible for identifying and referring children at risk of disability. The aims of this study were to better understand physician (1) use of developmental screening instruments, (2) referral practices for children at risk of developmental disability, (3) interpretation of screening results, and (4) anticipatory guidance topics prioritized over child screening. A nonprobability volunteer, self-selection sample of family physicians, general practitioners, and pediatricians (n = 398) completed a 60-item paper questionnaire. Items assessed included: (1) practitioner familiarity with, belief in, and use of screening instruments; (2) familiarity with early childhood intervention services; (3) perceived barriers to screening implementation; and (4) anticipatory topics prioritized over screening. Logistic regression was used to test a priori hypotheses. In general, family doctors and pediatricians practicing in public hospitals and primary health care centers in the State of Kuwait do not use or know how to use a developmental screening instrument, while over half prioritized immunization counseling over child screening. Screening confidence and training on using screening instruments increased the likelihood of tool use. Staff shortages, time constraints, and a perceived lack of Arabic screening instruments were barriers to tool use. Raising health care providers' awareness of standardized developmental screening instruments and establishment of an early identification system in the State of Kuwait are needed. Standardization and adaptation of technically sound Arabic-language screening tools for use in the State of Kuwait and physician training programs on screening are recommended.

Examining the Test Of Memory Malingering Trial 1 and Word Memory Test Immediate Recognition as screening tools for insufficient effort.

PubMed

Bauer, Lyndsey; O'Bryant, Sid E; Lynch, Julie K; McCaffrey, Robert J; Fisher, Jerid M

2007-09-01

Assessing effort level during neuropsychological evaluations is critical to support the accuracy of cognitive test scores. Many instruments are designed to measure effort, yet they are not routinely administered in neuropsychological assessments. The Test of Memory Malingering (TOMM) and the Word Memory Test (WMT) are commonly administered symptom validity tests with sound psychometric properties. This study examines the use of the TOMM Trial 1 and the WMT Immediate Recognition (IR) trial scores as brief screening tools for insufficient effort through an archival analysis of a combined sample of mild head-injury litigants ( N = 105) who were assessed in forensic private practices. Results show that both demonstrate impressive diagnostic accuracy and calculations of positive and negative predictive power are presented for a range of base rates. These results support the utility of Trial 1 of the TOMM and the WMT IR trial as screening methods for the assessment of insufficient effort in neuropsychological assessments.

Improving dementia care: The role of screening and detection of cognitive impairment

PubMed Central

Borson, Soo; Frank, Lori; Bayley, Peter J.; Boustani, Malaz; Dean, Marge; Lin, Pei-Jung; McCarten, J. Riley; Morris, John C.; Salmon, David P.; Schmitt, Frederick A.; Stefanacci, Richard G.; Mendiondo, Marta S.; Peschin, Susan; Hall, Eric J.; Fillit, Howard; Ashford, J. Wesson

2014-01-01

The value of screening for cognitive impairment, including dementia and Alzheimer's disease, has been debated for decades. Recent research on causes of and treatments for cognitive impairment has converged to challenge previous thinking about screening for cognitive impairment. Consequently, changes have occurred in health care policies and priorities, including the establishment of the annual wellness visit, which requires detection of any cognitive impairment for Medicare enrollees. In response to these changes, the Alzheimer's Foundation of America and the Alzheimer's Drug Discovery Foundation convened a workgroup to review evidence for screening implementation and to evaluate the implications of routine dementia detection for health care redesign. The primary domains reviewed were consideration of the benefits, harms, and impact of cognitive screening on health care quality. In conference, the workgroup developed 10 recommendations for realizing the national policy goals of early detection as the first step in improving clinical care and ensuring proactive, patient-centered management of dementia. PMID:23375564

Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) as a Cognitive Evaluation Tool for Patients with Normal Pressure Hydrocephalus.

PubMed

Nakatsu, Daisuke; Fukuhara, Toru; Chaytor, Naomi S; Phatak, Vaishali S; Avellino, Anthony M

2016-01-01

External lumbar drainage (ELD) is recognized as a screening method for ventriculo-peritoneal shunting (VPS) candidacy for possible normal pressure hydrocephalus (NPH). This study focused on the ELD predictability of the cognitive outcome after VPS for NPH. In addition, Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was examined in ELD cognition screening. ELD results were considered positive with any improvement in gait and/or cognition. Among 36 patients examined for possible NPH, 26 underwent VPS because of positive ELD. Cognitive outcome after VPS was assessed at 6-month follow-up. The RBANS scores, examined pre- and post-ELD, were evaluated statistically to identify consistency with the neuropsychologist judgment and the predictability of cognitive outcome after VPS. Among 26 shunted patients, gait was improved in 24. Cognitive improvement was rated in 19, and there were 9 false negative and 5 false positive in ELD cognition screening. The neuropsychologist judgment in ELD cognition screening is most consistent with the RBANS score in delayed memory. The patients rated as improved in cognition after VPS had significantly lower RBANS scores pre-ELD in immediate memory and delayed memory. If both scores at pre-ELD were ≤ 80 (13 patients), all were rated as improved in cognition after VPS. ELD screening was highly predictive of clinical gait improvement but not of cognitive improvement after VPS for possible NPH. Particularly among patients with a positive ELD gait response, pre-ELD low RBANS scores in memory predicted cognitive improvement after VPS. RBANS seems effective in evaluating cognition for NPH.

Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) as a Cognitive Evaluation Tool for Patients with Normal Pressure Hydrocephalus

PubMed Central

NAKATSU, Daisuke; FUKUHARA, Toru; CHAYTOR, Naomi S.; PHATAK, Vaishali S.; AVELLINO, Anthony M.

2016-01-01

External lumbar drainage (ELD) is recognized as a screening method for ventriculo-peritoneal shunting (VPS) candidacy for possible normal pressure hydrocephalus (NPH). This study focused on the ELD predictability of the cognitive outcome after VPS for NPH. In addition, Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was examined in ELD cognition screening. ELD results were considered positive with any improvement in gait and/or cognition. Among 36 patients examined for possible NPH, 26 underwent VPS because of positive ELD. Cognitive outcome after VPS was assessed at 6-month follow-up. The RBANS scores, examined pre- and post-ELD, were evaluated statistically to identify consistency with the neuropsychologist judgment and the predictability of cognitive outcome after VPS. Among 26 shunted patients, gait was improved in 24. Cognitive improvement was rated in 19, and there were 9 false negative and 5 false positive in ELD cognition screening. The neuropsychologist judgment in ELD cognition screening is most consistent with the RBANS score in delayed memory. The patients rated as improved in cognition after VPS had significantly lower RBANS scores pre-ELD in immediate memory and delayed memory. If both scores at pre-ELD were ≤ 80 (13 patients), all were rated as improved in cognition after VPS. ELD screening was highly predictive of clinical gait improvement but not of cognitive improvement after VPS for possible NPH. Particularly among patients with a positive ELD gait response, pre-ELD low RBANS scores in memory predicted cognitive improvement after VPS. RBANS seems effective in evaluating cognition for NPH. PMID:26369720

Non-Instrumental Movement Inhibition (NIMI) Differentially Suppresses Head and Thigh Movements during Screenic Engagement: Dependence on Interaction

PubMed Central

Witchel, Harry J.; Santos, Carlos P.; Ackah, James K.; Westling, Carina E. I.; Chockalingam, Nachiappan

2016-01-01

Background: Estimating engagement levels from postural micromovements has been summarized by some researchers as: increased proximity to the screen is a marker for engagement, while increased postural movement is a signal for disengagement or negative affect. However, these findings are inconclusive: the movement hypothesis challenges other findings of dyadic interaction in humans, and experiments on the positional hypothesis diverge from it. Hypotheses: (1) Under controlled conditions, adding a relevant visual stimulus to an auditory stimulus will preferentially result in Non-Instrumental Movement Inhibition (NIMI) of the head. (2) When instrumental movements are eliminated and computer-interaction rate is held constant, for two identically-structured stimuli, cognitive engagement (i.e., interest) will result in measurable NIMI of the body generally. Methods: Twenty-seven healthy participants were seated in front of a computer monitor and speakers. Discrete 3-min stimuli were presented with interactions mediated via a handheld trackball without any keyboard, to minimize instrumental movements of the participant's body. Music videos and audio-only music were used to test hypothesis (1). Time-sensitive, highly interactive stimuli were used to test hypothesis (2). Subjective responses were assessed via visual analog scales. The computer users' movements were quantified using video motion tracking from the lateral aspect. Repeated measures ANOVAs with Tukey post hoc comparisons were performed. Results: For two equivalently-engaging music videos, eliminating the visual content elicited significantly increased non-instrumental movements of the head (while also decreasing subjective engagement); a highly engaging user-selected piece of favorite music led to further increased non-instrumental movement. For two comparable reading tasks, the more engaging reading significantly inhibited (42%) movement of the head and thigh; however, when a highly engaging video game was compared to the boring reading, even though the reading task and the game had similar levels of interaction (trackball clicks), only thigh movement was significantly inhibited, not head movement. Conclusions: NIMI can be elicited by adding a relevant visual accompaniment to an audio-only stimulus or by making a stimulus cognitively engaging. However, these results presume that all other factors are held constant, because total movement rates can be affected by cognitive engagement, instrumental movements, visual requirements, and the time-sensitivity of the stimulus. PMID:26941666

Non-Instrumental Movement Inhibition (NIMI) Differentially Suppresses Head and Thigh Movements during Screenic Engagement: Dependence on Interaction.

PubMed

Witchel, Harry J; Santos, Carlos P; Ackah, James K; Westling, Carina E I; Chockalingam, Nachiappan

2016-01-01

Estimating engagement levels from postural micromovements has been summarized by some researchers as: increased proximity to the screen is a marker for engagement, while increased postural movement is a signal for disengagement or negative affect. However, these findings are inconclusive: the movement hypothesis challenges other findings of dyadic interaction in humans, and experiments on the positional hypothesis diverge from it. (1) Under controlled conditions, adding a relevant visual stimulus to an auditory stimulus will preferentially result in Non-Instrumental Movement Inhibition (NIMI) of the head. (2) When instrumental movements are eliminated and computer-interaction rate is held constant, for two identically-structured stimuli, cognitive engagement (i.e., interest) will result in measurable NIMI of the body generally. Twenty-seven healthy participants were seated in front of a computer monitor and speakers. Discrete 3-min stimuli were presented with interactions mediated via a handheld trackball without any keyboard, to minimize instrumental movements of the participant's body. Music videos and audio-only music were used to test hypothesis (1). Time-sensitive, highly interactive stimuli were used to test hypothesis (2). Subjective responses were assessed via visual analog scales. The computer users' movements were quantified using video motion tracking from the lateral aspect. Repeated measures ANOVAs with Tukey post hoc comparisons were performed. For two equivalently-engaging music videos, eliminating the visual content elicited significantly increased non-instrumental movements of the head (while also decreasing subjective engagement); a highly engaging user-selected piece of favorite music led to further increased non-instrumental movement. For two comparable reading tasks, the more engaging reading significantly inhibited (42%) movement of the head and thigh; however, when a highly engaging video game was compared to the boring reading, even though the reading task and the game had similar levels of interaction (trackball clicks), only thigh movement was significantly inhibited, not head movement. NIMI can be elicited by adding a relevant visual accompaniment to an audio-only stimulus or by making a stimulus cognitively engaging. However, these results presume that all other factors are held constant, because total movement rates can be affected by cognitive engagement, instrumental movements, visual requirements, and the time-sensitivity of the stimulus.

Developing the draft descriptive system for the child amblyopia treatment questionnaire (CAT-Qol): a mixed methods study.

PubMed

Carlton, Jill

2013-10-22

Amblyopia is a visual condition that occurs in childhood. Screening programmes exist within the United Kingdom (UK) to detect amblyopia, and once detected treatment is given.Existing patient reported outcome (PRO) measures for amblyopia do not meet current recommendations for the methods adopted during their development, or the way in which the instruments are administered. The overall aim of this study was to produce a self-complete PRO instrument for amblyopia for children aged 4-7 years that uses children's responses in the development phase. The study comprised a number of stages. This paper reports on the refinement of the descriptive system for the draft instrument (the Child Amblyopia Treatment Questionnaire, CAT-QoL) using qualitative and quantitative methods. The study consisted of three components. Children were asked to read, and complete the draft questionnaire as independently as possible. They were then asked about the questionnaire, and its format, in a cognitive debriefing exercise. Observations were made as to the child's ability to read the questionnaire, particular attention was made as to which individual words participants struggled to read. Children were also asked their opinion on the design layout of the questionnaire. Finally, some children were asked to complete a ranking task to help determine the order of the levels of the items as judged by the children. Mid-rank scoring and statistical level of agreement were calculated for the ranking exercise. Thirty-two (n=32) participants completed a draft questionnaire; each of these underwent a cognitive de-briefing interview. Twenty-two (n=22) children completed the ranking exercise. Ten children did not understand the concept of ranking. The results of the qualitative phase (cognitive de-briefing interview) were used to modify the wording of items and layout of the instrument. Results of the ranking exercise were used to inform the order of the response levels for the items. Responses of young children can be used in the development of PRO instruments. They are able to help inform the content, wording, and format of an instrument, ensuring good content and face validity. The results have been used to further refine the CAT-QoL, however further research is required to assess the psychometric properties of the instrument.

The influence of education on performance of adults on the Clock Drawing Test.

PubMed

de Noronha, Ísis Franci Cavalcanti; Barreto, Simone Dos Santos; Ortiz, Karin Zazo

2018-01-01

The Clock Drawing Test (CDT) is an important instrument for screening individuals suspected of having cognitive impairment. To determine the influence of education on the performance of healthy adults on the CDT. A total of 121 drawings by healthy adults without neurological complaints or impairments were analysed. Participants were stratified by educational level into 4 subgroups: 27 illiterate adults, 34 individuals with 1-4 years of formal education, 30 with 5-11 years, and 30 adults with >11 years' formal education. Scores on the CDT were analyzed based on a scale of 1-10 points according to the criteria of Sunderland et al. (1989).¹ The Kruskal-Wallis test was applied to compare the different education groups. Tukey's multiple comparisons test was used when a significant factor was found. Although scores were higher with greater education, statistically significant differences on the CDT were found only between the illiterate and other educated groups. The CDT proved especially difficult for illiterate individuals, who had lower scores. These results suggest that this screening test is suitable for assessing mainly visuoconstructional praxis and providing an overall impression of cognitive function among individuals, independently of years of education.

The influence of education on performance of adults on the Clock Drawing Test

PubMed Central

de Noronha, Ísis Franci Cavalcanti; Barreto, Simone dos Santos; Ortiz, Karin Zazo

2018-01-01

ABSTRACT The Clock Drawing Test (CDT) is an important instrument for screening individuals suspected of having cognitive impairment. Objective: To determine the influence of education on the performance of healthy adults on the CDT. Methods: A total of 121 drawings by healthy adults without neurological complaints or impairments were analysed. Participants were stratified by educational level into 4 subgroups: 27 illiterate adults, 34 individuals with 1-4 years of formal education, 30 with 5-11 years, and 30 adults with >11 years' formal education. Scores on the CDT were analyzed based on a scale of 1-10 points according to the criteria of Sunderland et al. (1989).¹ The Kruskal-Wallis test was applied to compare the different education groups. Tukey's multiple comparisons test was used when a significant factor was found. Results: Although scores were higher with greater education, statistically significant differences on the CDT were found only between the illiterate and other educated groups. Conclusion: The CDT proved especially difficult for illiterate individuals, who had lower scores. These results suggest that this screening test is suitable for assessing mainly visuoconstructional praxis and providing an overall impression of cognitive function among individuals, independently of years of education. PMID:29682235

Validation of problem drinking screening instruments for DWI offenders

DOT National Transportation Integrated Search

1999-05-01

This document summarizes the results of a validation study for five adult screening instruments in use for preliminary screening of driving while intoxicated (DWI) offenders for problem drinking. The instruments were the Driver Risk Inventory (DRI), ...

Mathematics Screening: The Development and Pilot Study of a Mathematics Screening Instrument for K-2 Grades

ERIC Educational Resources Information Center

Anderson, Stephen A.

2010-01-01

This paper summarizes an action research project to develop a math screening instrument that would be effective (valid and reliable) and efficient (time for administration). An instrument was developed after review of the mathematics assessment and mathematics disabilities literature. The instrument was administered to kindergarten, first, and…

Reviewing Two Types of Addiction – Pathological Gambling and Substance Use

PubMed Central

Jazaeri, Seyed Amir; Habil, Mohammad Hussain Bin

2012-01-01

Gambling, including pathological gambling and problem gambling, has received increased attention from clinicians and researchers over the past three decades since gambling opportunities have expanded around the world. Gambling disorders affect 0.2–5.3% of adults worldwide, although measurement and prevalence varies according to the screening instruments and methods used, and availability and accessibility of gambling opportunities. Several distinct treatment approaches have been favorably evaluated, such as cognitive behavioral and brief treatment models and pharmacological interventions. Although promising, family therapy and support from Gamblers Anonymous are less well empirically supported. Gambling disorders are highly comorbid with other mental health and substance use disorders, and a further understanding is needed of both the causes and treatment implications of this disorder. This article reviews definition, causes and associated features with substance abuse, screening and diagnosis, and treatment approaches. PMID:22661800

Screening for problem gambling within mental health services: a comparison of the classification accuracy of brief instruments.

PubMed

Dowling, Nicki A; Merkouris, Stephanie S; Manning, Victorian; Volberg, Rachel; Lee, Stuart J; Rodda, Simone N; Lubman, Dan I

2018-06-01

Despite the over-representation of people with gambling problems in mental health populations, there is limited information available to guide the selection of brief screening instruments within mental health services. The primary aim was to compare the classification accuracy of nine brief problem gambling screening instruments (two to five items) with a reference standard among patients accessing mental health services. The classification accuracy of nine brief screening instruments was compared with multiple cut-off scores on a reference standard. Eight mental health services in Victoria, Australia. A total of 837 patients were recruited consecutively between June 2015 and January 2016. The brief screening instruments were the Lie/Bet Questionnaire, Brief Problem Gambling Screen (BPGS) (two- to five-item versions), NODS-CLiP, NODS-CLiP2, Brief Biosocial Gambling Screen (BBGS) and NODS-PERC. The Problem Gambling Severity Index (PGSI) was the reference standard. The five-item BPGS was the only instrument displaying satisfactory classification accuracy in detecting any level of gambling problem (low-risk, moderate-risk or problem gambling) (sensitivity = 0.803, specificity = 0.982, diagnostic efficiency = 0.943). Several shorter instruments adequately detected both problem and moderate-risk, but not low-risk, gambling: two three-item instruments (NODS-CLiP, three-item BPGS) and two four-item instruments (NODS-PERC, four-item BPGS) (sensitivity = 0.854-0.966, specificity = 0.901-0.954, diagnostic efficiency = 0.908-0.941). The four-item instruments, however, did not provide any considerable advantage over the three-item instruments. Similarly, the very brief (two-item) instruments (Lie/Bet and two-item BPGS) adequately detected problem gambling (sensitivity = 0.811-0.868, specificity = 0.938-0.943, diagnostic efficiency = 0.933-0.934), but not moderate-risk or low-risk gambling. The optimal brief screening instrument for mental health services wanting to screen for any level of gambling problem is the five-item Brief Problem Gambling Screen (BPGS). Services wanting to employ a shorter instrument or to screen only for more severe gambling problems (moderate-risk/problem gambling) can employ the NODS-CLiP or the three-item BPGS. Services that are only able to accommodate a very brief instrument can employ the Lie/Bet Questionnaire or the two-item BPGS. © 2017 Society for the Study of Addiction.

Key Cognitive Issues in the Design of Electronic Displays of Instrument Approach Procedure Charts

DOT National Transportation Integrated Search

1993-11-01

This report provides a general introduction to the field of cognitive psychology and the application of well researched cognitive issues to the design of electronic instrument approach procedures (EIAP) displays. It presents 46 cognitive issues and 1...

[Legal capacity and instruments assessing cognitive functions in patients with dementia].

PubMed

Voskou, P; Papageorgiou, S; Economou, A; Douzenis, A

2017-01-01

The term "legal capacity" refers to the ability of a person to make a valid declaration of his will or to accept such a declaration. This ability constitutes the main condition for the validity of the legal transaction. The legal transaction includes issues that are adjusted by the Civil Code with which the relations of the citizens in a society are regulated. General practitioners and legal advisors, in any case of a person with cognitive impairment of various severity, should take into account that the assessment tests of the cognitive functions are not by themselves diagnostic of the dementia and they cannot be used as the only way of evaluation of the capacity of patients with cognitive impairment or possible dementia to respond to the needs of everyday life and in more complex decisions, such as the legal capacity. The existing methods for the assessment of the cognitive functions are valuable, mainly, for the detection of any cognitive impairment which may not be perceptible during the clinical evaluation of the patient and secondly for the detection of any changes in the cognitive status of the patient during its following up. The description and study of the instruments which are frequently used in the international scientific society for the assessment of the cognitive functions of the patients with mild cognitive impairment or dementia, during the evaluation of the legal capacity of these patients. The literature relevant to the existing methods assessing the cognitive functions during the evaluation of the legal capacity of patients with dementia was reviewed. The scientific database searched was Pubmed, Medline and Scopus. The key-words used were cognitive functions, dementia, instruments, legal capacity. Various instruments which assess the cognitive functions have been developed and can be grouped in 4 categories. The first one includes instruments used for the general assessment of the cognitive status. These instruments can be extensive or short and consist of subtests for the evaluation of several cognitive functions (memory, attention, perception, speech). The second category includes instruments for the specific assessment of the cognitive status, namely specific tests for one cognitive domain (for example, memory, speech flow, naming). The third category consists of methods which are based on the clinical evaluation during the interview with the patient and his familiars, giving emphasis on the frontal functions of the patient. Finally, the fourth group includes instruments which assess the executive functions of the patients. There is a great need for the development of more studies for the methods/instruments with which the cognitive functions of patients with probable dementia can be assessed during the evaluation of the legal capacity of these patients. The challenge for the scientists is to develop a clinically applicable instrument for the quick and reliable assessment of the legal capacity of people with dementia. The assessment of this ability should be done in relation with the needs, the feelings and the values of the patient.

A first approach to a neuropsychological screening tool using eye-tracking for bedside cognitive testing based on the Edinburgh Cognitive and Behavioural ALS Screen.

PubMed

Keller, Jürgen; Krimly, Amon; Bauer, Lisa; Schulenburg, Sarah; Böhm, Sarah; Aho-Özhan, Helena E A; Uttner, Ingo; Gorges, Martin; Kassubek, Jan; Pinkhardt, Elmar H; Abrahams, Sharon; Ludolph, Albert C; Lulé, Dorothée

2017-08-01

Reliable assessment of cognitive functions is a challenging task in amyotrophic lateral sclerosis (ALS) patients unable to speak and write. We therefore present an eye-tracking based neuropsychological screening tool based on the Edinburgh Cognitive and Behavioural ALS Screen (ECAS), a standard screening tool for cognitive deficits in ALS. In total, 46 ALS patients and 50 healthy controls matched for age, gender and education were tested with an oculomotor based and a standard paper-and-pencil version of the ECAS. Significant correlation between both versions was observed for ALS patients and healthy controls in the ECAS total score and in all of its ALS-specific domains (all r > 0.3; all p < 0.05). The eye-tracking version of the ECAS reliably distinguished between ALS patients and healthy controls in the ECAS total score (p < 0.05). Also, cognitively impaired and non-impaired patients could be reliably distinguished with a specificity of 95%. This study provides first evidence that the eye-tracking based ECAS version is a promising approach for assessing cognitive deficits in ALS patients who are unable to speak or write.

Assessment of the elderly's functional ability to manage their medication: a systematic literature review.

PubMed

Advinha, Ana Margarida; Lopes, Manuel José; de Oliveira-Martins, Sofia

2017-02-01

Background The evaluation of the elderly's ability to manage medication through the use of a validated tool can be a significant step in identifying inabilities and needs, with the objective of increasing their self-care skills, and promoting successful aging. Aim of the review To identify studies assessing the elderly's functional ability to manage their own medication. Method For the search strategy, the PICO method was used: P-Population (elderly), I-Instruments (tools for assessing medication management ability), C-Context (community) and O-Outcomes (functional ability to manage medication). The final search query was run in MEDLINE/PubMed, CINAHL Plus, ISI Web of Science and Scopus. The whole process was developed according to the PRISMA statement. Results The search retrieved 8051 records. In each screening stage, the selection criteria were applied to eliminate records where at least one of the exclusion criteria was verified. At the end of this selection, we obtained a total of 18 papers (17 studies). The results allow the conclusion to be drawn that studies use several different instruments, most of them not validated. The authors agree that medication management abilities decrease as cognitive impairment increases, even if a lot of studies assess only the physical dimension. DRUGS was the instrument most often used. Conclusion Older adults' ability to manage their medication should be assessed using tools specifically built and validate for the purpose. DRUGS (which uses the real regimen taken by the elderly) was the most widely used assessment instrument in the screened studies.

The UCSF screening exam effectively screens cognitive and behavioral impairment in patients with ALS.

PubMed

Murphy, Jennifer; Ahmed, Fizaa; Lomen-Hoerth, Catherine

2015-03-01

The University of California San Francisco (UCSF) Screening Battery provides clinicians with a uniquely tailored tool to measure ALS patients' cognitive and behavioral changes, adjusting for dysarthria and hand weakness. The battery consists of the ALS-CBS ( 1 ), Written Fluency Test ( 2 ), and a new revision of the Frontal Behavior Inventory (FBI-ALS) ( 3 ). The validity of each component was tested by comparing results with a gold standard neuropsychological exam (GNE). Consensus criteria-based GNE diagnoses ( 4 ) were assigned (n = 24) and concurrent validity was tested for each screening exam component. Results showed that each of the four cognitive and behavioral screening test components were significantly associated with diagnoses confirmed by GNE. GNE diagnoses were significantly associated with FBI-ALS negative score, written S-words score, and ALS-CBS cognitive score. The total FBI-ALS score and C-words tests were less predictive of GNE-diagnosed impairment. In conclusion, the UCSF Cognitive Screening Battery demonstrates good external validity compared with GNE in this modest sample, encouraging its use in larger investigations. These data suggest that this battery may provide an effective screen to identify ALS patients who will then benefit from a full examination to confirm their diagnosis.

Cognitive function of children with cystic fibrosis: deleterious effect of early malnutrition.

PubMed

Koscik, Rebecca L; Farrell, Philip M; Kosorok, Michael R; Zaremba, Kathleen M; Laxova, Anita; Lai, Hui-Chuan; Douglas, Jeff A; Rock, Michael J; Splaingard, Mark L

2004-06-01

Patients who have cystic fibrosis (CF) and experience delayed diagnosis by traditional methods have greater nutritional insult compared with peers diagnosed via neonatal screening. The objective of this study was to evaluate cognitive function in children with CF and the influence of both early diagnosis through neonatal screening and the potential effect of early malnutrition. Cognitive assessment data were obtained for 89 CF patients (aged 7.3-17 years) during routine clinic visits. Patients had been enrolled in either the screened (N = 42) or traditional diagnosis (control) group (N = 47) of the Wisconsin CF Neonatal Screening Project. The Test of Cognitive Skills, Second Edition was administered to generate the Cognitive Skills Index (CSI) and cognitive factor scores (Verbal, Nonverbal, and Memory). Cognitive scores in the overall study population were similar to normative data (CSI mean [standard deviation]: 102.5 [16.6]; 95% confidence interval: 99.1-105.9). The mean (standard deviation) CSI scores for the screened and control groups were 104.4 (14.4) and 99.8 (18.5), respectively. Significantly lower cognitive scores correlated with indicators of malnutrition and unfavorable family factors such as single parents, lower socioeconomic status, and less parental education. Our analyses revealed lower cognitive scores in patients with low plasma alpha-tocopherol (alpha-T) levels at diagnosis. In addition, patients in the control group who also had vitamin E deficiency at diagnosis (alpha-T < 300 microg/dl) showed significantly lower CSI scores in comparison with alpha-T-sufficient control subjects and both deficient and sufficient alpha-T subsets of screened patients. Results suggest that prevention of prolonged malnutrition by early diagnosis and nutritional therapy, particularly minimizing the duration of vitamin E deficiency, is associated with better cognitive functioning in children with CF.

How Can We Best Screen for Cognitive Impairment in Malaysia? A Pilot of the IDEA Cognitive Screen and Picture-Based Memory Impairment Scale and Comparison of Criterion Validity with the Mini Mental State Examination.

PubMed

Rosli, Roshaslina; Tan, Maw Pin; Gray, William K; Subramanian, Pathmawathi; Mohd Hairi, Noran Naqiah; Chin, Ai-Vyrn

2017-01-01

To pilot two new cognitive screening tools for use in an urban Malaysian population and to compare their criterion validity against a gold standard, the well-established Mini-Mental State Examination (MMSE). The IDEA cognitive screen, Picture-based Memory Impairment Scale (PMIS), and MMSE were administered to a convenience sample of elderly (≥ 65 years) from the community and outpatient clinics at an urban teaching hospital. Consensus diagnosis was performed by two geriatricians blinded to PMIS and IDEA cognitive screen scores using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) clinical criteria. The MMSE performance was used as a reference. The study enrolled 66 participants, with a median age of 78.5 years (interquartile range [IQR], 72.5-83.0) years and 11.0 median years of education (IQR, 9.0-13.0). Forty-three (65.2%) were female, and 32 (48.4%) were Chinese. The area under the receiver operating characteristic (AUROC) curve values were .962 (IDEA cognitive screen), .970 (PMIS), and .935 (MMSE). The optimal cutoff values for sensitivity and specificity were: IDEA cognitive screen: ≤ 11, 90.9% and 89.7%; PMIS: ≤ 6, 97.3% and 69.0%; and MMSE: ≤ 23, 84.6% and 76.0%. Although the sample size was small, multivariable logistic regression modelling suggested that all three screen scores did not appear to be educationally biased. The IDEA and PMIS tools are potentially valid screening tools for dementia in urban Malaysia, and perform at least as well as the MMSE. Further work on larger representative, cohorts is needed to further assess the psychometric properties. Study provides alternative screening tools for dementia for both non-specialists and specialists.

Reduced Gray Matter Volume Is Associated With Poorer Instrumental Activities of Daily Living Performance in Heart Failure.

PubMed

Alosco, Michael L; Brickman, Adam M; Spitznagel, Mary Beth; Narkhede, Atul; Griffith, Erica Y; Cohen, Ronald; Sweet, Lawrence H; Josephson, Richard; Hughes, Joel; Gunstad, John

2016-01-01

Heart failure patients require assistance with instrumental activities of daily living in part because of the high rates of cognitive impairment in this population. Structural brain insult (eg, reduced gray matter volume) is theorized to underlie cognitive dysfunction in heart failure, although no study has examined the association among gray matter, cognition, and instrumental activities of daily living in heart failure. The aim of this study was to investigate the associations among gray matter volume, cognitive function, and functional ability in heart failure. A total of 81 heart failure patients completed a cognitive test battery and the Lawton-Brody self-report questionnaire to assess instrumental activities of daily living. Participants underwent magnetic resonance imaging to quantify total gray matter and subcortical gray matter volume. Impairments in instrumental activities of daily living were common in this sample of HF patients. Regression analyses controlling for demographic and medical confounders showed that smaller total gray matter volume predicted decreased scores on the instrumental activities of daily living composite, with specific associations noted for medication management and independence in driving. Interaction analyses showed that reduced total gray matter volume interacted with worse attention/executive function and memory to negatively impact instrumental activities of daily living. Smaller gray matter volume is associated with greater impairment in instrumental activities of daily living in persons with heart failure, possibly via cognitive dysfunction. Prospective studies are needed to clarify the utility of clinical correlates of gray matter volume (eg, cognitive dysfunction) in identifying heart failure patients at risk for functional decline and determine whether interventions that target improved brain and cognitive function can preserve functional independence in this high-risk population.

Health literacy screening instruments for eHealth applications: a systematic review.

PubMed

Collins, Sarah A; Currie, Leanne M; Bakken, Suzanne; Vawdrey, David K; Stone, Patricia W

2012-06-01

To systematically review current health literacy (HL) instruments for use in consumer-facing and mobile health information technology screening and evaluation tools. The databases, PubMed, OVID, Google Scholar, Cochrane Library and Science Citation Index, were searched for health literacy assessment instruments using the terms "health", "literacy", "computer-based," and "psychometrics". All instruments identified by this method were critically appraised according to their reported psychometric properties and clinical feasibility. Eleven different health literacy instruments were found. Screening questions, such as asking a patient about his/her need for assistance in navigating health information, were evaluated in seven different studies and are promising for use as a valid, reliable, and feasible computer-based approach to identify patients that struggle with low health literacy. However, there was a lack of consistency in the types of screening questions proposed. There is also a lack of information regarding the psychometric properties of computer-based health literacy instruments. Only English language health literacy assessment instruments were reviewed and analyzed. Current health literacy screening tools demonstrate varying benefits depending on the context of their use. In many cases, it seems that a single screening question may be a reliable, valid, and feasible means for establishing health literacy. A combination of screening questions that assess health literacy and technological literacy may enable tailoring eHealth applications to user needs. Further research should determine the best screening question(s) and the best synthesis of various instruments' content and methodologies for computer-based health literacy screening and assessment. Copyright © 2012 Elsevier Inc. All rights reserved.

Cognitive Screening in Brain Tumors: Short but Sensitive Enough?

PubMed Central

Robinson, Gail A.; Biggs, Vivien; Walker, David G.

2015-01-01

Cognitive deficits in brain tumors are generally thought to be relatively mild and non-specific, although recent evidence challenges this notion. One possibility is that cognitive screening tools are being used to assess cognitive functions but their sensitivity to detect cognitive impairment may be limited. For improved sensitivity to recognize mild and/or focal cognitive deficits in brain tumors, neuropsychological evaluation tailored to detect specific impairments has been thought crucial. This study investigates the sensitivity of a cognitive screening tool, the Montreal Cognitive Assessment (MoCA), compared to a brief but tailored cognitive assessment (CA) for identifying cognitive deficits in an unselected primary brain tumor sample (i.e., low/high-grade gliomas, meningiomas). Performance is compared on broad measures of impairment: (a) number of patients impaired on the global screening measure or in any cognitive domain; and (b) number of cognitive domains impaired and specific analyses of MoCA-Intact and MoCA-Impaired patients on specific cognitive tests. The MoCA-Impaired group obtained lower naming and word fluency scores than the MoCA-Intact group, but otherwise performed comparably on cognitive tests. Overall, based on our results from patients with brain tumor, the MoCA has extremely poor sensitivity for detecting cognitive impairments and a brief but tailored CA is necessary. These findings will be discussed in relation to broader issues for clinical management and planning, as well as specific considerations for neuropsychological assessment of brain tumor patients. PMID:25815273

Comparison of three ADHD screening instruments in college students of varying cognitive ability.

PubMed

Fuller-Killgore, Melissa D; Burlison, Jonathan; Dwyer, William

2013-07-01

To assess three of the better known screeners for Attention Deficit/Hyperactive Disorder (ADHD) and review the relationship between ADHD and cognitive ability. The three ADHD screeners were administered to 111 college students enrolled in a college Introductory Psychology class, on whom ACT scores and total course performance were also available. As a measure of cognitive ability, the Wonderlic Personnel Test (Wonderlic, Inc., 2000) was also administered. Furthermore, self-report data were available from participants who had been diagnosed with ADHD. The three screeners were the Adult ADHD Self-Report Scale (ASRS) (Kessler et al., 2005), the Conners' Adult ADHD Rating Scale-Self-Report: Long Version (CAARS) (Conners, Erhardt, & Sparrow, 1999), and the Brown ADD Scales (Brown, 1996). The results are discussed in terms of the scales' reliability, as well as their relationship to academic aptitude, class performance, and their ability to identify self-reported ADHD diagnoses. All three screeners exhibited acceptable reliability levels. Criterion validity was demonstrated by the relationship between the CAARS's inattention subscale and self-reported cases of ADHD. Criterion validity was also seen in the relationship found between the CAARS's hyperactivity/restlessness subscale and the total course performance even after controlling for cognitive ability. Contrary to past research cognitive ability exhibited a weak but significant relationship with a few screeners and screener subscales.

Visual Search as a Tool for a Quick and Reliable Assessment of Cognitive Functions in Patients with Multiple Sclerosis

PubMed Central

Utz, Kathrin S.; Hankeln, Thomas M. A.; Jung, Lena; Lämmer, Alexandra; Waschbisch, Anne; Lee, De-Hyung; Linker, Ralf A.; Schenk, Thomas

2013-01-01

Background Despite the high frequency of cognitive impairment in multiple sclerosis, its assessment has not gained entrance into clinical routine yet, due to lack of time-saving and suitable tests for patients with multiple sclerosis. Objective The aim of the study was to compare the paradigm of visual search with neuropsychological standard tests, in order to identify the test that discriminates best between patients with multiple sclerosis and healthy individuals concerning cognitive functions, without being susceptible to practice effects. Methods Patients with relapsing remitting multiple sclerosis (n = 38) and age-and gender-matched healthy individuals (n = 40) were tested with common neuropsychological tests and a computer-based visual search task, whereby a target stimulus has to be detected amongst distracting stimuli on a touch screen. Twenty-eight of the healthy individuals were re-tested in order to determine potential practice effects. Results Mean reaction time reflecting visual attention and movement time indicating motor execution in the visual search task discriminated best between healthy individuals and patients with multiple sclerosis, without practice effects. Conclusions Visual search is a promising instrument for the assessment of cognitive functions and potentially cognitive changes in patients with multiple sclerosis thanks to its good discriminatory power and insusceptibility to practice effects. PMID:24282604

Psychometric properties of the Portuguese version of the Depressive Cognition Scale in Brazilian adults with diabetes mellitus.

PubMed

Sousa, Valmi D; Zanetti, Maria L; Zauszniewski, Jaclene A; Mendes, Isabel A C; Daguano, Michelle O

2008-01-01

Identifying depressive cognitions in Brazilians with diabetes can be important step to prevent the development of clinical depression, which is negatively associated with diabetes self-management. This study focused on the psychometric testing of the Portuguese version of the Depressive Cognition Scale, the Escala Cognitiva de Depressão (ECD), among 82 Brazilian adults with diabetes mellitus. The questionnaire was assessed for internal consistency, homogeneity, and construct validity using factor analysis and convergent validity assessment with the Portuguese version of the Beck Depression Inventory, the Inventário de Depressão Beck (IDB). Cronbach's alpha for the ECD was .88. The homogeneity of the instrument was supported by item-to-total correlations between .30 and .70. Factor extraction generated only one factor with eigenvalues greater than 1, which is consistent with the English version. The ECD's total score had a weak but significant correlation with the IDB's total score (r = .24, p < .05), indicating convergent validity. Evidence for the reliability and construct validity of the ECD was provided by this study. This scale has the potential to become a useful screening tool for depressive cognitions among Brazilians with diabetes.

Adaptation of a nursing home culture change research instrument for frontline staff quality improvement use.

PubMed

Hartmann, Christine W; Palmer, Jennifer A; Mills, Whitney L; Pimentel, Camilla B; Allen, Rebecca S; Wewiorski, Nancy J; Dillon, Kristen R; Snow, A Lynn

2017-08-01

Enhanced interpersonal relationships and meaningful resident engagement in daily life are central to nursing home cultural transformation, yet these critical components of person-centered care may be difficult for frontline staff to measure using traditional research instruments. To address the need for easy-to-use instruments to help nursing home staff members evaluate and improve person-centered care, the psychometric method of cognitive-based interviewing was used to adapt a structured observation instrument originally developed for researchers and nursing home surveyors. Twenty-eight staff members from 2 Veterans Health Administration (VHA) nursing homes participated in 1 of 3 rounds of cognitive-based interviews, using the instrument in real-life situations. Modifications to the original instrument were guided by a cognitive processing model of instrument refinement. Following 2 rounds of cognitive interviews, pretesting of the revised instrument, and another round of cognitive interviews, the resulting set of 3 short instruments mirrored the concepts of the original longer instrument but were significantly easier for frontline staff to understand and use. Final results indicated frontline staff found the revised instruments feasible to use and clinically relevant in measuring and improving the lived experience of a changing culture. This article provides a framework for developing or adapting other measurement tools for frontline culture change efforts in nursing homes, in addition to reporting on a practical set of instruments to measure aspects of person-centered care. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

77 FR 55217 - Submission for OMB Review; Comment Request: Cognitive Testing of Instrumentation and Materials...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-07

...; Comment Request: Cognitive Testing of Instrumentation and Materials for the Population Assessment of..., unless it displays a currently valid OMB control number. Proposed Collection: Title: Cognitive Testing of... Administration (FDA). NIDA is requesting generic approval from OMB for cognitive testing of the PATH study's...

Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians.

PubMed

Radford, Kylie; Mack, Holly A; Draper, Brian; Chalkley, Simon; Delbaere, Kim; Daylight, Gail; Cumming, Robert G; Bennett, Hayley; Broe, Gerald A

2015-01-01

Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking. In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus. All tests were culturally acceptable with good psychometric properties. Receiver operating characteristic curve analyses revealed that the MMSE and mKICA were the most accurate. The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population. © 2015 S. Karger AG, Basel.

The use of the Modified Telephone Interview for Cognitive Status (TICS-M) in the detection of amnestic mild cognitive impairment.

PubMed

Cook, Sarah E; Marsiske, Michael; McCoy, Karin J M

2009-06-01

Many screening tools for detecting cognitive decline require in-person assessment, which is often not cost-effective or feasible for those with physical limitations. The Modified Telephone Interview for Cognitive Status has been used for screening dementia, but little is known about its usefulness in detecting amnestic mild cognitive impairment. Community-dwelling participants (mean age=74.9, mean education = 16.1 years) were administered the Modified Telephone Interview for Cognitive Status during initial screening and subsequently given a multidomain neuropsychological battery. Participants were classified by consensus panel as cognitively normal older adult (noMCI, N=54) or amnestic mild cognitive impairment (N=17) based on neuropsychological performance and Clinical Dementia Rating Scale interview, but independent of Modified Telephone Interview for Cognitive Status score. There was a significant difference between groups in Modified Telephone Interview for Cognitive Status score (t=8.04, P<.01, noMCI range 32-43, mean [SD]=37.4 [2.5], amnestic mild cognitive impairment range 25-37, mean [SD]=31.2 [3.5]). Discriminant function analysis revealed that TICS-M alone correctly classified 85.9% of participants into their respective diagnostic classification (sensitivity=82.4%, specificity=87.0%). Receiver operating characteristics analysis resulted in cutoff score of 34 that optimized sensitivity and specificity of amnestic mild cognitive impairment classification. The Modified Telephone Interview for Cognitive Status is a brief, cost-effective screening measure for identifying those with and without amnestic mild cognitive impairment.

Psychometrics of the AAN Caregiver Driving Safety Questionnaire and contributors to caregiver concern about driving safety in older adults.

PubMed

Carvalho, Janessa O; Springate, Beth; Bernier, Rachel A; Davis, Jennifer

2018-03-01

ABSTRACTBackground:The American Academy of Neurology (AAN) updated their practice parameters in the evaluation of driving risk in dementia and developed a Caregiver Driving Safety Questionnaire, detailed in their original manuscript (Iverson Gronseth, Reger, Classen, Dubinsky, & Rizzo, 2010). They described four factors associated with decreased driving ability in dementia patients: history of crashes or citations, informant-reported concerns, reduced mileage, and aggressive driving. An informant-reported AAN Caregiver Driving Safety Questionnaire was designed with these elements, and the current study was the first to explore the factor structure of this questionnaire. Additionally, we examined associations between these factors and cognitive and behavioral measures in patients with mild cognitive impairment or early Alzheimer's disease and their informants. Exploratory factor analysis revealed a four-component structure, consistent with the theory behind the AAN scale composition. These four factor scores also were significantly associated with performance on cognitive screening instruments and informant reported behavioral dysfunction. Regressions revealed that behavioral dysfunction predicted caregiver concerns about driving safety beyond objective patient cognitive dysfunction. In this first known quantitative exploration of the scale, our results support continued use of this scale in office driving safety assessments. Additionally, patient behavioral changes predicted caregiver concerns about driving safety over and above cognitive status, which suggests that caregivers may benefit from psychoeducation about cognitive factors that may negatively impact driving safety.

The Woodcock-Johnson Tests of Cognitive Abilities III's Cognitive Performance Model: Empirical Support for Intermediate Factors within CHC Theory

ERIC Educational Resources Information Center

Taub, Gordon E.; McGrew, Kevin S.

2014-01-01

The Woodcock-Johnson Tests of Cognitive Ability Third Edition is developed using the Cattell-Horn-Carroll (CHC) measurement-theory test design as the instrument's theoretical blueprint. The instrument provides users with cognitive scores based on the Cognitive Performance Model (CPM); however, the CPM is not a part of CHC theory. Within the…

Comparative Analysis of Three Screening Instruments for Autism Spectrum Disorder in Toddlers at High Risk

ERIC Educational Resources Information Center

Oosterling, Iris J.; Swinkels, Sophie H.; van der Gaag, Rutger Jan; Visser, Janne C.; Dietz, Claudine; Buitelaar, Jan K.

2009-01-01

Several instruments have been developed to screen for autism spectrum disorders (ASD) in high-risk populations. However, few studies compare different instruments in one sample. Data were gathered from the "Early Screening of Autistic Traits Questionnaire," "Social Communication Questionnaire," "Communication and Symbolic…

Social-Cognitive Predictors of Low-Income Parents' Restriction of Screen Time among Preschool-Aged Children

ERIC Educational Resources Information Center

Lampard, Amy M.; Jurkowski, Janine M.; Davison, Kirsten K.

2013-01-01

Parents' rules regarding child television, DVD, video game, and computer use (screen time) have been associated with lower screen use in children. This study aimed to identify modifiable correlates of this behavior by examining social-cognitive predictors of parents' restriction of child screen time. Low-income parents ("N" = 147) of…

The Empirical Validation of Cognitive Domain Characteristics in the Gifted Screening Checklist

ERIC Educational Resources Information Center

Dalia, Nasvytiene; Agne, Brandisauskiene

2013-01-01

The identification of gifted children is an interactive procedure consisting of two consecutive steps--screening for above-average cognitive abilities, followed by their monitoring. Teacher nomination is among the most widely used methods of screening. However, it is not free from bias. The analysis of screening criteria is of prime importance for…

Further validation of the Internet-based Dementia Risk Assessment.

PubMed

Brandt, Jason; Blehar, Justin; Anderson, Allan; Gross, Alden L

2014-01-01

Most approaches to the detection of presymptomatic or prodromal Alzheimer's disease require the costly collection and analysis of biological samples or neuroimaging measurements. The Dementia Risk Assessment (DRA) was developed to facilitate this detection by collecting self-report and proxy-report of dementia risk variables and episodic memory performance on a free Internet website. We now report two validation studies. In Study 1, 130 community-residing older adults seeking memory screening at senior health fairs were tested using the Mini-Cog, and were then observed while taking the DRA. They were compared to a demographically-matched subsample from our anonymous Internet sample. Participants seeking memory screening had more dementia risk factors and obtained lower scores on the DRA's recognition memory test (RMT) than their Internet controls. In addition, those who failed the Mini-Cog obtained much lower scores on the RMT than those who passed the Mini-Cog. In Study 2, 160 older adults seeking evaluation of cognitive difficulties took the DRA prior to diagnostic evaluations at outpatient dementia clinics. Patients who ultimately received the diagnosis of a dementia syndrome scored significantly lower on the RMT than those diagnosed with other conditions or deemed normal. Lower education, family history of dementia, presence of hypercholesterolemia and diabetes, and memory test score distinguished the dementia and no-dementia groups with around 82% accuracy. In addition, score on the RMT correlated highly with scores on other instruments widely used to detect cognitive decline. These findings support the concurrent validity of the DRA for detecting prevalent cognitive impairment. Prospective studies of cognitively normal persons who subsequently develop dementia will be necessary to establish its predictive validity.

Online webcam-based eye tracking in cognitive science: A first look.

PubMed

Semmelmann, Kilian; Weigelt, Sarah

2018-04-01

Online experimentation is emerging in many areas of cognitive psychology as a viable alternative or supplement to classical in-lab experimentation. While performance- and reaction-time-based paradigms are covered in recent studies, one instrument of cognitive psychology has not received much attention up to now: eye tracking. In this study, we used JavaScript-based eye tracking algorithms recently made available by Papoutsaki et al. (International Joint Conference on Artificial Intelligence, 2016) together with consumer-grade webcams to investigate the potential of online eye tracking to benefit from the common advantages of online data conduction. We compared three in-lab conducted tasks (fixation, pursuit, and free viewing) with online-acquired data to analyze the spatial precision in the first two, and replicability of well-known gazing patterns in the third task. Our results indicate that in-lab data exhibit an offset of about 172 px (15% of screen size, 3.94° visual angle) in the fixation task, while online data is slightly less accurate (18% of screen size, 207 px), and shows higher variance. The same results were found for the pursuit task with a constant offset during the stimulus movement (211 px in-lab, 216 px online). In the free-viewing task, we were able to replicate the high attention attribution to eyes (28.25%) compared to other key regions like the nose (9.71%) and mouth (4.00%). Overall, we found web technology-based eye tracking to be suitable for all three tasks and are confident that the required hard- and software will be improved continuously for even more sophisticated experimental paradigms in all of cognitive psychology.

Computerized Cognitive Screen (CoCoSc): A Self-Administered Computerized Test for Screening for Cognitive Impairment in Community Social Centers.

PubMed

Wong, Adrian; Fong, Ching-Hang; Mok, Vincent Chung-Tong; Leung, Kam-Tat; Tong, Raymond Kai-Yu

2017-01-01

Computerized cognitive tests may serve as a preliminary, low-cost method to identify individuals with suspected cognitive impairment in the community. To develop a self-administered computerized test, namely the "Computerized Cognitive Screen (CoCoSc), Hong Kong version", for screening of individuals with cognitive impairment (CI) in community settings. The CoCoSc is a 15-min computerized cognitive screen covering memory, executive functions, orientation, attention and working memory, and prospective memory administered on a touchscreen computer. Individuals with CI and cognitively normal controls were administered the CoCoSc and the Montreal Cognitive Assessment (MoCA). Validity of the CoCoSc was assessed based on the relationship with the MoCA using Pearson correlation. Receiver operating characteristic curve (ROC) was used to examine the ability of the CoCoSc to differentiate CI from controls. Fifty-nine individuals with CI and 101 controls were recruited. Seventy-five (46.9%) participants had ≤6 years of education. Performance on the CoCoSc differed between normal and CI groups in both low and high education subgroups. Total scores of the CoCoSc and MoCA were significantly correlated (r = 0.71, p < 0.001). The area under ROC was 0.78, p < 0.001 for the CoCoSc total score in differentiating the CI group from the cognitively normal group. A cut-off of ≤30 on the CoCoSc was associated with a sensitivity of 0.78 and specificity of 0.69. The CoCoSc was well accepted by attendees of community social centers. The CoCoSc is a promising computerized cognitive screen for self-administration in community social centers. It is feasible for testing individuals with high or low education levels.

Predictors of neuropsychological outcome after pediatric concussion.

PubMed

Beauchamp, Miriam H; Aglipay, Mary; Yeates, Keith Owen; Désiré, Naddley; Keightley, Michelle; Anderson, Peter; Brooks, Brian L; Barrowman, Nick; Gravel, Jocelyn; Boutis, Kathy; Gagnon, Isabelle; Dubrovsky, Alexander Sasha; Zemek, Roger

2018-05-01

Previous research suggests that neuropsychological outcome after pediatric concussion is determined by unmodifiable, preexisting factors. This study aimed to predict neuropsychological outcome after pediatric concussion by using a sufficiently large sample to explore a vast array of predictors. A total of 311 children and adolescents (6-18 years old) with concussion were assessed in the emergency department to document acute symptomatology and to screen for cognitive functioning. At 4 and 12 weeks postinjury, they completed tests of intellectual functioning, attention/working memory, executive functions, verbal memory, processing speed, and fine motor abilities. Multiple hierarchical logistic and linear regressions were performed to assess the contribution of premorbid factors, acute symptoms, and acute cognitive screening (Standardized Assessment of Concussion-Child) to aspects of neuropsychological outcome: (a) cognitive inefficiency (defined using a modified Neuropsychological Impairment Rule; Beauchamp et al., 2015) and (b) neuropsychological performance (defined using principal component analysis). Neuropsychological impairment was present in 10.3% and 4.5% of participants at 4 and 12 weeks postinjury, respectively. At 4 weeks postinjury, cognitive inefficiency was predicted by premorbid factors and acute cognitive screening, whereas at 12 weeks it was predicted by acute symptoms. Neuropsychological performance at 4 weeks was predicted by a combination of premorbid factors, acute symptoms, and acute cognitive screening, whereas as at 12 weeks, only acute cognitive screening predicted performance. Neuropsychological outcome after pediatric concussion is not attributable solely to preexisting problems but is instead associated with a combination of preexisting and injury-related variables. Acute cognitive screening appears to be particularly useful in predicting neuropsychological status after concussion. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Cognitive function in early clinical phase huntington disease after rivastigmine treatment.

PubMed

Sešok, Sanja; Bolle, Nika; Kobal, Jan; Bucik, Valentin; Vodušek, David B

2014-09-01

In Huntington disease (HD) patients receiving rivastigmine treatment improvement of behavioral symptoms and of cognitive function (assessed with screening diagnostic instruments) has been reported. The aim of the present study was to verify such improvement in cognitive function by cognitive function assessment with a detailed neuropsychological battery covering all relevant cognitive systems expected to be impaired in early phase HD. Eighteen (18) HD patients entered the study and were randomly allocated to the rivastigmine and placebo group. All subjects underwent neuropsychological assessment at baseline. Follow-up neuropsychological assessment was applied after 6 months of rivastigmine or placebo treatment. Eighteen (18) healthy controls entered the study to control for practice effect and underwent neuropsychological assessment at baseline and after 6 months, without treatment. The neuropsychological battery consisted of assessment tools that are sensitive to cognitive impairment seen in early phase HD: CTMT, SDMT, Stroop (attention and information control), RFFT, TOL, Verbal fluency (executive functioning), CVLT-II, RCFT (learning and memory). Effect of rivastigmine and possible effect of practice was assessed using the mixed ANOVA model. No statistically significant effect of rivastigmine treatment on cognitive function in HD patients was detected. There was no evidence for practice or placebo effect. Detailed neuropsychological assessment did not confirm previously reported effect of rivastigmine treatment on cognitive function in HD patients. The limitations of our study are, in particular, small sample size and the lack of a single measure of relevant cognitive functioning in HD patients. Instead of focusing solely on statistical significance, a clinical relevance study is proposed to clarify the issue of rivastigmine effects in HD.

Screening emergency department patients for opioid drug use: A qualitative systematic review.

PubMed

Sahota, Preet Kaur; Shastry, Siri; Mukamel, Dana B; Murphy, Linda; Yang, Narisu; Lotfipour, Shahram; Chakravarthy, Bharath

2018-05-24

The opioid drug epidemic is a major public health concern and an economic burden in the United States. The purpose of this systematic review is to assess the reliability and validity of screening instruments used in emergency medicine settings to detect opioid use in patients and to assess psychometric data for each screening instrument. PubMed/MEDLINE, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, Cumulative Index to Nursing and Allied Health Literature and ClinicalTrials.gov were searched for articles published up to May 2018. The extracted articles were independently screened for eligibility by two reviewers. We extracted 1555 articles for initial screening and 95 articles were assessed for full-text eligibility. Six articles were extracted from the full-text assessment. Six instruments were identified from the final article list: Screener and Opioid Assessment for Patients with Pain - Revised; Drug Abuse Screening Test; Opioid Risk Tool; Current Opioid Misuse Measure; an Emergency Medicine Providers Clinician Assessment Questionnaire; and an Emergency Provider Impression Data Collection Form. Screening instrument characteristics, and reliability and validity data were extracted from the six studies. A meta-analysis was not conducted due to heterogeneity between the studies. There is a lack of validity and reliability evidence in all six articles; and sensitivity, specificity and predictive values varied between the different instruments. These instruments cannot be validated for use in emergency medicine settings. There is no clear evidence to state which screening instruments are appropriate for use in detecting opioid use disorders in emergency medicine patients. There is a need for brief, reliable, valid and feasible opioid use screening instruments in the emergency medicine setting. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cognitive Modifiability of Children with Developmental Disabilities: A Multicentre Study Using Feuerstein's Instrumental Enrichment-Basic Program

ERIC Educational Resources Information Center

Kozulin, A.; Lebeer, J.; Madella-Noja, A.; Gonzalez, F.; Jeffrey, I.; Rosenthal, N.; Koslowsky, M.

2010-01-01

The study aimed at exploring the effectiveness of cognitive intervention with the new "Instrumental Enrichment Basic" program (IE-basic), based on Feuerstein's theory of structural cognitive modifiability that contends that a child's cognitive functioning can be significantly modified through mediated learning intervention. The IE-basic…

Improving the quality of cognitive screening assessments: ACEmobile, an iPad-based version of the Addenbrooke's Cognitive Examination-III.

PubMed

Newman, Craig G J; Bevins, Adam D; Zajicek, John P; Hodges, John R; Vuillermoz, Emil; Dickenson, Jennifer M; Kelly, Denise S; Brown, Simona; Noad, Rupert F

2018-01-01

Ensuring reliable administration and reporting of cognitive screening tests are fundamental in establishing good clinical practice and research. This study captured the rate and type of errors in clinical practice, using the Addenbrooke's Cognitive Examination-III (ACE-III), and then the reduction in error rate using a computerized alternative, the ACEmobile app. In study 1, we evaluated ACE-III assessments completed in National Health Service (NHS) clinics ( n  = 87) for administrator error. In study 2, ACEmobile and ACE-III were then evaluated for their ability to capture accurate measurement. In study 1, 78% of clinically administered ACE-IIIs were either scored incorrectly or had arithmetical errors. In study 2, error rates seen in the ACE-III were reduced by 85%-93% using ACEmobile. Error rates are ubiquitous in routine clinical use of cognitive screening tests and the ACE-III. ACEmobile provides a framework for supporting reduced administration, scoring, and arithmetical error during cognitive screening.

Health Literacy Screening Instruments for eHealth Applications: A Systematic Review

PubMed Central

Collins, Sarah A.; Currie, Leanne M.; Bakken, Suzanne; Vawdrey, David K.; Stone, Patricia W.

