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Beishon LC, Elliott E, Hietamies TM, Mc Ardle R, O'Mahony A, Elliott AR, Quinn TJ. Diagnostic test accuracy of remote, multidomain cognitive assessment (telephone and video call) for dementia. Cochrane Database Syst Rev 2022; 4:CD013724. [PMID: 35395108 PMCID: PMC8992929 DOI: 10.1002/14651858.cd013724.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Remote cognitive assessments are increasingly needed to assist in the detection of cognitive disorders, but the diagnostic accuracy of telephone- and video-based cognitive screening remains unclear. OBJECTIVES To assess the test accuracy of any multidomain cognitive test delivered remotely for the diagnosis of any form of dementia. To assess for potential differences in cognitive test scoring when using a remote platform, and where a remote screener was compared to the equivalent face-to-face test. SEARCH METHODS We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group Specialized Register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, LILACS, and ClinicalTrials.gov (www. CLINICALTRIALS gov/) databases on 2 June 2021. We performed forward and backward searching of included citations. SELECTION CRITERIA We included cross-sectional studies, where a remote, multidomain assessment was administered alongside a clinical diagnosis of dementia or equivalent face-to-face test. DATA COLLECTION AND ANALYSIS Two review authors independently assessed risk of bias and extracted data; a third review author moderated disagreements. Our primary analysis was the accuracy of remote assessments against a clinical diagnosis of dementia. Where data were available, we reported test accuracy as sensitivity and specificity. We did not perform quantitative meta-analysis as there were too few studies at individual test level. For those studies comparing remote versus in-person use of an equivalent screening test, if data allowed, we described correlations, reliability, differences in scores and the proportion classified as having cognitive impairment for each test. MAIN RESULTS The review contains 31 studies (19 differing tests, 3075 participants), of which seven studies (six telephone, one video call, 756 participants) were relevant to our primary objective of describing test accuracy against a clinical diagnosis of dementia. All studies were at unclear or high risk of bias in at least one domain, but were low risk in applicability to the review question. Overall, sensitivity of remote tools varied with values between 26% and 100%, and specificity between 65% and 100%, with no clearly superior test. Across the 24 papers comparing equivalent remote and in-person tests (14 telephone, 10 video call), agreement between tests was good, but rarely perfect (correlation coefficient range: 0.48 to 0.98). AUTHORS' CONCLUSIONS Despite the common and increasing use of remote cognitive assessment, supporting evidence on test accuracy is limited. Available data do not allow us to suggest a preferred test. Remote testing is complex, and this is reflected in the heterogeneity seen in tests used, their application, and their analysis. More research is needed to describe accuracy of contemporary approaches to remote cognitive assessment. While data comparing remote and in-person use of a test were reassuring, thresholds and scoring rules derived from in-person testing may not be applicable when the equivalent test is adapted for remote use.
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Affiliation(s)
- Lucy C Beishon
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Emma Elliott
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Tuuli M Hietamies
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California, USA
| | - Riona Mc Ardle
- Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - Aoife O'Mahony
- CUBRIC, School of Psychology, Cardiff University, Cardiff, UK
| | - Amy R Elliott
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Academic Clinical Fellow, University Hospitals Leicester, Leicester, UK
| | - Terry J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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Doeller B, Kratochwil M, Sifari L, Hirnschall N, Findl O. Benefit of psychiatric evaluation on anxiety in patients with Charles Bonnet syndrome. BMJ Open Ophthalmol 2021; 6:e000463. [PMID: 33693058 PMCID: PMC7907871 DOI: 10.1136/bmjophth-2020-000463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 11/03/2022] Open
Abstract
Objective Charles Bonnet syndrome (CBS) is defined as an occurrence of visual hallucinations (VHs) in the absence of any psychiatric/neurological disorder. Significantly reduced vision due to age-related macular degeneration (AMD), cataract or glaucoma is the most common cause for CBS. Aim of this randomized controlled study was to assess whether additional treatment by a psychiatrist is beneficial for patients with CBS. Methods and Analysis Patients with visual acuity of 0.5 LogMAR or worse in the better eye were screened. Instruments used were an interview asking about details of the VH, a mental test and a questionnaire on quality of life. Patients with CBS were randomised into two groups: in group 1, a patient-doctor consultation was performed by an ophthalmologist, and in group 2 a consultation and, if needed, additional medical assessment and treatment was given by a psychiatrist. Results 4900 patients were screened. 390 patients met the inclusion criteria and among these a CBS prevalence of 34 patients (8.7%) was found. The female-to-male ratio was 4:1 and the average age was 79.3 ± 9.7 years. Four different types of VH were observed: 41% humans (n=14), 32% geometrical shapes/patterns (n=11), 15% plants (n=5) and 12% animals (n=4). The change in quality of life in patients with CBS was not significantly different in both groups (p=0.727, ophthalmologist: n=18, psychiatrist: n=16). Conclusion It is essential for medical staff involved with patients suffering from severe vision loss to be aware of CBS. This will help to better identify and interpret symptoms and could also lead to a more adequate treatment for affected patients. Discussion It is essential for medical staff involved with patients suffering from severe vision loss to be aware of CBS. This