2012-01-01

Objective To systematically review current health literacy (HL) instruments for use in consumer-facing and mobile health information technology screening and evaluation tools. Design The databases, PubMed, OVID, Google Scholar, Cochrane Library and Science Citation Index, were searched for health literacy assessment instruments using the terms “health”, “literacy”, “computer-based,” and “psychometrics”. All instruments identified by this method were critically appraised according to their reported psychometric properties and clinical feasibility. Results Eleven different health literacy instruments were found. Screening questions, such as asking a patient about his/her need for assistance in navigating health information, were evaluated in 7 different studies and are promising for use as a valid, reliable, and feasible computer-based approach to identify patients that struggle with low health literacy. However, there was a lack of consistency in the types of screening questions proposed. There is also a lack of information regarding the psychometric properties of computer-based health literacy instruments. Limitations Only English language health literacy assessment instruments were reviewed and analyzed. Conclusions Current health literacy screening tools demonstrate varying benefits depending on the context of their use. In many cases, it seems that a single screening question may be a reliable, valid, and feasible means for establishing health literacy. A combination of screening questions that assess health literacy and technological literacy may enable tailoring eHealth applications to user needs. Further research should determine the best screening question(s) and the best synthesis of various instruments’ content and methodologies for computer-based health literacy screening and assessment. PMID:22521719

[Use of "the Middlesex Elderly Assessment of Mental State" scale in the assessment of cognitive functioning in patients with aneurysmal subarachnoid haemorrhage].

PubMed

Chyza, Karolina Julia; Polityńska, Barbara; Kochanowicz, Jan; Lewko, Janusz

2007-03-01

It is now well established that cognitive deficits are a frequent consequence of aneurysmal subarachnoid haemorrhage (SAH). The cognitive status in the acute phase of the illness may provide valuable prognostic information in relation to the effects of the proposed treatment and long-term functioning of the patient. A prerequisite for this task is the identification of instruments that might prove useful in the diagnosis of neuropsychological deficits in patients with SAH. For these purposes we used The Middlesex Elderly Assessment of Mental State (MEAMS) in order to assess the cognitive deficits consequent upon SAH. To assess the cognitive functioning of patients undergoing treatment for SAH of aneurysmal origin in the acute stage of the illness, using a modified form of the MEAMS. 49 patients participated in the study, none of whom had a previous history of neurological or psychiatric illness. The age of the patients ranged between 23-70 years. 35 (71%) patients received surgical treatment (clipping of the aneurysm neck) and in 14 (29%) the aneurysm was embolised. The patients were assessed on two occasions: the first on admission to the Neurosurgery department following the SAH, and on the second, following treatment to secure the aneurysm. A modified version of the MEAMS in two parallel versions was used in the assessment. The results obtained were evaluated with reference to a control group. A range of cognitive impairments was identified with the aid of the MEAMS in patients undergoing treatment for aneurysmal SAH. These included deficits in visual and auditory memory, executive, perceptual and visuo-spatial functions together with the tendency to perseverate. In those patients who underwent surgery, deficits were observed in the following areas: disorientation in relation to self, time and place; perceptual, memory and visuo-spatial impairments. The results obtained indicate that the Middlesex Elderly Assessment of Mental State, in the form used in the present study appears to be a sensitive and useful instrument for the screening of cognitive impairments in patients following SAH, in the acute stages of the illness.

Development of the multiple sclerosis (MS) early mobility impairment questionnaire (EMIQ).

PubMed

Ziemssen, Tjalf; Phillips, Glenn; Shah, Ruchit; Mathias, Adam; Foley, Catherine; Coon, Cheryl; Sen, Rohini; Lee, Andrew; Agarwal, Sonalee

2016-10-01

The Early Mobility Impairment Questionnaire (EMIQ) was developed to facilitate early identification of mobility impairments in multiple sclerosis (MS) patients. We describe the initial development of the EMIQ with a focus on the psychometric evaluation of the questionnaire using classical and item response theory methods. The initial 20-item EMIQ was constructed by clinical specialists and qualitatively tested among people with MS and physicians via cognitive interviews. Data from an observational study was used to make additional updates to the instrument based on exploratory factor analysis (EFA) and item response theory (IRT) analysis, and psychometric analyses were performed to evaluate the reliability and validity of the final instrument's scores and screening properties (i.e., sensitivity and specificity). Based on qualitative interview analyses, a revised 15-item EMIQ was included in the observational study. EFA, IRT and item-to-item correlation analyses revealed redundant items which were removed leading to the final nine-item EMIQ. The nine-item EMIQ performed well with respect to: test-retest reliability (ICC = 0.858); internal consistency (α = 0.893); convergent validity; and known-groups methods for construct validity. A cut-point of 41 on the 0-to-100 scale resulted in sufficient sensitivity and specificity statistics for viably identifying patients with mobility impairment. The EMIQ is a content valid and psychometrically sound instrument for capturing MS patients' experience with mobility impairments in a clinical practice setting. Additional research is suggested to further confirm the EMIQ's screening properties over time.

Attitudes About Cognitive Screening: A Survey of Home Care Physical Therapists.

PubMed

Miles, Jean D; Staples, William H; Lee, Daniel J

2018-02-14

Home care physical therapists (PTs) are inconsistent regarding cognitive screening, possibly because screening tools were traditionally considered the domain of other home care disciplines, or because therapists perceive their dementia training to be inadequate. A cross sectional study was designed to survey home care therapists' attitudes and beliefs about the management of persons with dementia and to find out whether any specific cognitive tools or measures are currently used. A 5-point Likert-type survey was administered to home care PTs via an online survey. Three state home care associations and individual home care agencies agreed to share the survey link. The survey was also made available to American Physical Therapy Association members through the Home Health and Geriatric Section listservs. Two hundred fifty-one PTs opened the survey and 233 completed the survey. Respondents included 180 females and 53 males. Seventy-four had a bachelor's degree (BS), 53 held a master's degree (MS), 104 had achieved a doctor of physical therapy (DPT) or doctor of philosophy (PhD) degree, and 2 did not provide this information. Significant differences were found between those with the highest doctoral degrees and those with master's or bachelor's degrees (P = .01) regarding whether they were qualified to screen (strongly agree, agree) for cognitive deficits. Therapists with the highest degrees also attended continuing education for dementia training more than those with less formal education (P = .042.) Gender differences were found in 2 questions regarding positive outcomes (P = .010 and .42); for both questions, males were more likely to believe that dementia has a negative impact. Eighty-seven percent indicated that PTs are qualified (strongly agree, agree), but only 53% said that they possess the necessary skills (strongly agree, agree) to perform cognitive screens. Specialty certification revealed significant differences in several of the questions. No significance was found for any question regarding years of practice or years in home care. The Mini-Mental State Examination and the Clock Drawing Test were most frequently cited among PTs who conduct cognitive screening. Physical therapists recognize that they are qualified to perform cognitive screening but may need additional training to utilize cognitive findings to enhance interventions and outcomes in home care. More research is needed to determine which screens are most relevant for therapist use and to examine the effect of cognitive screening on therapy outcomes.

Development of a Language Screening Instrument for Swedish 4-Year-Olds

ERIC Educational Resources Information Center

Lavesson, Ann; Lövdén, Martin; Hansson, Kristina

2018-01-01

Background: The Swedish Program for health surveillance of preschool children includes screening of language and communication abilities. One important language screening is carried out at age 4 years as part of a general screening conducted by health nurses at child health centres. The instruments presently in use for this screening mainly focus…

Cognitive impairment in heart failure: issues of measurement and etiology.

PubMed

Riegel, Barbara; Bennett, Jill A; Davis, Andra; Carlson, Beverly; Montague, John; Robin, Howard; Glaser, Dale

2002-11-01

Clinicians need easy methods of screening for cognitive impairment in patients with heart failure. If correlates of cognitive impairment could be identified, more patients with early cognitive impairment could be treated before the problem interfered with adherence to treatment. To describe cognitive impairment in patients with heart failure, to explore the usefulness of 4 measures of cognitive impairment, and to assess correlates of cognitive impairment. A descriptive, correlational design was used. Four screening measures of cognition were assessed in 42 patients with heart failure: Commands subtest and Complex Ideational Material subtest of the Boston Diagnostic Aphasia Examination, Mini-Mental State Examination, and Draw-a-Clock Test. Cognitive impairment was defined as performance less than the standardized (T-score) cutoff point on at least 1 of the 4 measures. Possible correlates of cognitive impairment included age, education, hypotension, fluid overload (serum osmolality < 269 mOsm/kg), and dehydration (serum osmolality > or = 295 mOsm/kg). Cognitive impairment was detected in 12 (28.6%) of 42 participants. The 4 screening tests varied in effectiveness, but the Draw-a-Clock Test indicated impairment in 50% of the 12 impaired patients. A summed standardized score for the 4 measures was not significantly associated with age, education, hypotension, fluid overload, or dehydration in this sample. Cognitive impairment is relatively common in patients with heart failure. The Draw-a-Clock Test was most useful in detecting cognitive impairment, although it cannot be used to detect problems with verbal learning or delayed recall and should not be used as the sole screening method for patients with heart failure. Correlates of cognitive impairment require further study.

Development and content validity of a screening instrument for gaming addiction in adolescents: the Gaming Addiction Identification Test (GAIT).

PubMed

Vadlin, Sofia; Åslund, Cecilia; Nilsson, Kent W

2015-08-01

This study describes the development of a screening tool for gaming addiction in adolescents - the Gaming Addiction Identification Test (GAIT). Its development was based on the research literature on gaming and addiction. An expert panel comprising professional raters (n = 7), experiential adolescent raters (n = 10), and parent raters (n = 10) estimated the content validity of each item (I-CVI) as well as of the whole scale (S-CVI/Ave), and participated in a cognitive interview about the GAIT scale. The mean scores for both I-CVI and S-CVI/Ave ranged between 0.97 and 0.99 compared with the lowest recommended I-CVI value of 0.78 and the S-CVI/Ave value of 0.90. There were no sex differences and no differences between expert groups regarding ratings in content validity. No differences in the overall evaluation of the scale emerged in the cognitive interviews. Our conclusions were that GAIT showed good content validity in capturing gaming addiction. The GAIT needs further investigation into its psychometric properties of construct validity (convergent and divergent validity) and criterion-related validity, as well as its reliability in both clinical settings and in community settings with adolescents. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Predicting School Performance with the Early Screening Inventory.

ERIC Educational Resources Information Center

Meisels, Samuel J.; And Others

1984-01-01

Proposes criteria for defining and selecting preschool developmental screening instruments and describes the Early Screening Inventory (ESI), a developmental screening instrument designed to satisfy these criteria. Presents results of several studies demonstrating that the ESI predicts school performance with moderate to excellent accuracy through…

The role of fear in predicting sexually transmitted infection screening.

PubMed

Shepherd, Lee; Smith, Michael A

2017-07-01

This study assessed the extent to which social-cognitive factors (attitude, subjective norm and perceived control) and the fear of a positive test result predict sexually transmitted infection (STI) screening intentions and subsequent behaviour. Study 1 (N = 85) used a longitudinal design to assess the factors that predict STI screening intention and future screening behaviour measured one month later at Time 2. Study 2 (N = 102) used an experimental design to determine whether the relationship between fear and screening varied depending on whether STI or HIV screening was being assessed both before and after controlling for social-cognitive factors. Across the studies the outcome measures were sexual health screening. In both studies, the fear of having an STI positively predicted STI screening intention. In Study 1, fear, but not the social-cognitive factors, also predicted subsequent STI screening behaviour. In Study 2, the fear of having HIV did not predict HIV screening intention, but attitude negatively and response efficacy positively predicted screening intention. This study highlights the importance of considering the nature of the health condition when assessing the role of fear on health promotion.

Individual differences in aversion to ambiguity regarding medical tests and treatments: association with cancer screening cognitions.

PubMed

Han, Paul K J; Williams, Andrew E; Haskins, Amy; Gutheil, Caitlin; Lucas, F Lee; Klein, William M P; Mazor, Kathleen M

2014-12-01

Aversion to "ambiguity"-uncertainty about the reliability, credibility, or adequacy of information-about medical tests and treatments is an important psychological response that varies among individuals, but little is known about its nature and extent. The purpose of this study was to examine how individual-level ambiguity aversion relates to important health cognitions related to different cancer screening tests. A survey of 1,074 adults, ages 40 to 70 years, was conducted in four integrated U.S. healthcare systems. The Ambiguity Aversion in Medicine (AA-Med) scale, a measure of individual differences in aversion to ambiguity (AA) about medical tests and treatments, was administered along with measures of several cancer screening-related cognitions: perceived benefits and harms of colonoscopy, mammography, and PSA screening, and ambivalence and future intentions regarding these tests. Multivariable analyses were conducted to assess the associations between AA-Med scores and cancer screening cognitions. Individual-level AA as assessed by the AA-Med scale was significantly associated (P < 0.05) with lower perceived benefits, greater perceived harms, and greater ambivalence about all three screening tests, and lower intentions for colonoscopy but not mammography or PSA screening. Individual-level AA is broadly and simultaneously associated with various pessimistic cognitive appraisals of multiple cancer screening tests. The breadth of these associations suggests that the influence of individual-level AA is insensitive to the degree and nonspecific with respect to the causes of ambiguity. Individual-level AA constitutes a measurable, wide-ranging cognitive bias against medical intervention, and more research is needed to elucidate its mechanisms and effects. ©2014 American Association for Cancer Research.

[Screening for risk of child abuse and neglect. A practicable method?].

PubMed

Kindler, H

2010-10-01

Selective primary prevention programs for child abuse and neglect depend on risk screening instruments that have the goal of systematically identifying families who can profit most from early help. Based on a systematic review of longitudinal studies, a set of established risk factors for early child abuse and neglect is presented. Nearly half of the items included in screening instruments can be seen as validated. Available studies indicate a high sensitivity of risk screening instruments. Positive predictive values, however, are low. Overall, the use of risk screening instruments in the area of primary prevention for families at risk represents a feasible method, as long as stigmatizing effects can be avoided and participating families also benefit beyond preventing endangerment.

Cognitive assessment instruments in Parkinson's disease patients undergoing deep brain stimulation

PubMed Central

Romann, Aline Juliane; Dornelles, Silvia; Maineri, Nicole de Liz; Rieder, Carlos Roberto de Mello; Olchik, Maira Rozenfeld

2012-01-01

Deep Brain Stimulation (DBS) is a widely used surgical technique in individuals with Parkinson's disease (PD) that can lead to significant reductions in motor symptoms. Objectives To determine, from publications, the most commonly used instruments for cognitive evaluation of individuals with PD undergoing DBS. Methods A systematic review of the databases: PubMed, Medline, EBECS, Scielo and LILACS was conducted, using the descriptors "Deep Brain Stimulation", "Verbal Fluency", "Parkinson Disease", "Executive Function", "Cognition" and "Cognitive Assessment" in combination. Results The Verbal Fluency test was found to be the most used instrument for this investigation in the studies, followed by the Boston Naming Test. References to the Stroop Test, Trail Making Test, and Rey's Auditory Verbal Learning Test were also found. Conclusions The validation of instruments for this population is needed as is the use of batteries offering greater specificity and sensitivity for the detection of cognitive impairment. PMID:29213766

Developing a Cantonese Version of Birmingham Cognitive Screen for Stroke Survivors in Hong Kong

ERIC Educational Resources Information Center

Kong, Anthony Pak-Hin; Chan, John; Lau, Johnny King-L.; Bickerton, Wai-Ling; Weekes, Brendan; Humphreys, Glyn

2018-01-01

The "Birmingham Cognitive Screen" (BCoS) is a neuropsychological battery designed to assess impairment to a variety of cognitive domains including language in patients with brain injuries. Twenty-two stroke participants and 16 gender-, age-, and education-matched controls were recruited in Hong Kong. The stroke participants were…

A Proposal for Evaluating Cognition in Assertiveness

ERIC Educational Resources Information Center

Vagos, Paula; Pereira, Anabela

2010-01-01

This article presents the development process and initial psychometric features of an instrument for evaluating cognition in assertiveness. This is an essential social skill for adolescent development and seems to encompass emotional, behavioral, and cognitive aspects. The instrument was created by combining both empirical and theoretical methods…

Social-cognitive and socio-cultural predictors of hepatitis B virus-screening in Turkish migrants, the Netherlands.

PubMed

van der Veen, Y J J; van Empelen, P; Looman, C W N; Richardus, J H

2014-10-01

Hepatitis B virus (HBV) is an important health problem in the Turkish Dutch. Screening is necessary for detection and prevention of HBV. We aimed to identify social-cognitive and socio-cultural determinants of HBV-screening intention among Turkish Dutch. A cross-sectional survey was carried out amongst 335 Turkish Dutch, aged 16-40 years. Respondents showed favorable scores for the potential determinants of HBV-screening. Attitude, perceived behaviour control, social support and social norm, and the level of satisfaction with Dutch health care proved to be directly associated with screening intention. Relevant socio-cultural beliefs were shame, stigma, the association of screening with sexuality and family values. Persons with lower screening intentions had lower scores for attitude, perceived behaviour control, social support and subjective norms, but scored higher for feelings of shame and stigma regarding hepatitis B. This study shows how cultural values and social-cognitive factors are related to HBV-screening intention.

Improving Universal Suicide Prevention Screening in Primary Care by Reducing False Negatives

DTIC Science & Technology

2017-09-01

develop a shortened version of the Suicide Cognitions Scale (SCS) and to evaluate its efficacy as a universal suicide prevention screen for use in... Cognitions Scale (SCS) and to evaluate its efficacy as a universal suicide prevention screen for use in military primary care clinics. We propose to

Cognitive screening in Parkinson's disease: Comparison of the Parkinson Neuropsychometric Dementia Assessment (PANDA) with 3 other short scales.

PubMed

Gasser, A-I; Calabrese, P; Kalbe, E; Kessler, J; Rossier, P

2016-02-01

Cognitive screening is crucial in Parkinson's disease (PD). However, there is still a lack of short tools in French. In this study, we aimed to compare the Parkinson Neuropsychometric Dementia Assessment (PANDA) with the Mini Mental Parkinson (MMP), the Mini Mental State Examination (MMSE) and the Clock Test in French-speaking patients. We also aimed to propose cut-off scores for cognitive impairment and dementia for the French language version of the PANDA. Fifty-one patients with PD took the PANDA, the MMSE, the MMP, and the Clock Test. They also underwent extensive neuropsychological testing by a neuropsychologist who was blinded to the above-mentioned screening test results. Patients were classified as either having normal cognition (n=15), mild cognitive impairment (n=20) or dementia (n=16). When compared with the three other screening tools, the PANDA exhibited the highest area under the curve (AUC) for both cognitive disorders and dementia. Using the cut-off scores proposed for the German version, the PANDA had 94% specificity and 100% sensitivity for dementia and 100% and 72%, respectively for cognitive disorders. In our study, the PANDA exhibited a higher discriminative power than the three other tests in detecting cognitive disorders and dementia. In PD patients, the PANDA should thus be considered for the detection of cognitive impairment in routine clinical practice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

HIV and Cognitive Impairment in Clinical Practice: The Evaluation of a Stepwise Screening Protocol in Relation to Clinical Outcomes and Management.

PubMed

Hakkers, Charlotte S; Kraaijenhof, Jordan M; van Oers-Hazelzet, Esther B; Visser-Meily, Anne J M A; Hoepelman, Andy I M; Arends, Joop E; Barth, Roos E

2017-09-01

Neurocognitive impairment (NCI) is an increasingly important comorbidity in an ageing HIV+ population. Despite the lack of available treatment modalities, screening for NCI is recommended. In the UMC Utrecht, yearly NCI screening is done using the Montreal Cognitive Assessment (MoCA) tool and the HIV Dementia Scale (HDS). The aim of this study was to evaluate this screening protocol in relation to clinical outcomes and management. A retrospective cohort study was performed in suppressed adult HIV+ patients. Apart from the MoCa and the HDS, the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) and the Hospital Anxiety and Depression Scale (HADS) were performed. Patients scoring below average on cognitive screening tests or with subjective cognitive complaints were further evaluated using a standardized protocol, including optimizing cART and checking for somatic disorders. In patients with cognitive complaints and participation restrictions, cognitive rehabilitation was proposed. Two hundred eighty-six patients were screened. The vast majority were MSM with an average age of 49 years. One hundred forty-four out of 286 patients (50%) had an abnormal test score and/or had subjective cognitive complaints. Restrictions in participation were present in 23% of patients. Six patients on Efavirenz switched their regimes, as this drug is known for its potential central nervous system (CNS) side effects. A depressive component was present in 58 patients (40%). Five patients had a clinical relevant laboratory abnormality. Moreover, six patients were referred for cognitive rehabilitation, which resulted in a 100% success rate in set goals in the five evaluable patients. Although the protocol was not fully adhered to in all patients, it did result in detectable underlying causes of NCI in 59% of patients, and 21% was referred for further treatment. Moreover, cognitive rehabilitation appears to be a very successful intervention for patients with NCI who experience subjective complaints and participation restrictions.

Mid-Life Proteinuria and Late-Life Cognitive Function and Dementia in Elderly Men: The Honolulu-Asia Aging Study

PubMed Central

Higuchi, Masaya; Chen, Randi; Abbott, Robert D.; Bell, Christina; Launer, Lenore; Ross, G. Webster; Petrovitch, Helen; Masaki, Kamal

2015-01-01

Background Impaired renal function has been linked to cognitive impairment. We assessed mid-life proteinuria and late-life cognitive function in elderly Asian males. Methods The Honolulu Heart Program is a prospective study that began in 1965 with 8,006 Japanese-American men ages 45–68 years. Mid-life proteinuria was detected by urine dipstick in 1971–74. The Honolulu-Asia Aging Study began 20 years later, with cognitive assessment by the Cognitive Abilities Screening Instrument (CASI) in 3,734 men. Standard criteria were used to classify 8-year incident dementia and subtypes. RESULTS The age-adjusted incidence of dementia increased significantly from 13.8, to 22.8, to 39.7 per 1,000 person years follow-up, among those with no, trace and positive mid-life proteinuria, p=0.004. Using linear regression adjusting for age, education, APOEε4, stroke, hypertension, systolic blood pressure, diabetes, fasting blood glucose, physical activity and baseline CASI, those with positive proteinuria had significantly higher annual change in CASI over 8 years follow-up (−1.24, p=0.02), reference=no proteinuria. Multivariate Cox regression found positive proteinuria had a significant association with incident all-cause dementia (RR=2.66, 95%CI=1.09–6.53, p=0.03), but no significant associations with incident Alzheimer’s disease or vascular dementia. CONCLUSION Mid-life proteinuria was an independent predictor for late-life incident all-cause dementia and cognitive decline over 8 years. PMID:25626635

Prospective Evaluation of Pretreatment Executive Cognitive Impairment and Depression in Patients Referred for Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fuller, Clifton D.; Graduate Division of Radiological Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX; Department of Radiation Medicine, Oregon Health and Science University, Portland, OR

Purpose: Cancer patients are at risk of cognitive impairment and depression. We sought to ascertain the prevalence of executive, visuospatial, memory, and general cognitive performance deficits before radiotherapy in a radiation oncology clinic referral population and correlate the neurocognitive measures with the depression symptom burden. Methods and Materials: A total of 122 sequential patients referred for radiotherapy evaluation were administered a test battery composed of the Executive Interview (EXIT25), Executive Clock Drawing Task (CLOX1 and CLOX2), Mini Mental State Examination (MMSE), Memory Impairment Screen (MIS), and Geriatric Depression Scale (GDS). The mean age {+-} standard deviation was 58 {+-} 17more » years. Of 122 patients, 24 (20%) had been referred for breast cancer, 21 (17%) for gastrointestinal cancer, 17 (14%) for genitourinary disease, and 8 (7%) for brain lesions; the rest were a variety of tumor sites. The cognitive performance among the tumor cohorts was compared using Bonferroni-corrected analysis of variance and Tukey-Kramer tests. Pearson correlation coefficients were determined between each cognitive instrument and the GDS. Results: Of the 122 patients, 52 (43%) exhibited a detectable executive cognition decrement on one or more test measures. Five percent had poor memory performance (MIS), 18% had poor visuospatial performance (CLOX2), and 13% had poor global cognition (MMSE). Patients with brain tumors performed substantially worse on the EXIT25. No between-group differences were found for CLOX1, CLOX2, MIS, or GDS performance. The EXIT25 scores correlated significantly with the GDS scores (r = 0.26, p = 0.005). Conclusions: The results of this study have shown that patients referred for radiotherapy exhibit cognitive impairment profiles comparable to those observed in acutely ill medical inpatients. Executive control impairment appears more prevalent than global cognitive deficits, visuospatial impairment, or depression.« less

Dementia Screening Accuracy is Robust to Premorbid IQ Variation: Evidence from the Addenbrooke's Cognitive Examination-III and the Test of Premorbid Function.

PubMed

Stott, Joshua; Scior, Katrina; Mandy, William; Charlesworth, Georgina

2017-01-01

Scores on cognitive screening tools for dementia are associated with premorbid IQ. It has been suggested that screening scores should be adjusted accordingly. However, no study has examined whether premorbid IQ variation affects screening accuracy. To investigate whether the screening accuracy of a widely used cognitive screening tool for dementia, the Addenbrooke's cognitive examination-III (ACE-III), is improved by adjusting for premorbid IQ. 171 UK based adults (96 memory service attendees diagnosed with dementia and 75 healthy volunteers over the age of 65 without subjective memory impairments) completed the ACE-III and the Test of Premorbid Function (TOPF). The difference in screening performance between the ACE-III alone and the ACE-III adjusted for TOPF was assessed against a reference standard; the presence or absence of a diagnosis of dementia (Alzheimer's disease, vascular dementia, or others). Logistic regression and receiver operating curve analyses indicated that the ACE-III has excellent screening accuracy (93% sensitivity, 94% specificity) in distinguishing those with and without a dementia diagnosis. Although ACE-III scores were associated with TOPF scores, TOPF scores may be affected by having dementia and screening accuracy was not improved by accounting for premorbid IQ, age, or years of education. ACE-III screening accuracy is high and screening performance is robust to variation in premorbid IQ, age, and years of education. Adjustment of ACE-III cut-offs for premorbid IQ is not recommended in clinical practice. The analytic strategy used here may be useful to assess the impact of premorbid IQ on other screening tools.

Assessing and addressing cognitive impairment in bipolar disorder: the International Society for Bipolar Disorders Targeting Cognition Task Force recommendations for clinicians.

PubMed

Miskowiak, K W; Burdick, K E; Martinez-Aran, A; Bonnin, C M; Bowie, C R; Carvalho, A F; Gallagher, P; Lafer, B; López-Jaramillo, C; Sumiyoshi, T; McIntyre, R S; Schaffer, A; Porter, R J; Purdon, S; Torres, I J; Yatham, L N; Young, A H; Kessing, L V; Vieta, E

2018-05-01

Cognition is a new treatment target to aid functional recovery and enhance quality of life for patients with bipolar disorder. The International Society for Bipolar Disorders (ISBD) Targeting Cognition Task Force aimed to develop consensus-based clinical recommendations on whether, when and how to assess and address cognitive impairment. The task force, consisting of 19 international experts from nine countries, discussed the challenges and recommendations in a face-to-face meeting, telephone conference call and email exchanges. Consensus-based recommendations were achieved through these exchanges with no need for formal consensus methods. The identified questions were: (I) Should cognitive screening assessments be routinely conducted in clinical settings? (II) What are the most feasible screening tools? (III) What are the implications if cognitive impairment is detected? (IV) What are the treatment perspectives? Key recommendations are that clinicians: (I) formally screen cognition in partially or fully remitted patients whenever possible, (II) use brief, easy-to-administer tools such as the Screen for Cognitive Impairment in Psychiatry and Cognitive Complaints in Bipolar Disorder Rating Assessment, and (III) evaluate the impact of medication and comorbidity, refer patients for comprehensive neuropsychological evaluation when clinically indicated, and encourage patients to build cognitive reserve. Regarding question (IV), there is limited evidence for current evidence-based treatments but intense research efforts are underway to identify new pharmacological and/or psychological cognition treatments. This task force paper provides the first consensus-based recommendations for clinicians on whether, when, and how to assess and address cognition, which may aid patients' functional recovery and improve their quality of life. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Screening an elderly hearing impaired population for mild cognitive impairment using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).

PubMed

Lim, Magdalene Yeok Leng; Loo, Jenny Hooi Yin

2018-07-01

To determine if there is an association between hearing loss and poorer cognitive scores on Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) and to determine if poor hearing acuity affects scoring on the cognitive screening tests of MMSE and MoCA. One hundred fourteen elderly patients (Singapore residents) aged between 55 and 86 years were sampled. Participants completed a brief history questionnaire, pure tone audiometry, and 2 cognitive screening tests-the MMSE and MoCA. Average hearing thresholds of the better ear in the frequencies of 0.5, 1, 2, and 4 kHz were used for data analysis. Hearing loss was significantly associated with poorer cognitive scores in Poisson regression models adjusted for age. Mini-Mental State Examination scores were shown to decrease by 2.8% (P = .029), and MoCA scores by 3.5% (P = .013) for every 10 dB of hearing loss. Analysis of hearing-sensitive components of "Registration" and "Recall" in MMSE and MoCA using chi-square tests showed significantly poorer performance in the hearing loss group as compared to the normal hearing group. Phonetic analysis of target words with high error rates shows that the poor performance was likely contributed by decreased hearing acuity, on top of a possible true deficit in cognition in the hearing impaired. Hearing loss is associated with poorer cognitive scores on MMSE and MoCA, and cognitive scoring is likely confounded by poor hearing ability. This highlights an important, often overlooked aspect of sensory impairment during cognitive screening. Provisions should be made when testing for cognition in the hearing-impaired population to avoid over-referral and subsequent misdiagnoses of cognitive impairment. Copyright © 2018 John Wiley & Sons, Ltd.

A review of amnestic MCI screening in east/southeast Asian older adults with low education: implications for early informant-clinician collaboration.

PubMed

Lim, Magdalene L; Gomez, Rowena; Koopman, Cheryl

2015-02-01

The aim of this study is to review the recent literature on established cognitive tests and appropriate screening methods for amnestic mild cognitive impairment (MCI) in East/Southeast Asian older adults with a focus on those with low education. Peer-reviewed empirical studies conducted in Asia (China, Hong Kong, Japan, Korea, Singapore, and Taiwan) were identified using databases in psychology and medicine with combinations of the search terms "mild cognitive impairment," "dementia," "screening," "literacy," "illiteracy," "low education," "informant," "family," "cognitive test," "memory complaints," "activities of daily living," and "clinical dementia rating," limiting articles to those published in English since 1 January 2002. Of note, is that the term "amnestic mild cognitive impairment" was not used for searching the articles because the related cognitive impairment were often categorized non-specifically as MCI, but participants included those with amnestic cognitive challenges. Hence, the general term "MCI" has been used often throughout the text. Twelve studies that examined MCI screens were identified. An integrative approach using a combination of cognitive test and informant-based measure may be more sensitive or accurate than using any single screening method alone. MCI misdiagnosis may be prevalent, highlighting the need for early collaborative work between informants and clinicians to improve the accuracy of this diagnosis in older Asian adults with low education. Findings were suggestive, although restricted in generalizability even within similar cultural groups or neighboring regions. Clinical application is limited, but some findings provide guidance for future research. Copyright © 2014 John Wiley & Sons, Ltd.

Follow-Up Activities for the HISD Kindergarten Screening Instrument.

ERIC Educational Resources Information Center

Perry, Pat; Cater, Margot

The Kindergarten Screening Instrument consists of five sub-scales and attempts to screen for possible difficulty in the areas of distant vision, hearing, eye-hand coordination, language learning, and gross motor performance. In response to many requests for follow-up activities after screening, this manual was prepared by Volunteers in Public…

A Critical Review of the Technical Characteristics of Current Preschool Screening Batteries

ERIC Educational Resources Information Center

Emmons, Michael R.; Alfonso, Vincent C.

2005-01-01

The current review provides a summary and evaluation of the technical characteristics of five preschool screening batteries, including the Brigance Screens, DIAL-3, ESI-R, ESP, and FirstSTEP. These norm-referenced instruments were selected on the basis of their commercial availability, description as a screening instrument, and ability to assess…

Comparing the accuracy of brief versus long depression screening instruments which have been validated in low and middle income countries: a systematic review.

PubMed

Akena, Dickens; Joska, John; Obuku, Ekwaro A; Amos, Taryn; Musisi, Seggane; Stein, Dan J

2012-11-01

Given the high prevalence of depression in primary health care (PHC), the use of screening instruments has been recommended. Both brief and long depression screening instruments have been validated in low and middle income countries (LMIC), including within HIV care settings. However, it remains unknown whether the brief instruments validated in LMIC are as accurate as the long ones. We conducted a search of PUBMED, the COCHRANE library, AIDSLINE, and PSYCH-Info from their inception up to July 2011, for studies that validated depression screening instruments in LMIC. Data were extracted into tables and analyzed using RevMan 5.0 and STATA 11.2 for the presence of heterogeneity. Nineteen studies met our inclusion criteria. The reported prevalence of depression in LMIC ranged from 11.1 to 53%. The area under curve (AUC) scores of the validated instruments ranged from 0.69-0.99. Brief as well as long screening instruments showed acceptable accuracy (AUC≥0.7). Five of the 19 instruments were validated within HIV settings. There was statistically significant heterogeneity between the studies, and hence a meta-analysis could not be conducted to completion. Heterogeneity chi-squared = 189.23 (d.f. = 18) p<.001. Brief depression screening instruments in both general and HIV-PHC are as accurate as the long ones. Brief scales may have an edge over the longer instruments since they can be administered in a much shorter time. However, because the ultra brief scales do not include the whole spectrum of depression symptoms including suicide, their use should be followed by a detailed diagnostic interview.

Development and implementation of Persian test of Elderly for Assessment of Cognition and Executive function (PEACE).

PubMed

Javadi, Pari Sadat Haji Seyed; Zendehbad, Azadeh; Darabi, Fatemeh; Khosravifar, Shahrzad; Noroozian, Maryam

2015-11-01

A considerable segment of the elderly population in Iran is illiterate, and it seems the existing neuropsychological screening tests are not very useful for detecting dementia in illiterate participants. The purpose of this study was to develop and validate a tool called Persian test of Elderly for Assessment of Cognition and Executive function (PEACE) for detecting dementia in both illiterate and literate participants. First, in order to design some of the cognitive aspects of the PEACE assay, we considered other prevalent neuropsychological instruments, such as the General Practitioner assessment of Cognition (GPCOG), Functional Assessment Staging (FAST), Mini Mental State Examination (MMSE), and Wechsler Memory scale. The other domains of PEACE were designed according to our clinical proficiencies and the culture of the society. In the next step, the participants were classified into three distinct groups, i.e., the control group (n=33), the Mild Cognitive Impairment (MCI) group (n=30), and the Alzheimer's group (n=38). All of the participants in each group were divided according to their educational level, i.e., illiterate, semi-literate, and literate. We developed PEACE consisting of 14 items, each of which represents a specific cognitive function, with a maximum score of 91. The 14 items are Orientation, Praxis, Attention and Concentration, Attention and Calculation, Memory, Similarity, Abstract Thinking, General Information, Language, Judgment, Gnosis, Planning (Sequencing), Problem Solving, and Animal Naming. PEACE scores are highly correlated with those of the MMSE (r=0.78). The optimal cut-off point of PEACE chosen for diagnosis of Alzheimer's disease was 67.5 (sensitivity: 75.8%, specificity: 97.4%). The PEACE scores showed a significant difference between Participants with Alzheimer's disease and the control group (p=0.0000) and the MCI group (p=0.003). In addition, there was no significant difference between illiterate and literate participants in the Alzheimer's group. However, the PEACE scores differed significantly (p=0.0000) between illiterate and literate participants in the control group. The PEACE addresses the limitations of existing tests and is appropriate for use in countries that have high rates of illiteracy. It is a valid screening mechanism for the detection of dementia in both illiterate and literate participants.

Development and Validation of Two Instruments Measuring Intrinsic, Extraneous, and Germane Cognitive Load.

PubMed

Klepsch, Melina; Schmitz, Florian; Seufert, Tina

2017-01-01

Cognitive Load Theory is one of the most powerful research frameworks in educational research. Beside theoretical discussions about the conceptual parts of cognitive load, the main challenge within this framework is that there is still no measurement instrument for the different aspects of cognitive load, namely intrinsic, extraneous, and germane cognitive load. Hence, the goal of this paper is to develop a differentiated measurement of cognitive load. In Study 1 ( N = 97), we developed and analyzed two strategies to measure cognitive load in a differentiated way: (1) Informed rating: We trained learners in differentiating the concepts of cognitive load, so that they could rate them in an informed way. They were asked then to rate 24 different learning situations or learning materials related to either high or low intrinsic, extraneous, or germane load. (2) Naïve rating: For this type of rating of cognitive load we developed a questionnaire with two to three items for each type of load. With this questionnaire, the same learning situations had to be rated. In the second study ( N = between 65 and 95 for each task), we improved the instrument for the naïve rating. For each study, we analyzed whether the instruments are reliable and valid, for Study 1, we also checked for comparability of the two measurement strategies. In Study 2, we conducted a simultaneous scenario based factor analysis. The informed rating seems to be a promising strategy to assess the different aspects of cognitive load, but it seems not economic and feasible for larger studies and a standardized training would be necessary. The improved version of the naïve rating turned out to be a useful, feasible, and reliable instrument. Ongoing studies analyze the conceptual validity of this measurement with up to now promising results.

Asperger syndrome in adolescent and young adult males. Interview, self- and parent assessment of social, emotional, and cognitive problems.

PubMed

Cederlund, Mats; Hagberg, Bibbi; Gillberg, Christopher

2010-01-01

Descriptive and comparative follow-up studies of young adult males with Asperger syndrome (AS) diagnosed in childhood, using both interview, self- and parent assessment instruments for the study of aspects of emotional well-being, social functioning, and cognitive-practical skills have not been performed in the past. One-hundred males with AS diagnosed in childhood were approached for the assessment using the Asperger Syndrome Diagnostic Interview (ASDI), (personal and parent interview), the Leiter-R-Questionnaires, the Beck Depression Inventory (BDI), and the Dysexecutive Questionnaire (DEX). About 75% of the targeted group participated. The ASDI results came out significantly different at personal vs parent interviews in several key domains. In contrast, the Leiter-R-Questionnaires, showed no significant differences across the individuals with AS and their parents in the scoring of cognitive/social and emotional/adaptive skills. The BDI proved to be an adequate screening instrument for depression in that it correctly identified the vast majority of cases with clinical depression in the AS group. The DEX results suggested an executive function deficit problem profile in males with AS as severe as that reported in groups of individuals with traumatic brain injury and schizophrenia. Interviews (personal and collateral), and self-rating and parent-rating questionnaires all have a role in the comprehensive diagnostic process in AS and other autism spectrum disorders, and could be used as adjuncts when evaluating whether or not individuals meeting diagnostic symptom criteria for the condition have sufficient problems in daily life to warrant a clinical diagnosis of AS. Copyright 2009 Elsevier Ltd. All rights reserved.

Implementation of the Alarm Distress Baby Scale as a universal screening instrument in primary care: feasibility, acceptability, and predictors of professionals' adherence to guidelines.

PubMed

Smith-Nielsen, Johanne; Lønfeldt, Nicole; Guedeney, Antoine; Væver, Mette Skovgaard

2018-03-01

Infant socioemotional development is often held under informal surveillance, but a formal screening program is needed to ensure systematic identification of developmental risk. Even when screening programs exist, they are often ineffective because health care professionals do not adhere to screening guidelines, resulting in low screening prevalence rates. To examine feasibility and acceptability of implementing universal screening for infant socioemotional problems with the Alarm Distress Baby Scale in primary care. The following questions were addressed: Is it possible to obtain acceptable screening prevalence rates within a 1-year period? How do the primary care workers (in this case, health visitors) experience using the instrument? Are attitudes toward using the instrument related to screening prevalence rates? A longitudinal mixed-method study (surveys, data from the health visitors' digital filing system, and qualitative coding of answers to open-ended questions) was undertaken. Health visitors in three of five districts of the City of Copenhagen, Denmark (N=79). We describe and evaluate the implementation process from the date the health visitors started the training on how to use the Alarm Distress Baby Scale to one year after they began using the instrument in practice. To monitor screening prevalence rates and adherence to guidelines, we used three data extractions (6, 9, and 12 months post-implementation) from the electronic filing system. Surveys including both quantitative and open-ended questions (pre- and post-implementation) were used to examine experiences with and attitudes towards the instrument. Descriptive and inferential statistical and qualitative content analyses were used. Screening prevalence rates increased during the first year: Six months after implementation 47% (n=405) of the children had been screened; 12 months after implementation 79% (n=789) of the children were screened (the same child was not counted more than once). Most (92%) of the health visitors reported that the instrument made a positive contribution to their work. The majority (81%) also reported that it posed a challenge in their daily work at least to some degree. The health visitors' attitudes (positive and negative) toward the Alarm Distress Baby Scale, measured 7 months post-implementation, significantly predicted screening prevalence rates 12 months post-implementation. Adding the Alarm Distress Baby Scale to an established surveillance program is feasible and accepTable Screening prevalence rates may be related to the primary care worker's attitude toward the instrument, i.e. successful implementation relies on an instrument that adds value to the work of the screener. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effectiveness of music-based interventions on motricity or cognitive functioning in neurological populations: a systematic review.

PubMed

Moumdjian, Lousin; Sarkamo, Teppo; Leone, Carmela; Leman, Marc; Feys, Peter

2017-06-01

Motor and cognitive symptoms are frequent in persons with neurological disorders and often require extensive long-term rehabilitation. Recently, a variety of music-based interventions have been introduced into neurological rehabilitation as training tools. This review aims to 1) describe and define music-based intervention modalities and content which are applied in experimental studies; and 2) describe the effects of these interventions on motor and/or cognitive symptoms in the neurological population. The databases PubMed and Web of Science were searched. Cited references of included articles where screened for potential inclusion. A systematic literature search up to 20th of June 2016 was conducted to include controlled trials and cohort studies that have used music-based interventions for ≥3 weeks in the neurological population (in- and outpatients) targeting motor and/or cognitive symptoms. No limitations to publication date was set. EVIDENCE SYNTHESISː Nineteen articles comprising thirteen randomized controlled trials (total participants Nexp=241, Nctrl=269), four controlled trials (Nexp=59, Nctrl=53) and two cohort studies (N.=27) were included. Fourteen studies were conducted in stroke, three in Parkinson's disease, and two in multiple sclerosis population. Modalities of music-based interventions were clustered into four groups: instrument-based, listening-based, rhythm-based, and multicomponent-based music interventions. Overall, studies consistently showed that music-based interventions had similar or larger effects than conventional rehabilitation on upper limb function (N.=16; fine motricity, hand and arm capacity, finger and hand tapping velocity/variability), mobility (N.=7; gait parameters), and cognition (N.=4; verbal memory and focused attention). CONCLUSIONSː Variety of modalities using music-based interventions has been identified and grouped into four clusters. Effects of interventions demonstrate an improvement in the domains assessed. Evidence is most available for improving motricity in stroke. More studies are warranted to investigate cognition as well as motor and cognition dysfunctions in combination. Instrument-based music interventions can improve fine motor dexterity and gross motor functions in stroke. Rhythm-based music interventions can improve gait parameters of velocity and cadence in stroke, Parkinson's disease and multiple sclerosis. Cognition in the domains of verbal memory and focused attention can improve after listening-based music interventions in stroke.

Cognition and screening for hearing loss in nursing home residents.

PubMed

Jupiter, Tina

2012-10-01

To compare hearing screening results using pure tones and distortion product otoacoustic emissions (DPOAEs) with nursing home residents who have dementia and explore the relationship of hearing impairment and cognitive function using the Mini- Mental Status Evaluation (MMSE). A correlational design was implemented to evaluate residents in a large inner city nursing home. One hundred one nursing home residents 65-108 years. DPOAEs and pure tone screenings were conducted at 30 dB HL and 40 dB HL at 1, 2, and 3 kHz. Pure tone thresholds at 1, 2, and 3 kHz were obtained. The MMSE was administered to all participants. Results showed that all residents failed the DPOAE screen, 97.1% failed at 30 dB HL, and 90.0% failed at 40 dB HL. Kendall's tau, phi correlation, linear by linear association, and χ(2) results indicated no significant relationship for any of the screening protocols and cognitive status other than a significant finding with left ear screening at 40 dB HL. Logistic regression analysis indicated that individuals who passed the screen had better MMSE scores. Results of the t test and Mann-Whitney U test revealed a significant difference in cognitive function for residents with a mild hearing loss compared with those with a more significant hearing loss. For screening nursing home residents, 40 dB HL screening level or DPOAEs can be used. The significant finding that residents with greater than a mild hearing loss have poorer cognitive function reinforces the importance of identifying residents with a hearing loss and providing rehabilitation and follow-up. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Preliminary cognitive scale of basic and instrumental activities of daily living for dementia and mild cognitive impairment.

PubMed

Rodríguez-Bailón, María; Montoro-Membila, Nuria; Garcia-Morán, Tamara; Arnedo-Montoro, María Luisa; Funes Molina, María Jesús

2015-01-01

In the present study we explored cognitive and functional deficits in patients with multidomain mild cognitive impairment (MCI), patients with dementia, and healthy age-matched control participants using the Cognitive Scale for Basic and Instrumental Activities of Daily Living, a new preliminary informant-based assessment tool. This tool allowed us to evaluate four key cognitive abilities-task memory schema, error detection, problem solving, and task self-initiation-in a range of basic and instrumental activities of daily living (BADL and IADL, respectively). The first part of the present study was devoted to testing the psychometric adequateness of this new informant-based tool and its convergent validity with other global functioning and neuropsychological measures. The second part of the study was aimed at finding the patterns of everyday cognitive factors that best discriminate between the three groups. We found that patients with dementia exhibited impairment in all cognitive abilities in both basic and instrumental activities. By contrast, patients with MCI were found to have preserved task memory schema in both types of ADL; however, such patients exhibited deficits in error detection and task self-initiation but only in IADL. Finally, patients with MCI also showed a generalized problem solving deficit that affected even BADL. Studying various cognitive processes instantiated in specific ADL differing in complexity seems a promising strategy to further understand the specific relationships between cognition and function in these and other cognitively impaired populations.

The Development of a Clinical Screening Instrument For Tumour Predisposition Syndromes In Childhood Cancer Patients

PubMed Central

Hopman, Saskia M. J.; Merks, Johannes H. M.; de Borgie, Corianne A. J. M.; Aalfs, C. M.; Biesecker, Leslie G.; Cole, Trevor; Eng, Charis; Legius, Eric; Maher, Eamonn R.; van Noesel, Max M.; Verloes, Alain; Viskochil, David H.; Wagner, Anja; Weksberg, Rosanna; Caron, Huib N.; Hennekam, Raoul C. M.

2014-01-01

Background Identification of tumour predisposition syndromes in patients who have cancer in childhood is paramount for optimal care. A screening instrument that can help to identify such patients will facilitate physicians caring for children with cancer. The complete screening instrument should consist of a standardized series of pictures and a screening form for manifestations not visible in the pictures. Here we describe the development of such a screening form based on an international two-stage Delphi process and an initial validation of the complete instrument. Patients and Methods We identified manifestations that may contribute to the diagnosis of a tumour predisposition syndrome through the Winter-Baraitser Dysmorphology Database and the textbook “Gorlin's Syndromes of the Head and Neck”. In a two-round Delphi process, eight international content-experts scored the contribution of each of these manifestations. We performed a clinical validation of the instrument in a selected cohort of ten paediatric cancer patients from another centre. Results In total, 49 manifestations were found to contribute to the diagnosis of a tumour predisposition syndrome and were included in the screening form. The pilot validation study showed that patients suspect for having a tumour predisposition syndrome were recognized. Excellent correlation for indication for referral of a patient between the screening instrument and the reference standard (personal evaluation by an experienced clinical geneticist) was found.). Conclusions The Delphi process performed by international specialists with a function as opinion leaders in their field of expertise has led to a screening form and instrument with which those childhood cancer patients can be identified who may have a tumour predisposition syndrome and thus have an indication to be referred for further genetic analysis. PMID:23855994

Pre-donation cognitions of potential living organ donors: the development of the Donation Cognition Instrument in potential kidney donors.

PubMed

Wirken, Lieke; van Middendorp, Henriët; Hooghof, Christina W; Sanders, Jan-Stephan F; Dam, Ruth E; van der Pant, Karlijn A M I; Berendsen, Elsbeth C M; Wellink, Hiske; Dackus, Henricus J A; Hoitsma, Andries J; Hilbrands, Luuk B; Evers, Andrea W M

2017-03-01

Cognitions surrounding living organ donation, including the motivation to donate, expectations of donation and worries about donation, are relevant themes during living donor evaluation. However, there is no reliable psychometric instrument assessing all these different cognitions. This study developed and validated a questionnaire to assess pre-donation motivations, expectations and worries regarding donation, entitled the Donation Cognition Instrument (DCI). Psychometric properties of the DCI were examined using exploratory factor analysis for scale structure and associations with validated questionnaires for construct validity assessment. From seven Dutch transplantation centres, 719 potential living kidney donors were included. The DCI distinguishes cognitions about donor benefits, recipient benefits, idealistic incentives, gratitude and worries about donation (Cronbach's alpha 0.76-0.81). Scores on pre-donation cognitions differed with regard to gender, age, marital status, religion and donation type. With regard to construct validity, the DCI was moderately correlated with expectations regarding donor's personal well-being and slightly to moderately to health-related quality of life. The DCI is found to be a reliable instrument assessing cognitions surrounding living organ donation, which might add to pre-donation quality of life measures in facilitating psychosocial donor evaluation by healthcare professionals. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Movie for the Assessment of Social Cognition (MASC): Spanish Validation

ERIC Educational Resources Information Center

Lahera, G.; Boada, L.; Pousa, E.; Mirapeix, I.; Morón-Nozaleda, G.; Marinas, L.; Gisbert, L.; Pamiàs, M.; Parellada, M.

2014-01-01

We present the Spanish validation of the "Movie for the Assessment of Social Cognition" instrument (MASC-SP). We recruited 22 adolescents and young adults with Asperger syndrome and 26 participants with typical development. The MASC-SP and three other social cognition instruments (Ekman Pictures of Facial Affect test, Reading the Mind in…

Psychological variables potentially implicated in opioid-related mortality as observed in clinical practice.

PubMed

Passik, Steven D; Lowery, Amy

2011-06-01

Opioid-related deaths in the United States have become a public health problem, with accidental and unintended overdoses being especially troubling. Screening for psychological risk factors is an important first step in safeguarding against nonadherence practices and identifying patients who may be vulnerable to the risks associated with opioid therapy. Validated screening instruments can aid in this attempt as a complementary tool to clinicians' assessments. A structured screening is imperative as part of an assessment, as clinician judgment is not the most reliable method of identifying nonadherence. As a complement to formal screening, we present for discussion and possible future study certain psychological variables observed during years of clinical practice that may be linked to medication nonadherence and accidental overdose. These variables include catastrophizing, fear, impulsivity, attention deficit disorders, existential distress, and certain personality disorders. In our experience, chronic pain patients with dual diagnoses may become "chemical copers" as a way of coping with their negative emotion. For these patients, times of stress could lead to accidental overdose. Behavioral, cognitive-behavioral (acceptance and commitment, dialectical behavior), existential (meaning-centered, dignity), and psychotropic therapies have been effective in treating these high-risk comorbidities, while managing expectations of pain relief appears key to preventing accidental overdose. Wiley Periodicals, Inc.

Psychological Variables Potentially Implicated in Opioid-Related Mortality as Observed in Clinical Practice

PubMed Central

Passik, Steven D.; Lowery, Amy

2014-01-01

Opioid-related deaths in the United States have become a public health problem, with accidental and unintended overdoses being especially troubling. Screening for psychological risk factors is an important first step in safeguarding against nonadherence practices and identifying patients who may be vulnerable to the risks associated with opioid therapy. Validated screening instruments can aid in this attempt as a complementary tool to clinicians’ assessments. A structured screening is imperative as part of an assessment, as clinician judgment is not the most reliable method of identifying nonadherence. As a complement to formal screening, we present for discussion and possible future study certain psychological variables observed during years of clinical practice that may be linked to medication nonadherence and accidental overdose. These variables include catastrophizing, fear, impulsivity, attention deficit disorders, existential distress, and certain personality disorders. In our experience, chronic pain patients with dual diagnoses may become “chemical copers” as a way of coping with their negative emotion. For these patients, times of stress could lead to accidental overdose. Behavioral, cognitive-behavioral (acceptance and commitment, dialectical behavior), existential (meaning-centered, dignity), and psychotropic therapies have been effective in treating these high-risk comorbidities, while managing expectations of pain relief appears key to preventing accidental overdose. PMID:21668755

Sensitivity and specificity of the Chinese version of the Schizotypal Personality Questionnaire-Brief for identifying undergraduate students susceptible to psychosis.

PubMed

Ma, Wei-Fen; Wu, Po-Lun; Yang, Shu-Ju; Cheng, Kuang-Fu; Chiu, Hsien-Tsai; Lane, Hsien-Yuan

2010-12-01

Early interventions can improve treatment outcomes for individuals with major psychiatric disorders and with nonspecific symptoms but increasingly impaired cognitive perception, emotions, and behaviour. One way used to identify people susceptible to psychosis is through the schizotypal personality trait. Persons with schizotypal characteristics have been identified with the widely used Schizotypal Personality Questionnaire-Brief. However, no suitable instruments are available to screen individuals in the Taiwanese population for evidence of early psychotic symptoms. The purpose of this study was to test the sensitivity and specificity of the Chinese version of the Schizotypal Personality Questionnaire-Brief for identifying undergraduate students' susceptibility to psychosis. Two-stage, cross-sectional survey design. The self-administered scale was tested in a convenience sample of 618 undergraduate students at a medical university in Taiwan. Among these students, 54 completed the scale 2 weeks apart for test-retest reliability, and 80 were tested to identify their susceptibility to psychosis. In Stage I, participants with scores in the top 6.5% were classified as the high-score group (n=40). The control group (n=40) was randomly selected from the remaining participants with scores <15 and matched by gender. These 80 students were asked to participate in psychiatric interviews in Stage II. The instrument was tested for reliability using intraclass correlation coefficients and the Kuder-Richardson formula 20. The instrument was analysed for optimal sensitivity and specificity using odds-ratio analysis and receiver operating characteristic curves. The 22-item Chinese version of the Schizotypal Personality Questionnaire-Brief had a 2-week test-retest reliability of 0.82 and internal consistency of 0.76. The optimal cut-off score was 17, with odds ratios of 24.4 and an area under the receiver operating characteristic curves of 0.83. The instrument had a sensitivity of 80.0% and specificity of 85.9% in identifying undergraduate students' susceptibility to psychosis. The Chinese version Schizotypal Personality Questionnaire-Brief is a reliable instrument, but should not be used as a screening tool until its psychometric properties have been evaluated in more detail. Other screening tools need to be used in future studies with the CSPQ-B to improve the accuracy of identifying susceptibility to psychosis among young adults. Copyright © 2010. Published by Elsevier Ltd.

Early reading performance: a comparison of teacher-based and test-based assessments.

PubMed

Kenny, D T; Chekaluk, E

1993-04-01

An unresolved question in early screening is whether test-based or teacher-based assessments should form the basis of the classification of children at risk of educational failure. Available structured teacher rating scales are lacking in predictive validity, and teacher predictions of students likely to experience reading difficulties have yielded disappointing true positive rates, with teachers failing to identify the majority of severely disabled readers. For this study, three educational screening instruments were developed: (a) a single teacher rating, categorizing children into three levels of reading ability (advanced, average, poor); (b) a 15-item teacher questionnaire designed to measure students' cognitive and language ability, attentional and behavioral characteristics, and academic performance; and (c) a battery of language and reading tests that are predictive of, or correlate with, reading failure. The concurrent validity of each instrument was assessed in a sample of 312 Australian schoolchildren from kindergarten, Year 1, and Year 2. Students were assessed at the end of the 1989 school year after having completed 1, 2, or 3 years of schooling. The results suggest that the nature of the skills required for success in reading changes in the first 3 years of schooling. Both teachers and tests concur more closely as children progress through the elementary years and as the risk behavior (reading) becomes more accessible to direct measurement. Carefully focused teacher rating scales may be a cost-effective means of identifying children at risk of reading failure. Improved teacher rating scales should be developed and used to assist in the early screening process.

ADHD Symptoms in Pathological and Problem Gamblers in Singapore.

PubMed

Mak, Charles; Tan, Kok Kah; Guo, Song

2018-06-22

Background : There is relatively little research examining the relationship between Attention-Deficit/Hyperactivity Disorder (ADHD) and gambling addiction. This study seeks to explore for ADHD symptoms in adult gambling addiction patients and to evaluate their gambling-related cognitions. Materials and Methods : A cross-sectional survey was conducted at National Addictions Management Service, Institute of Mental Health, in Singapore. Patients presenting for gambling treatment were screened for ADHD symptoms and assessed for severity of gambling-related cognitions. The primary objective was to observe the rate of patients screening positive for ADHD. Results : 20% of the sample screened positive for ADHD. These individuals also had lower levels of gambling-related cognitions. No significant correlation was noted between ADHD symptoms and gambling-related cognition scores. Conclusions : Positive screening results for ADHD occurred frequently in our sample of Pathological Gambling (PG) and Problem Gambling patients and these affected individuals also exhibited lower levels of gambling-related cognitions. This finding may suggest that the gambling behavior in patients with ADHD-PG comorbidity is driven by impulsivity rather than gambling-related cognitions, which has implication on treatment considerations. Further research with a larger sample size is indicated.

Social-cognitive predictors of low-income parents' restriction of screen time among preschool-aged children.

PubMed

Lampard, Amy M; Jurkowski, Janine M; Davison, Kirsten K

2013-10-01

Parents' rules regarding child television, DVD, video game, and computer use (screen time) have been associated with lower screen use in children. This study aimed to identify modifiable correlates of this behavior by examining social-cognitive predictors of parents' restriction of child screen time. Low-income parents (N = 147) of preschool-aged children (2-6 years) completed self-administered questionnaires examining parent and child screen time, parent restriction of screen time, self-efficacy to restrict screen time, and beliefs about screen time. Structural equation modeling results indicated that greater self-efficacy to restrict screen time (β = .29, p = .016) and greater perceived importance of restricting child screen use (β = .55, p < .001) were associated with greater restriction of child screen use, after controlling for parent screen time. Family-based interventions that consider broader attitudinal factors around child screen time may be necessary to engage parents in restricting screen use.

Sociodemographic Correlates of Cognition in the Multi-Ethnic Study of Atherosclerosis (MESA).

PubMed

Fitzpatrick, Annette L; Rapp, Stephen R; Luchsinger, José; Hill-Briggs, Felicia; Alonso, Alvaro; Gottesman, Rebecca; Lee, Hochang; Carnethon, Mercedes; Liu, Kiang; Williams, Kayleen; Sharrett, A Richey; Frazier-Wood, Alexis; Lyketsos, Constantine; Seeman, Teresa

2015-07-01

To describe the methodology utilized to evaluate cognitive function in the Multi-Ethnic Study of Atherosclerosis (MESA) and to present preliminary results by age, sex, and race/ethnicity. Cross-sectional measurements of a prospective observational cohort. Residents of 6 U.S. communities free of cardiovascular disease at baseline (2000-02). 4,591 adults who completed the fifth MESA clinical examination in 2011-12; mean age 70.3 (SD: 9.5) years, 53.1% women, 40.7% non-Hispanic white, 26.4% non-Hispanic black, 21.4% Hispanic, and 11.5% Chinese. The cognitive battery consisted of the Cognitive Abilities Screening Instrument (version 2) to evaluate global cognition, the Digit Symbol Code for processing speed and Digit Spans Forward and Backward to assess memory. Demographic, socioeconomic, and cultural covariates were also collected for descriptive statistics and multivariate modeling. Associations between socioeconomic factors and cognition revealed that age, race/ethnicity, education, occupational status, household income, health insurance type, household size, place of birth, years and generation in U.S., and the presence of the ApoE4 allele were significantly associated with performance on the cognitive tests, although patterns varied by specific test, racial/ethnicity, and sociocultural factors. As many of the influencing cultural and socioeconomic factors measured here are complex, multifactorial, and may not be adequately quantified, caution has been recommended with regard to comparison and interpretation of racial/ethnic group performance differences from these cross-sectional models. These data provide a baseline for future exams and more comprehensive longitudinal analyses of the contributions of subclinical and clinical diseases to cognitive function and decline. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Sociodemographic Correlates of Cognition in the Multi-Ethnic Study of Atherosclerosis (MESA)

PubMed Central

Fitzpatrick, Annette L.; Rapp, Stephen R.; Luchsinger, Jose; Hill-Briggs, Felicia; Alonso, Alvaro; Gottesman, Rebecca; Lee, Hochang; Carnethon, Mercedes; Liu, Kiang; Williams, Kayleen; Sharrett, A. Richey.; Frazier-Wood, Alexis; Lyketsos, Constantine; Seeman, Teresa

2015-01-01

Objectives To describe the methodology utilized to evaluate cognitive function in the Multi-Ethnic Study of Atherosclerosis (MESA) and to present preliminary results by age, gender and race/ethnicity. Design Cross-sectional measurements of a prospective observational cohort. Setting Residents of 6 US communities free of cardiovascular disease at baseline (2000-02). Participants 4,591 adults who completed the 5th MESA clinical examination in 2011-12, mean age 70.3 (SD 9.5) years, 53.1% women, and 40.7% Non-Hispanic White, 26.4% Non-Hispanic Black, 21.4% Hispanic, and 11.5% Chinese. Measurements The cognitive battery consisted of the Cognitive Abilities Screening Instrument (version 2) to evaluate global cognition, the Digit Symbol Code for processing speed and Digit Spans Forward and Backward to assess memory. Demographic, socioeconomic, and cultural covariates were also collected for descriptive statistics and multivariate modeling. Results Associations between socio-economic factors and cognition revealed that age, race/ethnicity, education, occupational status, household income, health insurance type, household size, place of birth, years and generation in U.S., and the presence of the APOE4 allele were significantly associated with performance on the cognitive tests although patterns varied by specific test, racial/ethnicity, and socio-cultural factors. Conclusions As many of the influencing cultural and socioeconomic factors measured here are complex, multifactorial, and may not be adequately quantified, caution has been recommended with regard to comparison and interpretation of racial/ethnic group performance differences from these cross-sectional models. These data provide a baseline for future exams and more comprehensive longitudinal analyses of the contributions of subclinical and clinical diseases to cognitive function and decline. PMID:25704999

Cognitive Trajectory Changes Over 20 Years Before Dementia Diagnosis: A Large Cohort Study.

PubMed

Li, Ge; Larson, Eric B; Shofer, Jane B; Crane, Paul K; Gibbons, Laura E; McCormick, Wayne; Bowen, James D; Thompson, Mary Lou

2017-12-01

Longitudinal studies have shown an increase in cognitive decline many years before clinical diagnosis of dementia. We sought to estimate changes, relative to "normal" aging, in the trajectory of scores on a global cognitive function test-the Cognitive Abilities Screening Instrument (CASI). A prospective cohort study. Community-dwelling members of a U.S. health maintenance organization. Individuals aged 65 and older who had no dementia diagnosis at baseline and had at least two visits with valid CASI test score (N = 4,315). Average longitudinal trajectories, including changes in trajectory before clinical diagnosis in those who would be diagnosed with dementia, were estimated for CASI item response theory (IRT) scores. The impact of sex, education level, and APOE genotype on cognitive trajectories was assessed. Increased cognitive decline relative to "normal" aging was evident in CASI IRT at least 10 years before clinical diagnosis. Male gender, lower education, and presence of ≥1 APOE ε4 alleles were associated with lower average IRT scores. In those who would be diagnosed with dementia, a trajectory change point was estimated at an average of 3.1 years (95% confidence interval 3.0-3.2) before clinical diagnosis, after which cognitive decline appeared to accelerate. The change point did not differ by sex, education level, or APOE ε4 genotype. There were subtle differences in trajectory slopes by sex and APOE ε4 genotype, but not by education. Decline in average global cognitive function was evident at least 10 years before clinical diagnosis of dementia. The decline accelerated about 3 years before clinical diagnosis. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Cognitive impairment, the Mini-Mental State Examination and socio-demographic and dental variables in the elderly in Brazil.

PubMed

Miranda, Leonardo de Paula; Silveira, Marise F; Oliveira, Thatiane L; Alves, Sâmia F F; Júnior, Hercílio M; Batista, André U D; Bonan, Paulo R F

2012-06-01

Dementia, a syndrome characterised by multiple cognitive impairments, is an increasing medical and social problem across the world. The Mini-Mental State Examination (MMSE) is the instrument most often used in the evaluation of cognitive compromise and dementia in elderly individuals. It is noteworthy that there is a scarcity of works in the literature on the dimensions of the MMSE and its relation to dental variables in the elderly. To evaluate the condition of cognitive impairment, the dimensions of the MMSE, and the latter's relation to socio-demographic and dental variables in elderly individuals of Montes Claros, Minas Gerais, Brazil. This is a cross-sectional descriptive study, whereby 218 elderly users of the system were evaluated at the Sistema Único de Saúde (Brazilian health service) in Montes Claros. The collection of data involved the realisation of structured interviews and clinical dentistry examinations. The screening of cognitive impairment was carried out with the Portuguese version of MMSE. The data were subjected to descriptive and bivariate analyses. The prevalence of cognitive impairment found was 6.4%. A statistically significant association was observed between cognitive decline and age, marital status and use of dental prostheses. An association was also noted between several dimensions of MMSE and edentulism (time orientation, attention and calculation, and final score) and use of prostheses (except evocation memory and language). It was noticed that those who were 80 years old or more, not married and using prostheses were more likely to manifest cognitive impairment. Associations between some MMSE dimensions were established, including the final score, with edentulism and the use of prostheses. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

Cognitive Decline and Older Driver Crash Risk.

PubMed

Fraade-Blanar, Laura A; Ebel, Beth E; Larson, Eric B; Sears, Jeanne M; Thompson, Hilaire J; Chan, Kwun Chuen G; Crane, Paul K

2018-04-17

To examine automobile crash risk associated with cognition in older drivers without dementia. Retrospective secondary analysis of longitudinal cohort study. Our study used data from the Adult Changes in Thought (ACT) Study merged with Washington State crash reports and licensure records. Data were available from 2002 to 2015. Group Health enrollees from Washington State aged 65 and older with active driver's licenses (N=2,615). Cognitive function was assessed using the Cognitive Abilities Screening Instrument scored using item response theory (CASI-IRT). The study outcome was police-reported motor vehicle crash. We used a negative binomial mixed-effects model with robust standard errors clustered on the individual and considered associations between crash risk, level of cognition, and amount of decline since the previous study visit. Covariates included age, sex, education, alcohol, depression, medical comorbidities, eyesight, hearing, and physical function. Individuals were censored at dementia diagnosis, death, or failure to renew their license. Over an average of 7 years of follow-up, 350 (13%) people had at least one crash. A 1-unit lower CASI-IRT score was associated with a higher adjusted incidence rate ratio of crash of 1.26 (95% confidence interval=1.08-1.51). Beyond level of cognition, amount of cognitive decline between study visits was not associated with crash risk. This study suggests that, in older drivers, poorer performance on the CASI-IRT may be a risk factor for motor vehicle crashes, even in individuals without diagnosed dementia. Further research is needed to understand driving behavior and inform driving decisions for older adults with poor cognitive function. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Development of TUA-WELLNESS screening tool for screening risk of mild cognitive impairment among community-dwelling older adults

PubMed Central

Vanoh, Divya; Shahar, Suzana; Rosdinom, Razali; Din, Normah Che; Yahya, Hanis Mastura; Omar, Azahadi

2016-01-01

Background and aim Focus on screening for cognitive impairment has to be given particular importance because of the rising older adult population. Thus, this study aimed to develop and assess a brief screening tool consisting of ten items that can be self-administered by community dwelling older adults (TUA-WELLNESS). Methodology A total of 1,993 noninstitutionalized respondents aged 60 years and above were selected for this study. The dependent variable was mild cognitive impairment (MCI) assessed using neuropsychological test batteries. The items for the screening tool comprised a wide range of factors that were chosen mainly from the analysis of ordinal logistic regression (OLR) and based on past literature. A suitable cut-off point was developed using receiver operating characteristic analysis. Results A total of ten items were included in the screening tool. From the ten items, eight were found to be significant by ordinal logistic regression and the remaining two items were part of the tool because they showed strong association with cognitive impairment in previous studies. The area under curve (AUC), sensitivity, and specificity for cut-off 11 were 0.84%, 83.3%, and 73.4%, respectively. Conclusion TUA-WELLNESS screening tool has been used to screen for major risk factors of MCI among Malaysian older adults. This tool is only suitable for basic MCI risk screening purpose and should not be used for diagnostic purpose. PMID:27274208

STRUCTURE OF THE UNIVERSITY PERSONALITY INVENTORY FOR CHINESE COLLEGE STUDENTS.

PubMed

Zhang, Jieting; Lanza, Stephanie; Zhang, Minqiang; Su, Binyuan

2015-06-01

The University Personality Inventory, a mental health instrument for college students, is frequently used for screening in China. However, its unidimensionality has been questioned. This study examined its dimensions to provide more information about the specific mental problems for students at risk. Four subsamples were randomly created from a sample (N = 6,110; M age = 19.1 yr.) of students at a university in China. Principal component analysis with Promax rotation was applied on the first two subsamples to explore dimension of the inventory. Confirmatory factor analysis was conducted on the third subsample to verify the exploratory dimensions. Finally, the identified factors were compared to the Symptom Checklist-90 (SCL-90) to support validity, and sex differences were examined, based on the fourth subsample. Five factors were identified: Physical Symptoms, Cognitive Symptoms, Emotional Vulnerability, Social Avoidance, and Interpersonal Sensitivity, accounting for 60.3% of the variance. All the five factors were significantly correlated with the SCL-90. Women scored significantly higher than men on Cognitive Symptoms and Interpersonal Sensitivity.

The best way to tell you to use a condom: the interplay between message format and individuals' level of need for cognition.

PubMed

Carnaghi, A; Cadinu, M; Castelli, L; Kiesner, J; Bragantini, C

2007-03-01

The present study addressed how individuals in high versus low need for cognition react to a persuasive message (concerning safer sexual conduct) presented either in a written format or in a comic-strip format. A control group that did not receive any persuasive message was also included. With reference to the Theory of Reasoned Action, we analyzed participants' instrumental attitude and instrumental norm toward the use of condoms. Results indicated that, compared to participants in the control group, providing participants with the persuasive message bolstered their instrumental attitude and norm. More importantly, participants high in need for cognition displayed higher levels of both instrumental attitude and norm when the message was in a written, as compared to a comic-strip, format. In contrast, participants low in need for cognition reported a stronger level of both instrumental attitude and norm in reaction to a comic-strip than a written message. Results are discussed with respect to their theoretical and practical implications.

Discriminating cognitive screening and cognitive testing from neuropsychological assessment: implications for professional practice.

PubMed

Block, Cady K; Johnson-Greene, Doug; Pliskin, Neil; Boake, Corwin

2017-04-01

To provide clarification on the distinction between cognitive screening, cognitive testing, and neuropsychological assessment and highlight practical implications. Non-systematic brief clinical review. There is a present lack of explicit distinction between the various levels of measurement of cognitive functioning with regard to goals, indications for use, levels of complexity, and outcome. There is also a lack of guidance regarding the identification of who should be responsible for the administration and interpretation at each level. There is a growing awareness of the importance of cognitive health and disability, and of the importance of measurement of cognitive functions across the lifespan. For example, cognitive screening has been mandated by the Patient Protection and Affordable Care Act of 2010, and language contained within new psychiatric diagnostic criteria and healthcare regulatory changes reflect increased consideration of the importance of measurement of cognition. Changes such as these necessitate greater clarity on this important issue as it bears implications for professional practice, which ranges from education and training competencies, practice standards, and the way that neuropsychologists clarify and advocate for the value of specialty referrals for comprehensive assessment in a competitive and ever-changing healthcare market.

Development of an Instrument for Evaluating Anxiety Caused by Cognitive Conflict

NASA Astrophysics Data System (ADS)

Kim, Yeounsoo; Bao, Lei

2005-09-01

Physics learning situations often involve many cognitive conflicts between a student's present understandings and new information being learned. Cognitive conflict is known as an important factor in conceptual change. Therefore, it is important to help physics teachers and students develop skills and knowledge for more effective conflict management. However there is no readily available method to monitor the existence and features of cognitive conflicts that students may encounter during their learning. We focus the study on student anxiety caused by cognitive conflict so that we can improve student motivation. This study is targeted to develop an easy-to-use instrument that can be implemented in the classrooms to monitor student anxiety in cognitive conflict situations and the effects on student motivation. In this paper, we will discuss the structure of this instrument and show results from using this tool in our Physics by Inquiry class.

An assessment of Movement Disorder Society Task Force diagnostic criteria for mild cognitive impairment in Parkinson's disease.

PubMed

Uysal-Cantürk, P; Hanağası, H A; Bilgiç, B; Gürvit, H; Emre, M

2018-01-01

Cognitive impairment is one of the most disabling non-motor symptoms of Parkinson's disease. Mild cognitive impairment constitutes a major risk for the development of Parkinson's disease dementia in the course of the disease. A Movement Disorder Society Task Force proposed diagnostic criteria for mild cognitive impairment in Parkinson's disease (PD-MCI), comprising two operational levels: Level I and Level II. The objective of our study was to test the accuracy of Level I versus Level II diagnostic criteria. Eighty-six consecutive patients with Parkinson's disease were screened and 68 patients without dementia or depression were included in the study. We used the Montreal Cognitive Assessment, Mini-Mental State Examination and Addenbrooke's Cognitive Evaluation-R screening tools for Level I and an extensive neuropsychological battery for Level II assessment. We first diagnosed PD-MCI on the basis of Level II assessment and then calculated sensitivity, specificity and area under the receiver-operator characteristics curve, comparing the performance of the three screening batteries. None of the three screening batteries proposed for Level I assessment provided satisfactory combined sensitivity and specificity for detecting PD-MCI, and their performance was similar. Using the Level II criteria, 29 patients (43%) were diagnosed as having PD-MCI. Lowest cut-off levels that provided at least 80% sensitivity were 24 for the Montreal Cognitive Assessment, 29 for the Mini-Mental State Examination and 87 for the Addenbrooke's Cognitive Evaluation-R. However, specificity levels were below 80% at these cut-off levels. We conclude that Level I assessment alone using screening batteries is not sufficiently sensitive/specific to detect PD-MCI. © 2017 EAN.

Adolescent Risk Screening Instruments for Primary Care: An Integrative Review Utilizing the Donabedian Framework.

PubMed

Hiott, Deanna B; Phillips, Shannon; Amella, Elaine

2017-07-31

Adolescent risk-taking behavior choices can affect future health outcomes. The purpose of this integrative literature review is to evaluate adolescent risk screening instruments available to primary care providers in the United States using the Donabedian Framework of structure, process, and outcome. To examine the literature concerning multidimensional adolescent risk screening instruments available in the United States for use in the primary care setting, library searches, ancestry searches, and Internet searches were conducted. Library searches included a systematic search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Premier, Health Source Nursing Academic Ed, Medline, PsycINFO, the Psychology and Behavioral Sciences Collection, and PubMed databases with CINAHL headings using the following Boolean search terms: "primary care" and screening and pediatric. Criteria for inclusion consisted of studies conducted in the United States that involved broad multidimensional adolescent risk screening instruments for use in the pediatric primary care setting. Instruments that focused solely on one unhealthy behavior were excluded, as were developmental screens and screens not validated or designed for all ages of adolescents. In all 25 manuscripts reviewed, 16 screens met the inclusion criteria and were included in the study. These 16 screens were examined for factors associated with the Donabedian structure-process-outcome model. This review revealed that many screens contain structural issues related to cost and length that inhibit provider implementation in the primary care setting. Process limitations regarding the report method and administration format were also identified. The Pediatric Symptom Checklist was identified as a free, short tool that is valid and reliable.

Cognitive success: instrumental justifications of normative systems of reasoning.

PubMed

Schurz, Gerhard

2014-01-01

In the first part of the paper (sec. 1-4), I argue that Elqayam and Evan's (2011) distinction between normative and instrumental conceptions of cognitive rationality corresponds to deontological vs. teleological accounts in meta-ethics. I suggest that Elqayam and Evans' distinction be replaced by the distinction between a-priori intuition-based vs. a-posteriori success-based accounts of cognitive rationality. The value of cognitive success lies in its instrumental rationality for almost-all practical purposes. In the second part (sec. 5-7), I point out that the Elqayam and Evans's distinction between normative and instrumental rationality is coupled with a second distinction: between logically general vs. locally adaptive accounts of rationality. I argue that these are two independent distinctions that should be treated as independent dimensions. I also demonstrate that logically general systems of reasoning can be instrumentally justified. However, such systems can only be cognitively successful if they are paired with successful inductive reasoning, which is the area where the program of adaptive (ecological) rationality emerged, because there are no generally optimal inductive reasoning methods. I argue that the practical necessity of reasoning under changing environments constitutes a dilemma for ecological rationality, which I attempt to solve within a dual account of rationality.

Adapting a Developmental Screening Measure: Exploring the Effects of Language and Culture on a Parent-Completed SocialEmotional Screening Test

ERIC Educational Resources Information Center

Chen, Chieh-Yu; Chen, Ching-I; Squires, Jane; Bian, Xiaoyan; Heo, Kay H.; Filgueiras, Alberto; Kalinina, Svetlana; Samarina, Larissa; Ermolaeva, Evgeniya; Xie, Huichao; Yu, Ting-Ying; Wu, Pei-Fang; Landeira-Fernandez, Jesus

2017-01-01

Ages & Stages Questionnaires: Social-Emotional (ASQ:SE) is a widely used screening instrument for detecting social-emotional difficulties in infants and young children. To use a screening instrument across cultures and countries, it is necessary to identify potential item-level biases and ensure item equivalence. This study investigated the…

Age-Related Changes in Bimanual Instrument Playing with Rhythmic Cueing

PubMed Central

Kim, Soo Ji; Cho, Sung-Rae; Yoo, Ga Eul

2017-01-01

Deficits in bimanual coordination of older adults have been demonstrated to significantly limit their functioning in daily life. As a bimanual sensorimotor task, instrument playing has great potential for motor and cognitive training in advanced age. While the process of matching a person’s repetitive movements to auditory rhythmic cueing during instrument playing was documented to involve motor and attentional control, investigation into whether the level of cognitive functioning influences the ability to rhythmically coordinate movement to an external beat in older populations is relatively limited. Therefore, the current study aimed to examine how timing accuracy during bimanual instrument playing with rhythmic cueing differed depending on the degree of participants’ cognitive aging. Twenty one young adults, 20 healthy older adults, and 17 older adults with mild dementia participated in this study. Each participant tapped an electronic drum in time to the rhythmic cueing provided using both hands simultaneously and in alternation. During bimanual instrument playing with rhythmic cueing, mean and variability of synchronization errors were measured and compared across the groups and the tempo of cueing during each type of tapping task. Correlations of such timing parameters with cognitive measures were also analyzed. The results showed that the group factor resulted in significant differences in the synchronization errors-related parameters. During bimanual tapping tasks, cognitive decline resulted in differences in synchronization errors between younger adults and older adults with mild dimentia. Also, in terms of variability of synchronization errors, younger adults showed significant differences in maintaining timing performance from older adults with and without mild dementia, which may be attributed to decreased processing time for bimanual coordination due to aging. Significant correlations were observed between variability of synchronization errors and performance of cognitive tasks involving executive control and cognitive flexibility when asked for bimanual coordination in response to external timing cues at adjusted tempi. Also, significant correlations with cognitive measures were more prevalent in variability of synchronization errors during alternative tapping compared to simultaneous tapping. The current study supports that bimanual tapping may be predictive of cognitive processing of older adults. Also, tempo and type of movement required for instrument playing both involve cognitive and motor loads at different levels, and such variables could be important factors for determining the complexity of the task and the involved task requirements for interventions using instrument playing. PMID:29085309

Can a virtual reality cognitive training application fulfill a dual role? Using the virtual supermarket cognitive training application as a screening tool for mild cognitive impairment.

PubMed

Zygouris, Stelios; Giakoumis, Dimitrios; Votis, Konstantinos; Doumpoulakis, Stefanos; Ntovas, Konstantinos; Segkouli, Sofia; Karagiannidis, Charalampos; Tzovaras, Dimitrios; Tsolaki, Magda

2015-01-01

Recent research advocates the potential of virtual reality (VR) applications in assessing cognitive functions highlighting the possibility of using a VR application for mild cognitive impairment (MCI) screening. The aim of this study is to investigate whether a VR cognitive training application, the virtual supermarket (VSM), can be used as a screening tool for MCI. Two groups, one of healthy older adults (n = 21) and one of MCI patients (n = 34), were recruited from day centers for cognitive disorders and administered the VSM and a neuropsychological test battery. The performance of the two groups in the VSM was compared and correlated with performance in established neuropsychological tests. At the same time, the effectiveness of a combination of traditional neuropsychological tests and the VSM was examined. VSM displayed a correct classification rate (CCR) of 87.30% when differentiating between MCI patients and healthy older adults, while it was unable to differentiate between MCI subtypes. At the same time, the VSM correlates with various established neuropsychological tests. A limited number of tests were able to improve the CCR of the VSM when combined with the VSM for screening purposes. VSM appears to be a valid method of screening for MCI in an older adult population though it cannot be used for MCI subtype assessment. VSM's concurrent validity is supported by the large number of correlations between the VSM and established tests. It is considered a robust test on its own as the inclusion of other tests failed to improve its CCR significantly.

The Complex Interplay Between Depression/Anxiety and Executive Functioning: Insights From the ECAS in a Large ALS Population

PubMed Central

Solca, Federica; Faini, Andrea; Madotto, Fabiana; Lafronza, Annalisa; Monti, Alessia; Zago, Stefano; Doretti, Alberto; Ciammola, Andrea; Ticozzi, Nicola; Silani, Vincenzo; Poletti, Barbara

2018-01-01

Introduction: The observed association between depressive symptoms and cognitive performances has not been previously clarified in patients with amyotrophic lateral sclerosis (pALS). In fact, the use of cognitive measures often not accommodating for motor disability has led to heterogeneous and not conclusive findings about this issue. The aim of the present study was to evaluate the relationship between cognitive and depressive/anxiety symptoms by means of the recently developed Edinburgh Cognitive and Behavioral ALS Screen (ECAS), a brief assessment specifically designed for pALS. Methods: Sample included 168 pALS (114 males, 54 females); they were administered two standard cognitive screening tools (FAB; MoCA) and the ECAS, assessing different cognitive domains, including ALS-specific (executive functions, verbal fluency, and language tests) and ALS non-specific subtests (memory and visuospatial tests). Two psychological questionnaires for depression and anxiety (BDI; STAI/Y) were also administered to patients. Pearson’s correlation coefficient was used to assess the degree of association between cognitive and psychological measures. Results: Depression assessment negatively correlated with the ECAS, more significantly with regard to the executive functions subdomain. In particular, Sentence Completion and Social Cognition subscores were negatively associated with depression levels measured by BDI total score and Somatic-Performance symptoms subscore. Conversely, no significant correlations were observed between depression level and cognitive functions as measured by traditional screening tools for frontal abilities (FAB) and global cognition (MoCA) assessment. Finally, no significant correlations were observed between state/trait anxiety and the ECAS. Discussion and conclusion: This represents the first study focusing on the relationship between cognitive and psychological components in pALS by means of the ECAS, the current gold standard for ALS cognitive-behavioral assessment. If confirmed by further investigations, the observed association between depression and executive functions suggests the need for a careful screening and treatment of depression, to avoid overestimation of cognitive involvement and possibly improve cognitive performances in ALS. PMID:29674987

Evaluating the Effectiveness of a Non-Cognitive Assessment Instrument

ERIC Educational Resources Information Center

Di Tommaso, Kathrynn

2016-01-01

This paper presents a pilot study aiming to evaluate the effects of a non-cognitive assessment instrument which was developed and tailored for a community college in the New York City area. The instrument was pilot tested on a group of developmental students and asked a series of questions to determine the campus support services that might best…

An Instrument to Measure the Cognitive Ability Evaluation of the Taxonomy.

ERIC Educational Resources Information Center

Schaff, John F.

Described is the development of an instrument designed to measure the cognitive ability of evaluation in high school chemistry students. The instrument was composed of several situations found in chemistry courses, each designed to measure a student's evaluation ability based on his knowledge of kinetic-molecular theory as it applied to gases,…

Cognitive dissonance and attitudes toward unpleasant medical screenings.

PubMed

Ent, Michael R; Gerend, Mary A

2016-09-01

Two studies suggest that cognitive dissonance can lead people to adopt negative attitudes toward beneficial-yet unpleasant-medical screenings. People who thought that they were candidates for an unpleasant medical screening reported less favorable attitudes toward the screening than people who thought that they were ineligible (Study 1). The unpleasantness of a medical screening affected candidates' attitudes toward the screening to a greater extent than non-candidate's attitudes (Study 2). Limitations, including ambiguity regarding the extent to which participants' attitudes were affected specifically by dissonance, are discussed. This preliminary research suggests people attempt to reduce dissonance associated with their anticipated behavior. © The Author(s) 2015.

Validity of a novel computerized screening test system for mild cognitive impairment.

PubMed

Park, Jin-Hyuck; Jung, Minye; Kim, Jongbae; Park, Hae Yean; Kim, Jung-Ran; Park, Ji-Hyuk

2018-06-20

ABSTRACTBackground:The mobile screening test system for screening mild cognitive impairment (mSTS-MCI) was developed for clinical use. However, the clinical usefulness of mSTS-MCI to detect elderly with MCI from those who are cognitively healthy has yet to be validated. Moreover, the comparability between this system and traditional screening tests for MCI has not been evaluated. The purpose of this study was to examine the validity and reliability of the mSTS-MCI and confirm the cut-off scores to detect MCI. The data were collected from 107 healthy elderly people and 74 elderly people with MCI. Concurrent validity was examined using the Korean version of Montreal Cognitive Assessment (MoCA-K) as a gold standard test, and test-retest reliability was investigated using 30 of the study participants at four-week intervals. The sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were confirmed through Receiver Operating Characteristic (ROC) analysis, and the cut-off scores for elderly people with MCI were identified. Concurrent validity showed statistically significant correlations between the mSTS-MCI and MoCA-K and test-rests reliability indicated high correlation. As a result of screening predictability, the mSTS-MCI had a higher NPV than the MoCA-K. The mSTS-MCI was identified as a system with a high degree of validity and reliability. In addition, the mSTS-MCI showed high screening predictability, indicating it can be used in the clinical field as a screening test system for mild cognitive impairment.

Cognitive context detection in UAS operators using eye-gaze patterns on computer screens

NASA Astrophysics Data System (ADS)

Mannaru, Pujitha; Balasingam, Balakumar; Pattipati, Krishna; Sibley, Ciara; Coyne, Joseph

2016-05-01

In this paper, we demonstrate the use of eye-gaze metrics of unmanned aerial systems (UAS) operators as effective indices of their cognitive workload. Our analyses are based on an experiment where twenty participants performed pre-scripted UAS missions of three different difficulty levels by interacting with two custom designed graphical user interfaces (GUIs) that are displayed side by side. First, we compute several eye-gaze metrics, traditional eye movement metrics as well as newly proposed ones, and analyze their effectiveness as cognitive classifiers. Most of the eye-gaze metrics are computed by dividing the computer screen into "cells". Then, we perform several analyses in order to select metrics for effective cognitive context classification related to our specific application; the objective of these analyses are to (i) identify appropriate ways to divide the screen into cells; (ii) select appropriate metrics for training and classification of cognitive features; and (iii) identify a suitable classification method.

Vulnerabilities in Older Patients when Cancer Treatment is Initiated: Does a Cognitive Impairment Impact the Two-Year Survival?

PubMed Central

Borghgraef, Cindy; Etienne, Anne-Marie; Merckaert, Isabelle; Paesmans, Marianne; Reynaert, Christine; Roos, Myriam; Slachmuylder, Jean-Louis; Vandenbossche, Sandrine; Bron, Dominique; Razavi, Darius

2016-01-01

Introduction Dementia is a known predictor of shorter survival times in older cancer patients. However, no empirical evidence is available to determine how much a cognitive impairment shortens survival in older patients when cancer treatment is initiated. Purpose To longitudinally investigate how much a cognitive impairment detected at the initiation of cancer treatment influences survival of older patients during a two-year follow-up duration and to compare the predictive value of a cognitive impairment on patients survival with the predictive value of other vulnerabilities associated with older age. Methods Three hundred and fifty-seven consecutive patients (≥65 years old) admitted for breast, prostate, or colorectal cancer surgeries were prospectively recruited. A cognitive impairment was assessed with the Montreal Cognitive Assessment (MoCA<26). Socio-demographic, disease-related, and geriatric vulnerabilities were assessed using validated tools. Univariate and subsequent multivariate Cox proportional hazards models stratified for diagnosis (breast/prostate cancer versus colorectal cancer) and disease status (metastatic versus non-metastatic) were used. Results A cognitive impairment was detected in 46% (n = 163) of patients. Survival was significantly influenced by a cognitive impairment (HR = 6.13; 95% confidence interval [CI] = 2.07–18.09; p = 0.001), a loss in instrumental autonomy (IADL ≤7) (HR = 3.06; 95% CI = 1.31–7.11; p = 0.009) and fatigue (Mob-T<5) (HR = 5.98; 95% CI = 2.47–14.44; p <0.001). Conclusions During the two years following cancer treatment initiation, older patients with a cognitive impairment were up to six times more likely to die than patients without. Older patients should be screened for cognitive impairments at cancer treatment initiation to enable interventions to reduce morbidity and mortality. Further studies should address processes underlying the relationship between cognitive impairments and an increased risk of dying in older cancer patients. PMID:27479248

The interpretation of proverbs by elderly with high, medium and low educational level: Abstract reasoning as an aspect of executive functions

PubMed Central

Wachholz, Thalita Bianchi de Oliveira; Yassuda, Mônica Sanches

2011-01-01

It is now known that cognitive functions tend to decline with age. Executive functions (EF) are among the first abilities to decline with aging. A subcomponent of the EF is abstract reasoning. The Test of Proverbs is an instrument that can be used to evaluate the capacity of abstract reasoning. Objective To examine the association of performance in interpretation of proverbs, with education and with episodic memory and EF tasks. Methods A total of 67 individuals aged between 60 and 75 years were evaluated, and divided into three categories of education: 1-4 years, 5-8 years, and 9 or more years of schooling. The instruments used were a sociodemographic questionnaire (gender, age, marital status, education, income, previous occupation, current occupation and health perception), the Mini Mental State Examination, Brief Cognitive Screening Battery; Geriatric Depression Scale; Forward and Backward Digit Span (WAIS-III), and the Test of Proverbs. Results A high impact of education was seen on the interpretation of proverbs, with lower performance among the elderly with less education. A significant association between performance on the Test of Proverbs and scores on the MMSE, GDS, and verbal fluency tests was found. There was a modest association with incidental memory. Conclusions The capacity to interpret proverbs is strongly associated with education and with performance on other EF tasks. PMID:29213717

Bilingualism in older Mexican-American immigrants is associated with higher scores on cognitive screening.

PubMed

Padilla, Claudia; Mendez, Mario F; Jimenez, Elvira E; Teng, Edmond

2016-11-24

Bilingualism may protect against cognitive aging and delay the onset of dementia. However, studies comparing monolinguals and bilinguals on such metrics have produced inconsistent results complicated by confounding variables and methodological concerns. We addressed this issue by comparing cognitive performance in a more culturally homogeneous cohort of older Spanish-speaking monolingual (n = 289) and Spanish-English bilingual (n = 339) Mexican-American immigrants from the Sacramento Longitudinal Study on Aging. After adjusting for demographic differences and depressive symptoms, both groups performed similarly at baseline on verbal memory but the bilingual group performed significantly better than the monolingual group on a cognitive screening test, the Modified Mini-Mental State Examination (3MS; p < 0.001). Group differences on the 3MS were driven by language/executive and language/praxis factors. Within the bilingual group, neither language of testing nor degree of bilingualism was significantly associated with 3MS or verbal memory scores. Amongst individuals who performed in the normal or better range on both tests at baseline and were followed for an average of 6 years, both monolinguals and bilinguals exhibited similar rates of cognitive decline on both measures. These findings suggest that bilingualism is associated with modest benefits in cognitive screening performance in older individuals in cross-sectional analyses that persist across longitudinal analyses. The effects of bilingualism should be considered when cognitively screening is performed in aging immigrant populations.

Development and validation of an instrument to assess imminent risk of homelessness among veterans.

PubMed

Montgomery, Ann Elizabeth; Fargo, Jamison D; Kane, Vincent; Culhane, Dennis P

2014-01-01

Veterans are overrepresented within the homeless population compared with their non-veteran counterparts, particularly when controlling for poverty. The U.S. Department of Veterans Affairs (VA) aims to prevent new episodes of homelessness by targeting households at greatest risk; however, there are no instruments that systematically assess veterans' risk of homelessness. We developed and tested a brief screening instrument to identify imminent risk of homelessness among veterans accessing VA health care. The study team developed initial assessment items, conducted cognitive interviews with veterans experiencing homelessness, refined pilot items based on veterans' and experts' feedback and results of psychometric analyses, and assigned weights to items in the final instrument to indicate a measure of homelessness risk. One-third of veterans who responded to the field instrument reported imminent risk of homelessness (i.e., housing instability in the previous 90 days or expected in the next 90 days). The reliability coefficient for the instrument was 0.85, indicating good internal consistency. Veterans who had a recent change in income, had unpaid housing expenses, were living temporarily with family and friends, needed help to get or keep housing, and had poor rental and credit histories were more likely to report a risk of homelessness than those who did not. This study provides the field with an instrument to identify individuals and households at risk of or experiencing homelessness, which is necessary to prevent and end homelessness. In addition, it supports VA's investment in homelessness prevention and rapid rehousing services for veterans who are experiencing or are at risk for homelessness.

Development and Validation of Two Instruments Measuring Intrinsic, Extraneous, and Germane Cognitive Load

PubMed Central

Klepsch, Melina; Schmitz, Florian; Seufert, Tina

2017-01-01

Cognitive Load Theory is one of the most powerful research frameworks in educational research. Beside theoretical discussions about the conceptual parts of cognitive load, the main challenge within this framework is that there is still no measurement instrument for the different aspects of cognitive load, namely intrinsic, extraneous, and germane cognitive load. Hence, the goal of this paper is to develop a differentiated measurement of cognitive load. In Study 1 (N = 97), we developed and analyzed two strategies to measure cognitive load in a differentiated way: (1) Informed rating: We trained learners in differentiating the concepts of cognitive load, so that they could rate them in an informed way. They were asked then to rate 24 different learning situations or learning materials related to either high or low intrinsic, extraneous, or germane load. (2) Naïve rating: For this type of rating of cognitive load we developed a questionnaire with two to three items for each type of load. With this questionnaire, the same learning situations had to be rated. In the second study (N = between 65 and 95 for each task), we improved the instrument for the naïve rating. For each study, we analyzed whether the instruments are reliable and valid, for Study 1, we also checked for comparability of the two measurement strategies. In Study 2, we conducted a simultaneous scenario based factor analysis. The informed rating seems to be a promising strategy to assess the different aspects of cognitive load, but it seems not economic and feasible for larger studies and a standardized training would be necessary. The improved version of the naïve rating turned out to be a useful, feasible, and reliable instrument. Ongoing studies analyze the conceptual validity of this measurement with up to now promising results. PMID:29201011

Estimating functional cognition in older adults using observational assessments of task performance in complex everyday activities: A systematic review and evaluation of measurement properties.

PubMed

Wesson, Jacqueline; Clemson, Lindy; Brodaty, Henry; Reppermund, Simone

2016-09-01

Functional cognition is a relatively new concept in assessment of older adults with mild cognitive impairment or dementia. Instruments need to be reliable and valid, hence we conducted a systematic review of observational assessments of task performance used to estimate functional cognition in this population. Two separate database searches were conducted: firstly to identify instruments; and secondly to identify studies reporting on the psychometric properties of the instruments. Studies were analysed using a published checklist and their quality reviewed according to specific published criteria. Clinical utility was reviewed and the information formulated into a best evidence synthesis. We found 21 instruments and included 58 studies reporting on measurement properties. The majority of studies were rated as being of fair methodological quality and the range of properties investigated was restricted. Most instruments had studies reporting on construct validity (hypothesis testing), none on content validity and there were few studies reporting on reliability. Overall the evidence on psychometric properties is lacking and there is an urgent need for further evaluation of instruments. Copyright © 2016 Elsevier Ltd. All rights reserved.

Psychometric Properties of a Decisional Capacity Screening Tool for Individuals Contemplating Participation in Alzheimer's disease Research

PubMed Central

Seaman, Jennifer Burgher; Terhorst, Lauren; Gentry, Amanda; Hunsaker, Amanda; Parker, Lisa S.; Lingler, Jennifer Hagerty

2016-01-01

Background With the growing population of individuals affected by Alzheimer's disease (AD) and related disorders, there is a pressing demand for research on late life cognitive disorders. However, the high risk for decisional incapacity in this population necessitates the evaluation of capacity to consent to research participation, adding to the cost and complexity of the research process. The University of California, San Diego Brief Assessment of Capacity to Consent (UBACC) was initially validated in a sample of persons with schizophrenia and healthy controls. Objective To assess the psychometric properties of the UBACC when used in a sample of individuals contemplating participation in research on AD. Methods The UBACC was administered to a convenience sample (n=132) consisting of individuals with mild to moderate cognitive impairment (n=52), their study partners (n= 52) and healthy older adults control subjects (n=30), as part of a broader study to evaluate perceived burden of research participation. Reliability tests, correlational analyses, and exploratory factor analytic methods were used to examine the psychometric properties of the instrument. Results UBACC scores were significantly associated with both global cognition (rs = .564, p < .001) and verbal fluency (rs = .511, P <.001), indicating concurrent validity with related constructs. The resulting factor structure differed from that reported by the developers in their initial testing. Items clustered almost entirely on one factor, and items reflecting the construct of understanding accounted for 32.12% of the total variance, with no evidence for distinct reasoning or appreciation scales. Conclusion The UBACC shows promise when used to screen for decisional capacity among those considering participation in AD research. PMID:25765917

[Screening for dementia using telephone interviews. An evaluation and reliability study of the Telephone Interview for Cognitive Status (TICS) in its modified German version].

PubMed

Matrisch, M; Trampisch, U; Klaassen-Mielke, R; Pientka, L; Trampisch, H J; Thiem, U

2012-04-01

To assess cognitive impairment or dementia in epidemiologic studies using telephone interviews for data acquisition, valid, reliable and short instruments suitable for telephone administration are required. For the Telephone Interview for Cognitive Status (TICS) in its modified German version, the only instrument used in Germany so far, more data on reliability and practicability are needed. Participants were recruited in the offices of nine primary care physicians. Data from 197 participants (115 females, mean age 78.5±4.1 years) who were tested by telephone and in the office by means of the Mini-Mental State Examination (MMSE) were used for the evaluation. For assessing reliability, a group of 91 participants (55 females, mean age 78.1±4.1 years) was contacted twice during 30 days to be tested during a telephone interview by means of the TICS in its modified German version. The intraclass correlation coefficient (ICC), a measure of reliability, was 0.67 [95% confidence interval (CI): 0.53; 0.77]. The Bland-Altman plot did not reveal any relationship between the variability of the difference between repeated measures and the total amount of the measure. For the overall TICS score, no differences were found between repeated measurements. However, the tasks recall of the word list and counting backwards showed some improvement in the repeated tests. TICS and MMSE showed only moderate correlation, with a correlation coefficient of 0.48 (95% CI: 0.36; 0.58). TICS values were dependent on age and educational level of the person tested. The TICS in its modified German version appears to be of acceptable reliability for the assessment of cognitive impairment during a telephone interview. TICS values depend on age and educational level of the person tested. TICS and MMSE correlate only moderately.

Investigating the incremental validity of cognitive variables in early mathematics screening.

PubMed

Clarke, Ben; Shanley, Lina; Kosty, Derek; Baker, Scott K; Cary, Mari Strand; Fien, Hank; Smolkowski, Keith

2018-03-26

The purpose of this study was to investigate the incremental validity of a set of domain general cognitive measures added to a traditional screening battery of early numeracy measures. The sample consisted of 458 kindergarten students of whom 285 were designated as severely at-risk for mathematics difficulty. Hierarchical multiple regression results indicated that Wechsler Abbreviated Scales of Intelligence (WASI) Matrix Reasoning and Vocabulary subtests, and Digit Span Forward and Backward measures explained a small, but unique portion of the variance in kindergarten students' mathematics performance on the Test of Early Mathematics Ability-Third Edition (TEMA-3) when controlling for Early Numeracy Curriculum Based Measurement (EN-CBM) screening measures (R² change = .01). Furthermore, the incremental validity of the domain general cognitive measures was relatively stronger for the severely at-risk sample. We discuss results from the study in light of instructional decision-making and note the findings do not justify adding domain general cognitive assessments to mathematics screening batteries. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Response to an Abnormal Ovarian Cancer Screening Test Result: Test of the Social Cognitive Processing and Cognitive Social Health Information Processing Models

PubMed Central

Andrykowski, Michael A.; Pavlik, Edward J.

2009-01-01

All cancer screening tests produce a proportion of abnormal results requiring follow-up. Consequently, the cancer screening setting is a natural laboratory for examining psychological and behavioral response to a threatening health-related event. This study tested hypotheses derived from the Social Cognitive Processing and Cognitive-Social Health Information Processing models in trying to understand response to an abnormal ovarian cancer (OC) screening test result. Women (n=278) receiving an abnormal screening test result a mean of 7 weeks earlier were assessed prior to a repeat screening test intended to clarify their previous abnormal result. Measures of disposition (optimism, informational coping style), social environment (social support and constraint), emotional processing, distress, and benefit finding were obtained. Regression analyses indicated greater distress was associated with greater social constraint and emotional processing and a monitoring coping style in women with a family history of OC. Distress was unrelated to social support. Greater benefit finding was associated with both greater social constraint and support and greater distress. The primacy of social constraint in accounting for both benefit-finding and distress was noteworthy and warrants further research on the role of social constraint in adaptation to stressful events. PMID:20419561

Development of a language screening instrument for Swedish 4-year-olds.

PubMed

Lavesson, Ann; Lövdén, Martin; Hansson, Kristina

2018-05-01

The Swedish Program for health surveillance of preschool children includes screening of language and communication abilities. One important language screening is carried out at age 4 years as part of a general screening conducted by health nurses at child health centres. The instruments presently in use for this screening mainly focus on expressive phonology. This may result in both over-referral of children with phonological difficulties and under-referral of children with language disorders (LDs), involving difficulties with vocabulary, grammar and/or language comprehension. Previous research has proposed non-word repetition as a clinical marker for LD. It has also been found that higher predictive power is achieved when non-word repetition is combined with the assessment of lexical/semantic skills. Taking these findings into account, the construction of a language screening instrument may yield more adequate referrals to speech-language therapists (SLTs). To construct a new standardized language screening instrument for 4-year-olds and to test its properties. An instrument was developed and revised after piloting. A population of 352 children was screened at the regular 4-year check-up by 11 health nurses. The final sample consisted of 328 children aged 46-53 months (23% multilingual). Children performing below a preliminary cut-off were referred to an SLT (n = 52). Five SLTs carried out an assessment on average within 5 weeks using a gold standard language test battery. Children who screened negatively were followed up with a parent questionnaire at age 5;6. Thirty-one true-positives and 11 false-positives were identified after SLT assessment. A further six children were identified as false-negatives (two through referral to an SLT and four through parent questionnaire at age 5;6). A receiver-operating characteristics curve with a C statistic of .94 was calculated. Based on optimal cut-off, the sensitivity of the screening instrument was found to be .84, and specificity was .96. Multilingual children performed similar to monolingual children; boys performed significantly lower than girls; and children with a family history of language-related problems performed lower than those without. Interrater reliability was high, as was Cronbach's alpha. The screening instrument seems sufficiently valid for its purpose to identify children who need further assessment by an SLT. A follow-up study including SLT assessment for all children to check for false-negatives would be interesting in future, as would studies comparing results from the 4-year screening with those from earlier screens. © 2018 Royal College of Speech and Language Therapists.

Ultra-short screening instruments for major depressive episode and generalized anxiety disorder in epilepsy: The NDDIE-2 and the GAD-SI.

PubMed

Micoulaud-Franchi, Jean-Arthur; Bartolomei, Fabrice; McGonigal, Aileen

2017-03-01

Systematic screening is recommended for major depressive episode (MDE) with the Neurological Disorders Depression Inventory for Epilepsy NDDI-E, 6 items and generalized anxiety disorder (GAD) with the GAD 7 items in patients with epilepsy (PWE). Shorter versions of the NDDI-E and the GAD-7 could facilitate increased screening by busy clinicians and be more accessible to patients with mild cognitive and/or language impairments. The effectiveness of ultra-short versions of the NDDI-E (2 items) and the GAD-7 (the GAD-2, 2 items, and the GAD-SI with a single item) in comparison with the original versions were statistically tested using ROC analysis. ROC analysis of the NDDIE-2 showed an AUC of 0.926 (p<0.001), a sensitivity of 81.82% and a specificity of 89.16%, without significant difference with the NDDI-E (z=1.582, p=0.11). ROC analysis of the GAD-SI showed an AUC of 0.872 (p<0.001), a sensitivity of 83.67% and a specificity of 82.29%, without significant difference with the GAD-7 (z=1.281, p=0.2). The GAD-2 showed poorer psychometric properties. The limitation is the use of data from previously reported subjects in a single language version, the NDDIE-2 that lacks detection of dysphoric symptoms in comparison with the NDDIE-6 and the GAD-SI that exhibited a more than 10% lower sensitivity than the GAD-7. This study highlights the potential utility of the NDDIE-2 and the GAD-SI as ultra-short screening tools for MDE and GAD respectively in PWE. Further studies in a larger population, including multi-lingual versions, could be a valuable next step. However, the brevity and simplicity of this tool could be an advantage in PWE who present cognitive difficulties, especially attentional or language deficits. Copyright © 2017 Elsevier B.V. All rights reserved.

A proposal for evaluating cognition in assertiveness.

PubMed

Vagos, Paula; Pereira, Anabela

2010-09-01

This article presents the development process and initial psychometric features of an instrument for evaluating cognition in assertiveness. This is an essential social skill for adolescent development and seems to encompass emotional, behavioral, and cognitive aspects. The instrument was created by combining both empirical and theoretical methods for item construction, aiming to evaluate the cognitive realm of assertiveness. A sample of 996 adolescent students was used to test for reliability and validity. Results indicate good psychometric properties. The instrument is composed of 4 subscales: Outer Emotional Support, Functional Personal Ability, Interpersonal Management, and Affective Personal Ability. The Assertive Interpersonal Schema Questionnaire may potentially be a useful tool in the diagnosis of, understanding of, and development of a treatment plan for individuals with persistent difficulties in social events.

Is the Bayley Scales of Infant and Toddler Developmental Screening Test, Valid and Reliable for Persian Speaking Children?

PubMed

Soleimani, Farin; Azari, Nadia; Vameghi, Roshanak; Sajedi, Firoozeh; Shahshahani, Soheila; Karimi, Hossein; Kraskian, Adis; Shahrokhi, Amin; Teymouri, Robab; Gharib, Masoud

2016-10-01

Advances in perinatal and neonatal care have substantially improved the survival of at-risk infants over the past two decades. The purpose of this study was to assess the reliability and validity of the Bayley Scales of infant and toddler developmental Screening test in Persian-speaking children. This was a cross-sectional prospective study of 403 children aged 1 - 42-months. The Bayley scales screening instrument, which consists of five domains (cognitive, receptive, and expressive communication and fine and gross motor items), was used to measure infants' and toddlers' development. The psychometric properties examined included the face and content validity of the scale, in addition to cultural and linguistic modifications to the scale and its test-retest and inter-rater reliability. An expert team changed some of the test items relating to cultural and linguistic issues. In almost all the age groups, cultural or linguistic changes were made to items in the communication domains. According to Cronbach's alpha for internal consistency, the reliability of the cognitive scale was r = 0.79, and the reliability of the receptive scale was r = 0.76. The reliability for expressive communication, fine motor, and gross motor scales was r = 0.81, r = 0.80, and r = 0.81, respectively. The construct validity of the tests was confirmed using a factor analysis and comparison of the mean scores of the age groups. The intra- and inter-rater reliabilities of the Bayley Scales were good-to-excellent. The results indicated that the Bayley Scales had a high level of reliability in the present study. Thus, the scale can be used in a Persian population.

A Psychometric Study of the Substance Abuse Subtle Screening Inventory-3 Using Rasch Analysis

ERIC Educational Resources Information Center

Hill, Tara M.

2009-01-01

The Substance Abuse Subtle Screening Inventory-3 (SASSI-3; Miller & Lazowski, 1999) is a popular screening instrument used to assist professionals in the assessment of individuals who may be substance dependent. Many researchers have reported reliability and validity results on this instrument with mixed results, which at times have…

Specific algorithm method of scoring the Clock Drawing Test applied in cognitively normal elderly

PubMed Central

Mendes-Santos, Liana Chaves; Mograbi, Daniel; Spenciere, Bárbara; Charchat-Fichman, Helenice

2015-01-01

The Clock Drawing Test (CDT) is an inexpensive, fast and easily administered measure of cognitive function, especially in the elderly. This instrument is a popular clinical tool widely used in screening for cognitive disorders and dementia. The CDT can be applied in different ways and scoring procedures also vary. Objective The aims of this study were to analyze the performance of elderly on the CDT and evaluate inter-rater reliability of the CDT scored by using a specific algorithm method adapted from Sunderland et al. (1989). Methods We analyzed the CDT of 100 cognitively normal elderly aged 60 years or older. The CDT ("free-drawn") and Mini-Mental State Examination (MMSE) were administered to all participants. Six independent examiners scored the CDT of 30 participants to evaluate inter-rater reliability. Results and Conclusion A score of 5 on the proposed algorithm ("Numbers in reverse order or concentrated"), equivalent to 5 points on the original Sunderland scale, was the most frequent (53.5%). The CDT specific algorithm method used had high inter-rater reliability (p<0.01), and mean score ranged from 5.06 to 5.96. The high frequency of an overall score of 5 points may suggest the need to create more nuanced evaluation criteria, which are sensitive to differences in levels of impairment in visuoconstructive and executive abilities during aging. PMID:29213954

Using Cognitive Interviews to Pilot an International Survey of Principal Preparation: A Western Australian Perspective

ERIC Educational Resources Information Center

Wildy, Helen; Clarke, Simon

2009-01-01

This paper provides an example of the application of the cognitive interview, a qualitative tool for pre-testing a survey instrument to check its cognitive validity, that is, whether the items mean to respondents what they mean to the item designers. The instrument is the survey used in the final phase of the International Study of Principal…

The Choice of Screening Instrument Matters: The Case of Problematic Cannabis Use Screening in Spanish Population of Adolescents

PubMed Central

Domingo-Salvany, Antónia; Barrio Anta, Gregorio; Sánchez Mañez, Amparo; Llorens Aleixandre, Noelia; Brime Beteta, Begoña; Vicente, Julián

2013-01-01

The aim of this study was to examine the feasibility of problem cannabis use screening instruments administration within wide school surveys, their psychometric properties, overlaps, and relationships with other variables. Students from 7 Spanish regions, aged 14–18, who attended secondary schools were sampled by two-stage cluster sampling (net sample 14,589). Standardized, anonymous questionnaire including DSM-IV cannabis abuse criteria, Cannabis Abuse Screening Test (CAST), and Severity of Dependence Scale (SDS) was self-completed with paper and pencil in the selected classrooms. Data was analysed using classical psychometric theory, bivariate tests, and multinomial logistic regression analysis. Not responding to instruments' items (10.5–12.3%) was associated with reporting less frequent cannabis use. The instruments overlapped partially, with 16.1% of positives being positive on all three. SDS was more likely to identify younger users with lower frequency of use who thought habitual cannabis use posed a considerable problem. CAST positivity was associated with frequent cannabis use and related problems. It is feasible to use short psychometric scales in wide school surveys, but one must carefully choose the screening instrument, as different instruments identify different groups of users. These may correspond to different types of problematic cannabis use; however, measurement bias seems to play a role too. PMID:25969832

Cognitive Education with Deaf Adolescents: Effects of Instrumental Enrichment.

ERIC Educational Resources Information Center

Haywood, H. Carl; And Others

1988-01-01

Twenty-six deaf adolescents received instruction in a structured program of cognitive education called "Instrumental Enrichment." The program addresses, among other processes, comparison, classification, logical progression, spatial orientation, analysis and synthesis, and syllogistic thinking. Following training, the subjects showed…

Cognitive success: instrumental justifications of normative systems of reasoning

PubMed Central

Schurz, Gerhard

2014-01-01

In the first part of the paper (sec. 1–4), I argue that Elqayam and Evan's (2011) distinction between normative and instrumental conceptions of cognitive rationality corresponds to deontological vs. teleological accounts in meta-ethics. I suggest that Elqayam and Evans' distinction be replaced by the distinction between a-priori intuition-based vs. a-posteriori success-based accounts of cognitive rationality. The value of cognitive success lies in its instrumental rationality for almost-all practical purposes. In the second part (sec. 5–7), I point out that the Elqayam and Evans's distinction between normative and instrumental rationality is coupled with a second distinction: between logically general vs. locally adaptive accounts of rationality. I argue that these are two independent distinctions that should be treated as independent dimensions. I also demonstrate that logically general systems of reasoning can be instrumentally justified. However, such systems can only be cognitively successful if they are paired with successful inductive reasoning, which is the area where the program of adaptive (ecological) rationality emerged, because there are no generally optimal inductive reasoning methods. I argue that the practical necessity of reasoning under changing environments constitutes a dilemma for ecological rationality, which I attempt to solve within a dual account of rationality. PMID:25071624

The Alzheimer's Disease Cooperative Study Prevention Instrument Project: Longitudinal Outcome of Behavioral Measures as Predictors of Cognitive Decline

PubMed Central

Banks, Sarah Jane; Raman, Rema; He, Feng; Salmon, David P.; Ferris, Steven; Aisen, Paul; Cummings, Jeffrey

2014-01-01

Background/Methods The Alzheimer's Disease Cooperative Study Prevention Instrument Project is a longitudinal study that recruited 644 cognitively healthy older subjects (aged between 75 and 93 years, 58% women) at baseline and evaluated their cognitive change over 4 years. The study was structured like a clinical trial to anticipate a prevention trial and to determine the performance of novel trial instruments in a longitudinal non-interventional trial framework. Behavioral symptoms were assessed at baseline. Results The existence of participant-reported behavioral symptoms at baseline predicted conversion to Clinical Dementia Rating scale score ≥0.5 over the 4-year period. Conclusions The results imply that early anxiety and depression may be harbingers of future cognitive decline, and that patients exhibiting such symptoms, even in the absence of co-occurring cognitive symptoms, should be closely followed over time. PMID:25685141

Evidence-based guideline: Assessment and management of psychiatric disorders in individuals with MS

PubMed Central

Minden, Sarah L.; Feinstein, Anthony; Kalb, Rosalind C.; Miller, Deborah; Mohr, David C.; Patten, Scott B.; Bever, Christopher; Schiffer, Randolph B.; Gronseth, Gary S.; Narayanaswami, Pushpa

2014-01-01

Objective: To make evidence-based recommendations for screening, diagnosing, and treating psychiatric disorders in individuals with multiple sclerosis (MS). Methods: We reviewed the literature (1950 to August 2011) and evaluated the available evidence. Results and recommendations: Clinicians may consider using the Center for Neurologic Study Emotional Lability Scale to screen for pseudobulbar affect (Level C). Clinicians may consider the Beck Depression Inventory and a 2-question tool to screen for depressive disorders and the General Health Questionnaire to screen for broadly defined emotional disturbances (Level C). Evidence is insufficient to support/refute the use of other screening tools, the possibility that somatic/neurovegetative symptoms affect these tools' accuracy, or the use of diagnostic instruments or clinical evaluation procedures for identifying psychiatric disorders in MS (Level U). Clinicians may consider a telephone-administered cognitive behavioral therapy program for treating depressive symptoms (Level C). Although pharmacologic and nonpharmacologic therapies are widely used to treat depressive and anxiety disorders in individuals with MS, evidence is insufficient to support/refute the use of the antidepressants and individual and group therapies reviewed herein (Level U). For pseudobulbar affect, a combination of dextromethorphan and quinidine may be considered (Level C). Evidence is insufficient to determine the psychiatric effects in individuals with MS of disease-modifying and symptomatic therapies and corticosteroids; risk factors for suicide; and treatment of psychotic disorders (Level U). Research is needed on the effectiveness in individuals with MS of pharmacologic and nonpharmacologic treatments frequently used in the non-MS population. PMID:24376275

Development of a Psychosocial Risk Screener for Siblings of Children With Cancer: Incorporating the Perspectives of Parents.

PubMed

Long, Kristin A; Pariseau, Emily M; Muriel, Anna C; Chu, Andrea; Kazak, Anne E; Alderfer, Melissa A

2018-04-03

Although many siblings experience distress after a child's cancer diagnosis, their psychosocial functioning is seldom assessed in clinical oncology settings. One barrier to systematic sibling screening is the lack of a validated, sibling-specific screening instrument. Thus, this study developed sibling-specific screening modules in English and Spanish for the Psychosocial Assessment Tool (PAT), a well-validated screener of family psychosocial risk. A purposive sample of English- and Spanish-speaking parents of children with cancer (N = 29) completed cognitive interviews to provide in-depth feedback on the development of the new PAT sibling modules. Interviews were transcribed verbatim, cleaned, and analyzed using applied thematic analysis. Items were updated iteratively according to participants' feedback. Data collection continued until saturation was reached (i.e., all items were clear and valid). Two sibling modules were developed to assess siblings' psychosocial risk at diagnosis (preexisting risk factors) and several months thereafter (reactions to cancer). Most prior PAT items were retained; however, parents recommended changes to improve screening format (separately assessing each sibling within the family and expanding response options to include "sometimes"), developmental sensitivity (developing or revising items for ages 0-2, 3-4, 5-9, and 10+ years), and content (adding items related to sibling-specific social support, global assessments of sibling risk, emotional/behavioral reactions to cancer, and social ecological factors such as family and school). Psychosocial screening requires sibling-specific screening items that correspond to preexisting risk (at diagnosis) and reactions to cancer (several months after diagnosis). Validated, sibling-specific screeners will facilitate identification of siblings with elevated psychosocial risk.

Should Sensory Impairment Be Considered in Frailty Assessment? A Study in the GAZEL Cohort.

PubMed

Linard, M; Herr, M; Aegerter, P; Czernichow, S; Goldberg, M; Zins, M; Ankri, J

2016-01-01

The assessment of sensory difficulties is sometimes included in the screening of frailty in ageing population. This study aimed to compare the prevalence of frailty and associated risk of adverse outcomes depending on whether sensory difficulties participated in the definition of frailty. Prospective cohort study - GAZEL cohort. France. The 13,128 subjects who completed a questionnaire in 2012. According to the Strawbridge questionnaire, subjects were considered frail if they reported difficulties in two domains or more among physical, nutritive, cognitive and sensory domains. The risk of adverse health outcomes was assessed by using logistic regression models (hospitalisations, onset of difficulty in performing movements of everyday life) and multivariate Cox proportional hazards models (mortality). Mean age was 66.8 +/- 3.4 years and 73.8% were males. The prevalence of frailty varied from 4.4 to 14.2% depending on whether the sensory domain was excluded or included. During follow-up, 182 deaths (1.4%), 479 hospitalisations (3.6%) and 703 cases of new disability (8.0%) were observed. Both definitions of frailty predicted the onset of difficulties to perform everyday movements, with 2 to 3-fold increase in the risk. The inclusion of the sensory domain in the definition made frailty predictive of hospitalisations (Odds Ratio 1.31 [1.01-1.70]) but the association with mortality was only observed when sensory difficulties were ignored (Hazard Ratio 2.28 [1.32-3.92]). The inclusion of a sensory domain into a frailty screening instrument has a major impact in terms of prevalence and modifies the risk profile associated with frailty. In order to develop the use of frailty screening instruments in clinical practice, further researches will need to carefully evaluate the impact on risk prediction of the different domains involved.

Toddler Autism Screening Questionnaire: Development and Potential Clinical Validity

ERIC Educational Resources Information Center

Tsai, Wen-Che; Soong, Wei-Tsuen; Shyu, Yea-Ing Lotus

2012-01-01

No feasible screening instrument is available for early detection of children with autism in Taiwan. The existing instruments may not be appropriate for use in Taiwan due to different health care systems and child-rearing cultures. The purpose of this study was to develop and test a screening questionnaire for generic autism. The initial 18-item…

Comparative analysis of three screening instruments for autism spectrum disorder in toddlers at high risk.

PubMed

Oosterling, Iris J; Swinkels, Sophie H; van der Gaag, Rutger Jan; Visser, Janne C; Dietz, Claudine; Buitelaar, Jan K

2009-06-01

Several instruments have been developed to screen for autism spectrum disorders (ASD) in high-risk populations. However, few studies compare different instruments in one sample. Data were gathered from the Early Screening of Autistic Traits Questionnaire, Social Communication Questionnaire, Communication and Symbolic Behavior Scales-Developmental Profile, Infant-Toddler Checklist and key items of the Checklist for Autism in Toddlers in 238 children (mean age = 29.6 months, SD = 6.4) at risk for ASD. Discriminative properties are compared in the whole sample and in two age groups separately (8-24 months and 25-44 months). No instrument or individual item shows satisfying power in discriminating ASD from non-ASD, but pros and cons of instruments and items are discussed and directions for future research are proposed.

The Brief Anxiety and Depression Scale (BADS): a new instrument for detecting anxiety and depression in long-term care residents.

PubMed

Mansbach, William E; Mace, Ryan A; Clark, Kristen M

2015-04-01

Depression and anxiety are common among long-term care residents, yet both appear to be under-recognized and under-treated. In our survey of 164 geriatric health care professionals from 34 U.S. states, 96% of respondents reported that a new instrument that rapidly assesses both depression and anxiety is needed. The Brief Anxiety and Depression Scale (BADS) is a new screening tool that can identify possible major depressive episodes (MDE) and generalized anxiety disorders (GAD) in long-term care residents. The psychometric properties of the BADS were investigated in a sample of 224 U.S. long-term care residents (aged 80.52 ± 9.07). Participants completed a battery of several individually administered mood and cognitive tests, including the BADS. MDE and GAD were diagnosed based on the DSM-IV-TR criteria. Adequate internal consistency and construct validity were found. A principle component analysis (PCA) revealed an Anxiety Factor and a Depression Factor, which explained 50.26% of the total variance. The Anxiety Factor had a sensitivity of 0.73 and specificity of 0.81 for identifying GAD (PPV = 0.69, NPV = 0.84). The Depression Factor had a sensitivity of 0.76 and a specificity of 0.73 for identifying MDE (PPV = 0.77, NPV = 0.72). The BADS appears to be a reliable and valid screening instrument for MDE and GAD in long-term residents. The BADS can be rapidly administered, is sensitive to mood diagnoses in both patients without dementia and with dementia, and produces separate depression and anxiety factor scores that can be used clinically to identify probable mood diagnoses.

Computerized screening for cognitive impairment in patients with COPD.

PubMed

Campman, Carlijn; van Ranst, Dirk; Meijer, Jan Willem; Sitskoorn, Margriet

2017-01-01

COPD is associated with cognitive impairment. These impairments should be diagnosed, but due to time- and budget-reasons, they are often not investigated. The aim of this study is to examine the viability of a brief computerized cognitive test battery, Central Nervous System Vital Signs (CNSVS), in COPD patients. Patients with COPD referred to tertiary pulmonary rehabilitation were included. Cognitive functioning of patients was assessed with CNSVS before pulmonary rehabilitation and compared with age-corrected CNSVS norms. CNSVS is a 30 minute computerized test battery that includes tests of verbal and visual memory, psychomotor speed, processing speed, cognitive flexibility, complex attention, executive functioning, and reaction time. CNSVS was fully completed by 205 (93.2%, 105 females, 100 males) of the total group of patients (n=220, 116 females, 104 males). Z -tests showed that COPD patients performed significantly worse than the norms on all CNSVS cognitive domains. Slightly more than half of the patients (51.8%) had impaired functioning on 1 or more cognitive domains. Patients without computer experience performed significantly worse on CNSVS than patients using the computer frequently. The completion rate of CNSVS was high and cognitive dysfunctions measured with this screening were similar to the results found in prior research, including paper and pen cognitive tests. These results support the viability of this brief computerized cognitive screening in COPD patients, that may lead to better care for these patients. Cognitive performance of patients with little computer experience should be interpreted carefully. Future research on this issue is needed.

A Structured Implicit Abstraction Method to Evaluate whether Content of Counseling before Prostate Cancer Screening is Consistent with Recommendations by Experts

PubMed Central

Farrell, Michael H.; Chan, Evelyn C.Y.; Ladouceur, Lynnea K.; Stein, Jeffrey M.

2009-01-01

Objective To assess the content of counseling about prostate-specific antigen (PSA) screening. Guidelines recommend informed consent before screening because of concerns about benefits versus risks. As part of the professional practice standard for informed consent, clinicians should include content customarily provided by experts. Methods 40 transcripts of conversations between medicine residents and standardized patients were abstracted using an instrument derived from an expert Delphi panel that ranked 10 “facts that experts believe men ought to know.” Results Transcripts contained definite criteria for an average of 1.7 facts, and either definite or partial criteria for 5.1 facts. Second- and third-year residents presented more facts than interns (p=0.01). The most common facts were “false positive PSA tests can occur” and “use of the PSA test as a screening test is controversial.” There was an r=0.88 correlation between inclusion by residents and the experts’ ranking. Conclusion Counseling varied but most transcripts included some expert-recommended facts. The absence of other facts could be a quality deficit or an effort to prioritize messages and lessen cognitive demands on the patient. Practice implications Clinicians should adapt counseling for each patient, but our abstraction approach may help to assess the quality of informed consent over larger populations. PMID:19837527

Development and validation of a brief screening instrument for psychosocial risk associated with genetic testing: a pan-Canadian cohort study

PubMed Central

Esplen, Mary Jane; Cappelli, Mario; Wong, Jiahui; Bottorff, Joan L; Hunter, Jon; Carroll, June; Dorval, Michel; Wilson, Brenda; Allanson, Judith; Semotiuk, Kara; Aronson, Melyssa; Bordeleau, Louise; Charlemagne, Nicole; Meschino, Wendy

2013-01-01

Objectives To develop a brief, reliable and valid instrument to screen psychosocial risk among those who are undergoing genetic testing for Adult-Onset Hereditary Disease (AOHD). Design A prospective two-phase cohort study. Setting 5 genetic testing centres for AOHD, such as cancer, Huntington's disease or haemochromatosis, in ambulatory clinics of tertiary hospitals across Canada. Participants 141 individuals undergoing genetic testing were approached and consented to the instrument development phase of the study (Phase I). The Genetic Psychosocial Risk Instrument (GPRI) developed in Phase I was tested in Phase II for item refinement and validation. A separate cohort of 722 individuals consented to the study, 712 completed the baseline package and 463 completed all follow-up assessments. Most participants were female, at the mid-life stage. Individuals in advanced stages of the illness or with cognitive impairment or a language barrier were excluded. Interventions Phase I: GPRI items were generated from (1) a review of the literature, (2) input from genetic counsellors and (3) phase I participants. Phase II: further item refinement and validation were conducted with a second cohort of participants who completed the GPRI at baseline and were followed for psychological distress 1-month postgenetic testing results. Primary and secondary outcome measures GPRI, Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Brief Symptom Inventory (BSI) and Impact of Event Scale (IES). Results The final 20-item GPRI had a high reliability—Cronbach's α at 0.81. The construct validity was supported by high correlations between GPRI and BSI and IES. The predictive value was demonstrated by a receiver operating characteristic curve of 0.78 plotting GPRI against follow-up assessments using HAM-D and HAM-A. Conclusions With a cut-off score of 50, GPRI identified 84% of participants who displayed distress postgenetic testing results, supporting its potential usefulness in a clinical setting. PMID:23485718

Screening for cognitive dysfunction in ALS: validation of the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) using age and education adjusted normative data.

PubMed

Pinto-Grau, Marta; Burke, Tom; Lonergan, Katie; McHugh, Caroline; Mays, Iain; Madden, Caoifa; Vajda, Alice; Heverin, Mark; Elamin, Marwa; Hardiman, Orla; Pender, Niall

2017-02-01

Cognitive and behavioural changes are an important aspect in Amyotrophic Lateral Sclerosis (ALS). The Edinburgh Cognitive and Behavioural ALS Screen (ECAS) briefly assesses these changes in ALS. To validate the ECAS against a standardised neuropsychological battery and assess its sensitivity and specificity using age and education adjusted cut-off scores. 30 incident ALS cases were assessed on both, ECAS and neuropsychological battery. Age and education adjusted cut-off scores were created from a sample of 82 healthy controls. ECAS composite scores (Total, ALS Specific and Non-Specific) were highly correlated with battery composite scores. High correlations were also observed between ECAS and full battery cognitive domains and subtests. The ECAS Total, ALS Specific and Non-Specific scores were highly sensitive to cognitive impairment. ECAS ALS-Specific cognitive domains also evidenced high sensitivity. Individual subtest sensitivity was medium to low, suggesting that caution should be used when interpreting these scores. Low positive predictive values indicated the presence of false positives. Psychometric properties of the ECAS using age and education adjusted norms indicate that the ECAS, when used as an overall measure of cognitive decline, is highly sensitive. Further comprehensive assessment is required for patients that present as impaired on the ECAS.

Rapid cognitive screening in multiple sclerosis accomplished by the Free Recall and Recognition Test.

PubMed

Claesson, I M; Ytterberg, C; Johansson, S; Almkvist, O; von Koch, L

2007-03-01

This study sought to investigate the feasibility of the Free Recall and Recognition Test (FRRT) as a practical screening tool for cognitive impairment in multiple sclerosis (MS). Persons with MS (n = 227) were consecutively recruited and assessed with four cognitive tests; FRRT, Symbol Digit Modalities Test (SDMT), Paced Auditory Serial Addition Test (PASAT), and the Mini-Mental State Examination (MMSE). Disease severity was assessed by the Expanded Disability Status Scale (EDSS). The FRRT, which was completed by 99% of the cohort in approximately 5 minutes per assessment, correlated significantly with the other cognitive tests, as well as with the disease severity rating. A cut-off of 4 for the FRRT recall rendered 90% sensitivity and 25% specificity, and a cut-off of 4.2 for the FRRT recognition resulted in 70% sensitivity and 51% specificity. We conclude that the FRRT proved feasible as a practical screening tool for cognitive impairment in MS within a clinical setting.

Risk for poor outcomes in older patients discharged from an emergency department: feasibility of four screening instruments.

PubMed

Buurman, Bianca M; van den Berg, Wendy; Korevaar, Johanna C; Milisen, Koen; de Haan, Rob J; de Rooij, Sophia E

2011-08-01

To compare the prognostic value of four screening instruments used to detect the risk for poor outcomes [in terms of likelihood of recurrent emergency department (ED) visits, hospitalizations, or mortality] for older patients discharged home from an ED in the Netherlands. This is a prospective cohort study, which included all consecutive patients of at least 65 years discharged from the ED of a university teaching hospital in the Netherlands, between 1 December 2005, and 1 November 2006. Four screening instruments were tested: the identification of seniors at risk, the triage risk screening tool, and the Runciman and Rowland questionnaires. The cutoff of the Runciman questionnaire was adapted and the age cutoff was adapted for the other instruments. Recurrent ED visits, subsequent hospitalization, and mortality within 30 and 120 days after the index visit were collected from administrative data. In total, 381 patients were included, with a mean age of 79.1 years. Within 120 days, 14.7% of the patients returned to ED, 17.2% were hospitalized, and 2.9% died. The area under the curve was low for all instruments (between 0.43 and 0.60), indicating poor discriminatory power. Older ED patients discharged home are at higher risk of poor outcomes. None of the instruments were able to clearly discriminate between patients with and without poor outcomes. Differences in organization of the health care systems might influence the prognostic abilities of screening instruments.

Evaluation of a Screening Instrument for Autism Spectrum Disorders in Prisoners

PubMed Central

Robinson, Louise; Spencer, Michael D.; Thomson, Lindsay D. G.; Stanfield, Andrew C.; Owens, David G. C.; Hall, Jeremy; Johnstone, Eve C.

2012-01-01

There have been concerns that individuals with autism spectrum disorders (ASDs) are over-represented but not recognised in prison populations. A screening tool for ASDs in prisons has therefore been developed. Aims We aimed to evaluate this tool in Scottish prisoners by comparing scores with standard measures of autistic traits (Autism Quotient (AQ)), neurodevelopmental history (Asperger Syndrome (and High-Functioning Autism) Diagnostic Interview (ASDI)), and social cognition (Ekman 60 Faces test). Methods Prison officers across all 12 publicly-run closed prisons in Scotland assessed convicted prisoners using the screening tool. This sample included male and female prisoners and both adult and young offenders. Prisoners with high scores, along with an equal number of age and sex-matched controls, were invited to take part in interviews. Prisoners' relatives were contacted to complete a neurodevelopmental assessment. Results 2458 prisoners were screened using the tool, and 4% scored above the cut-off. 126 prisoners were further assessed using standardised measures. 7 of those 126 assessed scored 32 or above (cut-off) on the AQ. 44 interviews were completed with prisoners' relatives, no prisoner reached the cut-off score on the ASDI. Scores on the screening tool correlated significantly with AQ and ASDI scores, and not with the Ekman 60 Faces Test or IQ. Sensitivity was 28.6% and specificity 75.6%; AUC was 59.6%. Conclusions Although this screening tool measures autistic traits in this population, sensitivity for scores of 32 or above on the AQ is poor. We consider that this limits its usefulness and do not recommend that the tool is routinely used to screen for ASDs in prisons. PMID:22662113

The Value of Pre-Screening in the Alzheimer's Prevention Initiative (API) Autosomal Dominant Alzheimer's Disease Trial.

PubMed

Rios-Romenets, S; Giraldo-Chica, M; López, H; Piedrahita, F; Ramos, C; Acosta-Baena, N; Muñoz, C; Ospina, P; Tobón, C; Cho, W; Ward, M; Langbaum, J B; Tariot, P N; Reiman, E M; Lopera, F

2018-01-01

The Alzheimer's Prevention Initiative (API) Autosomal Dominant Alzheimer's Disease (ADAD) trial evaluates the anti-amyloid-β antibody crenezumab in cognitively unimpaired persons who, based on genetic background and age, are at high imminent risk of clinical progression, and provides a powerful test of the amyloid hypothesis. The Neurosciences Group of Antioquia implemented a pre-screening process with the goals of decreasing screen failures and identifying participants most likely to adhere to trial requirements of the API ADAD trial in cognitively unimpaired members of Presenilin1 E280A mutation kindreds. The pre-screening failure rate was 48.2%: the primary reason was expected inability to comply with the protocol, chiefly due to work requirements. More carriers compared to non-carriers, and more males compared to females, failed pre-screening. Carriers with illiteracy or learning/comprehension difficulties failed pre-screening more than non-carriers. With the Colombian API Registry and our prescreening efforts, we randomized 169 30-60 year-old cognitively unimpaired carriers and 83 non-carriers who agreed to participate in the trial for at least 60 months. Our findings suggest multiple benefits of implementing a pre-screening process for enrolling prevention trials in ADAD.

Development and implementation of Persian test of Elderly for Assessment of Cognition and Executive function (PEACE)

PubMed Central

Javadi, Pari Sadat Haji Seyed; Zendehbad, Azadeh; Darabi, Fatemeh; Khosravifar, Shahrzad; Noroozian, Maryam

2015-01-01

Introduction A considerable segment of the elderly population in Iran is illiterate, and it seems the existing neuropsychological screening tests are not very useful for detecting dementia in illiterate participants. The purpose of this study was to develop and validate a tool called Persian test of Elderly for Assessment of Cognition and Executive function (PEACE) for detecting dementia in both illiterate and literate participants. Methods First, in order to design some of the cognitive aspects of the PEACE assay, we considered other prevalent neuropsychological instruments, such as the General Practitioner assessment of Cognition (GPCOG), Functional Assessment Staging (FAST), Mini Mental State Examination (MMSE), and Wechsler Memory scale. The other domains of PEACE were designed according to our clinical proficiencies and the culture of the society. In the next step, the participants were classified into three distinct groups, i.e., the control group (n=33), the Mild Cognitive Impairment (MCI) group (n=30), and the Alzheimer’s group (n=38). All of the participants in each group were divided according to their educational level, i.e., illiterate, semi-literate, and literate. Results We developed PEACE consisting of 14 items, each of which represents a specific cognitive function, with a maximum score of 91. The 14 items are Orientation, Praxis, Attention and Concentration, Attention and Calculation, Memory, Similarity, Abstract Thinking, General Information, Language, Judgment, Gnosis, Planning (Sequencing), Problem Solving, and Animal Naming. PEACE scores are highly correlated with those of the MMSE (r=0.78). The optimal cut-off point of PEACE chosen for diagnosis of Alzheimer’s disease was 67.5 (sensitivity: 75.8%, specificity: 97.4%). The PEACE scores showed a significant difference between Participants with Alzheimer’s disease and the control group (p=0.0000) and the MCI group (p=0.003). In addition, there was no significant difference between illiterate and literate participants in the Alzheimer’s group. However, the PEACE scores differed significantly (p=0.0000) between illiterate and literate participants in the control group. Conclusion The PEACE addresses the limitations of existing tests and is appropriate for use in countries that have high rates of illiteracy. It is a valid screening mechanism for the detection of dementia in both illiterate and literate participants. PMID:26767112

Preinjury physical frailty and cognitive impairment among geriatric trauma patients determine postinjury functional recovery and survival.

PubMed

Maxwell, Cathy A; Mion, Lorraine C; Mukherjee, Kaushik; Dietrich, Mary S; Minnick, Ann; May, Addison; Miller, Richard S

2016-02-01

Injury is an external stressor that often initiates a cycle of decline in many older adults. The influence of physical frailty and cognitive decline on 6-month and 1-year outcomes after injury is unreported. We hypothesized that physical frailty and cognitive impairment would be predictive of 6-month and 1-year postinjury function and overall mortality. The sample involved patients who are 65 years or older admitted to a Level I trauma center between October 2013 and March 2014 with a primary injury diagnosis. Surrogates of 188 patients were interviewed within 48 hours of hospital admission to determine preinjury cognitive and physical frailty impairments using brief screening instruments. Follow-up was completed on 172 patients at 6 months and 176 patients at 1 year to determine posthospitalization status and outcomes. Data analysis involved frequencies, measures of central tendency, χ analyses, linear and logistic regression. The mean age of the patients was 77 years. The median Injury Severity Score (ISS) was 10. The mechanism of injury involved falls from standing (n = 101, 54%). Preinjury vulnerabilities included cognitive impairment (AD8 Dementia Screen [AD8] score ≥ 2, n = 93, 50%) and physical frailty (Vulnerable Elders Survey [VES-13] score ≥ 4, n = 94, 50%). Overall, median physical frailty scores did not return to baseline in the majority of survivors at 1 year. Multivariate regression analysis revealed that preinjury cognitive impairment (6 months, AD8, β = -0.20, p = 0.002) and preinjury physical frailty (6 months, Barthel Index, β = 0.60, p < 0.001; 1 year, Barthel Index, β = 0.52, p < 0.001) are independently associated with physical function (frailty). Multivariate logistic regression analysis revealed that age (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.04-1.14), injury severity (OR, 1.07; 95% CI, 1.02-1.12), and preinjury physical frailty (OR, 1.28; 95% CI, 1.14-1.47) are independently associated with overall mortality at 1 year. Preinjury physical frailty is the predominant predictor of postinjury functional status and mortality in geriatric trauma patients. Identification of frailty and appropriate follow-up are crucial for decision making by providers, patients, and family caregivers. Prognostic study, level II.

Chilean version of the INECO Frontal Screening (IFS-Ch): psychometric properties and diagnostic accuracy

PubMed Central

Jory, Josefina Ihnen; Bruna, Andrés Antivilo; Muñoz-Neira, Carlos; Chonchol, Andrea Slachevsky

2013-01-01

OBJECTIVE This study sought to analyze the psychometric properties and diagnostic accuracy of the Chilean version of the INECO Frontal Screening (IFS-Ch) in a sample of dementia patients and control subjects. METHODS After adapting the instrument to the Chilean context and obtaining content validity evidence through expert consultation, the IFS-Ch was administered to 31 dementia patients and 30 control subjects together with other executive assessments (Frontal Assessment Battery [FAB], Modified version of the Wisconsin Card Sorting Test [MCST], phonemic verbal fluencies [letters A and P] and semantic verbal fluency [animals]) and global cognitive efficiency tests (Mini mental State Examination [MMSE] and Addenbrooke's Cognitive Examination-Revised [ACE-R]). Caregivers of dementia patients and proxies of control subjects were interviewed with instruments measuring dysexecutive symptoms (Dysexecutive Questionnaire [DEX]), dementia severity (Clinical Dementia Rating Scale [CDR]) and functional status in activities of daily living (Activities of Daily Living Scale [IADL] and Technology-Activities of Daily Living Questionnaire [T-ADLQ]). Convergent and discriminant validity, internal consistency reliability, cut-off points, sensitivity and specificity for the IFS-Ch were estimated. RESULTS Evidence of content validity was obtained. Evidence of convergent validity was also found showing significant correlations (p<0.05) between the IFS-Ch and the other instruments measuring: executive functions (FAB, r=0.935; categories achieved in the MCST, r=0.791; perseverative errors in the MCST, r= -0.617; animal verbal fluency, r=0.728; "A" verbal fluency, r=0.681; and "P" verbal fluency, r=0.783), dysexecutive symptoms in daily living (DEX, r= -0.494), dementia severity (CDR, r= -0.75) and functional status in activities of daily living (T-ADLQ, r= -0.745; IADL, r=0.717). Regarding reliability, a Cronbach's alpha coefficient of 0.905 was obtained. For diagnostic accuracy, a cut-off point of 18 points (sensitivity=0.903; specificity=0.867) and an area under curve of 0.951 were estimated to distinguish between patients with dementia and control subjects. DISCUSSION The IFS-Ch showed acceptable psychometric properties, supported by evidence of validity and reliability for its use in the measurement of executive functions in patients with dementia. The diagnostic accuracy of the IFS-Ch for detecting dementia patients was also considered acceptable. PMID:29213818

Cognitive decline and slower reaction time in elderly individuals with mild cognitive impairment.

PubMed

Chen, Ko-Chia; Weng, Chia-Ying; Hsiao, Sigmund; Tsao, Wen-Long; Koo, Malcolm

2017-11-01

The relationship between declining performance, as measured by changes in reaction time, and declining cognitive function has not been critically studied. The aim of the present study was to investigate the association between reaction time during a task and cognitive ability in elderly Taiwanese individuals. Patients aged 65 years or older with mild cognitive impairment (MCI) (n = 33) and Alzheimer's disease (n = 26) were recruited from the neurology clinic of a regional hospital in southern Taiwan. In addition, 28 healthy controls aged 65 years or older were recruited from the community. The cognitive performance of the study participants was assessed using the Cognitive Abilities Screening Instrument (CASI). A computer-administered simple reaction time (SRT) task and a flanker reaction time (FRT) task were administered to assess participants' cognitive function. A non-parametric Kruskal-Wallis test was performed to compare CASI scores, SRT, and FRT among the three groups. anova was also used to compare CASI scores, inverse-transformed SRT, and inverse-transformed FRT among the three groups, with adjustment for age and years of education. Additionally, Pearson's partial correlation coefficients were used to assess the association of CASI scores with inverse-transformed SRT, and inverse-transformed FRT within each of the three groups. Significant differences in CASI scores, SRT, and FRT were found between the Alzheimer's disease group and the other two groups, either with or without adjustment for age or education. The reaction time of patients with Alzheimer's disease was significantly slower than the other two groups. Moreover, significant correlation between CASI and FRT was found in patients with MCI. Altered performance in a speed task was observed in patients with MCI. The FRT task should further be explored for its role as a marker for cognitive decline in elderly individuals, particularly in those with MCI. © 2017 Japanese Psychogeriatric Society.

Education and WHO Recommendations for Fruit and Vegetable Intake Are Associated with Better Cognitive Function in a Disadvantaged Brazilian Elderly Population: A Population-Based Cross-Sectional Study

PubMed Central

Pastor-Valero, Maria; Furlan-Viebig, Renata; Menezes, Paulo Rossi; da Silva, Simon Almeida; Vallada, Homero; Scazufca, Marcia

2014-01-01

Brazil has one of the fastest aging populations in the world and the incidence of cognitive impairment in the elderly is expected to increase exponentially. We examined the association between cognitive impairment and fruit and vegetable intake and associated factors in a low-income elderly population. A cross-sectional population-based study was carried out with 1849 individuals aged 65 or over living in São Paulo, Brazil. Cognitive function was assessed using the Community Screening Instrument for Dementia (CSI-D). Fruit and vegetable intake was assessed with a Food Frequency Questionnaire (FFQ) and categorized into quartiles of intake and into total daily fruit and vegetable intake using the cut-off points for the WHO recommendations (<400grams/day or ≥400 grams/day). The association between cognitive impairment and each quartile of intake, and WHO recommendation levels, was evaluated in two separate multivariate logistic models. The WHO recommendations for daily intakes ≥400 grams/day were significantly associated with 47% decreased prevalence of cognitive impairment. An effect modification was found in both models between cognitive impairment and “years of education and physical activity” and “years of education and blood levels of HDL” So that, having 1 or more years of education and being physically active or having 1 or more years of education and levels higher than 50 mg/dl of HDL-cholesterol strongly decreased the prevalence of cognitive impairment. In this socially deprived population with very low levels of education and physical activity and fruit and vegetable intake, those who attained WHO recommendations, had 1 year or more of education and were physically active had a significantly lower prevalence of cognitive impairment. A more comprehensive understanding of the social determinants of mental health is needed to develop effective public policies in developing countries. PMID:24736378

A Systematic Review of Instruments to Identify Mental Health and Substance Use Problems Among Children in the Emergency Department.

PubMed

Newton, Amanda S; Soleimani, Amir; Kirkland, Scott W; Gokiert, Rebecca J

2017-05-01

Specialized instruments to screen and diagnose mental health problems in children and adolescents are not yet standard components of clinical assessments in emergency departments (EDs). We conducted a systematic review to investigate the psychometric properties, accuracy, and performance metrics of instruments used in the ED to identify pediatric mental health and substance use problems. We searched seven electronic databases and the gray literature for psychometric validation studies, diagnostic studies, and cohort studies that assessed any instrument to screen for or diagnose mental illness, emotional or behavioral problems, or substance use disorders. Studies had to include children and adolescents with mental health presentations or positive screens for substance use. Two reviewers independently screened studies for relevance and quality. Diagnostic study quality was assessed with the four QUADAS-2 domains. Psychometric study quality was assessed with published criteria for instrument reliability, validity, and usability. We present a descriptive analysis of the reported psychometric properties and diagnostic performance of instruments for each study. Of the 4,832 references screened, 14 met inclusion criteria. Included studies evaluate 18 instruments for identifying suicide risk (six studies), alcohol use disorders (six studies), mood disorders (one study), and ED decision making (need for assessment, admission; one study). Nine studies include a psychometric focus but quality varies, with no studies fully meeting criteria for reliability, validity, and usability. Seven studies examine diagnostic performance of an instrument, but no study has a low risk of bias for all QUADAS-2 domains. The HEADS-ED instrument has good inter-rater reliability (r = 0.785) for identifying general mental health problems and modest evidence for ruling in patients requiring hospital admission (positive likelihood ratio [LR+] = 6.30). Internal consistency (reliability) varies for instruments to screen for suicide risk (α = 0.46-0.97), and no instruments have both high sensitivity and high specificity. The Ask Suicide-Screening Questions (ASQ) is highly sensitive (98%) and has strong evidence for ruling out risk (negative likelihood ratio [LR-] = 0.04). Among screening instruments for alcohol use disorders, internal consistency is high for the consumption subscale of the Alcohol Use Disorders Identification Test (α = 0.83-0.88) and the Adolescent Drinking Index (α = 0.92). Both instruments also had sound internal validity. Diagnostically, a two-item instrument based on DSM-IV criteria is the most accurate in identifying patients with a disorder (area under the curve = 0.89) and has modest evidence for ruling in and out risk (LR+ = 8.80, LR- = 0.13). From available evidence, we recommend that ED clinicians use 1) the HEADS-ED to rule in ED admission among pediatric patients with visits for mental health care, 2) the ASQ to rule out suicide risk among pediatric patients with any visit type, and 3) the DSM-IV two-item instrument to rule in/rule out alcohol use disorders among pediatric patients currently using alcohol. These instruments require minimal to no training or time commitment. We also recommend that clinicians become familiar with each instrument's psychometric properties to understand the quality of the evidence base. In this review, however, we identify methodologic limitations in the evidence base. To develop a robust evidence base, additional research is necessary. © 2017 by the Society for Academic Emergency Medicine.

Reading Touch Screen Storybooks with Mothers Negatively Affects 7-Year-Old Readers’ Comprehension but Enriches Emotional Engagement

PubMed Central

Ross, Kirsty M.; Pye, Rachel E.; Randell, Jordan

2016-01-01

Touch screen storybooks turn reading into an interactive multimedia experience, with hotspot-activated animations, sound effects, and games. Positive and negative effects of reading multimedia stories have been reported, but the underlying mechanisms which explain how children’s learning is affected remain uncertain. The present study examined the effect of storybook format (touch screen and print) on story comprehension, and considered how level of touch screen interactivity (high and low) and shared reading behaviors (cognitive and emotional scaffolding, emotional engagement) might contribute to comprehension. Seven-year-olds (n = 22) were observed reading one touch screen storybook and one print storybook with their mothers. Story comprehension was inferior for the touch screen storybooks compared to the print formats. Touch screen interactivity level had no significant effect on comprehension but did affect shared reading behaviors. The mother–child dyads spent less time talking about the story in the highly interactive touch screen condition, despite longer shared reading sessions because of touch screen interactions. Positive emotional engagement was greater for children and mothers in the highly interactive touch screen condition, due to additional positive emotions expressed during touch screen interactions. Negative emotional engagement was greater for children when reading and talking about the story in the highly interactive condition, and some mothers demonstrated negative emotional engagement with the touch screen activities. The less interactive touch screen storybook had little effect on shared reading behaviors, but mothers controlling behaviors were more frequent. Storybook format had no effect on the frequency of mothers’ cognitive scaffolding behaviors (comprehension questions, word help). Relationships between comprehension and shared reading behaviors were examined for each storybook, and although length of the shared reading session and controlling behaviors had significant effects on comprehension, the mechanisms driving comprehension were not fully explained by the data. The potential for touch screen storybooks to contribute to cognitive overload in 7-year-old developing readers is discussed, as is the complex relationship between cognitive and emotional scaffolding behaviors, emotional engagement, and comprehension. Sample characteristics and methodological limitations are also discussed to help inform future research. PMID:27899903

Older adult mistreatment risk screening: contribution to the validation of a screening tool in a domestic setting.

PubMed

Lindenbach, Jeannette M; Larocque, Sylvie; Lavoie, Anne-Marise; Garceau, Marie-Luce

2012-06-01

ABSTRACTThe hidden nature of older adult mistreatment renders its detection in the domestic setting particularly challenging. A validated screening instrument that can provide a systematic assessment of risk factors can facilitate this detection. One such instrument, the "expanded Indicators of Abuse" tool, has been previously validated in the Hebrew language in a hospital setting. The present study has contributed to the validation of the "e-IOA" in an English-speaking community setting in Ontario, Canada. It consisted of two phases: (a) a content validity review and adaptation of the instrument by experts throughout Ontario, and (b) an inter-rater reliability assessment by home visiting nurses. The adaptation, the "Mistreatment of Older Adult Risk Factors" tool, offers a comprehensive tool for screening in the home setting. This instrument is significant to professional practice as practitioners working with older adults will be better equipped to assess for risk of mistreatment.

Comparison of the GHQ-36, the GHQ-12 and the SCL-90 as psychiatric screening instruments in the Finnish population.

PubMed

Holi, Matti M; Marttunen, Mauri; Aalberg, Veikko

2003-01-01

The aim of the study was to compare the screening properties of two General Health Questionnaire (GHQ) versions and the Symptom Checklist (SCL-90), and to evaluate them as psychiatric screening instruments in Finland. We administered the GHQ-36 and the SCL-90 to psychiatric outpatients (n=207) and to a community sample (n=315). Receiver operating characteristic (ROC) analysis was used to estimate the screening performance of the two instruments and of the GHQ-12 extracted from the GHQ-36. The screening properties of the scales were found to be good and similar. Suggested optimal cut-off points were 3/4 for the GHQ-12, 8/9 for the GHQ-36 and 0.90/0.91 for the SCL-90. In conclusion, the scales functioned equally well in screening. This favors the GHQ-12 for pure screening. When information on the symptom level is also needed, the GHQ-36 and the SCL-90 become better choices. The cut-off points presented here should be considered in the future Finnish psychiatric screening studies.

Factors predicting health practitioners' awareness of UNHS program in Malaysian non-public hospitals.

PubMed

Ismail, Abdussalaam Iyanda; Abdul Majid, Abdul Halim; Zakaria, Mohd Normani; Abdullah, Nor Azimah Chew; Hamzah, Sulaiman; Mukari, Siti Zamratol-Mai Sarah

2018-06-01

The current study aims to examine the effects of human resource (measured with the perception of health workers' perception towards UNHS), screening equipment, program layout and screening techniques on healthcare practitioners' awareness (measured with knowledge) of universal newborn hearing screening (UNHS) in Malaysian non-public hospitals. Via cross sectional approach, the current study collected data using a validated questionnaire to obtain information on the awareness of UNHS program among the health practitioners and to test the formulated hypotheses. 51, representing 81% response rate, out of 63 questionnaires distributed to the health professionals were returned and usable for statistical analysis. The survey instruments involving healthcare practitioners' awareness, human resource, program layout, screening instrument, and screening techniques instruments were adapted and scaled with 7-point Likert scale ranging from 1 (little) to 7 (many). Partial Least Squares (PLS) algorithm and bootstrapping techniques were employed to test the hypotheses of the study. With the result involving beta values, t-values and p-values (i.e. β=0.478, t=1.904, p<0.10; β=0.809, t=3.921, p<0.01; β= -0.436, t=1.870, p<0.10), human resource, measured with training, functional equipment and program layout, are held to be significant predictors of enhanced knowledge of health practitioners. Likewise, program layout, human resource, screening technique and screening instrument explain 71% variance in health practitioners' awareness. Health practitioners' awareness is explained by program layout, human resource, and screening instrument with effect size (f2) of 0.065, 0.621, and 0.211 respectively, indicating that program layout, human resource, and screening instrument have small, large and medium effect size on health practitioners' awareness respectively. However, screening technique has zero effect on health practitioners' awareness, indicating the reason why T-statistics is not significant. Having started the UNHS program in 2003, non-public hospitals have more experienced and well-trained employees dealing with the screening tools and instrument, and the program layout is well structured in the hospitals. Yet, the issue of homogeneity exists. Non-public hospitals charge for the service they render, and, in turn, they would ensure quality service, given that they are profit-driven and/or profit-making establishments, and that they would have no option other than provision of value-added and innovative services. The employees in the non-public hospitals have less screening to carry out, given the low number of babies delivered in the private hospitals. In addition, non-significant relationship between screening techniques and healthcare practitioners' awareness of UNHS program is connected with the fact that the techniques that are practiced among public and non-public hospital are similar and standardized. Limitations and suggestions were discussed. Copyright © 2018 Elsevier B.V. All rights reserved.

Measurement Issues: Screening and diagnostic instruments for autism spectrum disorders – lessons from research and practice

PubMed Central

Charman, Tony; Gotham, Katherine

2012-01-01

Background and Scope Significant progress has been made over the past two decades in the development of screening and diagnostic instruments for autism spectrum disorders (ASD). This article reviews this progress, including recent innovations, focussing on those instruments for which the strongest research data on validity exists, and then turns to addressing issues arising from their use in clinical settings. Findings Research studies have evaluated the ability of screens to prospectively identify cases of ASD in population-based and clinically-referred samples, as well as the accuracy of diagnostic instruments to map onto ‘gold standard’ clinical best estimate diagnosis. However, extension of the findings to clinical services must be done with caution, with a full understanding that instrument properties are sample-specific. Furthermore, we are limited by the lack of a true test for ASD, which remains a behaviourally-defined disorder. In addition screening and diagnostic instruments help clinicians least in the cases where they are most in want of direction, since their accuracy will always be lower for marginal cases. Conclusion Instruments help clinicians to collect detailed, structured information and increase accuracy and reliability of referral for in-depth assessment and recommendations for support, but further research is needed to refine their effective use in clinical settings. PMID:23539140

The Usefulness of the DBC-ASA as a Screening Instrument for Autism in Children with Intellectual Disabilities: A Pilot Study

ERIC Educational Resources Information Center

Deb, Shoumitro; Dhaliwal, Akal-Joat; Roy, Meera

2009-01-01

Aims: To explore the validity of Developmental Behaviour Checklist-Autism Screening Algorithm (DBC-ASA) as a screening instrument for autism among children with intellectual disabilities. Method: Data were collected from the case notes of 109 children with intellectual disabilities attending a specialist clinic in the UK. Results: The mean score…

Optimizing Cognitive Load for Learning from Computer-Based Science Simulations

ERIC Educational Resources Information Center

Lee, Hyunjeong; Plass, Jan L.; Homer, Bruce D.

2006-01-01

How can cognitive load in visual displays of computer simulations be optimized? Middle-school chemistry students (N = 257) learned with a simulation of the ideal gas law. Visual complexity was manipulated by separating the display of the simulations in two screens (low complexity) or presenting all information on one screen (high complexity). The…

Investigating the Incremental Validity of Cognitive Variables in Early Mathematics Screening

ERIC Educational Resources Information Center

Clarke, Ben; Shanley, Lina; Kosty, Derek; Baker, Scott K.; Cary, Mari Strand; Fien, Hank; Smolkowski, Keith

2018-01-01

The purpose of this study was to investigate the incremental validity of a set of domain general cognitive measures added to a traditional screening battery of early numeracy measures. The sample consisted of 458 kindergarten students of whom 285 were designated as severely at-risk for mathematics difficulty. Hierarchical multiple regression…

How Affectively-Based and Cognitively-Based Attitudes Drive Intergroup Behaviours: The Moderating Role of Affective-Cognitive Consistency

PubMed Central

Zhou, Jie; Dovidio, John; Wang, Erping

2013-01-01

The moderating role of affective-cognitive consistency in the effects of affectively-based and cognitively-based attitudes on consummatory and instrumental behaviors was explored using two experimental studies in the intergroup context. Study 1 revealed that affectively-based attitudes were better predictors than cognitively-based attitudes regardless of affective-cognitive consistency for consummatory behaviors (e.g., undergraduates’ supportive behaviors toward government officials). Study 2, which investigated task groups’ supportive behaviors toward an immediate supervisory group, found that for these instrumental behaviors cognitively-based attitudes were better predictors than affectively-based attitudes only when affective-cognitive consistency was high. The present research also examined the mechanism by which affective-cognitive consistency moderates the relative roles of affectively-based and cognitively-based attitudes in attitude-behavior consistency. Results indicated that attitude-behavior consistency is eroded primarily because of the weaker relationship of affective or cognitive components to behaviors than to general attitudes. The reciprocal implications of research on attitudes and work on intergroup relations are considered. PMID:24244751

Evaluation of Standardized Instruments for Use in Universal Screening of Very Early School-Age Children: Suitability, Technical Adequacy, and Usability

ERIC Educational Resources Information Center

Miles, Sandra; Fulbrook, Paul; Mainwaring-Mägi, Debra

2018-01-01

Universal screening of very early school-age children (age 4-7 years) is important for early identification of learning problems that may require enhanced learning opportunity. In this context, use of standardized instruments is critical to obtain valid, reliable, and comparable assessment outcomes. A wide variety of standardized instruments is…

Estimating Premorbid Cognitive Abilities in Low-Educated Populations

PubMed Central

Apolinario, Daniel; Brucki, Sonia Maria Dozzi; Ferretti, Renata Eloah de Lucena; Farfel, José Marcelo; Magaldi, Regina Miksian; Busse, Alexandre Leopold; Jacob-Filho, Wilson

2013-01-01

Objective To develop an informant-based instrument that would provide a valid estimate of premorbid cognitive abilities in low-educated populations. Methods A questionnaire was drafted by focusing on the premorbid period with a 10-year time frame. The initial pool of items was submitted to classical test theory and a factorial analysis. The resulting instrument, named the Premorbid Cognitive Abilities Scale (PCAS), is composed of questions addressing educational attainment, major lifetime occupation, reading abilities, reading habits, writing abilities, calculation abilities, use of widely available technology, and the ability to search for specific information. The validation sample was composed of 132 older Brazilian adults from the following three demographically matched groups: normal cognitive aging (n = 72), mild cognitive impairment (n = 33), and mild dementia (n = 27). The scores of a reading test and a neuropsychological battery were adopted as construct criteria. Post-mortem inter-informant reliability was tested in a sub-study with two relatives from each deceased individual. Results All items presented good discriminative power, with corrected item-total correlation varying from 0.35 to 0.74. The summed score of the instrument presented high correlation coefficients with global cognitive function (r = 0.73) and reading skills (r = 0.82). Cronbach's alpha was 0.90, showing optimal internal consistency without redundancy. The scores did not decrease across the progressive levels of cognitive impairment, suggesting that the goal of evaluating the premorbid state was achieved. The intraclass correlation coefficient was 0.96, indicating excellent inter-informant reliability. Conclusion The instrument developed in this study has shown good properties and can be used as a valid estimate of premorbid cognitive abilities in low-educated populations. The applicability of the PCAS, both as an estimate of premorbid intelligence and cognitive reserve, is discussed. PMID:23555894

Evaluating brief cognitive impairment screening instruments among African Americans.

PubMed

Kiddoe, Jared M; Whitfield, Keith E; Andel, Ross; Edwards, Christopher L

2008-07-01

This article compared and contrasted the Telephone Interview of Cognitive Status (TICS) to the racially-sensitive Short Portable Mental Status Questionnaire (SPMSQ). The empirical questions addressed was whether the TICS over-represented African American (AA) cognitive impairment (CI) relative to the SPMSQ, if there were age differences in CI prevalence between younger subjects (ages 50-64) and older ones (>64 years) and on accuracy to detect CI in individuals with higher levels of educations (> or =13 years) versus those with lower education levels (<13 years). A secondary data analysis was performed on 396 AA participants from the Carolina African American Twin Study on Aging (CAATSA). The SPMSQ measured CI prevalence at 10.3% and the TICS at 45.0%. Within the younger group, TICS and CI prevalence was 49.3 and 80% among the older group. Within the younger group SPMSQ and CI prevalence was 14.5 and 53.8% among the older group. Within the higher educated group, TICS and CI prevalence was 36.7 and 51.4% among the lower educated. Within the higher educated group, SPMSQ and CI prevalence was 7.7 and 14.5% among the lower educated. Findings are consistent with our hypotheses that the TICS would be a less accurate assessor of CI among AAs.

European-French Cross-Cultural Adaptation of the Developmental Coordination Disorder Questionnaire and Pretest in French-Speaking Switzerland.

PubMed

Ray-Kaeser, Sylvie; Satink, Ton; Andresen, Mette; Martini, Rose; Thommen, Evelyne; Bertrand, Anne Martine

2015-05-01

The Developmental Coordination Disorder Questionnaire (DCDQ'07) is a Canadian-English instrument recommended for screening children aged 5 to 15 years who are at risk for developmental coordination disorder. While a Canadian-French version of the DCDQ'07 presently exists, a European-French version does not. To produce a cross-cultural adaptation of the DCDQ'07 for use in areas of Europe where French is spoken and to test its cultural relevance in French-speaking Switzerland. Cross-cultural adaptation was done using established guidelines. Cultural relevance was analyzed with cognitive interviews of thirteen parents of children aged 5.0 to 14.6 years (mean age: 8.5 years, SD = 3.4), using think-aloud and probing techniques. Cultural and linguistic differences were noted between the European-French, the Canadian-French, and the original versions of the DCDQ'07. Despite correct translation and expert committee review, cognitive interviews revealed that certain items of the European-French version were unclear or misinterpreted and further modifications were needed. After rewording items as a result of the outcomes of the cognitive interview, the European-French version of the DCDQ'07 is culturally appropriate for use in French-speaking Switzerland. Further studies are necessary to determine its psychometric properties.

Detection of Mild Cognitive Impairment and early stage dementia with an audio-recorded cognitive scale

PubMed Central

Sewell, Margaret C.; Luo, Xiaodong; Neugroschl, Judith; Sano, Mary

2014-01-01

BACKGROUND Physicians often miss a diagnosis of Mild Cognitive Impairment (MCI) or early dementia and screening measures can be insensitive to very mild impairments. Other cognitive assessments may take too much time or be frustrating to seniors. This study examined the ability of an audio-recorded scale, developed in Australia, to detect MCI or mild Alzheimer’s disease and compared cognitive domain specific performance on the audio-recorded scale to in-person battery and common cognitive screens. METHOD Seventy-six subjects from the Mount Sinai Alzheimer’s Disease Research Center were recruited. Subjects were 75 years or older, with clinical diagnosis of AD or MCI (n=51) or normal control (n=25). Participants underwent in-person neuropsychological testing followed by testing with the Audio-recorded Cognitive Screen (ARCS). RESULTS ARCS provided better discrimination between normal and impaired elders than either the Mini-Mental Status Exam (MMSE) or the clock drawing test. The in-person battery and ARCS analogous variables were significantly correlated, most in the .4 to .7 range, including verbal memory, executive function/attention, naming, and verbal fluency. The area under the curve generated from ROC curves indicated high and equivalent discrimination for ARCS and the in-person battery (0.972 vs. 0.988; p=0.23). CONCLUSION The ARCS demonstrated better discrimination between normal controls and those with mild deficits than typical screening measures. Performance on cognitive domains within the ARCS was well correlated with the in-person battery. Completion of the ARCS was accomplished despite mild difficulty hearing the instructions even in very elderly subjects, indicating that it may be a useful measure in primary care settings. PMID:23635663

Effect of education and gender adjustment on the sensitivity and specificity of a cognitive screening battery for dementia: results from the MoVIES Project. Monongahela Valley Independent Elders Survey.

PubMed

Belle, S H; Seaberg, E C; Ganguli, M; Ratcliff, G; DeKosky, S; Kuller, L H

1996-01-01

The Monongahela Valley Independent Elders Survey (MoVIES) used a multiphase process to identify demented persons among 1,366 randomly selected noninstitutionalized individuals 65 years and older. Raw test scores from a cognitive screening battery were used to identify cognitively impaired individuals who were referred for a clinical evaluation. Subsequently, test scores were adjusted for education and gender within age strata. Adjusting test scores affected sensitivity for dementia only among the most educated, increasing sensitivity among younger subjects and decreasing among the older subjects. Specificity increased among the least educated and the oldest subjects. Overall, the adjusted criteria did not perform as well as the unadjusted criteria in this sample. Adjustment for education will not necessarily improve the ability of a screening battery for cognitive function to identify demented persons, particularly if unadjusted scores perform well.

Cognitive function variations in postmenopausal women treated with continuous, combined HRT or tibolone. A comparison.

PubMed

Pan, Hsien-An; Wang, Shan-Tair; Pai, Ming-Chyi; Chen, Chih-Hung; Wu, Meng-Hsing; Huang, Ko-En

2003-05-01

To compare cognitive function in postmenopausal women receiving continuous hormone replacement therapy and those receiving tibolone. This was a 6-month, prospective, single-blind, single center, randomized study. A total of 50 healthy, postmenopausal women were enrolled. In the end, 40 women completed the 6-month follow-up. One group (23 subjects) received conjugated equine estrogens (CEE), 0.625 mg/d, and medroxyprogesterone acetate (MPA), 5 mg/d. The other group (17 subjects) received tibolone, 2.5 mg/d. Their serum estradiol levels and Cognitive Abilities Screening Instrument (CASI) and Mini-Mental State Examination (MMSE) scores were obtained before starting and after 3 and 6 months of treatment. There was a significant increase in the serum estradiol level in the CEE + MPA group, especially after 3 months of treatment, but there was no increase in the estradiol level in the tibolone group. The CASI and MMSE scores of the CEE + MPA group and the tibolone group after 3 and 6 months of treatment showed no significant difference between the two groups apart from the MMSE at the 3-month follow-up. We saw an increasing trend in CASI and MMSE scores after treatment in both groups; however, the increases were not statistically significant. The rate of increase of both CASI and MMSE scores in the CEE + MPA group was greater than in the tibolone group, though the difference was not significant. This preliminary study demonstrated that both CEE + MPA and tibolone can preserve cognitive function and may be able to prevent cognitive decline in postmenopausal women during short-term treatment. Our results also show that continuous, combined CEE + MPA seems to be marginally more effective than tibolone in improving cognitive processes; however, long-term study is needed to follow-up such effect.

Mapping cognitive overlaps between practice-based learning and improvement and evidence-based medicine: an operational definition for assessing resident physician competence.

PubMed

Chatterji, Madhabi; Graham, Mark J; Wyer, Peter C

2009-12-01

The complex competency labeled practice-based learning and improvement (PBLI) by the Accreditation Council for Graduate Medical Education (ACGME) incorporates core knowledge in evidence-based medicine (EBM). The purpose of this study was to operationally define a "PBLI-EBM" domain for assessing resident physician competence. The authors used an iterative design process to first content analyze and map correspondences between ACGME and EBM literature sources. The project team, including content and measurement experts and residents/fellows, parsed, classified, and hierarchically organized embedded learning outcomes using a literature-supported cognitive taxonomy. A pool of 141 items was produced from the domain and assessment specifications. The PBLI-EBM domain and resulting items were content validated through formal reviews by a national panel of experts. The final domain represents overlapping PBLI and EBM cognitive dimensions measurable through written, multiple-choice assessments. It is organized as 4 subdomains of clinical action: Therapy, Prognosis, Diagnosis, and Harm. Four broad cognitive skill branches (Ask, Acquire, Appraise, and Apply) are subsumed under each subdomain. Each skill branch is defined by enabling skills that specify the cognitive processes, content, and conditions pertinent to demonstrable competence. Most items passed content validity screening criteria and were prepared for test form assembly and administration. The operational definition of PBLI-EBM competence is based on a rigorously developed and validated domain and item pool, and substantially expands conventional understandings of EBM. The domain, assessment specifications, and procedures outlined may be used to design written assessments to tap important cognitive dimensions of the overall PBLI competency, as given by ACGME. For more comprehensive coverage of the PBLI competency, such instruments need to be complemented with performance assessments.

Mapping Cognitive Overlaps Between Practice-Based Learning and Improvement and Evidence-Based Medicine: An Operational Definition for Assessing Resident Physician Competence

PubMed Central

Chatterji, Madhabi; Graham, Mark J.; Wyer, Peter C.

2009-01-01

Purpose The complex competency labeled practice-based learning and improvement (PBLI) by the Accreditation Council for Graduate Medical Education (ACGME) incorporates core knowledge in evidence-based medicine (EBM). The purpose of this study was to operationally define a “PBLI-EBM” domain for assessing resident physician competence. Method The authors used an iterative design process to first content analyze and map correspondences between ACGME and EBM literature sources. The project team, including content and measurement experts and residents/fellows, parsed, classified, and hierarchically organized embedded learning outcomes using a literature-supported cognitive taxonomy. A pool of 141 items was produced from the domain and assessment specifications. The PBLI-EBM domain and resulting items were content validated through formal reviews by a national panel of experts. Results The final domain represents overlapping PBLI and EBM cognitive dimensions measurable through written, multiple-choice assessments. It is organized as 4 subdomains of clinical action: Therapy, Prognosis, Diagnosis, and Harm. Four broad cognitive skill branches (Ask, Acquire, Appraise, and Apply) are subsumed under each subdomain. Each skill branch is defined by enabling skills that specify the cognitive processes, content, and conditions pertinent to demonstrable competence. Most items passed content validity screening criteria and were prepared for test form assembly and administration. Conclusions The operational definition of PBLI-EBM competence is based on a rigorously developed and validated domain and item pool, and substantially expands conventional understandings of EBM. The domain, assessment specifications, and procedures outlined may be used to design written assessments to tap important cognitive dimensions of the overall PBLI competency, as given by ACGME. For more comprehensive coverage of the PBLI competency, such instruments need to be complemented with performance assessments. PMID:21975994

The Swedish translation and cross-cultural adaptation of the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (FACIT-CD): linguistic validity and reliability of the Swedish version.

PubMed

Rask, Marie; Oscarsson, Marie; Ludwig, Neil; Swahnberg, Katarina

2017-04-04

Cervical dysplasia is a precancerous condition, which has been shown to create anxiety in women. To be able to investigate these women's health-related quality of life, a disease-specific instrument is required. There does not seem to be a Swedish version of an instrument to screen for this specific disease. Therefore, this study aims to translate and cross-culturally adapt the Functional Assessment of Chronic Illness Therapy - Cervical Dysplasia (FACIT-CD) into a Swedish context and evaluate its linguistic validity and reliability. The Functional Assessment of Chronic Illness Therapy (FACIT) translation methodology was used, which consists of several steps including pilot testing of the FACIT-CD instrument through cognitive debriefing interviews. Ten women diagnosed with cervical dysplasia participated in the cognitive debriefing interviews. The internal consistency reliability of the Swedish FACIT-CD was estimated by Cronbach's alpha coefficient. Homogeneity of the items was evaluated by corrected item-total correlations. The sample consists of 34 women who were diagnosed with cervical dysplasia. The translation and cross-cultural adaptation went smoothly without any problems for the majority of the items. The cognitive debriefing interviews indicated that the Swedish FACIT-CD consists of relevant items, is easy to understand and complete, and has unambiguous and comprehensive response categories. The translation and cross-cultural adaptation resulted in a Swedish FACIT-CD, which is conceptually and semantically equivalent to the English version and linguistically valid. The total scale of the Swedish FACIT-CD exhibited good internal consistency reliability with a Cronbach's alpha coefficient of 0.84, and all of the subscales exhibited acceptable value between 0.71 and 0.81 except the Relationships subscale, which had a value of 0.67. Finally, all but four items exceeded the acceptable level for the corrected item-total correlations of ≥ 0.20. The Swedish FACIT-CD is conceptually and semantically equivalent to the English version and linguistically valid; further, it exhibits good internal consistency reliability.

Comparing the Use of Evidence and Culture in Targeted Colorectal Cancer Communication for African Americans

PubMed Central

Thompson, Vetta L. Sanders; Kalesan, Bindu; Wells, Anjanette; Williams, Sha-Lai; Caito, Nicole M.

2010-01-01

Objective This study examined the effects (affective reactions, cognitive reactions and processing, perceived benefits and barriers and intent to screen) of targeted Peripheral + Evidential (PE) and Peripheral+Evidential+Socio-cultural (PE+SC) colorectal cancer communications. Methods This study was a two-arm randomized control study of cancer communication effects on affective, cognitive processing, and behavioral outcomes over a 22-week intervention. There were 771 African American participants, 45 to 75 years, participating in the baseline survey related to CRC screening. Three follow-up interviews that assessed intervention effects on affective response to the publications, cognitive processing, and intent to obtain CRC screening were completed. Results There were no statistically significant differences between PE and PE+SC intervention groups for affect, cognitive processing or intent to screen. However, there were significant interactions effects on outcome variables. Conclusions The advantages and disadvantages of PE+SC targeted cancer communications and implications of sex differences are considered. Practice Implications While there do not appear to be significant differences in behavioral outcomes when using PE and PE+SC strategies, there appear to be subtle differences in affective and cognitive processing outcomes related to medical suspicion and ethnic identity, particularly as it relates to gender. PMID:20702056

Comparing the use of evidence and culture in targeted colorectal cancer communication for African Americans.

PubMed

Thompson, Vetta L Sanders; Kalesan, Bindu; Wells, Anjanette; Williams, Sha-Lai; Caito, Nicole M

2010-12-01

This study examined the effects (affective reactions, cognitive reactions and processing, perceived benefits and barriers and intent to screen) of targeted peripheral+evidential (PE) and peripheral+evidential+socio-cultural (PE+SC) colorectal cancer communications. This study was a two-arm randomized control study of cancer communication effects on affective, cognitive processing, and behavioral outcomes over a 22-week intervention. There were 771 African American participants, 45-75 years, participating in the baseline survey related to CRC screening. Three follow-up interviews that assessed intervention effects on affective response to the publications, cognitive processing, and intent to obtain CRC screening were completed. There were no statistically significant differences between PE and PE+SC intervention groups for affect, cognitive processing or intent to screen. However, there were significant interactions effects on outcome variables. The advantages and disadvantages of PE+SC targeted cancer communications and implications of sex differences are considered. While there do not appear to be significant differences in behavioral outcomes when using PE and PE+SC strategies, there appear to be subtle differences in affective and cognitive processing outcomes related to medical suspicion and ethnic identity, particularly as it relates to gender. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Cross-cultural comparisons of the Mini-mental State Examination between Japanese and U.S. cohorts

PubMed Central

Meguro, Kenichi; Ishii, Hiroshi; Yamaguchi, Satoshi; Saxton, Judith A.; Ganguli, Mary

2009-01-01

Background The Mini-mental State Examination (MMSE) is widely used in Japan and the U.S.A. for cognitive screening in the clinical setting and in epidemiological studies. A previous Japanese community study reported distributions of the MMSE total score very similar to that of the U.S.A. Methods Data were obtained from the Monongahela Valley Independent Elder's Study (MoVIES), a representative sample of community-dwelling elderly people aged 65 and older living near Pittsburgh, U.S.A., and from the Tajiri Project, with similar aims in Tajiri, Japan. We examined item-by-item distributions of the MMSE between two cohorts, comparing (1) percentage of correct answers for each item within each cohort, and (2) relative difficulty of each item measured by Item Characteristic Curve analysis (ICC), which estimates log odds of obtaining a correct answer adjusted for the remaining MMSE items, demographic variables (age, gender, education) and interactions of demographic variables and cohort. Results Median MMSE scores were very similar between the two samples within the same education groups. However, the relative difficulty of each item differed substantially between the two cohorts. Specifically, recall and auditory comprehension were easier for the Tajiri group, but reading comprehension and sentence construction were easier for the MoVIES group. Conclusions Our results reaffirm the importance of validation and examination of thresholds in each cohort to be studied when a common instrument is used as a dementia screening tool or for defining cognitive impairment. PMID:18925977

Uncovering Contents of Mentor Teachers' Interactive Cognitions during Mentoring Dialogues

ERIC Educational Resources Information Center

Hennissen, Paul; Crasborn, Frank; Brouwer, Niels; Korthagen, Fred; Bergen, Theo

2010-01-01

In the context of developing mentor teachers' use of supervisory skills, two consecutive studies were conducted, using stimulated recall. Firstly, with eight participants, an instrument was developed to categorize contents of interactive cognitions. Secondly, with 30 participants, the instrument was applied to uncover contents of mentor teachers'…

Measuring cognitive load during procedural skills training with colonoscopy as an exemplar.

PubMed

Sewell, Justin L; Boscardin, Christy K; Young, John Q; Ten Cate, Olle; O'Sullivan, Patricia S

2016-06-01

Few studies have investigated cognitive factors affecting learning of procedural skills in medical education. Cognitive load theory, which focuses on working memory, is highly relevant, but methods for measuring cognitive load during procedural training are not well understood. Using colonoscopy as an exemplar, we used cognitive load theory to develop a self-report instrument to measure three types of cognitive load (intrinsic, extraneous and germane load) and to provide evidence for instrument validity. We developed the instrument (the Cognitive Load Inventory for Colonoscopy [CLIC]) using a multi-step process. It included 19 items measuring three types of cognitive load, three global rating items and demographics. We then conducted a cross-sectional survey that was administered electronically to 1061 gastroenterology trainees in the USA. Participants completed the CLIC following a colonoscopy. The two study phases (exploratory and confirmatory) each lasted for 10 weeks during the 2014-2015 academic year. Exploratory factor analysis determined the most parsimonious factor structure; confirmatory factor analysis assessed model fit. Composite measures of intrinsic, extraneous and germane load were compared across years of training and with global rating items. A total of 477 (45.0%) invitees participated (116 in the exploratory study and 361 in the confirmatory study) in 154 (95.1%) training programmes. Demographics were similar to national data from the USA. The most parsimonious factor structure included three factors reflecting the three types of cognitive load. Confirmatory factor analysis verified that a three-factor model was the best fit. Intrinsic, extraneous and germane load items had high internal consistency (Cronbach's alpha 0.90, 0.87 and 0.96, respectively) and correlated as expected with year in training and global assessment of cognitive load. The CLIC measures three types of cognitive load during colonoscopy training. Evidence of validity is provided. Although CLIC items relate to colonoscopy, the development process we detail can be used to adapt the instrument for use in other learning settings in medical education. © 2016 John Wiley & Sons Ltd.

Differences in Early Cognitive and Receptive-Expressive Neurodevelopment by Ancestry and Underlying Pathways in Brazil and Argentina

PubMed Central

Wehby, George L.; Trujillo, Antonio J.

2017-01-01

We examine disparities in early child cognitive and receptive-expressive skills by ethnic ancestry among infants aged 3 to 24 months from Brazil and Argentina. We employ unique data on the neurodevelopment of children who were seeking routine well-child care at a set of pediatric clinics in these countries. The sample included children who had normal birth outcomes and no major health complications, allowing us to focus on variation in neurodevelopment among children without major physical health limitations. The physicians attending the pediatric clinics were trained in administering the Bayley Infant Neurodevelopmental Screener, a standardized instrument used to screen an infant’s risk of neurodevelopmental problems on various domains of abilities. We evaluate disparities in overall neurodevelopmental scores and risk for neurodevelopmental problems as well as in cognitive functioning and receptive-expressive neurodevelopment. We also examine the extent to which household demographic and socioeconomic characteristics and geographic location explain these disparities. We find large gaps in both cognitive and receptive-expressive neurodevelopment by ancestry. In Brazil, children of African ancestry have lower scores on both cognitive and receptive-expressive domains and on overall neurodevelopment than children of European ancestry. In Argentina, children of Native ancestry have lower scores on these outcomes than children of European ancestry. These gaps however are largely explained by differences in geographic location and household characteristics, highlighting the importance of policies that reduce socioeconomic and geographic disparities in social capital and economic development for eliminating ethnic disparities in infant neurodevelopment. PMID:28068525

Differences in early cognitive and receptive-expressive neurodevelopment by ancestry and underlying pathways in Brazil and Argentina.

PubMed

Wehby, George L; Trujillo, Antonio J

2017-02-01

We examine disparities in early child cognitive and receptive-expressive skills by ethnic ancestry among infants aged 3-24 months from Brazil and Argentina. We employ unique data on the neurodevelopment of children who were seeking routine well-child care at a set of pediatric clinics in these countries. The sample included children who had normal birth outcomes and no major health complications, allowing us to focus on variation in neurodevelopment among children without major physical health limitations. The physicians attending the pediatric clinics were trained in administering the Bayley Infant Neurodevelopmental Screener, a standardized instrument used to screen an infant's risk of neurodevelopmental problems on various domains of abilities. We evaluate disparities in overall neurodevelopmental scores and risk for neurodevelopmental problems as well as in cognitive functioning and receptive-expressive neurodevelopment. We also examine the extent to which household demographic and socioeconomic characteristics and geographic location explain these disparities. We find large gaps in both cognitive and receptive-expressive neurodevelopment by ancestry. In Brazil, children of African ancestry have lower scores on both cognitive and receptive-expressive domains and on overall neurodevelopment than children of European ancestry. In Argentina, children of Native ancestry have lower scores on these outcomes than children of European ancestry. These gaps however are largely explained by differences in geographic location and household characteristics, highlighting the importance of policies that reduce socioeconomic and geographic disparities in social capital and economic development for eliminating ethnic disparities in infant neurodevelopment. Copyright © 2016. Published by Elsevier Inc.

Can Touch Screen Tablets be Used to Assess Cognitive and Motor Skills in Early Years Primary School Children? A Cross-Cultural Study.

PubMed

Pitchford, Nicola J; Outhwaite, Laura A

2016-01-01

Assessment of cognitive and motor functions is fundamental for developmental and neuropsychological profiling. Assessments are usually conducted on an individual basis, with a trained examiner, using standardized paper and pencil tests, and can take up to an hour or more to complete, depending on the nature of the test. This makes traditional standardized assessments of child development largely unsuitable for use in low-income countries. Touch screen tablets afford the opportunity to assess cognitive functions in groups of participants, with untrained administrators, with precision recording of responses, thus automating the assessment process. In turn, this enables cognitive profiling to be conducted in contexts where access to qualified examiners and standardized assessments are rarely available. As such, touch screen assessments could provide a means of assessing child development in both low- and high-income countries, which would afford cross-cultural comparisons to be made with the same assessment tool. However, before touch screen tablet assessments can be used for cognitive profiling in low-to-high-income countries they need to be shown to provide reliable and valid measures of performance. We report the development of a new touch screen tablet assessment of basic cognitive and motor functions for use with early years primary school children in low- and high-income countries. Measures of spatial intelligence, visual attention, short-term memory, working memory, manual processing speed, and manual coordination are included as well as mathematical knowledge. To investigate if this new touch screen assessment tool can be used for cross-cultural comparisons we administered it to a sample of children ( N = 283) spanning standards 1-3 in a low-income country, Malawi, and a smaller sample of children ( N = 70) from first year of formal schooling from a high-income country, the UK. Split-half reliability, test-retest reliability, face validity, convergent construct validity, predictive criterion validity, and concurrent criterion validity were investigated. Results demonstrate "proof of concept" that touch screen tablet technology can provide reliable and valid psychometric measures of performance in the early years, highlighting its potential to be used in cross-cultural comparisons and research.

Test-Retest Reliability of a Serious Game for Delirium Screening in the Emergency Department.

PubMed

Tong, Tiffany; Chignell, Mark; Tierney, Mary C; Lee, Jacques S

2016-01-01

Introduction: Cognitive screening in settings such as emergency departments (ED) is frequently carried out using paper-and-pencil tests that require administration by trained staff. These assessments often compete with other clinical duties and thus may not be routinely administered in these busy settings. Literature has shown that the presence of cognitive impairments such as dementia and delirium are often missed in older ED patients. Failure to recognize delirium can have devastating consequences including increased mortality (Kakuma et al., 2003). Given the demands on emergency staff, an automated cognitive test to screen for delirium onset could be a valuable tool to support delirium prevention and management. In earlier research we examined the concurrent validity of a serious game, and carried out an initial assessment of its potential as a delirium screening tool (Tong et al., 2016). In this paper, we examine the test-retest reliability of the game, as it is an important criterion in a cognitive test for detecting risk of delirium onset. Objective: To demonstrate the test-retest reliability of the screening tool over time in a clinical sample of older emergency patients. A secondary objective is to assess whether there are practice effects that might make game performance unstable over repeated presentations. Materials and Methods: Adults over the age of 70 were recruited from a hospital ED. Each patient played our serious game in an initial session soon after they arrived in the ED, and in follow up sessions conducted at 8-h intervals (for each participant there were up to five follow up sessions, depending on how long the person stayed in the ED). Results: A total of 114 adults (61 females, 53 males) between the ages of 70 and 104 years ( M = 81 years, SD = 7) participated in our study after screening out delirious patients. We observed a test-retest reliability of the serious game (as assessed by correlation r -values) between 0.5 and 0.8 across adjacent sessions. Conclusion: The game-based assessment for cognitive screening has relatively strong test-retest reliability and little evidence of practice effects among elderly emergency patients, and may be a useful supplement to existing cognitive assessment methods.

STRUCTURE OF THE UNIVERSITY PERSONALITY INVENTORY FOR CHINESE COLLEGE STUDENTS1,2

PubMed Central

ZHANG, JIETING; LANZA, STEPHANIE; ZHANG, MINQIANG; SU, BINYUAN

2016-01-01

Summary The University Personality Inventory, a mental health instrument for college students, is frequently used for screening in China. However, its unidimensionality has been questioned. This study examined its dimensions to provide more information about the specific mental problems for students at risk. Four subsamples were randomly created from a sample (N = 6,110; M age = 19.1 yr.) of students at a university in China. Principal component analysis with Promax rotation was applied on the first two subsamples to explore dimension of the inventory. Confirmatory factor analysis was conducted on the third subsample to verify the exploratory dimensions. Finally, the identified factors were compared to the Sympton Checklist–90 (SCL–90) to support validity, and sex differences were examined, based on the fourth subsample. Five factors were identified: Physical Symptoms, Cognitive Symptoms, Emotional Vulnerability, Social Avoidance, and Interpersonal Sensitivity, accounting for 60.3% of the variance. All the five factors were significantly correlated with the SCL–90. Women significantly scored higher than men on Cognitive Symptoms and Interpersonal Sensitivity. PMID:25933045

Cognitive Vulnerabilities and Depression in Young Adults: An ROC Curves Analysis.

PubMed

Balsamo, Michela; Imperatori, Claudio; Sergi, Maria Rita; Belvederi Murri, Martino; Continisio, Massimo; Tamburello, Antonino; Innamorati, Marco; Saggino, Aristide

2013-01-01

Objectives and Methods. The aim of the present study was to evaluate, by means of receiver operating characteristic (ROC) curves, whether cognitive vulnerabilities (CV), as measured by three well-known instruments (the Beck Hopelessness Scale, BHS; the Life Orientation Test-Revised, LOT-R; and the Attitudes Toward Self-Revised, ATS-R), independently discriminate between subjects with different severities of depression. Participants were 467 young adults (336 females and 131 males), recruited from the general population. The subjects were also administered the Beck Depression Inventory-II (BDI-II). Results. Four first-order (BHS Optimism/Low Standard; BHS Pessimism; Generalized Self-Criticism; and LOT Optimism) and two higher-order factors (Pessimism/Negative Attitudes Toward Self, Optimism) were extracted using Principal Axis Factoring analysis. Although all first-order and second-order factors were able to discriminate individuals with different depression severities, the Pessimism factor had the best performance in discriminating individuals with moderate to severe depression from those with lower depression severity. Conclusion. In the screening of young adults at risk of depression, clinicians have to pay particular attention to the expression of pessimism about the future.

Preliminary Findings of the Brief Everyday Activities Measurement (BEAM) in Older Adults.

PubMed

Scharaga, E A; Holtzer, R

2015-11-01

Functional losses are common in healthy and cognitively impaired older adults. However, subtle declines in instrumental activities of daily living (IADLs) are not always detected in self-reports. Performance IADL measurements are financially and time burdensome, restricting their use in varied settings. To address these limitations, we developed the Brief Everyday Activities Measure (BEAM), a short (< 5 minutes) objective IADL measure that assesses medication and finance management. The BEAM was administered to 209 cognitively non-demented community-dwellers (ages 65 - 95 years). Participants completed standardized motor, neuropsychological, psychological, and self-report functional assessments. BEAM completion time ranged from 54.16 to 259.31 seconds. Interclass correlations (ICC) for total BEAM completion time was moderate (0.65, 95% CI [.43 -.78]). Accuracy for total BEAM performance was in the low-moderate range (Kappa = 0.38, p < .001, 95% CI [.18 -.54]). As predicted, lower accuracy and longer time to complete the BEAM were both associated with worse executive functions, attention, and processing speed. Medication and finance management can be efficiently assessed within five minutes. The BEAM may be a valuable screening tool to evaluate these functional abilities.

Computerized screening for cognitive impairment in patients with COPD

PubMed Central

Campman, Carlijn; van Ranst, Dirk; Meijer, Jan Willem; Sitskoorn, Margriet

2017-01-01

Purpose COPD is associated with cognitive impairment. These impairments should be diagnosed, but due to time- and budget-reasons, they are often not investigated. The aim of this study is to examine the viability of a brief computerized cognitive test battery, Central Nervous System Vital Signs (CNSVS), in COPD patients. Patients and methods Patients with COPD referred to tertiary pulmonary rehabilitation were included. Cognitive functioning of patients was assessed with CNSVS before pulmonary rehabilitation and compared with age-corrected CNSVS norms. CNSVS is a 30 minute computerized test battery that includes tests of verbal and visual memory, psychomotor speed, processing speed, cognitive flexibility, complex attention, executive functioning, and reaction time. Results CNSVS was fully completed by 205 (93.2%, 105 females, 100 males) of the total group of patients (n=220, 116 females, 104 males). Z-tests showed that COPD patients performed significantly worse than the norms on all CNSVS cognitive domains. Slightly more than half of the patients (51.8%) had impaired functioning on 1 or more cognitive domains. Patients without computer experience performed significantly worse on CNSVS than patients using the computer frequently. Conclusion The completion rate of CNSVS was high and cognitive dysfunctions measured with this screening were similar to the results found in prior research, including paper and pen cognitive tests. These results support the viability of this brief computerized cognitive screening in COPD patients, that may lead to better care for these patients. Cognitive performance of patients with little computer experience should be interpreted carefully. Future research on this issue is needed. PMID:29089756

The development and initial validation of a sensitive bedside cognitive screening test.

PubMed

Faust, D; Fogel, B S

1989-01-01

Brief bedside cognitive examinations such as the Mini-Mental State Examination are designed to detect delirium and dementia but not more subtle or delineated cognitive deficits. Formal neuropsychological evaluation provides greater sensitivity and detects a wider range of cognitive deficits but is too lengthy for efficient use at the bedside or in epidemiological studies. The authors developed the High Sensitivity Cognitive Screen (HSCS), a 20-minute interview-based test, to identify patients who show disorder on formal neuropsychological evaluation. An initial study demonstrated satisfactory test-retest and interrater reliability. The HSCS was then administered to 60 psychiatric and neurological patients with suspected cognitive deficits but without gross impairment, who also completed formal neuropsychological testing. Results of both tests were independently classified as either normal, borderline, or abnormal. The HSCS correctly classified 93% of patients across the normal-abnormal dichotomy and showed promise for characterizing the extent and severity of cognitive dysfunction.

Optimal Methods to Screen Men and Women for Intimate Partner Violence: Results from an Internal Medicine Residency Continuity Clinic

ERIC Educational Resources Information Center

Kapur, Nitin A.; Windish, Donna M.

2011-01-01

Contradictory data exist regarding optimal methods and instruments for intimate partner violence (IPV) screening in primary care settings. The purpose of this study was to determine the optimal method and screening instrument for IPV among men and women in a primary-care resident clinic. We conducted a cross-sectional study at an urban, academic,…

The distress thermometer predicts subjective, but not objective, cognitive complaints six months after treatment initiation in cancer patients.

PubMed

Lycke, Michelle; Lefebvre, Tessa; Pottel, Lies; Pottel, Hans; Ketelaars, Lore; Stellamans, Karin; Eygen, Koen Van; Vergauwe, Philippe; Werbrouck, Patrick; Goethals, Laurence; Schofield, Patricia; Boterberg, Tom; Debruyne, Philip R

2017-01-01

Research has indicated that cancer-related cognitive impairments (CRCI) may be influenced by psychosocial factors such as distress, worry and fatigue. Therefore, we aimed to validate the distress thermometer (DT) as a screening tool to detect CRCI six months post-treatment-initiation in a group of general cancer patients. Patients (≥18 years, n = 125) with a histologically confirmed diagnosis of a solid cancer or hematological malignancy, scheduled for a curative treatment, were evaluated at baseline (T0) and six months post-treatment-initiation (T1) for CRCI by a neuropsychological assessment, including patient-reported outcome measures (PROMs). Assessed cognitive domains included premorbid intelligence, attention, processing speed, flexibility, verbal and visual episodic memory and verbal fluency. PROMs entailed distress (DT, cut-off ≥4, range 0-10), anxiety and depression, fatigue (FACIT-fatigue scale) and subjective cognitive complaints. At T0, 60.4% of patients showed a DT score of ≥4, whereas 50% met this criterion at T1. According to the definition of the International Cognition and Cancer Task Force, 25.5% and 28.3% of patients presented with a CRCI at T0 and T1, respectively. When evaluating the DT as a screening tool for CRCI at T1, data showed an inverse relationship between the DT and CRCI. ROC-curve analysis revealed an AUC <0.5. ROC-curve analyses evaluating the DT and FACIT-fatigue scale as screening tools for subjective cognitive complaints showed an AUC ± SE of, respectively, 0.642 ± 0.067 and 0.794 ± 0.057. The DT at T0 cannot be used to screen for objective CRCI at T1, but both the DT and FACIT-fatigue scale at T0 showed potential as screening tools for subjective cognitive complaints at T1.

Single-Item Screening for Agoraphobic Symptoms: Validation of a Web-Based Audiovisual Screening Instrument

PubMed Central

van Ballegooijen, Wouter; Riper, Heleen; Donker, Tara; Martin Abello, Katherina; Marks, Isaac; Cuijpers, Pim

2012-01-01

The advent of web-based treatments for anxiety disorders creates a need for quick and valid online screening instruments, suitable for a range of social groups. This study validates a single-item multimedia screening instrument for agoraphobia, part of the Visual Screener for Common Mental Disorders (VS-CMD), and compares it with the text-based agoraphobia items of the PDSS-SR. The study concerned 85 subjects in an RCT of the effects of web-based therapy for panic symptoms. The VS-CMD item and items 4 and 5 of the PDSS-SR were validated by comparing scores to the outcomes of the CIDI diagnostic interview. Screening for agoraphobia was found moderately valid for both the multimedia item (sensitivity.81, specificity.66, AUC.734) and the text-based items (AUC.607–.697). Single-item multimedia screening for anxiety disorders should be further developed and tested in the general population and in patient, illiterate and immigrant samples. PMID:22844391

Distributed behavior model orchestration in cognitive internet of things solution

NASA Astrophysics Data System (ADS)

Li, Chung-Sheng; Darema, Frederica; Chang, Victor

2018-04-01

The introduction of pervasive and ubiquitous instrumentation within Internet of Things (IoT) leads to unprecedented real-time visibility (instrumentation), optimization and fault-tolerance of the power grid, traffic, transportation, water, oil & gas, to give some examples. Interconnecting those distinct physical, people, and business worlds through ubiquitous instrumentation, even though still in its embryonic stage, has the potential to create intelligent IoT solutions that are much greener, more efficient, comfortable, and safer. An essential new direction to materialize this potential is to develop comprehensive models of such systems dynamically interacting with the instrumentation in a feed-back control loop. We describe here opportunities in applying cognitive computing on interconnected and instrumented worlds (Cognitive Internet of Things-CIoT) and call out the system-of-systems trend among distinct but interdependent worlds, and Dynamic Data-Driven Application System (DDDAS)-based methods for advanced understanding, analysis, and real-time decision support capabilities with the accuracy of full-scale models.

[Summary of the practice guideline for the diagnosis and treatment of ADHD in adolescents and adults with addictions].

PubMed

Matthys, Frieda; Joostens, Peter; van den Brink, Wim; Sabbe, Bernard

2013-01-01

Various guidelines are available for the diagnosis and treatment of ADHD in adults, but not for patients with ADHD and a comorbid substance use disorder (SUD). In 2010, the Addiction Medicine Working Party, a division of the VAD (Verenigingvoor Alcohol- en andere Drugproblemen/Association for Alcohol and other Drug Problems) developed a practice guideline on how, when and by whom ADHD can be diagnosed in patients with an addiction, and how these patients should be treated. Given the high prevalence of ADHD in treatment-seeking SUD patients and the availability of valid screening instruments, all SUD patients should be screened for ADHD as soon as their drug use has stabilized. Acquiring information from external sources as well as clinical observation and questionnaires are important tools for the establishment of the diagnosis of ADHD. Integrated treatment primarily includes psycho-education, coaching and cognitive behavioural therapy in addition to pharmacotherapy. Evidence-based treatments for addiction may also be effective in patients with concomitant ADHD, provided the methods are adapted to the limitations that are associated with this condition.

Length-free near infrared measurement of newborn malnutrition

NASA Astrophysics Data System (ADS)

Mustafa, Fatin Hamimi; Bek, Emily J.; Huvanandana, Jacqueline; Jones, Peter W.; Carberry, Angela E.; Jeffery, Heather E.; Jin, Craig T.; McEwan, Alistair L.

2016-11-01

Under-nutrition in neonates can cause immediate mortality, impaired cognitive development and early onset adult disease. Body fat percentage measured using air-displacement-plethysmography has been found to better indicate under-nutrition than conventional birth weight percentiles. However, air-displacement-plethysmography equipment is expensive and non-portable, so is not suited for use in developing communities where the burden is often the greatest. We proposed a new body fat measurement technique using a length-free model with near-infrared spectroscopy measurements on a single site of the body - the thigh. To remove the need for length measurement, we developed a model with five discrete wavelengths and a sex parameter. The model was developed using air-displacement-plethysmography measurements in 52 neonates within 48 hours of birth. We identified instrumentation required in a low-cost LED-based screening device and incorporated a receptor device that can increase the amount of light collected. This near-infrared method may be suitable as a low cost screening tool for detecting body fat levels and monitoring nutritional interventions for malnutrition in neonates and young children in resource-constrained communities.

Prevalence of dementia in African-Caribbean compared with UK-born White older people: two-stage cross-sectional study.

PubMed

Adelman, Simon; Blanchard, Martin; Rait, Greta; Leavey, Gerard; Livingston, Gill

2011-08-01

Preliminary studies in the UK, all using screening instruments of unknown cultural validity, indicate that there may be an increased prevalence of dementia in African-Caribbean people, possibly related to vascular risk factors and potentially amenable to preventative measures. To determine the prevalence of dementia in older people of African-Caribbean country of birth compared with their White UK-born counterparts. A total of 218 people of African-Caribbean country of birth and 218 White UK-born people aged ≥60 years were recruited from five general practices in North London. Those who screened positive for cognitive impairment using a culturally valid instrument were offered a standardised diagnostic interview. Two independent assessors diagnosed dementia according to standard operationalised criteria. African-Caribbean participants were 2 years younger, and those with dementia nearly 8 years younger than their White counterparts. The prevalence of dementia was significantly higher in the African-Caribbean (9.6%) than the White group (6.9%) after adjustment for the confounders age and socioeconomic status (odds ratio (OR) = 3.1, 95%CI 1.3-7.3, P = 0.012). There is an increased prevalence of dementia in older people of African-Caribbean country of birth in the UK and at younger ages than in the indigenous White population. These findings have implications for service provision and preventive interventions. Further research is needed to explore the role of vascular risk factors and social adversity in the excess of dementia in this population.

Relationship between cognitive impairment and depression in dialysis patients.

PubMed

Jung, San; Lee, Young-Ki; Choi, Sun Ryoung; Hwang, Sung-Hee; Noh, Jung-Woo

2013-11-01

Patients with chronic kidney disease frequently show cognitive dysfunction. The association of depression and cognitive function is not well known in maintenance dialysis patients. We evaluated cognitive impairment and depression, as well as their relationship in regards to methods of dialysis, maintenance hemodialysis (MHD) and chronic peritoneal dialysis (CPD). Fifty-six maintenance dialysis patients were recruited and their clinical and laboratory data were collected. The Korean version of the mini-mental state exam (K-MMSE) was applied to screen the patient's cognitive function, while the Korean version of the Beck Depression Inventory (K-BDI) was used for depression screening. The average age of the participants was 54.2±10.2 years; 29 (51.8%) were female. The average dialysis vintage was 4.2±3.8 years. The CPD group showed significantly higher K-MMSE score (27.8±2.9 vs. 26.1±3.1, p=0.010) and lower K-BDI score (12.0±8.4 vs. 20.2±10.4, p=0.003) compared with the MHD group. The percentage of patients with depression symptoms was higher in the MHD group (51.7% vs. 18.5%). There was a negative correlation between cognitive function and prevalence of depressive symptoms. Depression and education level were shown to be independent predictors for cognitive impairment in multivariate analysis. Cognitive impairment was closely correlated with depression. It is important to detect cognitive impairment and depression early in maintenance dialysis patients with simple bedside screening tools.

Screening patients with stroke for rehabilitation needs: validation of the post-stroke rehabilitation guidelines.

PubMed

Edwards, Dorothy F; Hahn, Michele G; Baum, Carolyn M; Perlmutter, Monica S; Sheedy, Catherine; Dromerick, Alexander W

2006-03-01

The authors assessed patients with acute stroke to determine whether the systematic use of brief screening measures would more efficiently detect cognitive and sensory impairment than standard clinical practice. Fifty-three patients admitted to an acute stroke unit were assessed within 10 days of stroke onset. Performance on the screening measures was compared to information obtained from review of the patient's chart at discharge. Cognition, language, visual acuity, visual-spatial neglect, hearing, and depression were evaluated. Formal screening detected significantly more impairments than were noted in patient charts in every domain. Only 3 patients had no impairments identified on screening; all remaining patients had at least 1 impairment detected by screening that was not documented in the chart. Thirty-five percent had 3 or more undetected impairments. Memory impairment was most likely to be noted in the chart; for all other domains tested, undocumented impairment ranged from 61% (neglect) to 97% (anomia). Many acute stroke patients had cognitive and perceptual deficits that were not documented in their charts. These data support the Post-Stroke Rehabilitation Guidelines for systematic assessment even when deficits are not immediately apparent. Systematic screening may improve discharge planning, rehabilitation treatment, and long-term outcome of persons with stroke.

Social Cognitive Mediators of Sociodemographic Differences in Colorectal Cancer Screening Uptake

PubMed Central

Lo, Siu Hing; Waller, Jo; Vrinten, Charlotte; Kobayashi, Lindsay; von Wagner, Christian

2015-01-01

Background. This study examined if and how sociodemographic differences in colorectal cancer (CRC) screening uptake can be explained by social cognitive factors. Methods. Face-to-face interviews were conducted with individuals aged 60–70 years (n = 1309) living in England as part of a population-based omnibus survey. Results. There were differences in screening uptake by SES, marital status, ethnicity, and age but not by gender. Perceived barriers (stand. b = −0.40, p < 0.001), social norms (stand. b = 0.33, p < 0.001), and screening knowledge (stand. b = 0.17, p < 0.001) had independent associations with uptake. SES differences in uptake were mediated through knowledge, social norms, and perceived barriers. Ethnic differences were mediated through knowledge. Differences in uptake by marital status were primarily mediated through social norms and to a lesser extent through knowledge. Age differences were largely unmediated, except for a small mediated effect via social norms. Conclusions. Sociodemographic differences in CRC screening uptake were largely mediated through social cognitive factors. Impact. Our findings suggest that multifaceted interventions might be needed to reduce socioeconomic inequalities. Ethnic differences might be reduced through improved screening knowledge. Normative interventions could emphasise screening as an activity endorsed by important others outside the immediate family to appeal to a wider audience. PMID:26504782

The Value of Pre-Screening in the Alzheimer’s Prevention Initiative (API) Autosomal Dominant Alzheimer’s Disease Trial

PubMed Central

Rios-Romenets, S.; Giraldo-Chica, M.; López, H.; Piedrahita, F.; Ramos, C.; Acosta-Baena, N.; Muñoz, C.; Ospina, P.; Tobón, C.; Cho, W.; Ward, M.; Langbaum, J.B.; Tariot, P.N.; Reiman, E.M.; Lopera, F.

2018-01-01

The Alzheimer’s Prevention Initiative (API) Autosomal Dominant Alzheimer’s Disease (ADAD) trial evaluates the anti-amyloid-β antibody crenezumab in cognitively unimpaired persons who, based on genetic background and age, are at high imminent risk of clinical progression, and provides a powerful test of the amyloid hypothesis. The Neurosciences Group of Antioquia implemented a pre-screening process with the goals of decreasing screen failures and identifying participants most likely to adhere to trial requirements of the API ADAD trial in cognitively unimpaired members of Presenilin1 E280A mutation kindreds. The pre-screening failure rate was 48.2%: the primary reason was expected inability to comply with the protocol, chiefly due to work requirements. More carriers compared to non-carriers, and more males compared to females, failed pre-screening. Carriers with illiteracy or learning/comprehension difficulties failed pre-screening more than non-carriers. With the Colombian API Registry and our prescreening efforts, we randomized 169 30–60 year-old cognitively unimpaired carriers and 83 non-carriers who agreed to participate in the trial for at least 60 months. Our findings suggest multiple benefits of implementing a pre-screening process for enrolling prevention trials in ADAD. PMID:29405233

Autism Developmental Profiles and Cooperation with Oral Health Screening.

PubMed

Du, Rennan Y; Yiu, Cynthia C Y; Wong, Virginia C N; McGrath, Colman P

2015-09-01

To determine the associations between autism developmental profiles and cooperation with an oral health screening among preschool children with autism spectrum disorders (ASDs). A random sample of Special Child Care Centres registered with the Government Social Welfare Department in Hong Kong was selected (19 out of 37 Centres). All preschool children with ASDs were invited to participate in the oral health survey and 347 children agreed to participate (among 515 invited). A checklist of autism developmental profiles: (1) level of cognitive functioning, (2) social skills development, (3) communication skills development, (4) reading skills and (5) challenging behaviours was ascertained. Feasibility of conducting oral health screening in preschool children with ASDs was associated with their cognitive functioning (p = 0.001), social skills development (p = 0.002), communication skills development (p < 0.001), reading skills (p < 0.001) and challenging behaviours (p = 0.06). In regression analyses accounting for age (in months) and gender, inability to cooperate with an oral health screening was associated with high level of challenging behaviours (OR 10.50, 95 % CI 2.89-38.08, p < 0.001) and reduced cognitive functioning (OR 5.29, 95 % CI 1.14-24.61, p = 0.034). Age (in months) was positively associated with likelihood of cooperative behaviour with an oral health screening (OR 1.06, 95 % CI 1.03, 1.08, p < 0.001). Feasibility of conducting population-wide oral health screening among preschool children with ASDs is associated with their developmental profiles; and in particular levels of cognitive functioning, and challenging behaviours.

A deep learning and novelty detection framework for rapid phenotyping in high-content screening

PubMed Central

Sommer, Christoph; Hoefler, Rudolf; Samwer, Matthias; Gerlich, Daniel W.

2017-01-01

Supervised machine learning is a powerful and widely used method for analyzing high-content screening data. Despite its accuracy, efficiency, and versatility, supervised machine learning has drawbacks, most notably its dependence on a priori knowledge of expected phenotypes and time-consuming classifier training. We provide a solution to these limitations with CellCognition Explorer, a generic novelty detection and deep learning framework. Application to several large-scale screening data sets on nuclear and mitotic cell morphologies demonstrates that CellCognition Explorer enables discovery of rare phenotypes without user training, which has broad implications for improved assay development in high-content screening. PMID:28954863

Movie for the Assessment of Social Cognition (MASC): Spanish validation.

PubMed

Lahera, G; Boada, L; Pousa, E; Mirapeix, I; Morón-Nozaleda, G; Marinas, L; Gisbert, L; Pamiàs, M; Parellada, M

2014-08-01

We present the Spanish validation of the "Movie for the Assessment of Social Cognition" instrument (MASC-SP). We recruited 22 adolescents and young adults with Asperger syndrome and 26 participants with typical development. The MASC-SP and three other social cognition instruments (Ekman Pictures of Facial Affect test, Reading the Mind in the Eyes Test, and Happé's Strange Stories) were administered to both groups. Individuals with Asperger syndrome had significantly lower scores in all measures of social cognition. The MASC-SP showed strong correlations with all three measures and relative independence of general cognitive functions. Internal consistency was optimal (0.86) and the test-retest was good. The MASC-SP is an ecologically valid and useful tool for assessing social cognition in the Spanish population.

The Cognitive Processes Associated with Occupational/Career Indecision: A Model for Gifted Adolescents

ERIC Educational Resources Information Center

Jung, Jae Yup

2013-01-01

This study developed and tested a new model of the cognitive processes associated with occupational/career indecision for gifted adolescents. A survey instrument with rigorous psychometric properties, developed from a number of existing instruments, was administered to a sample of 687 adolescents attending three academically selective high schools…

Measurement in the Service of Mathematics Education Research: The Case of Cognitively Guided Instruction

ERIC Educational Resources Information Center

Helding, Brandon Alan

2010-01-01

The purpose of this dissertation is to demonstrate one iterate of a process for developing a measurement instrument for student knowledge within educational interventions. Student mathematical knowledge is framed within Cognitively Guided Instruction (CGI) and its tenets. That is, the construct underlying the measurement instrument corresponded…

Learning Style Profile Handbook: I. Developing Cognitive Skills.

ERIC Educational Resources Information Center

Jenkins, John M.; And Others

The National Association of Secondary School Principals (NASSP) published a new learning style instrument in 1986--the NASSP Learning Style Profile (LSP). The LSP yields independent scores on 24 discrete elements of learning style. Its purpose is to provide educators with a well-validated and easy to use instrument for diagnosing cognitive styles,…

The Modified Telephone Interview for Cognitive Status is More Predictive of Memory Abilities Than the Mini-Mental State Examination.

PubMed

Duff, Kevin; Tometich, Danielle; Dennett, Kathryn

2015-09-01

Although not as popular as the Mini-Mental State Examination (MMSE), the modified Telephone Interview for Cognitive Status (mTICS) has some distinct advantages when screening cognitive functioning in older adults. The current study compared these 2 cognitive screening measures in their ability to predict performance on a memory composite (ie, delayed recall of verbal and visual information) in a cohort of 121 community-dwelling older adults, both at baseline and after 1 year. Both the MMSE and the mTICS significantly correlated with the memory composite at baseline (r's of .41 and .62, respectively) and at 1 year (r's of .36 and .50, respectively). At baseline, stepwise linear regression indicated that the mTICS and gender best predicted the memory composite score (R (2) = .45, P < .001), and the MMSE and other demographic variables did not significantly improve the prediction. At 1 year, the results were very similar. Despite its lesser popularity, the mTICS may be a more attractive option when screening for cognitive abilities in this age range. © The Author(s) 2015.

Validity of Montreal Cognitive Assessment in non-english speaking patients with Parkinson's disease.

PubMed

Krishnan, Syam; Justus, Sunitha; Meluveettil, Radhamani; Menon, Ramshekhar N; Sarma, Sankara P; Kishore, Asha

2015-01-01

The Montreal Cognitive Assessment is a brief and easy screening tool for accurately testing cognitive dysfunction in Parkinson's disease. We tested its validity for use in non-English (Malayalam) speaking patients with Parkinson's disease. We developed a Malayalam (a south-Indian language) version of Montreal Cognitive Assessment and applied to 70 patients with Parkinson's disease and 60 age- and education-matched healthy controls. Metric properties were assessed, and the scores were compared with the performance in validated Malayalam versions of Mini Mental Status Examination and Addenbrooke's Cognitive Examination. The Montreal Cognitive Assessment-Malayalam showed good internal consistency and test-retest reliability and its scores correlated with Mini Mental Status Examination (patients: R = 0.70; P < 0.001; healthy controls: R = 0.26; P = 0.04) and Addenbrooke's Cognitive Examination (patients: R = 0.8; P < 0.001; healthy controls: R = 0.52; P < 0.001) scores. This study establishes the reliability of cross-cultural adaptation of Montreal Cognitive Assessment for assessing cognition in Malayalam-speaking Parkinson's disease patients for early screening and potential future interventions for cognitive dysfunction.

Evidence-based guideline: assessment and management of psychiatric disorders in individuals with MS: report of the Guideline Development Subcommittee of the American Academy of Neurology.

PubMed

Minden, Sarah L; Feinstein, Anthony; Kalb, Rosalind C; Miller, Deborah; Mohr, David C; Patten, Scott B; Bever, Christopher; Schiffer, Randolph B; Gronseth, Gary S; Narayanaswami, Pushpa

2014-01-14

To make evidence-based recommendations for screening, diagnosing, and treating psychiatric disorders in individuals with multiple sclerosis (MS). We reviewed the literature (1950 to August 2011) and evaluated the available evidence. Clinicians may consider using the Center for Neurologic Study Emotional Lability Scale to screen for pseudobulbar affect (Level C). Clinicians may consider the Beck Depression Inventory and a 2-question tool to screen for depressive disorders and the General Health Questionnaire to screen for broadly defined emotional disturbances (Level C). Evidence is insufficient to support/refute the use of other screening tools, the possibility that somatic/neurovegetative symptoms affect these tools' accuracy, or the use of diagnostic instruments or clinical evaluation procedures for identifying psychiatric disorders in MS (Level U). Clinicians may consider a telephone-administered cognitive behavioral therapy program for treating depressive symptoms (Level C). Although pharmacologic and nonpharmacologic therapies are widely used to treat depressive and anxiety disorders in individuals with MS, evidence is insufficient to support/refute the use of the antidepressants and individual and group therapies reviewed herein (Level U). For pseudobulbar affect, a combination of dextromethorphan and quinidine may be considered (Level C). Evidence is insufficient to determine the psychiatric effects in individuals with MS of disease-modifying and symptomatic therapies and corticosteroids; risk factors for suicide; and treatment of psychotic disorders (Level U). Research is needed on the effectiveness in individuals with MS of pharmacologic and nonpharmacologic treatments frequently used in the non-MS population.

Clinical Assessment of Cognitive Function in Patients with Head and Neck Cancer: Prevalence and Correlates.

PubMed

Williams, Amy M; Lindholm, Jamie; Siddiqui, Farzan; Ghanem, Tamer A; Chang, Steven S

2017-11-01

Objective Identify the prevalence and clinical correlates of cognitive impairment in patients presenting for treatment of head and neck cancer (HNC) using brief screening within a multidisciplinary care team. Study Design A case series with planned data collection of cognitive function, quality of life (QoL), and psychosocial variables. Setting Urban Midwest academic medical center. Subjects and Methods In total, 209 consecutive patients with a diagnosis of HNC between August 2015 and September 2016 who had a pretreatment assessment with a clinical health psychologist. At pretreatment assessment, the Montreal Cognitive Assessment (MoCA), a brief screening tool for cognitive function, was administered along with a semistructured interview to gather information on psychiatric symptoms, social support, and substance use. Patient information, including demographics, clinical variables, and psychosocial variables, was extracted via chart review. A subset of patients with HNC completed the Functional Assessment of Cancer Therapy-Head and Neck Cancer at pretreatment assessment and was included in the QoL analyses. Results Cognitive impairment was associated with current alcohol use, past tobacco use and number of pack years, time in radiotherapy, and adherence to treatment recommendations. Social, emotional, and functional QoL scales were associated with cognitive impairment, including executive function, language, and memory. Conclusion Cognitive impairment is common in patients with HNC, and there are important associations between cognitive impairment and psychosocial, QoL, and treatment adherence variables. The results argue for the incorporation of cognitive screening as part of pretreatment assessment for patients, as well as further research into more direct, causal relationships via longitudinal, prospective studies.

Mobile ultra-clean unidirectional airflow screen reduces air contamination in a simulated setting for intra-vitreal injection.

PubMed

Lapid-Gortzak, Ruth; Traversari, Roberto; van der Linden, Jan Willem; Lesnik Oberstein, Sarit Y; Lapid, Oren; Schlingemann, Reinier O

2017-02-01

The aim of this study is to determine whether the use of a mobile ultra-clean laminar airflow screen reduces the air-borne particle counts in the setting of a simulated procedure of an intra-vitreal injection. A mobile ultra-clean unidirectional airflow (UDF) screen was tested in a simulated procedure for intra-vitreal injections in a treatment room without mechanical ventilation. One UDF was passed over the instrument tray and the surgical area. The concentration of particles was measured in the background, over the instrument table, and next to the ocular area. The degree of protection was calculated at the instrument table and at the surgical site. Use of the UDF mobile screen reduced the mean particle concentration (particles > 0.3 microns) on the instrument table by a factor of at least 100.000 (p < 0.05), and over the patient's eye by at least a factor of 436 (p < 0.05), which in clinical practice translates into significantly reduced air contamination. Mobile UDF screen reduces the mean particle concentration substantially. The mobile UDF screen may therefore allow for a safer procedural environment for ambulatory care procedures such as intra-vitreal injections in treatment rooms.

Cognitive Modifiability and Cognitive Performance of Deaf and Hearing Preschool Children.

ERIC Educational Resources Information Center

Tzuriel, David; Caspi, Naomi

1992-01-01

This study, with 26 deaf and 26 pair-matched hearing preschool children, first assessed their cognitive modifiability using dynamic and static-convention instruments, and then compared the factorial pattern of the cognitive measures in both groups. Results are interpreted according to the Structural Cognitive Modifiability and Mediated Learning…

Feasibility of using touch screen technology for early cognitive assessment in children.

PubMed

Twomey, Deirdre M; Wrigley, Conal; Ahearne, Caroline; Murphy, Raegan; De Haan, Michelle; Marlow, Neil; Murray, Deirdre M

2018-03-13

To explore the feasibility of using a touch screen assessment tool to measure cognitive capacity in toddlers. 112 typically developing children with a median age of 31 months (IQR: 26-34) interacted with a touch screen cognitive assessment tool. We examined the sensitivity of the tool to age-related changes in cognition by comparing the number of items completed, speed of task completion and accuracy in two age groups; 24-29 months versus 30-36 months. Children aged 30-36 months completed more tasks (median: 18, IQR: 18-18) than those aged 24-29 months (median: 17, IQR: 15-18). Older children also completed two of the three working memory tasks and an object permanence task faster than their younger peers. Children became faster at completing the working memory items with each exposure and registered similar completion times on the hidden object retrieval items, despite task demands being twofold on the second exposure. A novel item required children to integrate what they had learnt on preceding items. The older group was more likely to complete this item and to do so faster than the younger group. Children as young as 24 months can complete items requiring cognitive engagement on a touch screen device, with no verbal instruction and minimal child-administrator interaction. This paves the way for using touch screen technology for language and administrator independent developmental assessment in toddlers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The validity of the Brain Injury Cognitive Screen (BICS) as a neuropsychological screening assessment for traumatic and non-traumatic brain injury.

PubMed

Vaughan, Frances L; Neal, Jo Anne; Mulla, Farzana Nizam; Edwards, Barbara; Coetzer, Rudi

2017-04-01

The Brain Injury Cognitive Screen (BICS) was developed as an in-service cognitive assessment battery for acquired brain injury patients entering community rehabilitation. The BICS focuses on domains that are particularly compromised following TBI, and provides a broader and more detailed assessment of executive function, attention and information processing than comparable screening assessments. The BICS also includes brief assessments of perception, naming, and construction, which were predicted to be more sensitive to impairments following non-traumatic brain injury. The studies reported here examine preliminary evidence for its validity in post-acute rehabilitation. In Study 1, TBI patients completed the BICS and were compared with matched controls. Patients with focal lesions and matched controls were compared in Study 2. Study 3 examined demographic effects in a sample of normative data. TBI and focal lesion patients obtained significantly lower composite memory, executive function and attention and information processing BICS scores than healthy controls. Injury severity effects were also obtained. Logistic regression analyses indicated that each group of BICS memory, executive function and attention measures reliably differentiated TBI and focal lesion participants from controls. Design Recall, Prospective Memory, Verbal Fluency, and Visual Search test scores showed significant independent regression effects. Other subtest measures showed evidence of sensitivity to brain injury. The study provides preliminary evidence of the BICS' sensitivity to cognitive impairment caused by acquired brain injury, and its potential clinical utility as a cognitive screen. Further validation based on a revised version of the BICS and more normative data are required.

Pavlovian to instrumental transfer of control in a human learning task.

PubMed

Nadler, Natasha; Delgado, Mauricio R; Delamater, Andrew R

2011-10-01

Pavlovian learning tasks have been widely used as tools to understand basic cognitive and emotional processes in humans. The present studies investigated one particular task, Pavlovian-to-instrumental transfer (PIT), with human participants in an effort to examine potential cognitive and emotional effects of Pavlovian cues upon instrumentally trained performance. In two experiments, subjects first learned two separate instrumental response-outcome relationships (i.e., R1-O1 and R2-O2) and then were exposed to various stimulus-outcome relationships (i.e., S1-O1, S2-O2, S3-O3, and S4-) before the effects of the Pavlovian stimuli on instrumental responding were assessed during a non-reinforced test. In Experiment 1, instrumental responding was established using a positive-reinforcement procedure, whereas in Experiment 2, a quasi-avoidance learning task was used. In both cases, the Pavlovian stimuli exerted selective control over instrumental responding, whereby S1 and S2 selectively elevated the instrumental response with which it shared an outcome. In addition, in Experiment 2, S3 exerted a nonselective transfer of control effect, whereby both responses were elevated over baseline levels. These data identify two ways, one specific and one general, in which Pavlovian processes can exert control over instrumental responding in human learning paradigms, suggesting that this method may serve as a useful tool in the study of basic cognitive and emotional processes in human learning.

Pavlovian to Instrumental Transfer of Control in a Human Learning Task

PubMed Central

Nadler, Natasha; Delgado, Mauricio R.; Delamater, Andrew R.

2011-01-01

Pavlovian learning tasks have been widely used as tools to understand basic cognitive and emotional processes in humans. The present studies investigated one particular task, Pavlovian-to-instrumental transfer (PIT), with human participants in an effort to examine potential cognitive and emotional effects of Pavlovian cues upon instrumentally-trained performance. In two experiments subjects first learned two separate instrumental response-outcome relationships (R1-O1, R2-O2) and then were exposed to various stimulus-outcome relationships (S1-O1, S2-O2, S3-O3, S4-) before the effects of the Pavlovian stimuli on instrumental responding were assessed during a nonreinforced test. In Experiment 1 instrumental responding was established using a positive reinforcement procedure whereas in Experiment 2 a quasi-avoidance learning task was used. In both cases the Pavlovian stimuli exerted selective control over instrumental responding, whereby S1 & S2 selectively elevated the instrumental response with which it shared an outcome. In addition, in Experiment 2, S3 exerted a nonselective transfer of control effect, whereby both responses were elevated over baseline levels. These data identify two ways, one specific and one general, in which Pavlovian processes can exert control over instrumental responding in human learning paradigms, and suggest that this method may serve as a useful tool in the study of basic cognitive and emotional processes in human learning. PMID:21534664

Parkinson's and Alzheimer's diseases in Costa Rica: a feasibility study toward a national screening program

PubMed Central

Wesseling, Catharina; Román, Norbel; Quirós, Indiana; Páez, Laura; García, Vilma; María Mora, Ana; Juncos, Jorge L.; Steenland, Kyle N.

2013-01-01

Background The integration of mental and neurologic services in healthcare is a global priority. The universal Social Security of Costa Rica aspires to develop national screening of neurodegenerative disorders among the elderly, as part of the non-communicable disease agenda. Objective This study assessed the feasibility of routine screening for Parkinson's disease (PD) and Alzheimer's disease (AD) within the public healthcare system of Costa Rica. Design The population (aged ≥65) in the catchment areas of two primary healthcare clinics was targeted for motor and cognitive screening during routine annual health check-ups. The screening followed a tiered three-step approach, with increasing specificity. Step 1 involved a two-symptom questionnaire (tremor-at-rest; balance) and a spiral drawing test for motor assessment, as well as a three-word recall and animal category fluency test for cognitive assessment. Step 2 (for those failing Step 1) was a 10-item version of the Unified Parkinson Disease Rating Scale and the Mini-Mental State Examination. Step 3 (for those failing Step 2) was a comprehensive neurologic exam with definitive diagnosis of PD, AD, mild cognitive impairment (MCI), other disorders, or subjects who were healthy. Screening parameters and disease prevalence were calculated. Results Of the 401 screened subjects (80% of target population), 370 (92%), 163 (45%), and 81 (56%) failed in Step 1, Step 2, and Step 3, respectively. Thirty-three, 20, and 35 patients were diagnosed with PD, AD, and MCI, respectively (7 were PD with MCI/AD); 90% were new cases. Step 1 sensitivities of motor and cognitive assessments regarding Step 2 were both 93%, and Step 2 sensitivities regarding definitive diagnosis 100 and 96%, respectively. Specificities for Step 1 motor and cognitive tests were low (23% and 29%, respectively) and for Step 2 tests acceptable (76%, 94%). Based on international data, PD prevalence was 3.7 times higher than expected; AD prevalence was as expected. Conclusion Proposed protocol adjustments will increase test specificity and reduce administration time. A routine screening program is feasible within the public healthcare system of Costa Rica. PMID:24378195

Parkinson's and Alzheimer's diseases in Costa Rica: a feasibility study toward a national screening program.

PubMed

Wesseling, Catharina; Román, Norbel; Quirós, Indiana; Páez, Laura; García, Vilma; Mora, Ana María; Juncos, Jorge L; Steenland, Kyle N

2013-12-27

The integration of mental and neurologic services in healthcare is a global priority. The universal Social Security of Costa Rica aspires to develop national screening of neurodegenerative disorders among the elderly, as part of the non-communicable disease agenda. This study assessed the feasibility of routine screening for Parkinson's disease (PD) and Alzheimer's disease (AD) within the public healthcare system of Costa Rica. The population (aged ≥65) in the catchment areas of two primary healthcare clinics was targeted for motor and cognitive screening during routine annual health check-ups. The screening followed a tiered three-step approach, with increasing specificity. Step 1 involved a two-symptom questionnaire (tremor-at-rest; balance) and a spiral drawing test for motor assessment, as well as a three-word recall and animal category fluency test for cognitive assessment. Step 2 (for those failing Step 1) was a 10-item version of the Unified Parkinson Disease Rating Scale and the Mini-Mental State Examination. Step 3 (for those failing Step 2) was a comprehensive neurologic exam with definitive diagnosis of PD, AD, mild cognitive impairment (MCI), other disorders, or subjects who were healthy. Screening parameters and disease prevalence were calculated. Of the 401 screened subjects (80% of target population), 370 (92%), 163 (45%), and 81 (56%) failed in Step 1, Step 2, and Step 3, respectively. Thirty-three, 20, and 35 patients were diagnosed with PD, AD, and MCI, respectively (7 were PD with MCI/AD); 90% were new cases. Step 1 sensitivities of motor and cognitive assessments regarding Step 2 were both 93%, and Step 2 sensitivities regarding definitive diagnosis 100 and 96%, respectively. Specificities for Step 1 motor and cognitive tests were low (23% and 29%, respectively) and for Step 2 tests acceptable (76%, 94%). Based on international data, PD prevalence was 3.7 times higher than expected; AD prevalence was as expected. Proposed protocol adjustments will increase test specificity and reduce administration time. A routine screening program is feasible within the public healthcare system of Costa Rica.

A personal health information toolkit for health intervention research.

PubMed

Kizakevich, Paul N; Eckhoff, Randall; Weger, Stacey; Weeks, Adam; Brown, Janice; Bryant, Stephanie; Bakalov, Vesselina; Zhang, Yuying; Lyden, Jennifer; Spira, James

2014-01-01

With the emergence of mobile health (mHealth) apps, there is a growing demand for better tools for developing and evaluating mobile health interventions. Recently we developed the Personal Health Intervention Toolkit (PHIT), a software framework which eases app implementation and facilitates scientific evaluation. PHIT integrates self-report and physiological sensor instruments, evidence-based advisor logic, and self-help interventions such as meditation, health education, and cognitive behavior change. PHIT can be used to facilitate research, interventions for chronic diseases, risky behaviors, sleep, medication adherence, environmental monitoring, momentary data collection health screening, and clinical decision support. In a series of usability evaluations, participants reported an overall usability score of 4.5 on a 1-5 Likert scale and an 85 score on the System Usability Scale, indicating a high percentile rank of 95%.

A preliminary psychometric evaluation of the eight-item cognitive load scale.

PubMed

Pignatiello, Grant A; Tsivitse, Emily; Hickman, Ronald L

2018-04-01

The aim of this article is to report the psychometric properties of the eight-item cognitive load scale. According to cognitive load theory, the formatting and delivery of healthcare education influences the degree to which patients and/or family members can engage their working memory systems for learning. However, despite its relevance, cognitive load has not yet been evaluated among surrogate decision makers exposed to electronic decision support for healthcare decisions. To date, no psychometric analyses of instruments evaluating cognitive load have been reported within healthcare settings. A convenience sample of 62 surrogate decision makers for critically ill patients were exposed to one of two healthcare decision support interventions were recruited from four intensive care units at a tertiary medical center in Northeast Ohio. Participants were administered a battery of psychosocial instruments and the eight-item cognitive load scale (CLS). The CLS demonstrated a bidimensional factor structure with acceptable discriminant validity and internal consistency reliability (Cronbach's α = 0.75 and 0.89). The CLS is a psychometrically sound instrument that may be used in the evaluation of decision support among surrogate decision makers of the critically ill. The authors recommend application of the cognitive load scale in the evaluation and development of healthcare education and interventions. Copyright © 2018 Elsevier Inc. All rights reserved.

Telephone-Based Cognitive-Behavioral Screening for Frontotemporal Changes in Patients with Amyotrophic Lateral Sclerosis (ALS)

PubMed Central

Christodoulou, Georgia; Gennings, Chris; Hupf, Jonathan; Factor-Litvak, Pam; Murphy, Jennifer; Goetz, Raymond R.; Mitsumoto, Hiroshi

2017-01-01

Objective To establish a valid and reliable battery of measures to evaluate frontotemporal dementia (FTD) in patients with ALS over the phone. Methods Thirty-one subjects were administered either in-person or telephone-based screening followed by the opposite mode of testing two weeks later, using a modified version of the UCSF Cognitive Screening Battery. Results Equivalence testing was performed for in-person and telephone-based tests. The standard ALS Cognitive Behavioral Screen (ALS-CBS) showed statistical equivalence at the 5% significance level when compared to a revised phone-version of the ALS-CBS. In addition, the Controlled Oral Word Association Test (COWAT) and Center for Neurologic Study-Lability Scale (CNS-LS) were also found to be equivalent at the 5% and 10% significance level respectively. Similarly, the Mini-Mental State Examination (MMSE) and the well-established Telephone Interview for Cognitive Status (TICS) were also statistically equivalent. Equivalence could not be claimed for the ALS-Frontal Behavioral Inventory (ALS-FBI) caregiver interview and the Written Verbal Fluency Index (WVFI). Conclusions Our study suggests that telephone-based versions of the ALS-CBS, COWAT, and CNS-LS may offer clinicians valid tools to detect frontotemporal changes in the ALS population. Development of telephone-based cognitive testing for ALS could become an integral resource for population-based research in the future. PMID:27121545

Telephone based cognitive-behavioral screening for frontotemporal changes in patients with amyotrophic lateral sclerosis (ALS).

PubMed

Christodoulou, Georgia; Gennings, Chris; Hupf, Jonathan; Factor-Litvak, Pam; Murphy, Jennifer; Goetz, Raymond R; Mitsumoto, Hiroshi

Our objective was to establish a valid and reliable battery of measures to evaluate frontotemporal dementia (FTD) in patients with ALS over the telephone. Thirty-one subjects were administered either in-person or by telephone-based screening followed by the opposite mode of testing two weeks later, using a modified version of the UCSF Cognitive Screening Battery. Equivalence testing was performed for in-person and telephone based tests. The standard ALS Cognitive Behavioral Screen (ALS-CBS) showed statistical equivalence at the 5% significance level compared to a revised phone version of the ALS-CBS. In addition, the Controlled Oral Word Association Test (COWAT) and Center for Neurologic Study-Lability Scale (CNS-LS) were also found to be equivalent at the 5% and 10% significance level, respectively. Similarly, the Mini-Mental State Examination (MMSE) and the well-established Telephone Interview for Cognitive Status (TICS) were also statistically equivalent. Equivalence could not be claimed for the ALS-Frontal Behavioral Inventory (ALS-FBI) caregiver interview and the Written Verbal Fluency Index (WVFI). In conclusion, our study suggests that telephone-based versions of the ALS-CBS, COWAT, and CNS-LS may offer clinicians valid tools to detect frontotemporal changes in the ALS population. Development of telephone based cognitive testing for ALS could become an integral resource for population based research in the future.

Taguchi-generalized regression neural network micro-screening for physical and sensory characteristics of bread.

PubMed

Besseris, George J

2018-03-01

Generalized regression neural networks (GRNN) may act as crowdsourcing cognitive agents to screen small, dense and complex datasets. The concurrent screening and optimization of several complex physical and sensory traits of bread is developed using a structured Taguchi-type micro-mining technique. A novel product outlook is offered to industrial operations to cover separate aspects of smart product design, engineering and marketing. Four controlling factors were selected to be modulated directly on a modern production line: 1) the dough weight, 2) the proofing time, 3) the baking time, and 4) the oven zone temperatures. Concentrated experimental recipes were programmed using the Taguchi-type L 9 (3 4 ) OA-sampler to detect potentially non-linear multi-response tendencies. The fused behavior of the master-ranked bread characteristics behavior was smart sampled with GRNN-crowdsourcing and robust analysis. It was found that the combination of the oven zone temperatures to play a highly influential role in all investigated scenarios. Moreover, the oven zone temperatures and the dough weight appeared to be instrumental when attempting to synchronously adjusting all four physical characteristics. The optimal oven-zone temperature setting for concurrent screening-and-optimization was found to be 270-240 °C. The optimized (median) responses for loaf weight, moisture, height, width, color, flavor, crumb structure, softness, and elasticity are: 782 g, 34.8 %, 9.36 cm, 10.41 cm, 6.6, 7.2, 7.6, 7.3, and 7.0, respectively.

Symptom Overlap and Screening for Symptoms of Attention-Deficit/Hyperactivity Disorder and Psychosis Risk in Help-Seeking Psychiatric Patients

PubMed Central

Corbisiero, Salvatore; Riecher-Rössler, Anita; Buchli-Kammermann, Jacqueline; Stieglitz, Rolf-Dieter

2017-01-01

Symptoms of attention-deficit/hyperactivity disorder (ADHD) and psychosis risk share features which might represent an early vulnerability marker for schizophrenia. Early detection of individuals with this symptomatic overlap is relevant and may assist clinicians in their decision making for diagnosis and treatment. This study sought to analyze the capability of different instruments in the screening of patients for ADHD symptoms or at psychosis risk, assess their classification accuracy, and describe the extent of symptoms overlap between them. 243 adult patients completed one instrument screening for ADHD and two instruments screening for psychosis risk symptoms [Adult ADHD Self-Report Scale Symptom Checklist (ASRS-v1.1); Prodromal Questionnaire Brief Version (PQ-16); Self-Screen Prodrome (SPro)]. The ability of these instruments to distinguish between the symptomaticity of these patients appears modest. The most satisfactory scale to identify subjects at psychosis risk was SPro with its subscale psychosis risk. ASRS-v1.1 showed good reliability in assessing individuals as not having ADHD symptoms and had higher probability to achieve its own and the cut-off of another questionnaire. Subjects having symptoms of psychosis risk and ADHD showed elevated symptomatology. Reliable instruments capable of separating ADHD symptoms from those of psychosis risk are needed to better identify the symptomatic overlap of this two conditions. PMID:29163233

An Experimental Evaluation of New Measures of Cognitive and Non-cognitive Performance for Elementary School Children.

ERIC Educational Resources Information Center

Emrick, John A.

Two experiments to develop psychometric and administrative data on instruments designated for a testing program with disadvantaged elementary school children were undertaken. These instruments provide measures of growth and development in such diverse areas as verbal expressiveness (the ITPA and the Hertzig/Birch scoring of the PSI), problem…

Examination of Cognitive and Instrumental Functional Performance as Indicators for Driving Cessation Risk across 3 Years

ERIC Educational Resources Information Center

Ackerman, Michelle L.; Edwards, Jerri D.; Ross, Lesley A.; Ball, Karlene K.; Lunsman, Melissa

2008-01-01

Purpose: The purpose of this study was to prospectively examine the role of cognitive and instrumental functional performance in driving cessation while simultaneously accounting for any contributions of demographics, vision, physical performance, and health among a sample of older adults without dementia. Design and Methods: Included in the…

School Self-Evaluation Instruments and Cognitive Validity. Do Items Capture What They Intend to?

ERIC Educational Resources Information Center

Faddar, Jerich; Vanhoof, Jan; De Maeyer, Sven

2017-01-01

School self-evaluation (SSE) often makes use of questionnaires in order to sketch a picture of the school. How respondents cognitively process questionnaire items determines the validity of SSE results. Still, one readily assumes that respondents interpret and answer items as intended by the instrument developer (referred to as cognitive…

Screenee perception and health-related quality of life in colorectal cancer screening: a review.

PubMed

Pizzo, Elena; Pezzoli, Alessandro; Stockbrugger, Reinhold; Bracci, Enrico; Vagnoni, Emidia; Gullini, Sergio

2011-01-01

Screening for colorectal cancer (CRC) has become established to varying degrees in several Western countries for the past 30 years. Because of its effectiveness, screening has been adopted or is planned in a number of other countries. In most countries, the screening method (e.g., fecal occult blood test [FOBT], sigmoidoscopy) is followed by colonoscopy, for verification. In other countries (e.g., United States, Germany), colonoscopy is the preferred first-line investigation method. However, because colonoscopy is considered to be invasive, might be poorly tolerated, and can be associated with complications, the idea of adopting colonoscopy as the primary screening method suffers. Negative effects of screening methods can reduce participation in programs and thereby negate the desired effect on individual and societal health. At present, there is no generally accepted method either to assess the perception and satisfaction of patients screened or the outcome of the screening procedures in CRC. In this review, we discuss the past development and present availability of instruments to measure health-related quality of life (HRQoL), the scarce studies in which such instruments have been used in screening campaigns, and the findings. We suggest the creation of a specific instrument for the assessment of HRQoL in CRC screening. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Defining and validating a short form Montreal Cognitive Assessment (s-MoCA) for use in neurodegenerative disease

PubMed Central

Roalf, David R; Moore, Tyler M; Wolk, David A; Arnold, Steven E; Mechanic-Hamilton, Dawn; Rick, Jacqueline; Kabadi, Sushila; Ruparel, Kosha; Chen-Plotkin, Alice S; Chahine, Lama M; Dahodwala, Nabila A; Duda, John E; Weintraub, Daniel A; Moberg, Paul J

2016-01-01

Introduction Screening for cognitive deficits is essential in neurodegenerative disease. Screening tests, such as the Montreal Cognitive Assessment (MoCA), are easily administered, correlate with neuropsychological performance and demonstrate diagnostic utility. Yet, administration time is too long for many clinical settings. Methods Item response theory and computerised adaptive testing simulation were employed to establish an abbreviated MoCA in 1850 well-characterised community-dwelling individuals with and without neurodegenerative disease. Results 8 MoCA items with high item discrimination and appropriate difficulty were identified for use in a short form (s-MoCA). The s-MoCA was highly correlated with the original MoCA, showed robust diagnostic classification and cross-validation procedures substantiated these items. Discussion Early detection of cognitive impairment is an important clinical and public health concern, but administration of screening measures is limited by time constraints in demanding clinical settings. Here, we provide as-MoCA that is valid across neurological disorders and can be administered in approximately 5 min. PMID:27071646

Validation of the Middlesex Elderly Assessment of Mental State (MEAMS) as a cognitive screening test in patients with acquired brain injury in Turkey.

PubMed

Kutlay, Sehim; Kuçukdeveci, Ayse A; Elhan, Atilla H; Yavuzer, Gunes; Tennant, Alan

2007-02-28

Assessment of cognitive impairment with a valid cognitive screening tool is essential in neurorehabilitation. The aim of this study was to test the reliability and validity of the Turkish-adapted version of the Middlesex Elderly Assessment of Mental State (MEAMS) among acquired brain injury patients in Turkey. Some 155 patients with acquired brain injury admitted for rehabilitation were assessed by the adapted version of MEAMS at admission and discharge. Reliability was tested by internal consistency, intra-class correlation coefficient (ICC) and person separation index; internal construct validity by Rasch analysis; external construct validity by associations with physical and cognitive disability (FIM); and responsiveness by Effect Size. Reliability was found to be good with Cronbach's alpha of 0.82 at both admission and discharge; and likewise an ICC of 0.80. Person separation index was 0.813. Internal construct validity was good by fit of the data to the Rasch model (mean item fit -0.178; SD 1.019). Items were substantially free of differential item functioning. External construct validity was confirmed by expected associations with physical and cognitive disability. Effect size was 0.42 compared with 0.22 for cognitive FIM. The reliability and validity of the Turkish version of MEAMS as a cognitive impairment screening tool in acquired brain injury has been demonstrated.

Analysis of Gambling in the Media Related to Screens: Immersion as a Predictor of Excessive Use?

PubMed

Rémond, Jean-Jacques; Romo, Lucia

2018-01-02

This study investigates the intricacies between the player interface proposed by the screens, (in particular on smartphone applications or in video games) and gambling. Recent research indicates connections between "immersion" and excessive screen practice. We want to understand the causal-effects between online gambling and the "immersion" variable and understand their relationship and its contingencies. This article empirically investigates whether and how it is possible to observe immersion with its sub-dimensions in gambling on different screens. The objective of this study was to analyze: (1) the costs and benefits associated with gambling practice on screens (2) the link between gambling practice and screen practice (video game, Internet, mobile screen); (3) to observe the propensity to immersion for individuals practicing gambling on screens; and (4) to examine the comorbidities and cognitive factors associated with the practice of gambling on screen. A total of 432 adults (212 men, 220 women), recruited from Ile-de-France (France), responded to a battery of questionnaires. Our study suggests that immersion variables make it possible to understand the cognitive participation of individuals towards screens in general, the practice of gambling on screens and the excessive practice of screens.

Analysis of Gambling in the Media Related to Screens: Immersion as a Predictor of Excessive Use?

PubMed Central

Rémond, Jean-Jacques; Romo, Lucia

2018-01-01

This study investigates the intricacies between the player interface proposed by the screens, (in particular on smartphone applications or in video games) and gambling. Recent research indicates connections between “immersion” and excessive screen practice. We want to understand the causal-effects between online gambling and the “immersion” variable and understand their relationship and its contingencies. This article empirically investigates whether and how it is possible to observe immersion with its sub-dimensions in gambling on different screens. The objective of this study was to analyze: (1) the costs and benefits associated with gambling practice on screens (2) the link between gambling practice and screen practice (video game, Internet, mobile screen); (3) to observe the propensity to immersion for individuals practicing gambling on screens; and (4) to examine the comorbidities and cognitive factors associated with the practice of gambling on screen. A total of 432 adults (212 men, 220 women), recruited from Ile-de-France (France), responded to a battery of questionnaires. Our study suggests that immersion variables make it possible to understand the cognitive participation of individuals towards screens in general, the practice of gambling on screens and the excessive practice of screens. PMID:29301311

Cognitive-Behavioral Therapy. Second Edition. Theories of Psychotherapy Series

ERIC Educational Resources Information Center

Craske, Michelle G.

2017-01-01

In this revised edition of "Cognitive-Behavioral Therapy," Michelle G. Craske discusses the history, theory, and practice of this commonly practiced therapy. Cognitive-behavioral therapy (CBT) originated in the science and theory of classical and instrumental conditioning when cognitive principles were adopted following dissatisfaction…

Students’ Cognitive Abilities in Plant Anatomy Practical Work

NASA Astrophysics Data System (ADS)

Setiono, S.; Rustaman, N. Y.; Rahmat, A.; Anggraeni, S.

2017-09-01

Cognitive abilities is fundamental for the students, as it is closely related to higher thinking skills such as the ability to think critically, creatively, and problem solving. This descriptive study aims to investigate the cognitive abilities of biology prospective teachers in the course of Plant Anatomy Practicum based on the cognitive process dimension and dimensions of knowledge the using the framework of Revision of Bloom taxonomy. A number of biology prospective teachers was involved in this study (n=42). The instrument used to collect data for students’ cognitive process mastery in the form of multiple choice with 5 options. Research finding shows that the average student’s cognitive ability is 68.10. The acquisition of knowledge mastery of cognitive ability is still under the criterion of mastery in the course of the Plant Anatomy Practicum (75). Validity and reliability of the instrument (0,71) and (0,81). It is necessary to design lecture programs both in the class and laboratory to develop student’ cognitive abilities.

Relationship between Cognitive Impairment and Depression in Dialysis Patients

PubMed Central

Jung, San; Choi, Sun Ryoung; Hwang, Sung-Hee; Noh, Jung-Woo

2013-01-01

Purpose Patients with chronic kidney disease frequently show cognitive dysfunction. The association of depression and cognitive function is not well known in maintenance dialysis patients. We evaluated cognitive impairment and depression, as well as their relationship in regards to methods of dialysis, maintenance hemodialysis (MHD) and chronic peritoneal dialysis (CPD). Materials and Methods Fifty-six maintenance dialysis patients were recruited and their clinical and laboratory data were collected. The Korean version of the mini-mental state exam (K-MMSE) was applied to screen the patient's cognitive function, while the Korean version of the Beck Depression Inventory (K-BDI) was used for depression screening. Results The average age of the participants was 54.2±10.2 years; 29 (51.8%) were female. The average dialysis vintage was 4.2±3.8 years. The CPD group showed significantly higher K-MMSE score (27.8±2.9 vs. 26.1±3.1, p=0.010) and lower K-BDI score (12.0±8.4 vs. 20.2±10.4, p=0.003) compared with the MHD group. The percentage of patients with depression symptoms was higher in the MHD group (51.7% vs. 18.5%). There was a negative correlation between cognitive function and prevalence of depressive symptoms. Depression and education level were shown to be independent predictors for cognitive impairment in multivariate analysis. Conclusion Cognitive impairment was closely correlated with depression. It is important to detect cognitive impairment and depression early in maintenance dialysis patients with simple bedside screening tools. PMID:24142650

Digital Screen Media and Cognitive Development.

PubMed

Anderson, Daniel R; Subrahmanyam, Kaveri

2017-11-01

In this article, we examine the impact of digital screen devices, including television, on cognitive development. Although we know that young infants and toddlers are using touch screen devices, we know little about their comprehension of the content that they encounter on them. In contrast, research suggests that children begin to comprehend child-directed television starting at ∼2 years of age. The cognitive impact of these media depends on the age of the child, the kind of programming (educational programming versus programming produced for adults), the social context of viewing, as well the particular kind of interactive media (eg, computer games). For children <2 years old, television viewing has mostly negative associations, especially for language and executive function. For preschool-aged children, television viewing has been found to have both positive and negative outcomes, and a large body of research suggests that educational television has a positive impact on cognitive development. Beyond the preschool years, children mostly consume entertainment programming, and cognitive outcomes are not well explored in research. The use of computer games as well as educational computer programs can lead to gains in academically relevant content and other cognitive skills. This article concludes by identifying topics and goals for future research and provides recommendations based on current research-based knowledge. Copyright © 2017 by the American Academy of Pediatrics.

Instrumented Trail-Making Task to Differentiate Persons with No Cognitive Impairment, Amnestic Mild Cognitive Impairment, and Alzheimer Disease: A Proof of Concept Study.

PubMed

Zhou, He; Sabbagh, Marwan; Wyman, Rachel; Liebsack, Carolyn; Kunik, Mark E; Najafi, Bijan

2017-01-01

Objective and time-effective tools are needed to identify motor-cognitive impairment and facilitate early intervention. We examined the feasibility, accuracy, and reliability of an instrumented trail-making task (iTMT) using a wearable sensor to identify motor-cognitive impairment among older adults. Thirty subjects (age = 82.2 + 6.1 years, body mass index = 25.7 + 4.8, female = 43.3%) in 3 age-matched groups, 11 healthy, 10 with amnestic mild cognitive impairment (aMCI), and 9 with Alzheimer disease (AD), were recruited. Subjects completed iTMT, using a wearable sensor attached to the leg, which translates the motion of the ankle into a human-machine interface. iTMT tests included reaching to 5 indexed circles on a computer screen by moving the ankle-joint while standing. iTMT was quantified by the time required to reach all circles in the correct sequence. Three iTMT tests were designed, including numbers (1-5) positioned in a fixed (iTMTfixed) or random (iTMTrandom) order, or numbers (1-3) and letters (A and B) positioned in random order (iTMTnumber-letter). Each test was repeated twice to examine test-retest reliability. In addition, the conventional trail-making task (TMT A and B), Montreal Cognitive Assessment (MoCA), and dual-task cost (DTC: gait-speed difference between walking alone and walking while counting backward) were used as references. Re sults: Good-to-excellent reliability was achieved for all iTMT tests (intraclass correlation [ICC] = 0.742-0.836). Between-group difference was more pronounced, when using iTMTnumber-letter, with average completion time of 26.3 ± 12.4, 37.8 ± 14.1, and 61.8 ± 34.1 s, respectively, for healthy, aMCI, and AD groups (p = 0.006). Pairwise comparison suggested strong effect sizes between AD and healthy (Cohen's d = 1.384, p = 0.001) and between aMCI and AD (d = 0.923, p = 0.028). Significant correlation was observed when comparing iTMTnumber-letter with MoCA (r = -0.598, p = 0.001), TMT A (r = 0.519, p = 0.006), TMT B (r = 0.666, p < 0.001), and DTC (r = 0.713, p < 0.001). This study demonstrated proof of concept of a simple, safe, and practical iTMT system with promising results to identify cognitive and dual-task ability impairment among older adults, including those with aMCI and AD. Future studies need to confirm these observations in larger samples, as well as iTMT's ability to track motor-cognitive decline over time. © 2016 S. Karger AG, Basel.

Psychometric Evaluation of a New Instrument to Evaluate School Nurses' Perceptions on Concussion Care Management.

PubMed

Schneider, Kathleen H

2017-10-01

The rate of concussions in adolescents has risen over the last decade, resulting in cognitive and emotional problems. Neurologists recommend cognitive and physical rest during the recovery period, followed by a transitional return-to-classroom protocol. The purpose of the study was to develop and test an instrument that explores the beliefs and roles of school nurses in concussion care management. The instrument was a cross-sectional descriptive survey based on the theory of planned behavior, using Qualtrics®. The psychometric properties of the instrument were assessed through exploratory factor analysis with orthogonal rotation. The reliability of the instrument was assessed for internal consistency reliability using Cronbach's α. Kaiser-Meyer-Olkin for sample adequacy was .8; Cronbach's α strong (.851).

Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire.

PubMed

Hirschfeld, R M; Williams, J B; Spitzer, R L; Calabrese, J R; Flynn, L; Keck, P E; Lewis, L; McElroy, S L; Post, R M; Rapport, D J; Russell, J M; Sachs, G S; Zajecka, J

2000-11-01

Bipolar spectrum disorders, which include bipolar I, bipolar II, and bipolar disorder not otherwise specified, frequently go unrecognized, undiagnosed, and untreated. This report describes the validation of a new brief self-report screening instrument for bipolar spectrum disorders called the Mood Disorder Questionnaire. A total of 198 patients attending five outpatient clinics that primarily treat patients with mood disorders completed the Mood Disorder Questionnaire. A research professional, blind to the Mood Disorder Questionnaire results, conducted a telephone research diagnostic interview by means of the bipolar module of the Structured Clinical Interview for DSM-IV. A Mood Disorder Questionnaire screening score of 7 or more items yielded good sensitivity (0.73) and very good specificity (0.90). The Mood Disorder Questionnaire is a useful screening instrument for bipolar spectrum disorder in a psychiatric outpatient population.

Parkinson's disease-cognitive rating scale: psychometrics for mild cognitive impairment.

PubMed

Fernández de Bobadilla, Ramón; Pagonabarraga, Javier; Martínez-Horta, Saül; Pascual-Sedano, Berta; Campolongo, Antonia; Kulisevsky, Jaime

2013-09-01

Lack of validated data on cutoff scores for mild cognitive impairment (MCI) and sensitivity to change in predementia stages of Parkinson's disease (PD) limit the utility of instruments measuring global cognition as screening and outcome measures in therapeutic trials. Investigators who were blinded to PD-Cognitive Rating Scale (PD-CRS) scores classified a cohort of prospectively recruited, nondemented patients into a PD with normal cognition (PD-NC) group and a PD with MCI (PD-MCI) group using Clinical Dementia Rating (CDR) and the Mattis Dementia Rating Scale-2 (MDRS-2). The discriminative power of the PD-CRS for PD-MCI was examined in a representative sample of 234 patients (145 in the PD-NC group; 89 in the PD-MCI group) and in a control group of 98 healthy individuals. Sensitivity to change in the PD-CRS score (the minimal clinically important difference was examined with the Clinical Global Impression of Change scale and was calculated with a combination of distribution-based and anchor-based approaches) was explored in a 6-month observational multicenter trial involving a subset of 120 patients (PD-NC, 63; PD-MCI, 57). Regression analysis demonstrated that PD-CRS total scores (P < 0.001) and age (P = 0.01) independently differentiated PD-NC from PD-MCI. Area under the receiver operating characteristic curve (AUC) analysis (AUC, 0.85; 95% confidence interval, 0.80-0.90) indicated that a score ≤ 81 of 134 was the optimal cutoff point on the total score for the PD-CRS (sensitivity, 79%; specificity, 80%; positive predictive value, 59%; negative predictive value, 91%). A range of change from 10 to 13 points on the PD-CRS total score was indicative of clinically significant change. These findings suggest that the PD-CRS is a useful tool to identify PD-MCI and to track cognitive changes in nondemented patients with PD. © 2013 International Parkinson and Movement Disorder Society.

Vitamin B12 deficiency: Characterization of psychometrics and MRI morphometrics.

PubMed

Hsu, Yen-Hsuan; Huang, Ching-Feng; Lo, Chung-Ping; Wang, Tzu-Lan; Tu, Min-Chien

2016-01-01

Vitamin B12 is essential for the integrity of the central nervous system. However, performances in different cognitive domains relevant to vitamin B12 deficiency remain to be detailed. To date, there have been limited studies that examined the relationships between cognitions and structural neuroimaging in a single cohort of low-vitamin B12 status. The present study aimed to depict psychometrics and magnetic resonance imaging (MRI) morphometrics among patients with vitamin B12 deficiency, and to examine their inter-relations. We compared 34 consecutive patients with vitamin B12 deficiency (serum level ≤ 250 pg/ml) to 34 demographically matched controls by their cognitive performances and morphometric indices of brain MRI. The correlations between psychometrics and morphometrics were analyzed. The vitamin B12 deficiency group had lower scores than the controls on total scores of Mini-Mental Status Examination (MMSE) and Cognitive Abilities Screening Instrument (CASI) (both P < 0.05), language (P < 0.01), orientation (P < 0.01), and mental manipulation (P < 0.05). The patients also showed a greater frontal horn ratio than the controls (P < 0.05). Bicaudate ratio, fronto-occipital ratio, uncotemporal index, and normalized interuncal distance all showed a strong correlation with the total score of MMSE and CASI (all P < 0.01). Among these psychometric and morphometric indices, pronounced correlations between bicaudate ratio and long-term memory, mental manipulation, orientation, language, and verbal fluency were noted (all P < 0.01). Vitamin B12 deficiency is associated with a global cognition decline with language, orientation, and mental manipulation selectively impaired. Preferential atrophy in frontal regions is the main neuroimaging feature. Although the frontal ratio highlights the relevant atrophy among patients, the bicaudate ratio might be the best index on the basis of its strong association with global cognition and related cognitive domains, implying dysfunction of fronto-subcortical circuits as the fundamental pathogenesis related to vitamin B12 deficiency.

Test-Retest Reliability of a Serious Game for Delirium Screening in the Emergency Department

PubMed Central

Tong, Tiffany; Chignell, Mark; Tierney, Mary C.; Lee, Jacques S.

2016-01-01

Introduction: Cognitive screening in settings such as emergency departments (ED) is frequently carried out using paper-and-pencil tests that require administration by trained staff. These assessments often compete with other clinical duties and thus may not be routinely administered in these busy settings. Literature has shown that the presence of cognitive impairments such as dementia and delirium are often missed in older ED patients. Failure to recognize delirium can have devastating consequences including increased mortality (Kakuma et al., 2003). Given the demands on emergency staff, an automated cognitive test to screen for delirium onset could be a valuable tool to support delirium prevention and management. In earlier research we examined the concurrent validity of a serious game, and carried out an initial assessment of its potential as a delirium screening tool (Tong et al., 2016). In this paper, we examine the test-retest reliability of the game, as it is an important criterion in a cognitive test for detecting risk of delirium onset. Objective: To demonstrate the test-retest reliability of the screening tool over time in a clinical sample of older emergency patients. A secondary objective is to assess whether there are practice effects that might make game performance unstable over repeated presentations. Materials and Methods: Adults over the age of 70 were recruited from a hospital ED. Each patient played our serious game in an initial session soon after they arrived in the ED, and in follow up sessions conducted at 8-h intervals (for each participant there were up to five follow up sessions, depending on how long the person stayed in the ED). Results: A total of 114 adults (61 females, 53 males) between the ages of 70 and 104 years (M = 81 years, SD = 7) participated in our study after screening out delirious patients. We observed a test-retest reliability of the serious game (as assessed by correlation r-values) between 0.5 and 0.8 across adjacent sessions. Conclusion: The game-based assessment for cognitive screening has relatively strong test-retest reliability and little evidence of practice effects among elderly emergency patients, and may be a useful supplement to existing cognitive assessment methods. PMID:27872590

[The Basel Screening Instrument for Psychosis (BSIP): development, structure, reliability and validity].

PubMed

Riecher-Rössler, A; Aston, J; Ventura, J; Merlo, M; Borgwardt, S; Gschwandtner, U; Stieglitz, R-D

2008-04-01

Early detection of psychosis is of growing clinical importance. So far there is, however, no screening instrument for detecting individuals with beginning psychosis in the atypical early stages of the disease with sufficient validity. We have therefore developed the Basel Screening Instrument for Psychosis (BSIP) and tested its feasibility, interrater-reliability and validity. Aim of this paper is to describe the development and structure of the instrument, as well as to report the results of the studies on reliability and validity. The instrument was developed based on a comprehensive search of literature on the most important risk factors and early signs of schizophrenic psychoses. The interraterreliability study was conducted on 24 psychiatric cases. Validity was tested based on 206 individuals referred to our early detection clinic from 3/1/2000 until 2/28/2003. We identified seven categories of relevance for early detection of psychosis and used them to construct a semistructured interview. Interrater-reliability for high risk individuals was high (Kappa .87). Predictive validity was comparable to other, more comprehensive instruments: 16 (32 %) of 50 individuals classified as being at risk for psychosis by the BSIP have in fact developed frank psychosis within an follow-up period of two to five years. The BSIP is the first screening instrument for the early detection of psychosis which has been validated based on transition to psychosis. The BSIP is easy to use by experienced psychiatrists and has a very good interrater-reliability and predictive validity.

Validation of a clinical screening instrument for tumour predisposition syndromes in patients with childhood cancer (TuPS): protocol for a prospective, observational, multicentre study

PubMed Central

Postema, Floor A M; Hopman, Saskia M J; de Borgie, Corianne A J M; Hammond, Peter; Hennekam, Raoul C; Merks, Johannes H M; Aalfs, Cora M; Anninga, Jakob K; Berger, Lieke PV; Bleeker, Fonnet E; de Bont, Eveline SJM; de Borgie, Corianne AJM; Dommering, Charlotte J; van Eijkelenburg, Natasha KA; Hammond, Peter; Hennekam, Raoul C; van den Heuvel-Eibrink, Marry M; Hopman, Saskia MJ; Jongmans, Marjolijn CJ; Kors, Wijnanda A; Letteboer, Tom GW; Loeffen, Jan LCM; Merks, Johannes HM; Olderode-Berends, Maran JW; Postema, Floor AM; Wagner, Anja

2017-01-01

Introduction Recognising a tumour predisposition syndrome (TPS) in patients with childhood cancer is of significant clinical relevance, as it affects treatment, prognosis and facilitates genetic counselling. Previous studies revealed that only half of the known TPSs are recognised during standard paediatric cancer care. In current medical practice it is impossible to refer every patient with childhood cancer to a clinical geneticist, due to limited capacity for routine genetic consultation. Therefore, we have developed a screening instrument to identify patients with childhood cancer with a high probability of having a TPS. The aim of this study is to validate the clinical screening instrument for TPS in patients with childhood cancer. Methods and analysis This study is a prospective nationwide cohort study including all newly diagnosed patients with childhood cancer in the Netherlands. The screening instrument consists of a checklist, two- and three-dimensional photographic series of the patient. 2 independent clinical geneticists will assess the content of the screening instrument. If a TPS is suspected based on the instrument data and thus further evaluation is indicated, the patient will be invited for full genetic consultation. A negative control group consists of 20% of the patients in whom a TPS is not suspected based on the instrument; they will be randomly invited for full genetic consultation. Primary outcome measurement will be sensitivity of the instrument. Ethics and dissemination The Medical Ethical Committee of the Academic Medical Centre stated that the Medical Research Involving Human Subjects Act does not apply to this study and that official approval of this study by the Committee was not required. The results will be offered for publication in peer-reviewed journals and presented at International Conferences on Oncology and Clinical Genetics. The clinical data gathered in this study will be available for all participating centres. Trial registration number NTR5605. PMID:28110285

Distinct Patterns of Cognitive Aging Modified by Education Level and Gender among Adults with Limited or No Formal Education: A Normative Study of the Mini-Mental State Examination.

PubMed

Xie, Haiqun; Zhang, Chengguo; Wang, Yukai; Huang, Shuyun; Cui, Wei; Yang, Wenbin; Koski, Lisa; Xu, Xiping; Li, Youbao; Zheng, Meili; He, Mingli; Fu, Jia; Shi, Xiuli; Wang, Kai; Tang, Genfu; Wang, Binyan; Huo, Yong

2016-01-01

Dementia is increasingly prevalent due to rapid aging of the population, but under-recognized among people with low education levels. This is partly due to a lack of appropriate and precise normative data, which underestimates cognitive aging in the use of screening tools for dementia. We aimed to improve the precision of screening for cognitive impairment, by characterizing the patterns of cognitive aging and derived normative data of the Mini-Mental State Examination (MMSE) for illiterate and low-educated populations. This community-based study included data from 2,280 individuals aged 40 years or older from two rural areas. Multiple linear modeling examined the effect of aging on cognition reflected by the MMSE, stratified by education level and gender. Threshold effect of age on cognition was performed using a smoothing function. The majority of participants (60.4%) were illiterate or had attended only primary school (24.6%). The effect of aging on cognition varied by gender and education. Primary-school educated females and males remained cognitively stable up to 62 and 71 years of age, respectively, with MMSE score declining 0.4 and 0.8 points/year in females and males thereafter. Illiterates females scored 2.3 points lower than illiterate males, and scores for both declined 0.2 points/year. According to these results, normative data stratified by age, education and gender was generated. This study suggests gender and educational differences exist in cognitive aging among adults with limited or no formal education. To improve screening precision for cognitive impairment with the use of MMSE in low-educated population, age, gender, and education level should be considered.

Progression and effect of cognitive-behavioral changes in patients with amyotrophic lateral sclerosis.

PubMed

Bock, Meredith; Duong, Y-Nhy; Kim, Anthony; Allen, Isabel; Murphy, Jennifer; Lomen-Hoerth, Catherine

2017-12-01

To prospectively evaluate the progression of cognitive-behavioral function in amyotrophic lateral sclerosis (ALS) and examine the association of cognitive-behavioral deficits with disease progression, patient quality of life (QOL), and caregiver burden. We evaluated cognitive-behavioral function using the Amyotrophic Lateral Sclerosis Cognitive Behavioral Screen at enrollment and after 7 months in a cohort of patients with ALS. Paired t tests were used to evaluate the change in the 2 assessments. Linear regression and Kruskal-Wallis tests were applied to investigate how initial cognitive or behavioral status related to outcomes. The mean test-retest interval was 6.8 months (SD 1.6). Cognitive status of the study population (n = 49) overall did not change over the study period ( p = 0.06) despite progression of motor weakness ( p < 0.001), though small subsets of the sample demonstrate cognitive change. Patients initially classified as behaviorally normal showed increased behavioral problems over time ( t = -2.8, p = 0.009). Decline in cognitive (β = -1.3, p = 0.03) and behavioral (β = -0.76, p = 0.002) status predicted increasing caregiver burden. Behavioral abnormalities predicted decline in forced vital capacity and ALS Functional Rating Scale-Revised score ( p = 0.008, 0.012) in the study population and patient QOL in the most severely affected group ( t = 4.3, p = 0.003). Cognitive-behavioral change is a key aspect of disease heterogeneity in ALS. Executive function in ALS overall remains stable over 7 months as detected by an administered screening tool. However, patients may develop caregiver-reported behavioral symptoms in that time period. Screening for caregiver-reported symptoms has a particular utility in predicting future clinical decline, increased caregiver burden, and worsening patient QOL.

Fear, knowledge, and efficacy beliefs differentially predict the frequency of digital rectal examination versus prostate specific antigen screening in ethnically diverse samples of older men.

PubMed

Consedine, Nathan S; Horton, David; Ungar, Tracey; Joe, Andrew K; Ramirez, Paul; Borrell, Luisa

2007-03-01

Emotional and cognitive characteristics have been studied in the context of women's cancer screening but have received scant attention in the study of men's screening behavior. Researchers know little about how such factors interact to predict screening or whether digital rectal examination (DRE) and prostate specific antigen (PSA) screens are predicted by the same characteristics. This study examines the relevance of emotional and cognitive characteristics to DRE and PSA screening among 180 U.S.-born African American, U.S.- born European American, and immigrant Jamaican men. The study identifies the expected effects in which fear is negatively related and efficacy beliefs positively related to DRE and PSA screening. Greater efficacy and (marginally) knowledge appear to "offset" the negative impact of fear on screening, and fear appears particularly relevant to DRE frequency. Results are discussed in terms of their implications for the development of health belief and self-regulatory models in the context of prostate cancer screening among minority men.

Concentrations of rivastigmine and NAP 226-90 and the cognitive response in Taiwanese Alzheimer's disease patients.

PubMed

Chou, Mei-Chuan; Chen, Chun-Hung; Liu, Ching-Kuan; Chen, Su-Hwei; Wu, Shyh-Jong; Yang, Yuan-Han

2012-01-01

The aim of this small pilot study was to evaluate the association between plasma concentrations of rivastigmine and its metabolite, NAP 226-90, and cognitive function in patients with Alzheimer's disease (AD). Rivastigmine-treated AD patients, who had been maintained on a fixed regimen of twice daily rivastigmine (6 to 12 mg/d) for ≥6 months, were eligible for evaluation. The assessments included cognitive assessment screening instrument (CASI) and clinical dementia rating scale, conducted at baseline and at 6-month follow-up. The 9 subdomains of CASI at baseline and follow-up were analyzed in relation to the plasma concentrations of rivastigmine and NAP 226-90, as measured by capillary electrophoresis. Logistic regression was performed to adjust for age, gender, education level, apolipoprotein E ε4 genotype status, and baseline CASI score to investigate the association between plasma rivastigmine and NAP 226-90 concentrations and the cognitive response. The total sample consisted of 53 clinically diagnosed AD patients taking rivastigmine only at doses of 6 mg to 9 mg/d because of intolerability at 12 mg/d. Higher rivastigmine concentration was significantly associated with improved or preserved short-term memory and worsened abstraction/judgment (p < 0.05), but not with changes in other domains (p > 0.05). Higher NAP 226-90 concentration was significantly associated with worsened abstraction/judgment (p < 0.05), but not with changes in other domains. Higher plasma rivastigmine concentration was significantly associated with improved or preserved short-term memory but worsened abstraction/judgment. An optimal concentration of rivastigmine should be quantified for each patient because of differential cognitive responses.

Validation of the Arab Youth Mental Health scale as a screening tool for depression/anxiety in Lebanese children

PubMed Central

2011-01-01

Background Early detection of common mental disorders, such as depression and anxiety, among children and adolescents requires the use of validated, culturally sensitive, and developmentally appropriate screening instruments. The Arab region has a high proportion of youth, yet Arabic-language screening instruments for mental disorders among this age group are virtually absent. Methods We carried out construct and clinical validation on the recently-developed Arab Youth Mental Health (AYMH) scale as a screening tool for depression/anxiety. The scale was administered with 10-14 year old children attending a social service center in Beirut, Lebanon (N = 153). The clinical assessment was conducted by a child and adolescent clinical psychiatrist employing the DSM IV criteria. We tested the scale's sensitivity, specificity, and internal consistency. Results Scale scores were generally significantly associated with how participants responded to standard questions on health, mental health, and happiness, indicating good construct validity. The results revealed that the scale exhibited good internal consistency (Cronbach's alpha = 0.86) and specificity (79%). However, it exhibited moderate sensitivity for girls (71%) and poor sensitivity for boys (50%). Conclusions The AYMH scale is useful as a screening tool for general mental health states and a valid screening instrument for common mental disorders among girls. It is not a valid instrument for detecting depression and anxiety among boys in an Arab culture. PMID:21435213

The Borderline Syndrome Index: a validation study using the personality assessment schedule.

PubMed

Marlowe, M J; O'Neill-Byrne, K; Lowe-Ponsford, F; Watson, J P

1996-01-01

This study examines the validity and screening properties of the Borderline Syndrome Index--BSI (developed in the USA) for categories of the Personality Assessment Schedule--PAS (developed in the UK). Patients were recruited by case control sampling. Chance corrected agreement between instruments and screening properties of the BSI were calculated. The BSI proved a moderately sensitive but non-specific screen. Questionnaire scores were highly correlated with symptom measures. The results do not support the validity of the BSI or its use as a screening instrument. BSI scores may be distorted by current symptoms.

Screening youth for suicide risk in medical settings: time to ask questions.

PubMed

Horowitz, Lisa M; Bridge, Jeffrey A; Pao, Maryland; Boudreaux, Edwin D

2014-09-01

This paper focuses on the National Action Alliance for Suicide Prevention's Research Prioritization Task Force's Aspirational Goal 2 (screening for suicide risk) as it pertains specifically to children, adolescents, and young adults. Two assumptions are forwarded: (1) strategies for screening youth for suicide risk need to be tailored developmentally; and (2) we must use instruments that were created and tested specifically for suicide risk detection and developed specifically for youth. Recommendations for shifting the current paradigm include universal suicide screening for youth in medical settings with validated instruments. Published by Elsevier Inc.

Screening for DSM-IV-TR Cognitive Disorder NOS in Parkinson’s disease using the Mattis Dementia Rating Scale

PubMed Central

Pontone, Gregory M.; Palanci, Justin; Williams, James R.; Bassett, Susan Spear

2012-01-01

Objective This study explores the utility of the Mattis Dementia Rating Scale (MDRS) as a screening tool for the Diagnostic and Statistical Manual for Mental Disorders 4th edition (DSM-IV-TR) diagnosis Cognitive Disorder Not Otherwise Specified in Parkinson’s disease(PD). Methods 125 individuals with PD were diagnosed using DSM-IV-TR criteria for Cognitive Disorder NOS and dementia. Receiver operating characteristics tested the discriminant validity of the MDRS, with the clinician’s diagnosis serving as the gold standard. Results The MDRS ROC curve to discriminate subjects with Cognitive Disorder NOS from non-demented subjects had an AUC of 0.59 (std. err.= 0.08, 95% CI: 0.43–0.74). Conclusions The MDRS is not effective for identifying PD patients with Cognitive Disorder NOS without dementia. PMID:22628158

Psychometric Evaluation of a New Instrument to Evaluate School Nurses' Perceptions on Concussion Care Management

ERIC Educational Resources Information Center

Schneider, Kathleen H.

2017-01-01

The rate of concussions in adolescents has risen over the last decade, resulting in cognitive and emotional problems. Neurologists recommend cognitive and physical rest during the recovery period, followed by a transitional return-to-classroom protocol. The purpose of the study was to develop and test an instrument that explores the beliefs and…

Predicting Geriatric Falls Following an Episode of Emergency Department Care: A Systematic Review

PubMed Central

Carpenter, Christopher R.; Avidan, Michael S.; Wildes, Tanya; Stark, Susan; Fowler, Susan A.; Lo, Alexander X.

2015-01-01

Background Falls are the leading cause of traumatic mortality in geriatric adults. Despite recent multispecialty guideline recommendations that advocate for proactive fall prevention protocols in the emergency department (ED), the ability of risk factors or risk stratification instruments to identify subsets of geriatric patients at increased risk for short-term falls is largely unexplored. Objectives This was a systematic review and meta-analysis of ED-based history, physical examination, and fall risk stratification instruments with the primary objective of providing a quantitative estimate for each risk factor’s accuracy to predict future falls. A secondary objective was to quantify ED fall risk assessment test and treatment thresholds using derived estimates of sensitivity and specificity. Methods A medical librarian and two emergency physicians (EPs) conducted a medical literature search of PUBMED, EMBASE, CINAHL, CENTRAL, DARE, the Cochrane Registry, and Clinical Trials. Unpublished research was located by a hand search of emergency medicine (EM) research abstracts from national meetings. Inclusion criteria for original studies included ED-based assessment of pre-ED or post-ED fall risk in patients 65 years and older with sufficient detail to reproduce contingency tables for meta-analysis. Original study authors were contacted for additional details when necessary. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) was used to assess individual study quality for those studies that met inclusion criteria. When more than one qualitatively similar study assessed the same risk factor for falls at the same interval following an ED evaluation, then meta-analysis was performed using Meta-DiSc software. The primary outcomes were sensitivity, specificity, and likelihood ratios for fall risk factors or risk stratification instruments. Secondary outcomes included estimates of test and treatment thresholds using the Pauker method based on accuracy, screening risk, and the projected benefits or harms of fall prevention interventions in the ED. Results A total of 608 unique and potentially relevant studies were identified, but only three met our inclusion criteria. Two studies that included 660 patients assessed 29 risk factors and two risk stratification instruments for falls in geriatric patients in the 6 months following an ED evaluation, while one study of 107 patients assessed the risk of falls in the preceding 12 months. A self-report of depression was associated with the highest positive likelihood ratio (LR) of 6.55 (95% confidence interval [CI] = 1.41 to 30.48). Six fall predictors were identified in more than one study (past falls, living alone, use of walking aid, depression, cognitive deficit, and more than six medications) and meta-analysis was performed for these risk factors. One screening instrument was sufficiently accurate to identify a subset of geriatric ED patients at low risk for falls with a negative LR of 0.11 (95% CI = 0.06 to 0.20). The test threshold was 6.6% and the treatment threshold was 27.5%. Conclusions This study demonstrates the paucity of evidence in the literature regarding ED-based screening for risk of future falls among older adults. The screening tools and individual characteristics identified in this study provide an evidentiary basis on which to develop screening protocols for geriatrics adults in the ED to reduce fall risk PMID:25293956

Predicting geriatric falls following an episode of emergency department care: a systematic review.

PubMed

Carpenter, Christopher R; Avidan, Michael S; Wildes, Tanya; Stark, Susan; Fowler, Susan A; Lo, Alexander X

2014-10-01

Falls are the leading cause of traumatic mortality in geriatric adults. Despite recent multispecialty guideline recommendations that advocate for proactive fall prevention protocols in the emergency department (ED), the ability of risk factors or risk stratification instruments to identify subsets of geriatric patients at increased risk for short-term falls is largely unexplored. This was a systematic review and meta-analysis of ED-based history, physical examination, and fall risk stratification instruments with the primary objective of providing a quantitative estimate for each risk factor's accuracy to predict future falls. A secondary objective was to quantify ED fall risk assessment test and treatment thresholds using derived estimates of sensitivity and specificity. A medical librarian and two emergency physicians (EPs) conducted a medical literature search of PUBMED, EMBASE, CINAHL, CENTRAL, DARE, the Cochrane Registry, and Clinical Trials. Unpublished research was located by a hand search of emergency medicine (EM) research abstracts from national meetings. Inclusion criteria for original studies included ED-based assessment of pre-ED or post-ED fall risk in patients 65 years and older with sufficient detail to reproduce contingency tables for meta-analysis. Original study authors were contacted for additional details when necessary. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) was used to assess individual study quality for those studies that met inclusion criteria. When more than one qualitatively similar study assessed the same risk factor for falls at the same interval following an ED evaluation, then meta-analysis was performed using Meta-DiSc software. The primary outcomes were sensitivity, specificity, and likelihood ratios for fall risk factors or risk stratification instruments. Secondary outcomes included estimates of test and treatment thresholds using the Pauker method based on accuracy, screening risk, and the projected benefits or harms of fall prevention interventions in the ED. A total of 608 unique and potentially relevant studies were identified, but only three met our inclusion criteria. Two studies that included 660 patients assessed 29 risk factors and two risk stratification instruments for falls in geriatric patients in the 6 months following an ED evaluation, while one study of 107 patients assessed the risk of falls in the preceding 12 months. A self-report of depression was associated with the highest positive likelihood ratio (LR) of 6.55 (95% confidence interval [CI] = 1.41 to 30.48). Six fall predictors were identified in more than one study (past falls, living alone, use of walking aid, depression, cognitive deficit, and more than six medications) and meta-analysis was performed for these risk factors. One screening instrument was sufficiently accurate to identify a subset of geriatric ED patients at low risk for falls with a negative LR of 0.11 (95% CI = 0.06 to 0.20). The test threshold was 6.6% and the treatment threshold was 27.5%. This study demonstrates the paucity of evidence in the literature regarding ED-based screening for risk of future falls among older adults. The screening tools and individual characteristics identified in this study provide an evidentiary basis on which to develop screening protocols for geriatrics adults in the ED to reduce fall risk. © 2014 by the Society for Academic Emergency Medicine.

Automated, Quantitative Cognitive/Behavioral Screening of Mice: For Genetics, Pharmacology, Animal Cognition and Undergraduate Instruction

PubMed Central

Gallistel, C. R.; Balci, Fuat; Freestone, David; Kheifets, Aaron; King, Adam

2014-01-01

We describe a high-throughput, high-volume, fully automated, live-in 24/7 behavioral testing system for assessing the effects of genetic and pharmacological manipulations on basic mechanisms of cognition and learning in mice. A standard polypropylene mouse housing tub is connected through an acrylic tube to a standard commercial mouse test box. The test box has 3 hoppers, 2 of which are connected to pellet feeders. All are internally illuminable with an LED and monitored for head entries by infrared (IR) beams. Mice live in the environment, which eliminates handling during screening. They obtain their food during two or more daily feeding periods by performing in operant (instrumental) and Pavlovian (classical) protocols, for which we have written protocol-control software and quasi-real-time data analysis and graphing software. The data analysis and graphing routines are written in a MATLAB-based language created to simplify greatly the analysis of large time-stamped behavioral and physiological event records and to preserve a full data trail from raw data through all intermediate analyses to the published graphs and statistics within a single data structure. The data-analysis code harvests the data several times a day and subjects it to statistical and graphical analyses, which are automatically stored in the "cloud" and on in-lab computers. Thus, the progress of individual mice is visualized and quantified daily. The data-analysis code talks to the protocol-control code, permitting the automated advance from protocol to protocol of individual subjects. The behavioral protocols implemented are matching, autoshaping, timed hopper-switching, risk assessment in timed hopper-switching, impulsivity measurement, and the circadian anticipation of food availability. Open-source protocol-control and data-analysis code makes the addition of new protocols simple. Eight test environments fit in a 48 in x 24 in x 78 in cabinet; two such cabinets (16 environments) may be controlled by one computer. PMID:24637442

Automated, quantitative cognitive/behavioral screening of mice: for genetics, pharmacology, animal cognition and undergraduate instruction.

PubMed

Gallistel, C R; Balci, Fuat; Freestone, David; Kheifets, Aaron; King, Adam

2014-02-26

We describe a high-throughput, high-volume, fully automated, live-in 24/7 behavioral testing system for assessing the effects of genetic and pharmacological manipulations on basic mechanisms of cognition and learning in mice. A standard polypropylene mouse housing tub is connected through an acrylic tube to a standard commercial mouse test box. The test box has 3 hoppers, 2 of which are connected to pellet feeders. All are internally illuminable with an LED and monitored for head entries by infrared (IR) beams. Mice live in the environment, which eliminates handling during screening. They obtain their food during two or more daily feeding periods by performing in operant (instrumental) and Pavlovian (classical) protocols, for which we have written protocol-control software and quasi-real-time data analysis and graphing software. The data analysis and graphing routines are written in a MATLAB-based language created to simplify greatly the analysis of large time-stamped behavioral and physiological event records and to preserve a full data trail from raw data through all intermediate analyses to the published graphs and statistics within a single data structure. The data-analysis code harvests the data several times a day and subjects it to statistical and graphical analyses, which are automatically stored in the "cloud" and on in-lab computers. Thus, the progress of individual mice is visualized and quantified daily. The data-analysis code talks to the protocol-control code, permitting the automated advance from protocol to protocol of individual subjects. The behavioral protocols implemented are matching, autoshaping, timed hopper-switching, risk assessment in timed hopper-switching, impulsivity measurement, and the circadian anticipation of food availability. Open-source protocol-control and data-analysis code makes the addition of new protocols simple. Eight test environments fit in a 48 in x 24 in x 78 in cabinet; two such cabinets (16 environments) may be controlled by one computer.

Utilization of Professional Mental Health Services Related to Population-Level Screening for Anxiety, Depression, and Post-traumatic Stress Disorder Among Public High School Students.

PubMed

Prochaska, John D; Le, Vi Donna; Baillargeon, Jacques; Temple, Jeff R

2016-08-01

This study examines results from three mental health screening measures in a cohort of adolescent public school students in seven public schools in Southeast Texas affiliated with the Dating it Safe study. We estimated the odds of receiving professional mental health treatment in the previous year given results from different mental health screening batteries: the CES-D 10 battery for depression screening, the Screen for Child Anxiety Related Disorders, and the Primary Care Posttraumatic Stress Disorder screen. Overall, students with higher scores on screening instruments for depression, posttraumatic stress disorder, and combinations of screening instruments were more likely to have sought past-year professional mental health treatment than non-symptomatic youth. However, the proportion of students screening positive and receiving professional treatment was low, ranging from 11 to 16 %. This study emphasizes the need for broader evaluation of population-based mental health screening among adolescents.

Utilization of Professional Mental Health Services Related to Population-Level Screening for Anxiety, Depression, and Post-traumatic Stress Disorder among Public High School Students

PubMed Central

Prochaska, John D.; Le, Vi Donna; Baillargeon, Jacques; Temple, Jeff R.

2016-01-01

This study examines results from three mental health screening measures in a cohort of adolescent public school students in seven public schools in Southeast [State removed for peer review] affiliated with the [name of study removed for blind review]. We estimated the odds of receiving professional mental health treatment in the previous year given results from different mental health screening batteries: the CES-D 10 battery for depression screening, the Screen for Child Anxiety Related Disorders (SCARED), and the Primary Care Posttraumatic Stress Disorder screen (PC-PTSD). Overall, students with higher scores on screening instruments for depression, posttraumatic stress disorder, and combinations of screening instruments were more likely to have sought past-year professional mental health treatment than non-symptomatic youth. However, the proportion of students screening positive and receiving professional treatment was low, ranging from 11 to 16%. This study emphasizes the need for broader evaluation of population-based mental health screening among adolescents. PMID:26733335

The Screening Role of an Introductory Course in Cognitive Therapy Training

ERIC Educational Resources Information Center

Pehlivanidis, Artemios; Papanikolaou, Katerina; Politis, Antonis; Liossi, Angeliki; Daskalopoulou, Evgenia; Gournellis, Rossetos; Soldatos, Marina; Papakosta, Vasiliki Maria; Zervas, Ioannis; Papakostas, Yiannis G.

2006-01-01

Objective: This study examines the role of an introductory course in cognitive therapy and the relative importance of trainees' characteristics in the selection process for an advanced course in cognitive therapy. Method: The authors assessed the files of all trainees who completed one academic year introductory course in cognitive therapy over…

The Effects of Metaphorical Interface on Germane Cognitive Load in Web-Based Instruction

ERIC Educational Resources Information Center

Cheon, Jongpil; Grant, Michael M.

2012-01-01

The purpose of this study was to examine the effects of a metaphorical interface on germane cognitive load in Web-based instruction. Based on cognitive load theory, germane cognitive load is a cognitive investment for schema construction and automation. A new instrument developed in a previous study was used to measure students' mental activities…

Identifying cases of undiagnosed, clinically significant COPD in primary care: qualitative insight from patients in the target population

PubMed Central

Leidy, Nancy K; Kim, Katherine; Bacci, Elizabeth D; Yawn, Barbara P; Mannino, David M; Thomashow, Byron M; Barr, R Graham; Rennard, Stephen I; Houfek, Julia F; Han, Meilan K; Meldrum, Catherine A; Make, Barry J; Bowler, Russ P; Steenrod, Anna W; Murray, Lindsey T; Walsh, John W; Martinez, Fernando

2015-01-01

Background: Many cases of chronic obstructive pulmonary disease (COPD) are diagnosed only after significant loss of lung function or during exacerbations. Aims: This study is part of a multi-method approach to develop a new screening instrument for identifying undiagnosed, clinically significant COPD in primary care. Methods: Subjects with varied histories of COPD diagnosis, risk factors and history of exacerbations were recruited through five US clinics (four pulmonary, one primary care). Phase I: Eight focus groups and six telephone interviews were conducted to elicit descriptions of risk factors for COPD, recent or historical acute respiratory events, and symptoms to inform the development of candidate items for the new questionnaire. Phase II: A new cohort of subjects participated in cognitive interviews to assess and modify candidate items. Two peak expiratory flow (PEF) devices (electronic, manual) were assessed for use in screening. Results: Of 77 subjects, 50 participated in Phase I and 27 in Phase II. Six themes informed item development: exposure (smoking, second-hand smoke); health history (family history of lung problems, recurrent chest infections); recent history of respiratory events (clinic visits, hospitalisations); symptoms (respiratory, non-respiratory); impact (activity limitations); and attribution (age, obesity). PEF devices were rated easy to use; electronic values were significantly higher than manual (P<0.0001). Revisions were made to the draft items on the basis of cognitive interviews. Conclusions: Forty-eight candidate items are ready for quantitative testing to select the best, smallest set of questions that, together with PEF, can efficiently identify patients in need of diagnostic evaluation for clinically significant COPD. PMID:26028486

The role of different types of instrumentality in motivation, study strategies, and performance: know why you learn, so you'll know what you learn!

PubMed

Simons, Joke; Dewitte, Siegfried; Lens, Willy

2004-09-01

Two theories in the field of motivation and achievement, namely the future time perspective theory and goal theory, result in conflicting recommendations for enhancing students' motivation, because of their differential emphasis on the task at hand and on the future consequences of a task. We will present a framework consisting of four types of instrumentality that combines both perspectives. The implications of those different types for goal orientation, motivation, cognitive strategies, study habits and performance are investigated. Participants were a group of 184 first-year nurse students with ages ranging from 18 to 45 years. Questionnaires were administered that measured instrumentality, goal orientation, motivation, deep and surface level learning strategies, study habits, and a manipulation check. At the end of the year, exam scores were collected. The results showed that different types of instrumentality are related differently to the motivational, cognitive and achievement measures. Being internally regulated and perceiving the utility of the courses resulted both in a more adaptive goal orientation and higher intrinsic motivation, which led to the use of more adaptive cognitive strategies and to better study habits, which ultimately enhanced performance. Linking performance to extrinsic rewards and not seeing the utility of the course for the future yielded the opposite pattern. Type of instrumentality has indeed a differential influence on motivational, cognitive, and behavioural variables.

The conceptualization and measurement of cognitive health sophistication.

PubMed

Bodie, Graham D; Collins, William B; Jensen, Jakob D; Davis, Lashara A; Guntzviller, Lisa M; King, Andy J

2013-01-01

This article develops a conceptualization and measure of cognitive health sophistication--the complexity of an individual's conceptual knowledge about health. Study 1 provides initial validity evidence for the measure--the Healthy-Unhealthy Other Instrument--by showing its association with other cognitive health constructs indicative of higher health sophistication. Study 2 presents data from a sample of low-income adults to provide evidence that the measure does not depend heavily on health-related vocabulary or ethnicity. Results from both studies suggest that the Healthy-Unhealthy Other Instrument can be used to capture variability in the sophistication or complexity of an individual's health-related schematic structures on the basis of responses to two simple open-ended questions. Methodological advantages of the Healthy-Unhealthy Other Instrument and suggestions for future research are highlighted in the discussion.

Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise.

PubMed

Militello, Laura G; Saleem, Jason J; Borders, Morgan R; Sushereba, Christen E; Haverkamp, Donald; Wolf, Steven P; Doebbeling, Bradley N

2016-03-01

Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration's EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability.

Designing Colorectal Cancer Screening Decision Support: A Cognitive Engineering Enterprise

PubMed Central

Militello, Laura G.; Saleem, Jason J.; Borders, Morgan R.; Sushereba, Christen E.; Haverkamp, Donald; Wolf, Steven P.; Doebbeling, Bradley N.

2016-01-01

Adoption of clinical decision support has been limited. Important barriers include an emphasis on algorithmic approaches to decision support that do not align well with clinical work flow and human decision strategies, and the expense and challenge of developing, implementing, and refining decision support features in existing electronic health records (EHRs). We applied decision-centered design to create a modular software application to support physicians in managing and tracking colorectal cancer screening. Using decision-centered design facilitates a thorough understanding of cognitive support requirements from an end user perspective as a foundation for design. In this project, we used an iterative design process, including ethnographic observation and cognitive task analysis, to move from an initial design concept to a working modular software application called the Screening & Surveillance App. The beta version is tailored to work with the Veterans Health Administration’s EHR Computerized Patient Record System (CPRS). Primary care providers using the beta version Screening & Surveillance App more accurately answered questions about patients and found relevant information more quickly compared to those using CPRS alone. Primary care providers also reported reduced mental effort and rated the Screening & Surveillance App positively for usability. PMID:26973441

Use of a brief standardized screening instrument in a primary care setting to enhance detection of social-emotional problems among youth in foster care.

PubMed

Jee, Sandra H; Halterman, Jill S; Szilagyi, Moira; Conn, Anne-Marie; Alpert-Gillis, Linda; Szilagyi, Peter G

2011-01-01

To determine whether systematic use of a validated social-emotional screening instrument in a primary care setting is feasible and improves detection of social-emotional problems among youth in foster care. Before-and-after study design, following a practice intervention to screen all youth in foster care for psychosocial problems using the Strengths and Difficulties Questionnaire (SDQ), a validated instrument with 5 subdomains. After implementation of systematic screening, youth aged 11 to 17 years and their foster parents completed the SDQ at routine health maintenance visits. We assessed feasibility of screening by measuring the completion rates of SDQ by youth and foster parents. We compared the detection of psychosocial problems during a 2-year period before systematic screening to the detection after implementation of systematic screening with the SDQ. We used chart reviews to assess detection at baseline and after implementing systematic screening. Altogether, 92% of 212 youth with routine visits that occurred after initiation of screening had a completed SDQ in the medical record, demonstrating high feasibility of systematic screening. Detection of a potential mental health problem was higher in the screening period than baseline period for the entire population (54% vs 27%, P < .001). More than one-fourth of youth had 2 or more significant social-emotional problem domains on the SDQ. Systematic screening for potential social-emotional problems among youth in foster care was feasible within a primary care setting and doubled the detection rate of potential psychosocial problems. Copyright © 2011 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Screen Twice, Cut Once: Assessing the Predictive Validity of Applicant Selection Tools

ERIC Educational Resources Information Center

Goldhaber, Dan; Grout, Cyrus; Huntington-Klein, Nick

2017-01-01

Despite their widespread use, there is little academic evidence on whether applicant selection instruments can improve teacher hiring. We examine the relationship between two screening instruments used by Spokane Public Schools to select classroom teachers and three teacher outcomes: value added, absences, and attrition. We observe all applicants…

A Brief Screening Instrument for Emotionally Unstable and Dissocial Personality Disorder in Male Offenders with Intellectual Disabilities

ERIC Educational Resources Information Center

Taylor, John L.; Novaco, Raymond W.

2013-01-01

Personality disorder is prevalent among offenders with intellectual disabilities (ID), and it is associated with their risk for violence and recurrent offending behaviour. A new staff-rated instrument, the Personality Disorder Characteristics Checklist (PDCC), designed to screen for ICD-10 dissocial and emotionally unstable personality…

What Is Available for Case Identification in Autism Research in Mainland China?

ERIC Educational Resources Information Center

Sun, Xiang; Allison, Carrie; Auyeung, Bonnie; Matthews, Fiona E.; Baron-Cohen, Simon; Brayne, Carol

2013-01-01

Little is known about research on Autism Spectrum Conditions (ASC) in mainland China. The few available studies in mainland China have shown the screening and diagnostic instruments for ASC used in mainland China were different from the West. Literature on screening and diagnostic instruments and criteria were reviewed and current available…

Screening for Autism Spectrum Disorder in Low- and Middle-Income Countries: A Systematic Review

ERIC Educational Resources Information Center

Stewart, Lydia A.; Lee, Li-Ching

2017-01-01

This review contributes to the growing body of global autism spectrum disorder literature by examining the use of screening instruments in low- and middle-income countries with respect to study design and methodology, instrument adaptation and performance, and collaboration with community stakeholders in research. A systematic review was conducted…

Identifying instruments to quantify financial management skills in adults with acquired cognitive impairments.

PubMed

Engel, Lisa; Bar, Yael; Beaton, Dorcas E; Green, Robin E; Dawson, Deirdre R

2016-01-01

Financial management skills-that is, the skills needed to handle personal finances such as banking and paying bills-are essential to a person's autonomy, independence, and community living. To date, no comprehensive review of financial management skills instruments exists, making it difficult for clinicians and researchers to choose relevant instruments. The objectives of this review are to: (a) identify all available instruments containing financial management skill items that have been used with adults with acquired cognitive impairments; (b) categorize the instruments by source (i.e., observation based, self-report, proxy report); and (c) describe observation-based performance instruments by populations, overarching concepts measured, and comprehensiveness of financial management items. Objective (c) focuses on observation-based performance instruments as these measures can aid in situations where the person with cognitive impairment has poor self-awareness or where the proxy has poor knowledge of the person's current abilities. Two reviewers completed two systematic searches of five databases. Instruments were categorized by reviewing published literature, copies of the instruments, and/or communication with instrument authors. Comprehensiveness of items was based on nine key domains of financial management skills developed by the authors. A total of 88 discrete instruments were identified. Of these, 44 were categorized as observation-based performance and 44 as self- and/or proxy-reports. Of the 44 observation-based performance instruments, 8 had been developed for acquired brain injury populations and 24 for aging and dementia populations. Only 7 of the observation-based performance instruments had items spanning 6 or more of the 9 financial management skills domains. The majority of instruments were developed for aging and dementia populations, and few were comprehensive. This review provides foundation for future instrument psychometric and clinimetric reviews. It a necessary first step in providing information to support decision making for clinicians and researchers selecting financial management skills instruments.

Systematic Review of Measurement Property Evidence for 8 Financial Management Instruments in Populations With Acquired Cognitive Impairment.

PubMed

Engel, Lisa; Chui, Adora; Beaton, Dorcas E; Green, Robin E; Dawson, Deirdre R

2018-03-07

To critically appraise the measurement property evidence (ie, psychometric) for 8 observation-based financial management assessment instruments. Seven databases were searched in May 2015. Two reviewers used an independent decision-agreement process to select studies of measurement property evidence relevant to populations with adulthood acquired cognitive impairment, appraise the quality of the evidence, and extract data. Twenty-one articles were selected. This review used the COnsensus-based Standards for the selection of health Measurement Instruments review guidelines and 4-point tool to appraise evidence. After appraising the methodologic quality, the adequacy of results and volume of evidence per instrument were synthesized. Measurement property evidence with high risk of bias was excluded from the synthesis. The volume of measurement property evidence per instrument is low; most instruments had 1 to 3 included studies. Many included studies had poor methodologic quality per measurement property evidence area examined. Six of the 8 instruments reviewed had supporting construct validity/hypothesis-testing evidence of fair methodologic quality. There is a dearth of acceptable quality content validity, reliability, and responsiveness evidence for all 8 instruments. Rehabilitation practitioners assess financial management functions in adults with acquired cognitive impairments. However, there is limited published evidence to support using any of the reviewed instruments. Practitioners should exercise caution when interpreting the results of these instruments. This review highlights the importance of appraising the quality of measurement property evidence before examining the adequacy of the results and synthesizing the evidence. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Construct Validity and Reliability of a New Spanish Empathy Questionnaire for Children and Early Adolescents

PubMed Central

Richaud, Maria C.; Lemos, Viviana N.; Mesurado, Belen; Oros, Laura

2017-01-01

Empathy is a basic socio-emotional process of human development that involves the ability to perceive, share, and understand the emotional states of others. This process is essential to successful social functioning. However, despite its significance, empathy has been difficult to define and measure, particularly when incorporating both its emotional and cognitive aspects. The purpose of this study was to develop an Empathy Questionnaire for children aged 9–12 years based on a model of social cognitive neuroscience and to analyze its construct validity and reliability. This questionnaire aimed to integrate the following aspects: emotional contagion, self-other awareness, perspective-taking, emotional regulation, and empathic action. Three studies were conducted. Study 1 evaluated the discriminative power of the items and studied the underlying structure of the instrument using exploratory factor analysis. In Study 2, confirmatory factor analysis was performed to test the model obtained. Finally, the goal of Study 3 was to analyze the convergent and discriminant validity of the questionnaire and the internal consistency of its dimensions. The final version of the instrument contained 15 items that operationalized the previously listed dimensions. The results of the 3 studies indicated that the questionnaire had good validity and reliability. This study has important implications for research and clinical practice. Given its simplicity and brevity, this new self-report scale may work well as a screening method to evaluate the key psychological issues underlying numerous child behaviors that predict the success or failure of social relationships, individual quality of life, and mental well-being. PMID:28659848

Construct Validity and Reliability of a New Spanish Empathy Questionnaire for Children and Early Adolescents.

PubMed

Richaud, Maria C; Lemos, Viviana N; Mesurado, Belen; Oros, Laura

2017-01-01

Empathy is a basic socio-emotional process of human development that involves the ability to perceive, share, and understand the emotional states of others. This process is essential to successful social functioning. However, despite its significance, empathy has been difficult to define and measure, particularly when incorporating both its emotional and cognitive aspects. The purpose of this study was to develop an Empathy Questionnaire for children aged 9-12 years based on a model of social cognitive neuroscience and to analyze its construct validity and reliability. This questionnaire aimed to integrate the following aspects: emotional contagion, self-other awareness, perspective-taking, emotional regulation , and empathic action. Three studies were conducted. Study 1 evaluated the discriminative power of the items and studied the underlying structure of the instrument using exploratory factor analysis. In Study 2, confirmatory factor analysis was performed to test the model obtained. Finally, the goal of Study 3 was to analyze the convergent and discriminant validity of the questionnaire and the internal consistency of its dimensions. The final version of the instrument contained 15 items that operationalized the previously listed dimensions. The results of the 3 studies indicated that the questionnaire had good validity and reliability. This study has important implications for research and clinical practice. Given its simplicity and brevity, this new self-report scale may work well as a screening method to evaluate the key psychological issues underlying numerous child behaviors that predict the success or failure of social relationships, individual quality of life, and mental well-being.

Perceived cognitive difficulties and cognitive test performance as predictors of employment outcomes in people with multiple sclerosis.

PubMed

Honan, Cynthia A; Brown, Rhonda F; Batchelor, Jennifer

2015-02-01

Perceived cognitive difficulties and cognitive impairment are important determinants of employment in people with multiple sclerosis (pwMS). However, it is not clear how they are related to adverse work outcomes and whether the relationship is influenced by depressive symptoms. Thus, this study examined perceived and actual general cognitive and prospective memory function, and cognitive appraisal accuracy, in relation to adverse work outcomes. The possible mediating and/or moderating role of depression was also examined. A cross-sectional community-based sample of 111 participants (33 males, 78 females) completed the Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ), Beck Depression Inventory - Fast Screen (BDI-FS), and questions related to their current or past employment. They then underwent cognitive testing using the Screening Examination for Cognitive Impairment, Auditory Consonant Trigrams test, Zoo Map Test, and Cambridge Prospective Memory Test. Perceived general cognitive and prospective memory difficulties in the workplace and performance on the respective cognitive tests were found to predict unemployment and reduced work hours since MS diagnosis due to MS. Depression was also related to reduced work hours, but it did not explain the relationship between perceived cognitive difficulties and the work outcomes. Nor was it related to cognitive test performance. The results highlight a need to address the perceptions of cognitive difficulties together with cognitive impairment and levels of depression in vocational rehabilitation programs in pwMS.

Child Abuse and Neglect: Screening for Risks During the Perinatal Period

PubMed Central

Besier, T.; Pillhofer, M.; Botzenhart, S.; Ziegenhain, U.; Kindler, H.; Spangler, G.; Bovenschen, I.; Gabler, S.; Künster, A. K.

2012-01-01

Purpose: Currently, there is a claim for earlier interventions for families in order to prevent child maltreatment. Here, a screening instrument to assess risk indicators for child abuse and neglect already in the context of maternity clinics is introduced. The present study is the first report on the psychometric properties of this instrument, the “short questionnaire for risk indices around birth” (RIAB). Material and Methods: Data were collected in the context of three different studies conducted at Ulm University Hospital. To examine interrater reliability eight case vignettes were rated by n = 90 study participants (50 students and 40 experts working at a maternity clinic). Criterion validity was examined in two studies applying the German version of the child abuse potential inventory CAPI (n = 96 families at risk and n = 160 additional families). Results: Both laymen and experts were able to understand and use the screening instrument correctly, leading to a high agreement with the sample solutions given. A high concordance was found between parentsʼ and expertsʼ ratings: In case of no reported risk factors applying the screening instrument RIAB, parents themselves reported significantly less stressors and burdens, compared to those parents with an indication for a thorough examination as pointed out in the RIAB. Conclusion: In the context of maternity clinics the RIAB is a useful, broadly applicable instrument, screening for existing risk factors at the earliest and thus allowing for the initiation of specific interventions when needed. PMID:25298543

Validation and adaptation of the Norwegian version of Hayes Ability Screening Index for intellectual difficulties in a psychiatric sample.

PubMed

Søndenaa, Erik; Nygård, Øyvind; Nøttestad, Jim Aage; Linaker, Olav Martin

2011-02-01

Intellectual disabilities (ID) among psychiatric patients have traditionally been neglected. A lack of convenient instruments and competency in ID may have worsened the conditions and treatment availability for these patients. Validation and adaptation of a screening instrument for ID (Hayes Ability Screening Index; HASI) in a psychiatric hospital setting. This is a cross-sectional study of 50 psychiatric patients in two Norwegian psychiatric hospitals comparing results of the HASI with the Wechsler Abbreviated Scale of Intelligence (WASI). The HASI correlated well with the standard IQ test used (r= 0.67, P< 0.001). At a stated cut-off score of 85, the HASI had a sensitivity of 100% and specificity of 34%. The HASI is a valid and time-saving screening instrument for ID among psychiatric patients. The prescribed cut-off score, however, resulted in a large number of false positives.

Screening of depression in adolescents through the Internet : sensitivity and specificity of two screening questionnaires.

PubMed

Cuijpers, Pim; Boluijt, Petra; van Straten, Annemieke

2008-02-01

The Internet may offer new opportunities for treating depressed adolescents. However, before such treatments are possible, well-validated screening instruments are needed. In the current study, we validate two Internet-based screening instruments for depression among adolescents, the major depression inventory (MDI), and the Center for Epidemiological Studies-Depression scale (CES-D). A total of 1,392 adolescents, recruited through high schools and the Internet, filled in the online questionnaires. Of these, 243 (17%) were interviewed with the MINI diagnostic interview to assess the presence of a mood disorder. Cronbach's alpha was high for both the CES-D (0.93) and the MDI (0.88), and both correlated highly with each other (0.88; P < .001). The scores on both instruments were significantly increased in all subjects with a mood disorder, whether current or lifetime, except for lifetime minor depression. In the ROC analyses, high areas under the curve were found for the MDI (0.89) and CES-D (0.90). The best cut-off point for the MDI was 19 (sensitivity: 90.48; specificity: 71.53), and for the CES-D it was 22 (sensitivity: 90.48; specificity: 74.31). We conclude that the MDI and CES-D are reliable and valid instruments that can be used for this screening.

A cultural research approach to instrument development: the case of breast and cervical cancer screening among Latino and Anglo women

PubMed Central

Betancourt, Hector; Flynn, Patricia M.; Riggs, Matt; Garberoglio, Carlos

2010-01-01

To illustrate the implementation of a bottom-up approach to the study of culture in health disparities, this article describes the development of a cultural cancer screening scale (CCSS) using mixed methodologies. The aim was to identify cultural factors relevant to breast and cervical cancer screening, develop an instrument to assess them and examine its preliminary psychometric properties among Latin American (Latino) and non-Latino White (Anglo) women in Southern California. Seventy-eight Latino and Anglo women participated in semi-structured interviews, which were content coded based on Triandis' methods for the analysis of subjective culture. Based on the emerging cultural elements, items relevant to cancer screening were developed and pilot tested with 161 participants. After the instrument was refined, 314 Latino and Anglo women from various socioeconomic backgrounds completed the CCSS and data were factor analyzed resulting in five cultural factors: cancer screening fatalism, negative beliefs about health professionals, catastrophic disease expectations, symptomatic deterrents and sociocultural deterrents. The instrument demonstrated measurement equivalence, adequate reliability and predictive validity. The research and the CCSS are discussed in terms of implications for the study of culture in relation to health disparities and the development of evidence-based interventions with culturally diverse populations and their health professionals. PMID:20864605

Using cognitive pre-testing methods in the development of a new evidenced-based pressure ulcer risk assessment instrument.

PubMed

Coleman, S; Nixon, J; Keen, J; Muir, D; Wilson, L; McGinnis, E; Stubbs, N; Dealey, C; Nelson, E A

2016-11-16

Variation in development methods of Pressure Ulcer Risk Assessment Instruments has led to inconsistent inclusion of risk factors and concerns about content validity. A new evidenced-based Risk Assessment Instrument, the Pressure Ulcer Risk Primary Or Secondary Evaluation Tool - PURPOSE-T was developed as part of a National Institute for Health Research (NIHR) funded Pressure Ulcer Research Programme (PURPOSE: RP-PG-0407-10056). This paper reports the pre-test phase to assess and improve PURPOSE-T acceptability, usability and confirm content validity. A descriptive study incorporating cognitive pre-testing methods and integration of service user views was undertaken over 3 cycles comprising PURPOSE-T training, a focus group and one-to-one think-aloud interviews. Clinical nurses from 2 acute and 2 community NHS Trusts, were grouped according to job role. Focus group participants used 3 vignettes to complete PURPOSE-T assessments and then participated in the focus group. Think-aloud participants were interviewed during their completion of PURPOSE-T. After each pre-test cycle analysis was undertaken and adjustment/improvements made to PURPOSE-T in an iterative process. This incorporated the use of descriptive statistics for data completeness and decision rule compliance and directed content analysis for interview and focus group data. Data were collected April 2012-June 2012. Thirty-four nurses participated in 3 pre-test cycles. Data from 3 focus groups, 12 think-aloud interviews incorporating 101 PURPOSE-T assessments led to changes to improve instrument content and design, flow and format, decision support and item-specific wording. Acceptability and usability were demonstrated by improved data completion and appropriate risk pathway allocation. The pre-test also confirmed content validity with clinical nurses. The pre-test was an important step in the development of the preliminary PURPOSE-T and the methods used may have wider instrument development application. PURPOSE-T proposes a new approach to pressure ulcer risk assessment, incorporating a screening stage, the inclusion of skin status to distinguish between those who require primary prevention and those who require secondary prevention/treatment and the use of colour to support pathway allocation and decision making. Further clinical evaluation is planned to assess the reliability and validity of PURPOSE-T and it's impact on care processes and patient outcomes.

The Community College Survey of Men: An Initial Validation of the Instrument's Non-Cognitive Outcomes Construct

ERIC Educational Resources Information Center

Wood, J. \\Luke; Harris, Frank, III.

2013-01-01

The purpose of this manuscript is to discuss the utility of the Community College Survey of Men (CCSM[c]), an instrument designed to examine predictors of student success for men in community colleges. The authors highlight initial validation results from a recent pilot of the CCSM[c], with a focus on the non-cognitive outcomes construct employed…

Cognition, social cognition and functional disability in early-stage schizophrenia: A study from southern India.

PubMed

Kurtz, Matthew M; Gopal, Subhashini; John, Sujit; Thara, R

2018-04-24

In high-income countries a wealth of studies has revealed cognitive and social cognitive deficits in schizophrenia and a close relationship of these deficits to psychosocial functioning. Studies examining these illness features in middle and low-income countries are rare, particularly in early-stage samples. Sixty adult participants within 5 years of diagnosis with schizophrenia and 53 matched, healthy control were assessed with the MATRICS Consensus Cognitive Battery and the PEAT emotion identification task at study entry, and the WHODAS functioning scale one year later. Deficits on cognitive instruments ranged from d = 0.64-1.04 and were consistent with those reported in Western samples. Negative symptoms were linked to function longitudinally. Deficits in social cognitive skills and longitudinal links between cognition and functioning were not evident. These findings suggest a highly consistent magnitude of neurocognitive deficits in people with schizophrenia across widely varying cultures, but with limited evidence of social cognitive skill deficits using Western-based instruments. There was little evidence of a relationship between cognition and psychosocial disability in people with early-stage schizophrenia in this sample. Copyright © 2018 Elsevier B.V. All rights reserved.

Head-Up Displays and Attention Capture

NASA Technical Reports Server (NTRS)

Prinzel, Lawrence J., III; Risser, Matthew

2004-01-01

The primary role of head-up displays (HUDs) is to provide primary flight, navigation, and guidance information to the pilot in a forward field-of-view on a head-up transparent screen. Therefore, this theoretically allows for optimal control of an aircraft through the simultaneous scanning of both instrument data and the out-the-window scene. However, despite significant aviation safety benefits afforded by HUDs, a number of accidents have shown that their use does not come without costs. The human factors community has identified significant issues related to the pilot distribution of near and far domain attentional resources because of the compellingness of symbology elements on the HUD; a concern termed, attention or cognitive capture. The paper describes the phenomena of attention capture and presents a selected survey of the literature on the etiology and potential prescriptions.

Using health psychology to help patients: common mental health disorders and psychological distress.

PubMed

Barley, Elizabeth; Lawson, Victoria

2016-09-22

This article provides an overview of how health psychology can be used by nurses to help patients experiencing common mental health problems and psychological distress. Mental health problems are common and are associated with poor outcomes, especially for patients with comorbid physical health conditions. Mental health problems are associated with unhealthy behaviours such as smoking, physical inactivity, overeating and excessive alcohol use, which will result in poorer outcomes for patients. Consideration of a patient's psychological health is therefore important for all nurses providing holistic care. Awareness of the symptoms of psychological distress, good communication skills and simple screening instruments can be used by nurses to assess patients' mental health. The cognitive and behavioural risk factors associated with depression and anxiety are also explored, as an understanding of these can help nurses to provide appropriate care.

Internet addiction in young people.

PubMed

Ong, Say How; Tan, Yi Ren

2014-07-01

In our technology-savvy population, mental health professionals are seeing an increasing trend of excessive Internet use or Internet addiction. Researchers in China, Taiwan and Korea have done extensive research in the field of Internet addiction. Screening instruments are available to identify the presence of Internet addiction and its extent. Internet addiction is frequently associated with mental illnesses such as anxiety, depression, conduct disorder and attention deficit hyperactivity disorder (ADHD). Treatment modalities include individual and group therapies, cognitive behavioural therapy (CBT), family therapy and psychotropic medications. A significant proportion of Singapore adolescents engaging in excessive Internet use are also diagnosed to have concomitant Internet addiction. Despite the presence of a variety of treatment options, future research in this area is needed to address its growing trend and to minimise its negative psychological and social impact on the individuals and their families.

Integrated Cognitive-neuroscience Architectures for Understanding Sensemaking (ICArUS): Phase 1 Challenge Problem Walkthrough

DTIC Science & Technology

2014-11-01

Integrated Cognitive-neuroscience Architectures for Understanding Sensemaking (ICArUS): Phase 1 Challenge Problem Walkthrough Kevin Burns...4. TITLE AND SUBTITLE Integrated Cognitive-neuroscience Architectures for Understanding Sensemaking (ICArUS): Phase 1 Challenge Problem Walkthrough...Integrated Cognitive-neuroscience Architectures for Understanding Sensemaking (ICArUS) Phase 1 challenge problem. The pages include screen shots

The Music Attentiveness Screening Assessment, Revised (MASA-R): A Study of Technical Adequacy.

PubMed

Waldon, Eric G; Lesser, Alexander; Weeden, Lydia; Messick, Emily

2016-01-01

Evidence suggests that attention is an important consideration when designing procedural support interventions for children undergoing distressing medical procedures. As such, the extent to which children can attend to musical stimuli used during music-based procedural support interventions would seem important. The Music Attentiveness Screening Assessment (MASA) was designed to assess a child's ability to attend to musical stimuli, but further revisions were deemed necessary to improve administration, test-retest reliability, and interobserver agreement for the measure's items. This study investigated the technical adequacy of the Music Attentiveness Screening Assessment, Revised (MASA-R), with a non-clinical sample of children aged 4 to 9 years by examining (a) Construct validity using comparator instruments measuring auditory attention; (b) Test-retest reliability following a two-week delay; and (c) Interobserver agreement when administered by two independent examiners. This non-clinical sample included 69 children who were administered both items from MASA-R and two comparator instruments: the Auditory Attention subtest from the NEPSY-II (NII-AA) for children aged 5 to 9 years (n = 47); and the Auditory Attention subtest from the Woodcock-Johnson Tests of Cognitive Abilities, 3rd ed. (WJIII-AA), for children aged 4 years (n = 22). A significant proportion of score variance was shared by both MASA-R items and the comparator measures: R (2) = .16, F(2, 66) = 6.30, p = .003. MASA-R score estimates with regard to test-retest reliability (Item I, intra-class correlation [ICC] = .88; Item II, ICC = .91) and interobserver agreement (Item I, ICC = .99; Item II, ICC = .98) also fell into acceptable ranges. Estimates of MASA-R score construct validity, test-retest reliability, and interobserver agreement appear improved over its predecessor, MASA. While findings are promising, additional investigation of its use with a clinical sample is needed before it can be confidently used in pediatrics. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Beside the Geriatric Depression Scale: the WHO-Five Well-being Index as a valid screening tool for depression in nursing homes.

PubMed

Allgaier, Antje-Kathrin; Kramer, Dietmar; Saravo, Barbara; Mergl, Roland; Fejtkova, Sabina; Hegerl, Ulrich

2013-11-01

The aim of the study was to compare criterion validities of the WHO-Five Well-being Index (WHO-5) and the Geriatric Depression Scale 15-item version (GDS-15) and 4-item version (GDS-4) as screening instruments for depression in nursing home residents. Data from 92 residents aged 65-97 years without severe cognitive impairment (Mini Mental State Examination ≥15) were analysed. Criterion validities of the WHO-5, the GDS-15 and the GDS-4 were assessed against diagnoses of major and minor depression provided by the Structured Clinical Interview for DSM-IV. Subanalyses were performed for major and minor depression. Areas under the receiver operating curve (AUCs) as well as sensitivities and specificities at optimal cut-off points were computed. Prevalence of depressive disorder was 28.3%. The AUC value of the WHO-5 (0.90) was similar to that of the GDS-15 (0.82). Sensitivity of the WHO-5 (0.92) at its optimal cut-off of ≤12 was significantly higher than that of the GDS-15 (0.69) at its optimal cut-off of ≥7. The WHO-5 was equally sensitive for the subgroups of major and minor depression (0.92), whereas the GDS-15 was sensitive only for major depression (0.85), but not for minor depression (0.54). For specificity, there was no significant difference between WHO-5 (0.79) and GDS-15 (0.88), but both instruments outperformed the GDS-4 (0.53). The WHO-5 demonstrated high sensitivity for major and minor depression. Being shorter than the GDS-15 and superior to the GDS-4, the WHO-5 is a promising screening tool that could help physicians improve low recognition rates of depression in nursing home residents. Copyright © 2013 John Wiley & Sons, Ltd.

The Effects of Hypertension on Cognitive Function in Children and Adolescents

PubMed Central

Cha, Stephen D.; Patel, Hiren P.; Hains, David S.; Mahan, John D.

2012-01-01

Hypertension (HTN) is found in about 3-4% of the pediatric population with long-term risks of end organ damage if untreated or poorly controlled. Although children with HTN are being more frequently screened for end organ damage (i.e., LVH), the cognitive effects of HTN and methods to screen for cognitive dysfunction have not been extensively explored. In recent years, there have been a small number of studies that have provided important insights that can guide future research in this area. These studies show that HTN can be associated with headaches, restlessness, sleep disturbance, anxiety, depression, decreased attention, and also poor executive functioning. By increasing the utilization of cognitive tests in hypertensive children and adolescents, important cognitive defects secondary to HTN may be detected. More research is needed in the area, and the results of future studies could have far reaching implications for long-term outcomes in hypertensive children and adolescents. PMID:22518186

CFAI-Plus: Adding cognitive frailty as a new domain to the comprehensive frailty assessment instrument.

PubMed

De Roeck, Ellen Elisa; Dury, Sarah; De Witte, Nico; De Donder, Liesbeth; Bjerke, Maria; De Deyn, Peter Paul; Engelborghs, Sebastiaan; Dierckx, Eva

2018-07-01

Cognitive frailty is characterized by the presence of cognitive impairment in exclusion of dementia. In line with other frailty domains, cognitive frailty is associated with negative outcomes. The Comprehensive Frailty Assessment Instrument (CFAI) measures 4 domains of frailty, namely physical, psychological, social, and environmental frailty. The absence of cognitive frailty is a limitation. An expert panel selected 6 questions from the Informant Questionnaire on Cognitive Decline that were, together with the CFAI and the Montreal cognitive assessment administered to 355 older community dwelling adults (mean age = 77). After multivariate analysis, 2 questions were excluded. All the questions from the original CFAI were implemented in a principal component analysis together with the 4 cognitive questions, showing that the 4 cognitive questions all load on 1 factor, representing the cognitive domain of frailty. By adding the cognitive domain to the CFAI, the reliability of the adapted CFAI (CFAI-Plus), remains good (Cronbach's alpha: .767). This study showed that cognitive frailty can be added to the CFAI without affecting its good psychometric properties. In the future, the CFAI-Plus needs to be validated in an independent cohort, and the interaction with the other frailty domains needs to be studied. Copyright © 2018 John Wiley & Sons, Ltd.

Performance of the Automated Neuropsychological Assessment Metrics (ANAM) in detecting cognitive impairment in heart failure patients.

PubMed

Xie, Susan S; Goldstein, Carly M; Gathright, Emily C; Gunstad, John; Dolansky, Mary A; Redle, Joseph; Hughes, Joel W

2015-01-01

Evaluate capacity of the Automated Neuropsychological Assessment Metrics (ANAM) to detect cognitive impairment (CI) in heart failure (HF) patients. CI is a key prognostic marker in HF. Though the most widely used cognitive screen in HF, the Mini-Mental State Examination (MMSE) is insufficiently sensitive. The ANAM has demonstrated sensitivity to cognitive domains affected by HF, but has not been assessed in this population. Investigators administered the ANAM and MMSE to 57 HF patients, compared against a composite model of cognitive function. ANAM efficiency (p < .05) and accuracy scores (p < .001) successfully differentiated CI and non-CI. ANAM efficiency and accuracy scores classified 97.7% and 93.0% of non-CI patients, and 14.3% and 21.4% with CI, respectively. The ANAM is more effective than the MMSE for detecting CI, but further research is needed to develop a more optimal cognitive screen for routine use in HF patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Cognitive impairment and driving safety.

PubMed

Eby, David W; Molnar, Lisa J

2012-11-01

As the populations of many countries continue to age, cognitive impairment will likely become more common. Individuals with cognitive impairment pose special challenges for families, health professionals, driving safety professionals, and the larger community, particularly if these older adults depend on driving as their primary means of community mobility. It is vital that we continue to extend our knowledge about the driving behavior of individuals' with cognitive impairment, as well as try to develop effective means of screening and assessing these individuals for fitness to drive and help facilitate their transition to non-driving when appropriate. This special issue is intended to provide researchers and practitioners an opportunity to present the most recent research findings on driving-related issues among older adults with cognitive impairment. The issue contains 11 original contributions from seven countries. The topics covered by these papers are: crash risks; screening, assessment, and fitness to drive; driving performance using a driving simulator; and driving behaviors and driving-related decisions of people with cognitive impairments. Copyright © 2012. Published by Elsevier Ltd.

The screening role of an introductory course in cognitive therapy training.

PubMed

Pehlivanidis, Artemios; Papanikolaou, Katerina; Politis, Antonis; Liossi, Angeliki; Daskalopoulou, Evgenia; Gournellis, Rossetos; Soldatos, Marina; Papakosta, Vasiliki Maria; Zervas, Ioannis; Papakostas, Yiannis G

2006-01-01

This study examines the role of an introductory course in cognitive therapy and the relative importance of trainees' characteristics in the selection process for an advanced course in cognitive therapy. The authors assessed the files of all trainees who completed one academic year introductory course in cognitive therapy over the last seven consecutive years (N = 203). The authors examined variables such as previous training, overall involvement during the course, performance, and ability to relate to others, as well as the trainer's evaluations of their performance. Interaction skills in group situations and performance in written assignments were better predictors for admission into the advanced course. Trainees' abilities to learn and to successfully relate to others in group situations are critical for entering an advanced cognitive therapy training course. These findings question the policy of full-scale training in cognitive therapy based merely on the candidates' professional background, stressing instead the merits of an introductory course as an appropriate screening procedure.

Does routine psychosocial screening improve referral to psychosocial care providers and patient-radiotherapist communication? A cluster randomized controlled trial.

PubMed

Braeken, Anna P B M; Lechner, Lilian; Eekers, Daniëlle B P; Houben, Ruud M A; van Gils, Francis C J M; Ambergen, Ton; Kempen, Gertrudis I J M

2013-11-01

This study tests whether using a screening instrument improves referral to psychosocial care providers (e.g. psychologist) and facilitates patient-radiotherapist communication. A cluster randomized controlled trial was used. Fourteen radiotherapists were randomly allocated to the experimental or control group and 568 of their patients received care in accordance with the group to which their radiotherapist was allocated. Patients in the experimental group were asked to complete a screening instrument before and at the end of the radiation treatment period. All patients were requested to complete questionnaires concerning patient-physician communication after the first consultation and concerning psychosocial care 3 and 12 months post-intervention. Patients who completed the screening instrument were referred to social workers at an earlier stage than patients who did not (P<0.01). No effects were observed for numbers of referred patients, or for improved patient-radiotherapist communication. Our results suggest that a simple screening procedure can be valuable for the timely treatment of psychosocial problems in patients. Future efforts should be directed at appropriate timing of screening and enhancing physicians' awareness regarding the importance of identifying, discussing and treating psychosocial problems in cancer patients. Psychosocial screening can be enhanced by effective radiotherapist-patient communication. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A Clinical Update on Delirium: From Early Recognition to Effective Management

PubMed Central

Cerejeira, Joaquim; Mukaetova-Ladinska, Elizabeta B.

2011-01-01

Delirium is a neuropsychiatric syndrome characterized by altered consciousness and attention with cognitive, emotional and behavioural symptoms. It is particularly frequent in elderly people with medical or surgical conditions and is associated with adverse outcomes. Predisposing factors render the subject more vulnerable to a congregation of precipitating factors which potentially affect brain function and induce an imbalance in all the major neurotransmitter systems. Early diagnosis of delirium is crucial to improve the prognosis of patients requiring the identification of subtle and fluctuating signs. Increased awareness of clinical staff, particularly nurses, and routine screening of cognitive function with standardized instruments, can be decisive to increase detection rates of delirium. General measures to prevent delirium include the implementation of protocols to systematically identify and minimize all risk factors present in a particular clinical setting. As soon as delirium is recognized, prompt removal of precipitating factors is warranted together with environmental changes and early mobilization of patients. Low doses of haloperidol or olanzapine can be used for brief periods, for the behavioural control of delirium. All of these measures are a part of the multicomponent strategy for prevention and treatment of delirium, in which the nursing care plays a vital role. PMID:21994844

Selective information seeking: can consumers' avoidance of evidence-based information on colorectal cancer screening be explained by the theory of cognitive dissonance?

PubMed

Steckelberg, Anke; Kasper, Jürgen; Mühlhauser, Ingrid

2007-08-27

Evidence-based patient information (EBPI) is a prerequisite for informed decision-making. However, presentation of EBPI may lead to irrational reactions causing avoidance, minimisation and devaluation of the information. To explore whether the theory of cognitive dissonance is applicable to medical decision-making and useful to explain these phenomena. 261 volunteers from Hamburg (157 women), >or=50 years old without diagnosis of colorectal cancer. DESIGN AND VARIABLES: Within an experiment we simulated information seeking on colorectal cancer screening. Consumers' attitudes towards screening were surveyed using a rating scale from -5 (participate in no way) to +5 (participate unconditionally) (independent variable). Using a cover story, participants were asked to sort 5 article headlines according to their reading preferences. The headlines simulated the pro to contra variety of contents to be found in print media about colorectal cancer screening. The dependent variable was the sequence of article headlines. Participants were very much in favour of screening with scores for faecal occult blood test of 4.0 (0.1) and for colonoscopy 3.3 (0.1). According to our hypothesis we found statistically significant positive correlations between the stimuli in favour of screening and attitudes and significant negative correlations between the stimuli against screening and attitudes. The theory of cognitive dissonance is applicable to medical decision-making. It may explain some phenomena of irrational reactions to evidence-based patient information.

Selective information seeking: can consumers' avoidance of evidence-based information on colorectal cancer screening be explained by the theory of cognitive dissonance?

PubMed Central

Steckelberg, Anke; Kasper, Jürgen; Mühlhauser, Ingrid

2007-01-01

Background: Evidence-based patient information (EBPI) is a prerequisite for informed decision-making. However, presentation of EBPI may lead to irrational reactions causing avoidance, minimisation and devaluation of the information. Objective: To explore whether the theory of cognitive dissonance is applicable to medical decision-making and useful to explain these phenomena. Setting and participants: 261 volunteers from Hamburg (157 women), ≥50 years old without diagnosis of colorectal cancer. Design and variables: Within an experiment we simulated information seeking on colorectal cancer screening. Consumers’ attitudes towards screening were surveyed using a rating scale from -5 (participate in no way) to +5 (participate unconditionally) (independent variable). Using a cover story, participants were asked to sort 5 article headlines according to their reading preferences. The headlines simulated the pro to contra variety of contents to be found in print media about colorectal cancer screening. The dependent variable was the sequence of article headlines. Results: Participants were very much in favour of screening with scores for faecal occult blood test of 4.0 (0.1) and for colonoscopy 3.3 (0.1). According to our hypothesis we found statistically significant positive correlations between the stimuli in favour of screening and attitudes and significant negative correlations between the stimuli against screening and attitudes. Conclusion: The theory of cognitive dissonance is applicable to medical decision-making. It may explain some phenomena of irrational reactions to evidence-based patient information. PMID:19675713

Assessing the Sensitivity and Specificity of the MAYSI-2 for Detecting Trauma among Youth in Juvenile Detention

ERIC Educational Resources Information Center

Kerig, Patricia K.; Moeddel, Melissa Arnzen; Becker, Stephen P.

2011-01-01

This study investigated the sensitivity and specificity of the most widely used mental health screening instrument in juvenile detention, the Massachusetts Youth Screening Instrument (MAYSI-2), for detecting trauma and symptoms of posttraumatic stress disorder (PTSD) among detained youth. The MAYSI-2 scales measuring Substance Use,…

A Preliminary Language Validity Analysis of the Problem Oriented Screening Instrument for Teenagers (POSIT).

ERIC Educational Resources Information Center

Mason, Michael J.

1995-01-01

The Problem Oriented Screening Inventory for Teenagers (POSIT) was analyzed in a Hispanic majority school district to determine the test/retest correlation of the English and Spanish versions of the instrument. Data analysis indicated fairly weak agreement between the English and Spanish POSIT version results for this sample of bilingual…

Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) for the diagnosis of dementia within a secondary care setting.

PubMed

Harrison, Jennifer K; Fearon, Patricia; Noel-Storr, Anna H; McShane, Rupert; Stott, David J; Quinn, Terry J

2015-03-10

The diagnosis of dementia relies on the presence of new-onset cognitive impairment affecting an individual's functioning and activities of daily living. The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) is a questionnaire instrument, completed by a suitable 'informant' who knows the patient well, designed to assess change in functional performance secondary to cognitive change; it is used as a tool to identifying those who may have dementia.In secondary care there are two specific instances where patients may be assessed for the presence of dementia. These are in the general acute hospital setting, where opportunistic screening may be undertaken, or in specialist memory services where individuals have been referred due to perceived cognitive problems. To ensure an instrument is suitable for diagnostic use in these settings, its test accuracy must be established. To determine the diagnostic accuracy of the informant-based questionnaire IQCODE, for detection of all-cause (undifferentiated) dementia in adults presenting to secondary-care services. We searched the following sources on the 28th of January 2013: ALOIS (Cochrane Dementia and Cognitive Improvement Group), MEDLINE (Ovid SP), EMBASE (Ovid SP), PsycINFO (Ovid SP), BIOSIS Previews (Thomson Reuters Web of Science), Web of Science Core Collection (includes Conference Proceedings Citation Index) (Thomson Reuters Web of Science), CINAHL (EBSCOhost) and LILACS (BIREME). We also searched sources specific to diagnostic test accuracy: MEDION (Universities of Maastricht and Leuven); DARE (Database of Abstracts of Reviews of Effects - via the Cochrane Library); HTA Database (Health Technology Assessment Database via the Cochrane Library) and ARIF (Birmingham University). We also checked reference lists of relevant studies and reviews, used searches of known relevant studies in PubMed to track related articles, and contacted research groups conducting work on IQCODE for dementia diagnosis to try to find additional studies. We developed a sensitive search strategy; search terms were designed to cover key concepts using several different approaches run in parallel and included terms relating to cognitive tests, cognitive screening and dementia. We used standardised database subject headings such as MeSH terms (in MEDLINE) and other standardised headings (controlled vocabulary) in other databases, as appropriate. We selected those studies performed in secondary-care settings, which included (not necessarily exclusively) IQCODE to assess for the presence of dementia and where dementia diagnosis was confirmed with clinical assessment. For the 'secondary care' setting we included all studies which assessed patients in hospital (e.g. acute unscheduled admissions, referrals to specialist geriatric assessment services etc.) and those referred for specialist 'memory' assessment, typically in psychogeriatric services. We screened all titles generated by electronic database searches, and reviewed abstracts of all potentially relevant studies. Two independent assessors checked full papers for eligibility and extracted data. We determined quality assessment (risk of bias and applicability) using the QUADAS-2 tool, and reporting quality using the STARD tool. From 72 papers describing IQCODE test accuracy, we included 13 papers, representing data from 2745 individuals (n = 1413 (51%) with dementia). Pooled analysis of all studies using data presented closest to a cut-off of 3.3 indicated that sensitivity was 0.91 (95% CI 0.86 to 0.94); specificity 0.66 (95% CI 0.56 to 0.75); the positive likelihood ratio was 2.7 (95% CI 2.0 to 3.6) and the negative likelihood ratio was 0.14 (95% CI 0.09 to 0.22).There was a statistically significant difference in test accuracy between the general hospital setting and the specialist memory setting (P = 0.019), suggesting that IQCODE performs better in a 'general' setting.We found no significant differences in the test accuracy of the short (16-item) versus the 26-item IQCODE, or in the language of administration.There was significant heterogeneity in the included studies, including a highly varied prevalence of dementia (10.5% to 87.4%). Across the included papers there was substantial potential for bias, particularly around sampling of included participants and selection criteria, which may limit generalisability. There was also evidence of suboptimal reporting, particularly around disease severity and handling indeterminate results, which are important if considering use in clinical practice. The IQCODE can be used to identify older adults in the general hospital setting who are at risk of dementia and require specialist assessment; it is useful specifically for ruling out those without evidence of cognitive decline. The language of administration did not affect test accuracy, which supports the cross-cultural use of the tool. These findings are qualified by the significant heterogeneity, the potential for bias and suboptimal reporting found in the included studies.

Linguistic validation of the Alberta Context Tool and two measures of research use, for German residential long term care.

PubMed

Hoben, Matthias; Bär, Marion; Mahler, Cornelia; Berger, Sarah; Squires, Janet E; Estabrooks, Carole A; Kruse, Andreas; Behrens, Johann

2014-01-31

To study the association between organizational context and research utilization in German residential long term care (LTC), we translated three Canadian assessment instruments: the Alberta Context Tool (ACT), Estabrooks' Kinds of Research Utilization (RU) items and the Conceptual Research Utilization Scale. Target groups for the tools were health care aides (HCAs), registered nurses (RNs), allied health professionals (AHPs), clinical specialists and care managers. Through a cognitive debriefing process, we assessed response processes validity-an initial stage of validity, necessary before more advanced validity assessment. We included 39 participants (16 HCAs, 5 RNs, 7 AHPs, 5 specialists and 6 managers) from five residential LTC facilities. We created lists of questionnaire items containing problematic items plus items randomly selected from the pool of remaining items. After participants completed the questionnaires, we conducted individual semi-structured cognitive interviews using verbal probing. We asked participants to reflect on their answers for list items in detail. Participants' answers were compared to concept maps defining the instrument concepts in detail. If at least two participants gave answers not matching concept map definitions, items were revised and re-tested with new target group participants. Cognitive debriefings started with HCAs. Based on the first round, we modified 4 of 58 ACT items, 1 ACT item stem and all 8 items of the RU tools. All items were understood by participants after another two rounds. We included revised HCA ACT items in the questionnaires for the other provider groups. In the RU tools for the other provider groups, we used different wording than the HCA version, as was done in the original English instruments. Only one cognitive debriefing round was needed with each of the other provider groups. Cognitive debriefing is essential to detect and respond to problematic instrument items, particularly when translating instruments for heterogeneous, less well educated provider groups such as HCAs. Cognitive debriefing is an important step in research tool development and a vital component of establishing response process validity evidence. Publishing cognitive debriefing results helps researchers to determine potentially critical elements of the translated tools and assists with interpreting scores.

Linguistic validation of the Alberta Context Tool and two measures of research use, for German residential long term care

PubMed Central

2014-01-01

Background To study the association between organizational context and research utilization in German residential long term care (LTC), we translated three Canadian assessment instruments: the Alberta Context Tool (ACT), Estabrooks’ Kinds of Research Utilization (RU) items and the Conceptual Research Utilization Scale. Target groups for the tools were health care aides (HCAs), registered nurses (RNs), allied health professionals (AHPs), clinical specialists and care managers. Through a cognitive debriefing process, we assessed response processes validity–an initial stage of validity, necessary before more advanced validity assessment. Methods We included 39 participants (16 HCAs, 5 RNs, 7 AHPs, 5 specialists and 6 managers) from five residential LTC facilities. We created lists of questionnaire items containing problematic items plus items randomly selected from the pool of remaining items. After participants completed the questionnaires, we conducted individual semi-structured cognitive interviews using verbal probing. We asked participants to reflect on their answers for list items in detail. Participants’ answers were compared to concept maps defining the instrument concepts in detail. If at least two participants gave answers not matching concept map definitions, items were revised and re-tested with new target group participants. Results Cognitive debriefings started with HCAs. Based on the first round, we modified 4 of 58 ACT items, 1 ACT item stem and all 8 items of the RU tools. All items were understood by participants after another two rounds. We included revised HCA ACT items in the questionnaires for the other provider groups. In the RU tools for the other provider groups, we used different wording than the HCA version, as was done in the original English instruments. Only one cognitive debriefing round was needed with each of the other provider groups. Conclusion Cognitive debriefing is essential to detect and respond to problematic instrument items, particularly when translating instruments for heterogeneous, less well educated provider groups such as HCAs. Cognitive debriefing is an important step in research tool development and a vital component of establishing response process validity evidence. Publishing cognitive debriefing results helps researchers to determine potentially critical elements of the translated tools and assists with interpreting scores. PMID:24479645

Bias in discriminating very mild dementia for older adults with different levels of education in Hong Kong.

PubMed

Chang, Jianfang; Tse, Chi-Shing; Leung, Grace Tak Yu; Fung, Ada Wai Tung; Hau, Kit-Tai; Chiu, Helen Fung Kum; Lam, Linda Chiu Wa

2014-06-01

Education has a profound effect on older adults' cognitive performance. In Hong Kong, some dementia screening tasks were originally designed for developed population with, on average, higher education. We compared the screening power of these tasks for Chinese older adults with different levels of education. Community-dwelling older adults who were healthy (N = 383) and with very mild dementia (N = 405) performed the following tasks: Mini-Mental State Examination, Alzheimer's Disease Assessment Scale-Cognitive subscales, Verbal Fluency, Abstract Thinking, and Visual/Digit Span. Logistic regression was used to examine the power of these tasks to predict Clinical Dementia Rating (CDR 0.5 vs. 0). Logistic regression analysis showed that while the screening power of the total scores in all tasks was similar for high and low education groups, there were education biases in some items of these tasks. The differential screening power in high and low education groups was not identical across items in some tasks. Thus, in cognitive assessments, we should exercise great caution when using these potentially biased items for older adults with limited education.

Reading on Paper and Screen among Senior Adults: Cognitive Map and Technophobia

PubMed Central

Hou, Jinghui; Wu, Yijie; Harrell, Erin

2017-01-01

While the senior population has been increasingly engaged with reading on mobile technologies, research that specifically documents the impact of technologies on reading for this age group has still been lacking. The present study investigated how different reading media (screen versus paper) might result in different reading outcomes among older adults due to both cognitive and psychological factors. Using a laboratory experiment with 81participants aged 57 to 85, our results supported past research and showed the influence of cognitive map formation on readers’ feelings of fatigue. We contributed empirical evidence to the contention that reading on a screen could match that of reading from paper if the presentation of the text on screen resemble that of the print. Our findings also suggested that individual levels of technophobia was an important barrier to older adults’ effective use of mobile technologies for reading. In the post hoc analyses, we further showed that technophobia was correlated with technology experience, certain personality traits, and age. The present study highlights the importance of providing tailored support that helps older adults overcome psychological obstacles in using technologies. PMID:29312073

The acceptability of TV-based game platforms as an instrument to support the cognitive evaluation of senior adults at home.

PubMed

Rivas Costa, Carlos; Fernández Iglesias, Manuel José; Anido Rifón, Luis Eulogio; Gómez Carballa, Miguel; Valladares Rodríguez, Sonia

2017-01-01

The computing capabilities of state-of-the-art television sets and media centres may facilitate the introduction of computer-assisted evaluation at home. This approach would help to overcome the drawbacks of traditional pen-and-paper evaluations administered in clinical facilities, as they could be performed in a more comfortable environment, the subject's home, and they would be more flexible for designing complex environments for the evaluation of neuropsychological constructs that are difficult to assess through traditional testing. The objective of this work was to obtain some initial evidence about the technical acceptance by senior adults of serious games played at home on the TV set and therefore about the convenience of further investigating such an approach to cognitive assesment. We developed a collection of games to be deployed on a TV environment. These games were tried by a group of senior adults at their homes. The Technology Acceptance Model (TAM) was used to validate this approach. Surveys were performed to study the perceived usefulness and perceived ease of use of such technical setting as an instrument for their cognitive evaluation; that is, its technical acceptance. Subjective information collected from participants was correlated with actual interaction data captured. An additional survey was performed 36 months after pilot testing to have an indication about the long-term perceptions about usefulness and ease of use. More than 90% of participating subjects perceived cognitive games on TV as useful or very useful. The majority of participants selected the TV set as their preferred option to interact with serious games at home, when compared to other devices such as smartphones, tablets or PCs. This result correlates with the number of participants perceiving them as easily usable or very easy to use, and also with automatically captured interaction data. Three out of four seniors expressed their interest in keeping the system at home after the pilot. Besides, these perceptions are fairly stable in time as shown by the survey performed 36 months after pilot testing. Although participating users are a representative sample of the Galician population, which in turn is comparable to the population of most rural areas in Europe, a larger and more diverse user sample would be needed to obtain significant results for a wider population profile. The study confirmed the technical acceptance, that is, the perceived usefulness and perceived ease of use, of the TV-based home technical setting introduced as a means of cognitive evaluation. This study provides initial evidence on the viability of a TV-based serious games approach for cognitive longitudinal screening at home with little intervention of clinical professionals, thus contributing to the early detection of cognitive impairments in the senior population.

Removing the Stress from Selecting Instruments: Arming Social Workers to Take Leadership in Routine Distress Screening Implementation

PubMed Central

Rohan, Elizabeth A.

2015-01-01

Quality cancer care requires identifying and addressing the psychosocial needs of cancer patients. Oncology social workers have long been on the forefront of this endeavor. Although there has been longstanding interest in screening cancer patients for distress, it has recently been included as a quality of care metric in institutions accredited by the American College of Surgeons. Implementing routine screening for distress in oncology settings requires thoughtful planning, including assessing various screening instruments and considering a host of variables within each practice setting. Oncology social workers are best positioned to provide leadership in operationalizing this mandate and to lead their team in the choice of a distress measure for compliance with the screening guideline. This article highlights the most popular distress screening measures used in oncology and their psychometric properties. PMID:23101550

Removing the stress from selecting instruments: arming social workers to take leadership in routine distress screening implementation.

PubMed

Rohan, Elizabeth A

2012-01-01

Quality cancer care requires identifying and addressing the psychosocial needs of cancer patients. Oncology social workers have long been on the forefront of this endeavor. Although there has been longstanding interest in screening cancer patients for distress, it has recently been included as a quality of care metric in institutions accredited by the American College of Surgeons. Implementing routine screening for distress in oncology settings requires thoughtful planning, including assessing various screening instruments and considering a host of variables within each practice setting. Oncology social workers are best positioned to provide leadership in operationalizing this mandate and to lead their team in the choice of a distress measure for compliance with the screening guideline. This article highlights the most popular distress screening measures used in oncology and their psychometric properties.

Brief screening for co-occurring disorders among women entering substance abuse treatment.

PubMed

Lincoln, Alisa K; Liebschutz, Jane M; Chernoff, Miriam; Nguyen, Dana; Amaro, Hortensia

2006-09-07

Despite the importance of identifying co-occurring psychiatric disorders in substance abuse treatment programs, there are few appropriate and validated instruments available to substance abuse treatment staff to conduct brief screen for these conditions. This paper describes the development, implementation and validation of a brief screening instrument for mental health diagnoses and trauma among a diverse sample of Black, Hispanic and White women in substance abuse treatment. With input from clinicians and consumers, we adapted longer existing validated instruments into a 14 question screen covering demographics, mental health symptoms and physical and sexual violence exposure. All women entering treatment (methadone, residential and out-patient) at five treatment sites were screened at intake (N = 374). Eighty nine percent reported a history of interpersonal violence, and 70% reported a history of sexual assault. Eighty-eight percent reported mental health symptoms in the last 30 days. The screening questions administered to 88 female clients were validated against in-depth psychiatric diagnostic assessments by trained mental health clinicians. We estimated measures of predictive validity, including sensitivity, specificity and predictive values positive and negative. Screening items were examined multiple ways to assess utility. The screen is a useful and valid proxy for PTSD but not for other mental illness. Substance abuse treatment programs should incorporate violence exposure questions into clinical use as a matter of policy. More work is needed to develop brief screening tools measures for front-line treatment staff to accurately assess other mental health needs of women entering substance abuse treatment.

Quality of health literacy instruments used in children and adolescents: a systematic review.

PubMed

Guo, Shuaijun; Armstrong, Rebecca; Waters, Elizabeth; Sathish, Thirunavukkarasu; Alif, Sheikh M; Browne, Geoffrey R; Yu, Xiaoming

2018-06-14

Improving health literacy at an early age is crucial to personal health and development. Although health literacy in children and adolescents has gained momentum in the past decade, it remains an under-researched area, particularly health literacy measurement. This study aimed to examine the quality of health literacy instruments used in children and adolescents and to identify the best instrument for field use. Systematic review. A wide range of settings including schools, clinics and communities. Children and/or adolescents aged 6-24 years. Measurement properties (reliability, validity and responsiveness) and other important characteristics (eg, health topics, components or scoring systems) of health literacy instruments. There were 29 health literacy instruments identified from the screening process. When measuring health literacy in children and adolescents, researchers mainly focus on the functional domain (basic skills in reading and writing) and consider participant characteristics of developmental change (of cognitive ability), dependency (on parents) and demographic patterns (eg, racial/ethnic backgrounds), less on differential epidemiology (of health and illness). The methodological quality of included studies as assessed via measurement properties varied from poor to excellent. More than half (62.9%) of measurement properties were unknown, due to either poor methodological quality of included studies or a lack of reporting or assessment. The 8-item Health Literacy Assessment Tool (HLAT-8) showed best evidence on construct validity, and the Health Literacy Measure for Adolescents showed best evidence on reliability. More rigorous and high-quality studies are needed to fill the knowledge gap in measurement properties of health literacy instruments. Although it is challenging to draw a robust conclusion about which instrument is the most reliable and the most valid, this review provides important evidence that supports the use of the HLAT-8 to measure childhood and adolescent health literacy in future school-based research. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Operationalizing hippocampal volume as an enrichment biomarker for amnestic MCI trials: effect of algorithm, test-retest variability and cut-point on trial cost, duration and sample size

PubMed Central

Yu, P.; Sun, J.; Wolz, R.; Stephenson, D.; Brewer, J.; Fox, N.C.; Cole, P.E.; Jack, C.R.; Hill, D.L.G.; Schwarz, A.J.

2014-01-01

Objective To evaluate the effect of computational algorithm, measurement variability and cut-point on hippocampal volume (HCV)-based patient selection for clinical trials in mild cognitive impairment (MCI). Methods We used normal control and amnestic MCI subjects from ADNI-1 as normative reference and screening cohorts. We evaluated the enrichment performance of four widely-used hippocampal segmentation algorithms (FreeSurfer, HMAPS, LEAP and NeuroQuant) in terms of two-year changes in MMSE, ADAS-Cog and CDR-SB. We modeled the effect of algorithm, test-retest variability and cut-point on sample size, screen fail rates and trial cost and duration. Results HCV-based patient selection yielded not only reduced sample sizes (by ~40–60%) but also lower trial costs (by ~30–40%) across a wide range of cut-points. Overall, the dependence on the cut-point value was similar for the three clinical instruments considered. Conclusion These results provide a guide to the choice of HCV cut-point for aMCI clinical trials, allowing an informed trade-off between statistical and practical considerations. PMID:24211008

Development of functional oral health literacy assessment instruments: application of literacy and cognitive theories.

PubMed

Bridges, Susan M; Parthasarathy, Divya S; Au, Terry K F; Wong, Hai Ming; Yiu, Cynthia K Y; McGrath, Colman P

2014-01-01

This paper describes the development of a new literacy assessment instrument, the Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P). Its relationship to literacy theory is analyzed to establish content and face validity. Implications for construct validity are examined by analyzing cognitive demand to determine how "comprehension" is measured. Key influences from literacy assessment were identified to analyze item development. Cognitive demand was analyzed using an established taxonomy. The HKOHLAT-P focuses on the functional domain of health literacy assessment. Items had strong content and face validity reflecting established principles from modern literacy theory. Inclusion of new text types signified relevant developments in the area of new literacies. Analysis of cognitive demand indicated that this instrument assesses the "comprehension" domain, specifically the areas of factual and procedural knowledge, with some assessment of conceptual knowledge. Metacognitive knowledge was not assessed. Comprehension tasks assessing patient health literacy predominantly examine functional health literacy at the lower levels of comprehension. Item development is influenced by the fields of situated and authentic literacy. Inclusion of content regarding multiliteracies is suggested for further research. Development of functional health literacy assessment instruments requires careful consideration of the clinical context in determining construct validity. © 2013 American Association of Public Health Dentistry.

Effects of tai chi on cognition and instrumental activities of daily living in community dwelling older people with mild cognitive impairment.

PubMed

Siu, Mei-Yi; Lee, Diana T F

2018-02-02

Cognitive impairment places older adults at high risk of functional disability in their daily-life activities, and thus affecting their quality of life. This study aimed to examine the effects of Tai Chi on general cognitive functions and instrumental activities of daily living (IADL) in community-dwelling older people with mild cognitive impairment (MCI) in Hong Kong. The study adopted a multi-site nonequivalent control-group pretest-posttest design. 160 community-dwelling older people, aged ≥60, with MCI, from four community elderly centers participated in the study. The intervention group (IG, n = 80) received training in the Yang-style simple form of Tai Chi, at a frequency of two lessons per week for 16 weeks. Each lesson lasted for one hour. The control group (CG, n = 80) had no treatment regime and joined different recreational activity groups in community centers as usual within the study period. Outcome measures included measures of global cognitive status and IADL. The Chinese version of the Mini-Mental State Examination (CMMSE) was used for global cognitive assessment. The Hong Kong Chinese version of Lawton's Instrumental Activities of Daily Living (IADL-CV) was used to assess the participants' IADL levels. General Estimating Equations (GEE) was used to examine each of the outcome variables for the two groups at the two study time points (the baseline and at the end of the study). Meanwhile, minimum detectable change (MDC) was calculated to estimate the magnitude of changes required to eradicate the possibility of measurement error of outcome measures. Seventy four participants in the IG and 71 participants in the CG completed the study. With adjustments for differences in age, education, marital status and living conditions, the findings revealed that the participants in the IG scored significantly better on the CMMSE test (P = 0.001), and the instrumental ADL questionnaire (P = 0.004). However, those scores changes did not exceed the limits of the respective MDCs in the study, the possibility of measurement variation due to error could not be excluded. Tai Chi may be an effective strategy to enhance cognitive health and maintain functional abilities in instrumental ADL in older people with MCI. NCT03404765 (Retrospectively registered January 19, 2018).

Relationships Between Performance on Assessments of Executive Function and Fall Risk Screening Measures in Community-Dwelling Older Adults.

PubMed

Blackwood, Jennifer; Shubert, Tiffany; Forgarty, Kieran; Chase, Carla

2016-01-01

Fall-related injuries are a leading cause of institutionalization and morbidity in older adults. Limitations in cognition, including deficits in higher cognitive processes, like executive function (EF), contribute to a higher risk of falling in older adults. Specifically, declines in EF have been associated with changes in gait, limited mobility, and an increased frequency of falling. It is unknown whether associations between performance on commonly used clinical assessments of EF and performance on commonly used physical performance measures of fall risk are present. The purpose of this study was to examine the relationship between a clinical measure of EF, the Trail Making Test Part B (TMT-B), and 3 physical performance measures of fall risk: the Timed Up and Go (TUG) test, gait speed, and the Five Times Sit to Stand (FTSTS) test, in a group of community-dwelling older adults. Forty-seven community-dwelling older adults met the inclusion/exclusion criteria. Demographic information was obtained and measures of fall risk and cognition were performed. Correlations and linear regression analyses to assess relationships between measures were completed. To account for the high prevalence of mild cognitive impairment (MCI) in this population, the sample was screened and stratified for MCI in post hoc analyses. The EF performance was not significantly correlated with performance on the FTSTS test (ρ = 0.26, P > .05) but was significantly correlated with the TUG test (ρ = 0.31, P < .05) and gait speed (r = -0.36, P < .05). These relationships remained after adjusting for age and education in multivariate models. Results from post hoc analyses demonstrated that only those with MCI had significant relationships between EF and physical performance measures. TMT-B scores in the MCI group were significantly correlated with gait speed (ρ = -0.51, P < .05) and TUG test (ρ = 0.58, P < .05). A significant relationship exists between performance on clinical assessments of EF and fall risk assessments that integrate a mobility task for those individuals who screen positive for MCI. For those who screened negative, no significant relationship exists. Given the large prevalence of undiagnosed MCI in community-dwelling older adults, this finding could be used as an indication to screen older adults for MCI. Screening tools that require cognitive resources such as gait speed appear to have significant relationships with performance of EF for those who screen positive for MCI. This information could be used clinically to identify older adults with cognitive limitations, which could put them at higher risk for falling.

The intensive care delirium screening checklist: translation and reliability testing in a Swedish ICU.

PubMed

Neziraj, M; Sarac Kart, N; Samuelson, Karin

2011-08-01

The view of delirium has changed considerably over the last decade, and delirium is now a very topical issue within the intensive care unit (ICU) setting. Delirium has proved to be common in critically ill patients and is manifested as acute changes in mental status with reduced cognitive ability, incoherent thought patterns, impaired consciousness, agitation and acute confusion. In order to be able to prevent, identify and alleviate problems related to delirium it is important that validated instruments for delirium screening are implemented and evaluated. The aim of this study was to translate the Intensive Care Delirium Screening Checklist (ICDSC) into Swedish and test the inter-rater reliability in a Swedish general ICU setting. The study was carried out during 2009 in a general Swedish ICU. A translation of the scale from English into Swedish was made, including back-translation, critical review and pilot testing. A total of 49 paired ratings were carried out using the Swedish version of the ICDSC scale. The inter-rater reliability was tested using weighted kappa (κ) statistics (linear weighting). The ICDSC scale was successfully translated into Swedish and the inter-rater reliability testing of the Swedish version resulted in a weighted k value of 0.92. The result of this study indicates that the Swedish version of the ICDSC scale has a very good inter-rater reliability. The high inter-rater reliability and the ease of administration make the ICDSC scale applicable for delirium screening in a Swedish ICU setting. © 2011 The Authors. Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation.

Analytical techniques for steroid estrogens in water samples - A review.

PubMed

Fang, Ting Yien; Praveena, Sarva Mangala; deBurbure, Claire; Aris, Ahmad Zaharin; Ismail, Sharifah Norkhadijah Syed; Rasdi, Irniza

2016-12-01

In recent years, environmental concerns over ultra-trace levels of steroid estrogens concentrations in water samples have increased because of their adverse effects on human and animal life. Special attention to the analytical techniques used to quantify steroid estrogens in water samples is therefore increasingly important. The objective of this review was to present an overview of both instrumental and non-instrumental analytical techniques available for the determination of steroid estrogens in water samples, evidencing their respective potential advantages and limitations using the Need, Approach, Benefit, and Competition (NABC) approach. The analytical techniques highlighted in this review were instrumental and non-instrumental analytical techniques namely gas chromatography mass spectrometry (GC-MS), liquid chromatography mass spectrometry (LC-MS), enzyme-linked immuno sorbent assay (ELISA), radio immuno assay (RIA), yeast estrogen screen (YES) assay, and human breast cancer cell line proliferation (E-screen) assay. The complexity of water samples and their low estrogenic concentrations necessitates the use of highly sensitive instrumental analytical techniques (GC-MS and LC-MS) and non-instrumental analytical techniques (ELISA, RIA, YES assay and E-screen assay) to quantify steroid estrogens. Both instrumental and non-instrumental analytical techniques have their own advantages and limitations. However, the non-instrumental ELISA analytical techniques, thanks to its lower detection limit and simplicity, its rapidity and cost-effectiveness, currently appears to be the most reliable for determining steroid estrogens in water samples. Copyright © 2016 Elsevier Ltd. All rights reserved.

Measurement of cognitive performance in computer programming concept acquisition: interactive effects of visual metaphors and the cognitive style construct.

PubMed

McKay, E

2000-01-01

An innovative research program was devised to investigate the interactive effect of instructional strategies enhanced with text-plus-textual metaphors or text-plus-graphical metaphors, and cognitive style on the acquisition of programming concepts. The Cognitive Styles Analysis (CSA) program (Riding,1991) was used to establish the participants' cognitive style. The QUEST Interactive Test Analysis System (Adams and Khoo,1996) provided the cognitive performance measuring tool, which ensured an absence of error measurement in the programming knowledge testing instruments. Therefore, reliability of the instrumentation was assured through the calibration techniques utilized by the QUEST estimate; providing predictability of the research design. A means analysis of the QUEST data, using the Cohen (1977) approach to size effect and statistical power further quantified the significance of the findings. The experimental methodology adopted for this research links the disciplines of instructional science, cognitive psychology, and objective measurement to provide reliable mechanisms for beneficial use in the evaluation of cognitive performance by the education, training and development sectors. Furthermore, the research outcomes will be of interest to educators, cognitive psychologists, communications engineers, and computer scientists specializing in computer-human interactions.

Applicability of the Telephone Interview for Cognitive Status (Modified) in a community sample with low education level: association with an extensive neuropsychological battery.

PubMed

Castanho, Teresa Costa; Portugal-Nunes, Carlos; Moreira, Pedro Silva; Amorim, Liliana; Palha, Joana Almeida; Sousa, Nuno; Correia Santos, Nadine

2016-02-01

To explore the applicability of a Portuguese (PT) version of the Telephone Interview for Cognitive Status (TICS), with a delayed recall item [modified (M)], here termed TICSM-PT, against an extensive (in-person) battery of neuropsychological instruments, in a sample of older individuals with low educational level and without clinically manifest/diagnosed cognitive impairment. Following translation/back-translation and pilot testing in 33 community dwellers, 142 community dwellers aged 52 to 84 years (mean = 67.45, SD = 7.91) were selected from local health care centres for the study (convenience sampling; stratified age and gender). Cronbach's alpha was used to assess internal consistency, and convergent validity was evaluated through the correlation between TICSM-PT and the Mini Mental State Examination (MMSE), as well as with a comprehensive battery of cognitive instruments. Divergent/discriminant validity was assessed through a battery of psychological instruments. The receiver operating curve was determined for TICSM-PT to classify participants with and without possible indication of cognitive impairment. TICSM-PT showed a satisfactory internal consistency (Cronbach's alpha = 0.705), convergent validity and discriminant validity. TICSM-PT presented a positive association with the global cognitive measures Mini Mental State Examination and the Montreal Cognitive Assessment, and also with most neuropsychological parameters. Receiver operating curve curves presented a sensitivity of 90.6% and specificity of 73.7%. The area under the curve statistic yielded a threshold score equal or below 13.5 for cognitive impairment. TICSM-PT is a practical tool for rapid cognitive assessment among older individuals with low educational background. Copyright © 2015 John Wiley & Sons, Ltd.

Testing for cognitive function in animals in a regulatory context.

PubMed

Bushnell, Philip J

2015-01-01

Superior cognitive functions have allowed the human species to proliferate in a world of incredible biological diversity. Threats to these essential capacities cannot be ignored, and a strategy is needed to evaluate the hazard posed by exposure to chemical and other agents. Because people exposed to chemicals often complain about confusion and forgetfulness, it is commonly thought that cognitive functions should be sensitive indicators of adverse consequences of chemical exposure. For these reasons, complex tests of cognitive function have been developed and deployed in experimental animal laboratories for decades. However, the results of these tests are rarely used as points of departure for chemical risk assessments. Due to their high cost in time, animals, and equipment, the efficacy and utility of these tests need to be evaluated in relation to cheaper and faster whole-animal screening methods. This review examines evidence for the assertions that cognitive functions represent uniquely sensitive indicators of chemical exposure, and that animal models of these functions are necessary to detect and quantify the neurotoxicity of chemicals. Studies conducted since the early 1980s to compare these approaches to assess the neurotoxicity of chemicals are reviewed for both adult and perinatal exposures in experimental rodents. Forty-one studies of 35 chemicals were found that directly compared acute effects using complex tests (i.e., tests that require training animals) with acute effects using screening tests (i.e., tests that do not require training animals) in adult rodents. Complex tests detected effects of three substances (bitertanol, iso-amyl nitrite, and Pfiesteria toxin) that had no effect on screening tests; for an additional five chemicals (carbaryl, deltamethrin, methyl mercury, tetraethyl tin, and Isopar-C), complex tests identified effects at lower doses than did screening tests. Fewer comparable cases were found for developmental exposures: screening and complex tests were found to be equivalent for trimethyltin, n-propylthiouracil (PTU), and elemental mercury. Analysis of two studies yielded an inconclusive case for lead. Evidence for the insufficiency of screening tests was found for PCBs and inhaled ethanol, though it is not clear that the measured effects of these chemicals reflected cognitive deficits per se. Whether these benefits are worth the additional time and expense of conducting complex tests is a matter for discussion in the research and risk management communities. Published by Elsevier Inc.

Content validity--establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: part 1--eliciting concepts for a new PRO instrument.

PubMed

Patrick, Donald L; Burke, Laurie B; Gwaltney, Chad J; Leidy, Nancy Kline; Martin, Mona L; Molsen, Elizabeth; Ring, Lena

2011-12-01

The importance of content validity in developing patient reported outcomes (PRO) instruments is stressed by both the US Food and Drug Administration and the European Medicines Agency. Content validity is the extent to which an instrument measures the important aspects of concepts that developers or users purport it to assess. A PRO instrument measures the concepts most significant and relevant to a patient's condition and its treatment. For PRO instruments, items and domains as reflected in the scores of an instrument should be important to the target population and comprehensive with respect to patient concerns. Documentation of target population input in item generation, as well as evaluation of patient understanding through cognitive interviewing, can provide the evidence for content validity. Developing content for, and assessing respondent understanding of, newly developed PRO instruments for medical product evaluation will be discussed in this two-part ISPOR PRO Good Research Practices Task Force Report. Topics include the methods for generating items, documenting item development, coding of qualitative data from item generation, cognitive interviewing, and tracking item development through the various stages of research and preparing this tracking for submission to regulatory agencies. Part 1 covers elicitation of key concepts using qualitative focus groups and/or interviews to inform content and structure of a new PRO instrument. Part 2 covers the instrument development process, the assessment of patient understanding of the draft instrument using cognitive interviews and steps for instrument revision. The two parts are meant to be read together. They are intended to offer suggestions for good practices in planning, executing, and documenting qualitative studies that are used to support the content validity of PRO instruments to be used in medical product evaluation. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The impact of routine cognitive screening by using the clock drawing task in the evaluation of elderly patients in the emergency department.

PubMed

Salen, Philip; Heller, Michael; Oller, Carlo; Reed, James

2009-07-01

The prevalence of cognitive impairment, as reflected by failure to correctly perform a clock drawing task, in elderly Emergency Department (ED) patients was assessed. Additionally, we evaluated whether primary care provider notification of cognitive impairment spurred further cognitive evaluation. The clock drawing task was administered to a convenience sample of 100 elderly, English-speaking subjects presenting for reasons other than altered mentation at a community hospital ED. Primary care providers were contacted regarding abnormal clock drawing task results immediately and again after 2 months to determine if there was further evaluation of cognition. Of the 100 subjects enrolled, 30% were unable to correctly complete the clock drawing task, but only 8 had further evaluation of their cognitive abilities, resulting in four new diagnoses of dementia. Subjects who drew incorrect clocks (54%; 16/30) were more likely to be reevaluated in the ED within 2 months than those who drew correct clocks (29%; 20/70; p < 0.02). Cognitive screening of elderly ED patients with the clock drawing task identified a substantial number with unsuspected abnormal cognition. Further evaluation by their primary care physicians in follow-up was disappointing.

Diagnostic accuracy of a two-item Drug Abuse Screening Test (DAST-2).

PubMed

Tiet, Quyen Q; Leyva, Yani E; Moos, Rudolf H; Smith, Brandy

2017-11-01

Drug use is prevalent and costly to society, but individuals with drug use disorders (DUDs) are under-diagnosed and under-treated, particularly in primary care (PC) settings. Drug screening instruments have been developed to identify patients with DUDs and facilitate treatment. The Drug Abuse Screening Test (DAST) is one of the most well-known drug screening instruments. However, similar to many such instruments, it is too long for routine use in busy PC settings. This study developed and validated a briefer and more practical DAST for busy PC settings. We recruited 1300 PC patients in two Department of Veterans Affairs (VA) clinics. Participants responded to a structured diagnostic interview. We randomly selected half of the sample to develop and the other half to validate the new instrument. We employed signal detection techniques to select the best DAST items to identify DUDs (based on the MINI) and negative consequences of drug use (measured by the Inventory of Drug Use Consequences). Performance indicators were calculated. The two-item DAST (DAST-2) was 97% sensitive and 91% specific for DUDs in the development sample and 95% sensitive and 89% specific in the validation sample. It was highly sensitive and specific for DUD and negative consequences of drug use in subgroups of patients, including gender, age, race/ethnicity, marital status, educational level, and posttraumatic stress disorder status. The DAST-2 is an appropriate drug screening instrument for routine use in PC settings in the VA and may be applicable in broader range of PC clinics. Published by Elsevier Ltd.

Frontal Assessment Battery (FAB) is a simple tool for detecting executive deficits in chronic cannabis users.

PubMed

Fontes, Maria Alice; Bolla, Karen I; Cunha, Paulo Jannuzzi; Almeida, Priscila Previato; Jungerman, Flávia; Laranjeira, Ronaldo Ramos; Bressan, Rodrigo A; Lacerda, Acioly L T

2011-06-01

Cannabis is the most used illicit drug in the world, and its use has been associated with prefrontal cortex (PFC) dysfunction, including deficits in executive functions (EF). Considering that EF may influence treatment outcome, it would be interesting to have a brief neuropsychological battery to assess EF in chronic cannabis users (CCU). In the present study, the Frontal Assessment Battery (FAB), a brief, easy to use neuropsychological instrument aimed to evaluate EF, was used to evaluate cognitive functioning of CCU. We evaluated 107 abstinent CCU with the FAB and compared with 44 controls matched for age, estimated IQ, and years of education. CCU performed poorly as compared to controls (FAB total score = 16.53 vs. 17.09, p < .05). CCU had also a poor performance in the Motor Programming subtest (2.47 vs. 2.73, p < .05). This study examined effects of cannabis in executive functioning and showed evidence that the FAB is sensitive to detect EF deficits in early abstinent chronic cannabis users. Clinical significance of these findings remains to be investigated in further longitudinal studies. FAB may be useful as a screening instrument to evaluate the necessity for a complete neuropsychological assessment in this population.

Use of the MC-FAQ and MMSE-FAQ in cognitive screening of older African Americans, Hispanic Americans, and European Americans.

PubMed

Tappen, Ruth M; Rosselli, Monica; Engstrom, Gabriella

2012-11-01

The purpose of this study was to examine the performance of the Mini-Cog-Functional Activities Questionnaire (MC-FAQ) and the Mini-Mental State Examination-Functional Activities Questionnaire (MMSE-FAQ) in cognitive screening of a multiethnic sample of older adults. This is a descriptive psychometric study. Cognitive screening was done in senior centers, at health fairs, and within the nine participating memory disorder centers in the State of Florida. African American, Hispanic American, and European American older adults who participated in this screening were matched on gender, age within 3 years and education within 3 years yielding a sample of 225. The MC-FAQ is a combination of the Mini-Cog and Functional Activities Questionnaire. The MMSE-FAQ combines the MMSE with the FAQ. The Geriatric Depression Scale was used to assess depressive symptoms. African Americans reported significantly less depressive symptoms (F[2, 217] = 10.31, p <0.001) and European Americans had significantly higher mean MMSE scores than the other two groups (F[2, 222] = 3.33, p = 0.037). Participants did not differ by ethnic group on the MC-FAQ or MMSE-FAQ classifications of normal, mild cognitive impairment, or dementia. Age, years of education, and depressive symptoms were significant predictors of MC-FAQ and MMSE-FAQ classifications. The results suggest that these combinations of screening measures may have less culture bias than the MMSE alone. Sensitivity and specificity should be evaluated in these groups with confirmatory neurological and psychiatric diagnosis. 2012 American Association for Geriatric Psychiatry

Using Bloom's Taxonomy to Evaluate the Cognitive Levels of Master Class Textbook's Questions

ERIC Educational Resources Information Center

Assaly, Ibtihal R.; Smadi, Oqlah M.

2015-01-01

This study aimed at evaluating the cognitive levels of the questions following the reading texts of Master Class textbook. A checklist based on Bloom's Taxonomy was the instrument used to categorize the cognitive levels of these questions. The researchers used proper statistics to rank the cognitive levels of the comprehension questions. The…

Examining the Relationships of Different Cognitive Load Types Related to User Interface in Web-Based Instruction

ERIC Educational Resources Information Center

Cheon, Jongpil; Grant, Michael

2012-01-01

This study proposes a new instrument to measure cognitive load types related to user interface and demonstrates theoretical assumptions about different load types. In reconsidering established cognitive load theory, the inadequacies of the theory are criticized in terms of the adaption of learning efficiency score and distinction of cognitive load…

A Factor Analytic Investigation of the BASC-2 Behavioral and Emotional Screening System Parent Form: Psychometric Properties, Practical Implications, and Future Directions

ERIC Educational Resources Information Center

Dowdy, Erin; Chin, Jenna K.; Twyford, Jennifer M.; Dever, Bridget V.

2011-01-01

The Behavior Assessment System for Children, Second Edition (BASC-2) Behavioral and Emotional Screening System Parent Form (BESS Parent; Kamphaus & Reynolds, 2007) is a recently developed instrument designed to identify behavioral and emotional risk in students. To describe the underlying factor structure for this instrument, exploratory (EFA)…

Comparison of the Validity of Four Fall-Related Psychological Measures in a Community-Based Falls Risk Screening

ERIC Educational Resources Information Center

Moore, Delilah S.; Ellis, Rebecca; Kosma, Maria; Fabre, Jennifer M.; McCarter, Kevin S.; Wood, Robert H.

2011-01-01

We examined the measurement properties of fall-related psychological instruments with a sample of 133 older adults (M age = 74.4 years, SD = 9.4). Measures included the Comprehensive Falls Risk Screening Instrument, Falls-efficacy Scale-International (FES-I), Activities-specific Balance Confidence (ABC), modified Survey of Activities and Fear of…

A Path Analysis of Factors Influencing Racial Differences on the Massachusetts Youth Screening Instrument-Version 2

ERIC Educational Resources Information Center

McCoy, Henrika

2011-01-01

Thousands of juveniles with mental health disorders enter the juvenile justice system every year. The Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2) is often used to assess them. The disproportionate numbers of African American youth in the juvenile justice system and the large numbers of youth with mental health needs necessitate…

Digital Technology and Student Cognitive Development

ERIC Educational Resources Information Center

Cavanaugh, J. Michael; Giapponi, Catherine C.; Golden, Timothy D.

2016-01-01

Digital technology has proven a beguiling, some even venture addictive, presence in the lives of our 21st century (millennial) students. And while screen technology may offer select cognitive benefits, there is mounting evidence in the cognitive neuroscience literature that digital technology is restructuring the way our students read and think,…

Assertion Training and Cognitive Restructuring With College Women.

ERIC Educational Resources Information Center

Terrill, Marilyn J.

The process of assertive behavior change of college women who received assertion training (AT) and cognitive restructuring was examined to assess the relative effects of different durations of exposure to cognitive restructuring. Undergraduate and graduate women students (N=27) at a state university volunteered and were screened for AT groups.…

Normative data for the Tygerberg Cognitive Battery and Mini-Mental Status Examination in a South African population.

PubMed

Roos, Annerine; Calata, Dorothy; Jonkers, Liesl; Maritz, Stephan J; Kidd, Martin; Daniels, Willie M U; Hugo, Frans J

2010-01-01

Normative data for the Tygerberg Cognitive Battery (TCB) and Mini-Mental Status Examination (MMSE) (in South Africa) have not been formally examined before. The TCB was developed for the bedside pen-and-paper screening of cognitive impairment in each of the 6 main cognitive domains, including attention and concentration, speech, memory, praxis, gnosis, and executive functioning. The test is also used to diagnose different neuropsychiatric conditions. The MMSE is an established screen of cognitive status, which is often used as a comparative standard for novel screening tests such as the TCB. The TCB was initially developed in English and Afrikaans, and a Xhosa version was also initiated with this study so that the 3 most common languages of the region could be accommodated. The first aim of the study was to estimate normative test performance on the TCB and MMSE among controls, and the second aim was to develop a Xhosa version of the TCB. Assessments of the TCB and MMSE were carried out in a population of healthy individuals (n = 157). In addition, healthy Xhosa-speaking participants (n = 14) were screened using a Xhosa version of the TCB. Reliability scores for all forms of the TCB were satisfactory. Age and education correlated significantly with TCB scores (r = -0.26, P < .01; r = 0.64, P < .01, respectively), whereas only education significantly correlated with MMSE scores (r = 0.32, P < .05). Normative values were calculated accordingly, that is, controlled for the effects of age and education. The TCB scores also correlated significantly with MMSE scores (r = 0.49, P < .05), demonstrating the potential of the TCB to serve as an alternate cognitive assessment tool, along with the MMSE, to focus neuropsychiatric investigations. Scores on the Xhosa version differed significantly on speech, praxis, and gnosis between the Afrikaans and English participant scores. These normative data can be used to increase precision and to provide an impartial evaluation when applying TCB to evaluate the cognitive ability of neuropsychiatrically impaired adult patients. However, age and education effects should be considered when computing the results of cognitive assessment. Copyright 2010 Elsevier Inc. All rights reserved.

Comparison of the MoCA and BEARNI tests for detection of cognitive impairment in in-patients with alcohol use disorders.

PubMed

Pelletier, Stéphanie; Alarcon, Régis; Ewert, Valérie; Forest, Margot; Nalpas, Bertrand; Perney, Pascal

2018-06-01

Screening of cognitive impairment is a major challenge in alcoholics seeking treatment, since cognitive dysfunction may impair the overall efficacy of rehabilitation programs and consequently increase relapse rate. We compared the performance of two screening tools: the MoCA (Montreal Cognitive Assessment), which is widely used in patients with neurological diseases and already used in patients with alcohol use disorder (AUD), and the BEARNI (Brief Evaluation of Alcohol-Related Neuropsychological Impairments), a recent test specifically developed for the alcoholic population. We compared the sensitivity and specificity of the MoCA and the BEARNI in a sample of AUD patients with and without cognitive impairment assessed by a battery of neuropsychological tests. Ninety patients were included. There were 67 men and 23 women aged 48.9 ± 9.6 years. According to the neuropsychological tests, 51.1% of patients had no cognitive impairment, while it was mild or moderate to severe in 31.1 and 17.8%, respectively. The BEARNI sensitivity was extremely high (1.0), since all patients with cognitive impairment were identified, but its specificity was very low (0.04). The MoCA had a lower sensitivity (0.79) than the BEARNI, but its specificity was significantly better (0.65). A detailed analysis of the BEARNI scores showed a discrepancy between the qualitative and quantitative interpretation of the test which could, at least in part, explain its low specificity. Both the MoCA and the BEARNI are screening tools which identified alcoholic patients with cognitive impairment. However, in routine use, the MoCA appeared to be more appropriate given the low specificity of the BEARNI. Copyright © 2018 Elsevier B.V. All rights reserved.

Memory and Executive Screening for the Detection of Cognitive Impairment in Obstructive Sleep Apnea.

PubMed

Mu, Li; Peng, Liping; Zhang, Zhengjiao; Jie, Jing; Jia, Siqi; Yuan, Haibo

2017-10-01

Obstructive sleep apnea (OSA) is commonly associated with cognitive dysfunction, which is more apparent in severe OSA and impairs quality of life. However, the clinical screening methods for these impairments in OSA are still limited. In this study, we evaluated the feasibility of using the Memory and Executive Screening (MES) for assessing cognitive performance in OSA. Twenty-four patients with nonsevere OSA and 36 patients with severe OSA participated in this study. All participants underwent comprehensive, laboratory-based polysomnography and completed assessments of cognitive function, which included both the MES and the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ). Both the total MES scores and 5 recall scores of the MES (MES-5R) were significantly lower in the severe OSA group than those in the nonsevere OSA group. The patients with severe OSA performed worse on the memory subtests of the MES-5R, especially on immediate recall. The sensitivity and specificity of the MES for identifying cognitive impairment in patients with OSA were 63.89% and 66.67%, respectively, for a cutoff value of <92 out of 100 points. An optimal cutoff between nonsevere and severe OSA was also set at 45 points (MES-5R) and at 0.94 points (MES ratio). Compared with the MES, the MoCA-BJ had similar sensitivity (61.11%) and specificity (66.67%). The MES is an acceptable tool for detecting cognitive dysfunction in patients with OSA. The sensitivity and specificity of the MES were similar to those of the MoCA-BJ. The MES-5R and total MES scores can assess the presence and severity of cognitive impairment in patients with severe OSA. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Intimate partner violence against Spanish pregnant women: application of two screening instruments to assess prevalence and associated factors.

PubMed

Velasco, Casilda; Luna, Juan D; Martin, Aurelia; Caño, Africa; Martin-de-Las-Heras, Stella

2014-10-01

To investigate the prevalence of intimate partner violence in Spanish women during the 12 months prior to delivery and to identify associated risk factors using two screening instruments. A population-based study. Fifteen public hospitals in southern Spain. A total of 779 women admitted to the hospital obstetrics department. Intimate partner violence was diagnosed with the Abuse Assessment Screen and Index of Spouse Abuse screening instruments. Prevalence and associated risk factors of intimate partner violence during pregnancy. According to the Abuse Assessment Screen, intimate partner violence during the pre-delivery year was experienced by 7.7% of the women, emotional abuse by 4.8%, and physical abuse by 1.7%. According to the Index of Spouse Abuse, non-physical intimate partner violence during this period was reported by 21.0% of the women and physical intimate partner violence by 3.6%. After adjusting for socio-demographic characteristics, multivariate regression models showed that an uncommitted relationship and absence of kin support were significantly associated with an increased intimate partner violence risk during the pre-delivery year. Employment was a significant protective factor against any of the three forms of intimate partner violence (Abuse Assessment Screen) and physical intimate partner violence (Index of Spouse Abuse) during this period. A high proportion of women in Spain experience intimate partner violence during or just before pregnancy. Pregnant women in an uncommitted relationship or without kin support were at greater risk of intimate partner violence. Screening instruments for intimate partner violence during pregnancy should be evaluated in different cultural contexts. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Recruitment and Baseline Characteristics of Participants in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER)—A Randomized Controlled Lifestyle Trial †

PubMed Central

Ngandu, Tiia; Lehtisalo, Jenni; Levälahti, Esko; Laatikainen, Tiina; Lindström, Jaana; Peltonen, Markku; Solomon, Alina; Ahtiluoto, Satu; Antikainen, Riitta; Hänninen, Tuomo; Jula, Antti; Mangialasche, Francesca; Paajanen, Teemu; Pajala, Satu; Rauramaa, Rainer; Strandberg, Timo; Tuomilehto, Jaakko; Soininen, Hilkka; Kivipelto, Miia

2014-01-01

Our aim is to describe the study recruitment and baseline characteristics of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study population. Potential study participants (age 60–77 years, the dementia risk score ≥6) were identified from previous population-based survey cohorts and invited to the screening visit. To be eligible, cognitive performance measured at the screening visit had to be at the mean level or slightly lower than expected for age. Of those invited (n = 5496), 48% (n = 2654) attended the screening visit, and finally 1260 eligible participants were randomized to the intervention and control groups (1:1). The screening visit non-attendees were slightly older, less educated, and had more vascular risk factors and diseases present. The mean (SD) age of the randomized participants was 69.4 (4.7) years, Mini-Mental State Examination 26.7 (2.0) points, systolic blood pressure 140.1 (16.2) mmHg, total serum cholesterol 5.2 (1.0) mmol/L for, and fasting glucose 6.1 (0.9) mmol/L for, with no difference between intervention and control groups. Several modifiable risk factors were present at baseline indicating an opportunity for the intervention. The FINGER study will provide important information on the effect of lifestyle intervention to prevent cognitive impairment among at risk persons. PMID:25211775

Cognitive Styles and Educational-Vocational Preferences and Selection

ERIC Educational Resources Information Center

Osipow, Samuel H.

1969-01-01

Vocational Preference Inventory (VPI) and other instruments administered to 365 students, both undecided and in various interest fields, revealed several differences in cognitive style. No differences regarding cognitive style variations and VPI high-point codes or ease of vocational selection were observed. (Author/CJ)

Approximate entropy: a new evaluation approach of mental workload under multitask conditions

NASA Astrophysics Data System (ADS)

Yao, Lei; Li, Xiaoling; Wang, Wei; Dong, Yuanzhe; Jiang, Ying

2014-04-01

There are numerous instruments and an abundance of complex information in the traditional cockpit display-control system, and pilots require a long time to familiarize themselves with the cockpit interface. This can cause accidents when they cope with emergency events, suggesting that it is necessary to evaluate pilot cognitive workload. In order to establish a simplified method to evaluate cognitive workload under a multitask condition. We designed a series of experiments involving different instrument panels and collected electroencephalograms (EEG) from 10 healthy volunteers. The data were classified and analyzed with an approximate entropy (ApEn) signal processing. ApEn increased with increasing experiment difficulty, suggesting that it can be used to evaluate cognitive workload. Our results demonstrate that ApEn can be used as an evaluation criteria of cognitive workload and has good specificity and sensitivity. Moreover, we determined an empirical formula to assess the cognitive workload interval, which can simplify cognitive workload evaluation under multitask conditions.

Development of HomeSTEAD's physical activity and screen time physical environment inventory.

PubMed

Hales, Derek; Vaughn, Amber E; Mazzucca, Stephanie; Bryant, Maria J; Tabak, Rachel G; McWilliams, Christina; Stevens, June; Ward, Dianne S

2013-12-05

The home environment has a significant influence on children's physical activity, sedentary behavior, dietary intake, and risk for obesity and chronic disease. Our understanding of the most influential factors and how they interact and impact child behavior is limited by current measurement tools, specifically the lack of a comprehensive instrument. HomeSTEAD (the Home Self-administered Tool for Environmental assessment of Activity and Diet) was designed to address this gap. This new tool contains four sections: home physical activity and media equipment inventory, family physical activity and screen time practices, home food inventory, and family food practices. This paper will describe HomeSTEAD's development and present reliability and validity evidence for the first section. The ANGELO framework guided instrument development, and systematic literature reviews helped identify existing items or scales for possible inclusion. Refinement of items was based on expert review and cognitive interviews. Parents of children ages 3-12 years (n = 125) completed the HomeSTEAD survey on three separate occasions over 12-18 days (Time 1, 2, and 3). The Time 1 survey also collected demographic information and parent report of child behaviors. Between Time 1 and 2, staff conducted an in-home observation and measured parent and child BMI. Kappa and intra-class correlations were used to examine reliability (test-retest) and validity (criterion and construct). Reliability and validity was strong for most items (97% having ICC > 0.60 and 72% having r > 0.50, respectively). Items with lower reliability generally had low variation between people. Lower validity estimates (r < 0.30) were more common for items that assessed usability and accessibility, with observers generally rating usability and accessibility lower than parents. Small to moderate, but meaningful, correlations between physical environment factors and BMI, outside time, and screen time were observed (e.g., amount of child portable play equipment in good condition and easy to access was significantly associated with child BMI: r = -0.23), providing evidence of construct validity. The HomeSTEAD instrument represents a clear advancement in the measurement of factors in the home environment related to child weight and weight-related behaviors. HomeSTEAD, in its entirety, represents a useful tool for researchers from which they can draw particular scales of greatest interest and highest relevance to their research questions.

The Standardized Assessment of Personality-Abbreviated Scale as a screening instrument for personality disorders in substance-dependent criminal offenders.

PubMed

Jansen, Brigitte P M; Damen, Katinka F M; Hoffman, Tonko O; Vellema, Sietske L

2013-05-01

Personality disorders (PDs) are considered to be potential predictors of treatment outcome in substance-dependent patients and potential treatment matching variables. There is a need for a brief and simple screening instrument for PDs that can be used in routine psychological assessment, especially in a treatment setting for previously substance-dependent criminal offenders, where a high prevalence of PDs is expected. This study investigated the psychometric properties of the Standardized Assessment of Personality-Abbreviated Scale (SAPAS), a commonly used screening interview for PDs, in a population of inpatient criminal offenders with a history of substance dependence. Various statistical procedures were used to establish reliability and validity measures, such as Kuder-Richardson 20, confirmative factor analysis, receiver operating characteristic analysis and multitrait multimethod matrix. The SAPAS was administered to 101 inpatient criminal offenders with a history of substance dependence at baseline. Within three weeks, participants were administered the Structured Interview for DSM-IV Personality in order to assess the presence of PDs. Results show limited evidence to make firm conclusions on the psychometric qualities of the SAPAS as a screening instrument for comorbid PDs in a substance dependence treatment setting for criminal offenders. Suggestions for improvement concerning the psychometric qualities of the SAPAS as a screening instrument for this population are noted. Copyright © 2012 John Wiley & Sons, Ltd.

Brief screening for mild cognitive impairment: validation of the Brazilian version of the Montreal cognitive assessment.

PubMed

Memória, Cláudia M; Yassuda, Mônica S; Nakano, Eduardo Y; Forlenza, Orestes V

2013-01-01

The Montreal Cognitive Assessment (MoCA) is a brief cognitive schedule that has been developed for the screening of patients with Mild Cognitive Impairment (MCI). MCI is recognized as a high-risk state for Alzheimer's disease. The aim of the present study is to examine the reliability and validity of the Brazilian version of the MoCA test (MoCA-BR) in a sample of older individuals with at least 4 years of education. The MoCA-BR was administered to 112 older adults who were classified into three diagnostic groups according to their cognitive state (Alzheimer's disease, n = 28; MCI, n = 43; normal controls, n = 41). This procedure was based on clinical and neuropsychological data. The performance in the MoCA-BR was compared with the Mini-mental state examination (MMSE) and the Cambridge Cognitive Examination. Diagnostic accuracy was examined with the receiver operating characteristic (ROC) curve analyses. Cronbach's alpha for the MoCA-BR was 0.75. Temporal stability (retesting after 3 months) using intraclass correlation coefficient was 0.75 (p < 0.001). The sensitivity and specificity of the MoCA-BR for MCI were 81% and 77%, respectively, with a cut-off score of 25 points. The area under the ROC curve for predicting MCI was 0.82 ± 0.06. The present results indicate that the MoCA-BR maintains its core diagnostic properties rendering it a valid and reliable tool for the screening of MCI among older individuals with at least 4 years of education. Copyright © 2012 John Wiley & Sons, Ltd.

Electroencephalogram associations to cognitive performance in clinically active nurses.

PubMed

Lees, Ty; Khushaba, Rami; Lal, Sara

2016-07-01

Cognitive impairment is traditionally identified via cognitive screening tools that have limited ability in detecting early or transitional stages of impairment. The dynamic nature of physiological variables such as the electroencephalogram (EEG) may provide alternate means for detecting these transitions. However, previous research examining EEG and cognitive performance is largely confined to samples with diagnosed cognitive impairments, and research examining non-impaired, and occupation specific samples, is limited. The present study aimed to investigate the associations between frontal pole and central EEG and cognitive performance in a sample of male and female nurses, and to determine the significance of these associations. Fifty seven nurses participated in the study, in which two lead bipolar EEG was recorded at positions Fp1 (frontal polar), Fp2, C3 (central) and C4 during a baseline and an active phase involving the common neuropsychological Stroop test. Participants' cognitive performance was assessed using the mini-mental state exam (MMSE) and Cognistat screening tools. Significant correlations between EEG beta activity and the outcome of MMSE and Cognistat were revealed, where an increased beta activity was associated to an increased global cognitive performance. Additionally, domain specific cognitive performance was also significantly associated to various EEG variables. The study identified potential EEG biomarkers for global and domain specific cognitive performance, and provides initial groundwork for the development of future EEG based biomarkers for detection of cognitive pathologies.

Sensitivity and specificity of clinician administered screening instruments in detecting depression among HIV-positive individuals in Uganda.

PubMed

Akena, Dickens; Joska, John; Obuku, Ekwaro A; Stein, Dan J

2013-01-01

Depressive disorders are highly prevalent in Africa where diseases such as HIV/AIDS are common. The aim of this study was to assess the validity of commonly used depression screening instruments in a setting characterized by low literacy, where patients may not be able to self-administer depression scales. We explored the validity of the Patient Health Questionaire-9 (PHQ-9), Centre for Epidemiological Surveys for Depression (CES-D), and the Kessler-10 (K-10), using the Mini International Neuropsychiatric Instrument (MINI) as a gold standard in 368 persons living with HIV/AIDS (PLWHA) in Uganda. The shorter versions of the K-10 and PHQ-9 were extracted to assess their performance in comparison to the longer versions. We used STATA 11.2 to analyze the data. The prevalence of a MINI defined depression in this patient sample was 17.4%. The three instruments all performed well, with areas under the curve (AUC) ranging from 0.82 to 0.96. The PHQ-9 showed the best performance characteristics with an AUC of 0.96, a sensitivity of 91.6%, and specificity 81.2%. The extracted versions performed more modestly. All three instruments showed good properties as screening tools; the PHQ-9 has particularly high sensitivity and specificity, and so can be considered useful for screening HIV-positive patients for depression.

[Cognitive impairments in alcohol dependence: From screening to treatment improvements].

PubMed

Cabé, N; Laniepce, A; Ritz, L; Lannuzel, C; Boudehent, C; Vabret, F; Eustache, F; Beaunieux, H; Pitel, A-L

2016-02-01

Alcohol-related cognitive impairments are largely underestimated in clinical practice, even though they could limit the benefit of alcohol treatment and hamper the patient's ability to remain abstinent or to respect his/her therapeutic contract. These neuropsychological deficits can impact the management of patients well before the development of the well-known Korsakoff's syndrome. Indeed, even in the absence of ostensible neurological complications, excessive and chronic alcohol consumption results in damage of brain structure and function. The frontocerebellar circuit and the circuit of Papez, respectively involved in motor and executive abilities and episodic memory, are mainly affected. Those brain dysfunctions are associated with neuropsychological deficits, including deficits of executive functions, episodic memory, social cognition, as well as visuospatial and motor abilities. Such cognitive disorders can interfere with the motivation process to abandon maladjusted drinking behavior in favor of a healthier lifestyle (such as abstinence or controlled alcohol consumption). They can also limit the patient's capacity to fully benefit from treatment (notably psychoeducation and cognitive-behavioural treatments) currently widely proposed in French Addiction departments. In addition, they may contribute to relapse which is multi-determinated. A neuropsychological assessment appears therefore crucial to take relevant clinical decisions. However, very few addiction departments have the human and financial resources to conduct an extensive neuropsychological examination of all patients with alcohol dependence. Some brief screening tools can be used, notably the MOntreal Cognitive Assessment and the Brief Evaluation of Alcohol-Related Neuropsychological Impairments, which has been especially designed to assess cognitive and motor deficits in alcoholism. These tools can be used by non-psychologist clinicians to detect alcohol-related cognitive deficits, which require an extensive cognitive examination conducted by a neuropsychologist. The presence of cognitive dysfunctions in patients early in abstinence should encourage clinicians to adjust the modalities of the treatment. The fact to favor recovery of cognitive functions and brain volumes with abstinence or drastic reduction of alcohol consumption could be a first way to make it possible for patients to be cognitively able to benefit from treatment. Further studies are required to determine whether specifically designed cognitive remediation could boost (accelerate or increase) the recovery of brain functioning. Additionally, a potential effect of thiamine to limit alcohol-related cognitive deficits before the development of neurological complications remains to be determined. In this review, we presented the pattern of structural brain damage and the associated cognitive and motor impairments in alcohol-dependent patients. We then emphasized the harmful effects of neuropsychological deficits in the management of these patients. We also pointed how relevant it is to screen patients with neuropsychological impairments and we focused on the presentation of two brief screening tools for cognitive impairments, especially designed for alcohol-related deficits or not. Finally, we reported how these neuropsychological impairments could be taken into consideration the treatment of alcohol addiction by adjusting its timing and modalities. Copyright © 2015 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Status of Cognitive Testing of Adults in India

PubMed Central

Porrselvi, A. P.; Shankar, V.

2017-01-01

The assessment of cognitive function is a challenging yet an integral component of psychological, psychiatric, and neurological evaluation. Cognitive assessment tools either can be administered quickly for screening for neurocognitive disorders or can be comprehensive and detailed to identify cognitive deficits for the purpose of localization, diagnosis, and rehabilitation. This article is a comprehensive review of published research that discusses the current challenges for cognitive testing in India, available tools used for the assessment of cognitive function in India, and future directions for cognitive testing in India. PMID:29184333

Resident Wellness and Social Support: Development and Cognitive Validation of a Resident Social Capital Assessment Tool.

PubMed

Kaplan, Stephen J; Seabott, Heather M; Cunningham, Erika B; Helman, James D; Calderon, Alvin; Thirlby, Richard C; Schenarts, Kimberly D

The purpose of this study is to develop and generate validity evidence for an instrument to measure social capital in residents. Mixed-methods, phased approach utilizing a modified Delphi technique, focus groups, and cognitive interviews. Four residency training institutions in Washington state between February 2016 and March 2017. General surgery, anesthesia, and internal medicine residents ranging from PGY-1 to PGY-6. The initial resident-focused instrument underwent revision via Delphi process with 6 experts; 100% expert consensus was achieved after 4 cycles. Three focus groups were conducted with 19 total residents. Focus groups identified 6 of 11 instrument items with mean quality ratings ≤4.0 on a 1-5 scale. The composite instrument rating of the draft version was 4.1 ± 0.5. After refining the instrument, cognitive interviews with the final version were completed with 22 residents. All items in the final version had quality ratings >4.0; the composite instrument rating was 4.8 ± 0.1. Social capital may be an important factor in resident wellness as residents rely upon each other and external social support to withstand fatigue, burnout, and other negative sequelae of rigorous training. This instrument for assessment of social capital in residents may provide an avenue for data collection and potentially, identification of residents at-risk for wellness degradation. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Barriers to Mammography among Inadequately Screened Women

ERIC Educational Resources Information Center

Stoll, Carolyn R. T.; Roberts, Summer; Cheng, Meng-Ru; Crayton, Eloise V.; Jackson, Sherrill; Politi, Mary C.

2015-01-01

Mammography use has increased over the past 20 years, yet more than 30% of women remain inadequately screened. Structural barriers can deter individuals from screening, however, cognitive, emotional, and communication barriers may also prevent mammography use. This study sought to identify the impact of number and type of barriers on mammography…

Detection and Differentiation of Frontotemporal Dementia and Related Disorders From Alzheimer Disease Using the Montreal Cognitive Assessment.

PubMed

Coleman, Kristy K L; Coleman, Brenda L; MacKinley, Julia D; Pasternak, Stephen H; Finger, Elizabeth C

2016-01-01

The Montreal Cognitive Assessment (MoCA) is a cognitive screening tool used by practitioners worldwide. The efficacy of the MoCA for screening frontotemporal dementia (FTD) and related disorders is unknown. The objectives were: (1) to determine whether the MoCA detects cognitive impairment (CI) in FTD subjects; (2) to determine whether Alzheimer disease (AD) and FTD subtypes and related disorders can be parsed using the MoCA; and (3) describe longitudinal MoCA performance by subtype. We extracted demographic and testing data from a database of patients referred to a cognitive neurology clinic who met criteria for probable AD or FTD (N=192). Logistic regression was used to determine whether dementia subtypes were associated with overall scores, subscores, or combinations of subscores on the MoCA. Initial MoCA results demonstrated CI in the majority of FTD subjects (87%). FTD subjects (N=94) performed better than AD subjects (N=98) on the MoCA (mean scores: 18.1 vs. 16.3; P=0.02). Subscores parsed many, but not all subtypes. FTD subjects had a larger decline on the MoCA within 13 to 36 months than AD subjects (P=0.02). The results indicate that the MoCA is a useful tool to identify and track progression of CI in FTD. Further, the data informs future research on scoring models for the MoCA to enhance cognitive screening and detection of FTD patients.

Screening Children for Family Violence: A Review of the Evidence for the US Preventive Services Task Force

PubMed Central

Nygren, Peggy; Nelson, Heidi D.; Klein, Jonathan

2004-01-01

BACKGROUND We wanted to evaluate the benefits and harms of screening children in primary health care settings for abuse and neglect resulting from family violence by examining the evidence on the performance of screening instruments and the effectiveness of interventions. METHODS We searched for relevant studies in MEDLINE, PsycINFO, CINAHL, ERIC, Cochrane Controlled Trials Register, and reference lists. English language abstracts with original data about family violence against children focusing on screening and interventions initiated or based in health care settings were included. We extracted selected information about study design, patient populations and settings, methods of assessment or intervention, and outcome measures, and applied a set of criteria to evaluate study quality. RESULTS All instruments designed to screen for child abuse and neglect were directed to parents, particularly pregnant women. These instruments had fairly high sensitivity but low specificity when administered in high-risk study populations and have not been widely tested in other populations. Randomized controlled trials of frequent nurse home visitation programs beginning during pregnancy that address behavioral and psychological factors indicated improved abuse measures and outcomes. No studies were identified about interventions in older children or harms associated with screening and intervention. CONCLUSIONS No trials of the effectiveness of screening in a health care setting have been published. Clinician referrals to nurse home visitation during pregnancy and in early childhood may reduce abuse in selected populations. There are no studies about harms of screening and interventions. PMID:15083858

Screening and Identification in Pediatric Primary Care

ERIC Educational Resources Information Center

Simonian, Susan J.

2006-01-01

This article reviews issues related to behavioral screening in pediatric primary care settings. Structural-organizational issues affecting the use of pediatric primary care screening are discussed. This study also reviewed selected screening instruments that have utility for use in the primary care setting. Clinical and research issues related to…

A systematic review finds limited data on measurement properties of instruments measuring outcomes in adult intensive care unit survivors.

PubMed

Robinson, Karen A; Davis, Wesley E; Dinglas, Victor D; Mendez-Tellez, Pedro A; Rabiee, Anahita; Sukrithan, Vineeth; Yalamanchilli, Ramakrishna; Turnbull, Alison E; Needham, Dale M

2017-02-01

There is a growing number of studies evaluating the physical, cognitive, mental health, and health-related quality of life (HRQOL) outcomes of adults surviving critical illness. However, there is little consensus on the most appropriate instruments to measure these outcomes. To inform the development of such consensus, we conducted a systematic review of the performance characteristics of instruments measuring physical, cognitive, mental health, and HRQOL outcomes in adult intensive care unit (ICU) survivors. We searched PubMed, Embase, PsycInfo, Cumulative Index of Nursing and Allied Health Literature, and The Cochrane Library in March 2015. We also conducted manual searches of reference lists of eligible studies and relevant review articles. Two people independently selected studies, completed data abstraction, and assessed the quality of eligible studies using the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) initiative checklist. We identified 20 studies which explicitly evaluated measurement properties for 21 different instruments assessing outcomes in ICU survivors. Eleven of the instruments assessed quality of life, with few instruments assessing other domains. Of the nine measurement properties evaluated on the COSMIN checklist, six were assessed in <10% of the evaluations. Overall quality of eligible studies was generally poor to fair based on the COSMIN checklist. Although an increasing number of studies measure physical, cognitive, mental health, and HRQOL outcomes in adult ICU survivors, data on the measurement properties of such instruments are sparse and generally of poor to fair quality. Empirical analyses evaluating the performance of instruments in adult ICU survivors are needed to advance research in this field. Copyright © 2016 Elsevier Inc. All rights reserved.

Curling Up With a Good E-Book: Mother-Child Shared Story Reading on Screen or Paper Affects Embodied Interaction and Warmth

PubMed Central

Yuill, Nicola; Martin, Alex F.

2016-01-01

This study compared changes in cognitive, affective, and postural aspects of interaction during shared mother and child book reading on screen and on paper. Readers commonly express strong preferences for reading on paper, but several studies have shown marginal, if any, effects of text medium on cognitive outcomes such as recall. Shared reading with a parent is an engaging, affective and embodied experience across time, as well as a cognitive task, so it is important to understand how paper vs. screen affects broader aspects of these shared experiences. Mid-childhood sees a steep rise in screen use alongside a shift from shared to independent reading. We assessed how the medium of paper or screen might alter children’s shared reading experiences at this transitional age. Twenty-four 7- to 9-year-old children and their mothers were videotaped sharing a story book for 8 min in each of four conditions: mother or child as reader, paper, or tablet screen as medium. We rated videotapes for interaction warmth and child engagement by minute and analyzed dyadic postural synchrony, mothers’ commentaries and quality of children’s recall, also interviewing participants about their experiences of reading and technology. We found no differences in recall quality but interaction warmth was lower for screen than for paper, and dropped over time, notably when children read on screen. Interactions also differed between mother-led and child-led reading. We propose that mother - child posture for paper reading supported more shared activity and argue that cultural affordances of screens, together with physical differences between devices, support different behaviors that affect shared engagement, with implications for the design and use of digital technology at home and at school. We advocate studying embodied and affective aspects of shared reading to understand the overall implications of screens in children’s transition to independent reading. PMID:28018283

Curling Up With a Good E-Book: Mother-Child Shared Story Reading on Screen or Paper Affects Embodied Interaction and Warmth.

PubMed

Yuill, Nicola; Martin, Alex F

2016-01-01

This study compared changes in cognitive, affective, and postural aspects of interaction during shared mother and child book reading on screen and on paper. Readers commonly express strong preferences for reading on paper, but several studies have shown marginal, if any, effects of text medium on cognitive outcomes such as recall. Shared reading with a parent is an engaging, affective and embodied experience across time, as well as a cognitive task, so it is important to understand how paper vs. screen affects broader aspects of these shared experiences. Mid-childhood sees a steep rise in screen use alongside a shift from shared to independent reading. We assessed how the medium of paper or screen might alter children's shared reading experiences at this transitional age. Twenty-four 7- to 9-year-old children and their mothers were videotaped sharing a story book for 8 min in each of four conditions: mother or child as reader, paper, or tablet screen as medium. We rated videotapes for interaction warmth and child engagement by minute and analyzed dyadic postural synchrony, mothers' commentaries and quality of children's recall, also interviewing participants about their experiences of reading and technology. We found no differences in recall quality but interaction warmth was lower for screen than for paper, and dropped over time, notably when children read on screen. Interactions also differed between mother-led and child-led reading. We propose that mother - child posture for paper reading supported more shared activity and argue that cultural affordances of screens, together with physical differences between devices, support different behaviors that affect shared engagement, with implications for the design and use of digital technology at home and at school. We advocate studying embodied and affective aspects of shared reading to understand the overall implications of screens in children's transition to independent reading.

Intimate Partner Violence Programs in a Children's Hospital: Comprehensive Assessment Utilizing a Delphi Instrument.

PubMed

Randell, Kimberly A; Evans, Sarah E; O'Malley, Donna; Dowd, M Denise

2015-03-01

The purpose of this study was to conduct a baseline assessment of intimate partner violence (IPV) practices in a pediatric hospital system. The Delphi Instrument for Hospital-based Domestic Violence Programs was used to assess the structure and components of the hospital system's IPV practices. Through key stakeholder interviews, we also assessed IPV practices in individual patient care areas. Qualitative analysis of interview data used a grounded theory approach. The hospital scored 17 of 100 points on the Delphi instrument assessment. Key areas of weakness identified by the Delphi instrument and interviews included lack of coordinated provider training and evaluation of IPV-related processes and no standards for IPV screening, safety assessment, and documentation. Most interviewees supported addressing IPV; all identified barriers to IPV screening at individual provider and institutional levels. Institutional barriers included lack of a standardized response to IPV disclosure, need for individualized screening protocols for different patient care settings, lack of standardized provider training, concerns about overextending social work resources, and lack of resources for hospital staff experiencing vicarious trauma. Individual barriers included concern that screening may harm physician-patient-family relationships and the perception that physicians are unwilling to address psychosocial issues. The Delphi Instrument for Hospital-based Domestic Violence Programs identified weaknesses and key areas for improvement in IPV practices. Deficiencies revealed by the Delphi instrument were affirmed by individual interview results. Institutional and individual provider level barriers must be addressed to optimize IPV practices in a pediatric hospital system. Copyright © 2015 by the American Academy of Pediatrics.

Pediatric provider processes for behavioral health screening, decision making, and referral in sites with colocated mental health services.

PubMed

Hacker, Karen; Goldstein, Joel; Link, David; Sengupta, Nandini; Bowers, Rachael; Tendulkar, Shalini; Wissow, Larry

2013-01-01

Validated behavioral health (BH) screens are recommended for use at well-child visits. This study aimed to explore how pediatricians experience and use these screens for subsequent care decisions in primary care. The study took place at 4 safety net health centers. Fourteen interviews were conducted with pediatricians who were mandated to use validated BH screens at well-child visits. Interview questions focused on key domains, including clinic BH context, screening processes, assessment of screening scores, and decision making about referral to mental health services. Qualitative analysis used the Framework Approach. A variety of themes emerged: BH screens were well accepted and valued for the way they facilitated discussion of mental health issues. However, screening results were not always used in the way that instrument designers intended. Providers' beliefs about the face validity of the instruments, and their observations about performance of instruments, led to discounting scored results. As a result, clinical decisions were made based on a variety of evidence, including individual item responses, parent or patient concerns, and perceived readiness for treatment. Additionally, providers, although interested in expanding their mental health discussions, perceived a lack of time and of their own skills to be major obstacles in this pursuit. Screens act as important prompts to stimulate discussion of BH problems, but their actual scored results play a variable role in problem identification and treatment decisions. Modifications to scheduling policies, additional provider training, and enhanced collaboration with mental health professionals could support better BH integration in pediatric primary care.

Brief Report: An Evaluation of the AQ-10 as a Brief Screening Instrument for ASD in Adults

ERIC Educational Resources Information Center

Booth, Tom; Murray, Aja Louise; McKenzie, Karen; Kuenssberg, Renate; O'Donnell, Michael; Burnett, Hollie

2013-01-01

There is a need for brief screening instruments for autistic spectrum disorders (ASD) that can be used by frontline healthcare professionals to aid in the decision as to whether an individual should be referred for a full diagnostic assessment. In this study we evaluated the ability of a short form of the autism spectrum quotient (AQ)…

A Critical Review of Screening and Diagnostic Instruments for Autism Spectrum Disorders in People with Sensory Impairments in Addition to Intellectual Disabilities

ERIC Educational Resources Information Center

de Vaan, Gitta; Vervloed, Mathijs P. J.; Hoevenaars-van den Boom, Marella; Antonissen, Anneke; Knoors, Harry; Verhoeven, Ludo

2016-01-01

Instruments that are used for diagnosing of, or screening for, autism spectrum disorder (ASD) may not be applicable to people with sensory disabilities in addition to intellectual disabilities. First, because they do not account for equifinality, the possibility that different conditions may lead to the same outcome. Second, because they do not…

Ground Training Devices in Job Sample Approach to UPT [Undergraduate Pilot Training] Selection and Screening. Final Report, September 1972-August 1974.

ERIC Educational Resources Information Center

LeMaster, W. Dean; Gray, Thomas H.

The purpose of this study was to develop a screening procedure for undergraduate pilot training (UPT). This procedure was based upon the use of ground-based instrument trainers in which UPT candidates, naive to flying, were evaluated in their performance of job sample tasks; i.e., basic instrument flying. Training and testing sessions were…

Brief Screening Instrument of Posttraumatic Stress Disorder for Children and Adolescents 7-15 Years of Age

ERIC Educational Resources Information Center

Liu, AiZhong; Tan, Hongzhuan; Zhou, Jia; Li, Shuoqi; Yang, Tubao; Sun, Zhenqiu; Wen, Shi Wu

2007-01-01

The objective of this paper is to develop a brief screening instrument of posttraumatic stress disorder (PTSD) for young victims of natural disasters. Data were derived from flood victims in 1998 and 1999 in Hunan, China. A representative population sample of 6,852 subjects 7-15 years of age was selected. Among them, 6,073 (88.6%) were…

A cross-sectional study of quality of life in incident stroke survivors in rural northern Tanzania.

PubMed

Howitt, Suzanne C; Jones, Matthew P; Jusabani, Ahmed; Gray, William K; Aris, Eric; Mugusi, Ferdinand; Swai, Mark; Walker, Richard W

2011-08-01

The aim of this study was to evaluate changes to, and predictors of, quality of life (QOL) in a community-based cohort of stroke survivors from an earlier stroke incidence study in rural northern Tanzania. Patients were assessed 1-5 years after their incident stroke. The study cohort was compared with an age- and sex-matched control group from the same rural district within a cross-sectional design. Patients and controls were asked a series of questions relating to their QOL [World Health Organization quality of life, abbreviated version (WHOQOL-BREF)], levels of anxiety and depression [hospital anxiety and depression (HAD) scale], cognitive function [community screening instrument for dementia (CSI-D) screening tool], socioeconomic status and demographic characteristics (e.g. age, sex, education and abode). Patients were further assessed for functional outcome and disability (Barthel index, modified Rankin scale), post-stroke care and psychosocial functioning. Patients (n = 58) were found to have significantly lower QOL than controls (n = 58) in all six domains of the WHOQOL-BREF. Gender, socioeconomic status, cognitive function and time elapsed since stroke were not associated with QOL. Older patients and those with more impaired motor function and disability (Barthel index, modified Rankin score) had significantly poorer physical health-related QOL. Greater anxiety and depression, reduced muscle power and less involvement in social events were significantly correlated with lower physical and psychological health-related QOL. To our knowledge, this is the first long-term study of QOL in survivors of incident stroke in Sub-Saharan Africa (SSA). Poorer QOL was associated with greater levels of physical disability, anxiety and depression and reduced social interaction. Demographic factors appear to be much less significant. Modifying these QOL predictors could be important in planning effective post-stroke care within a stretched healthcare system.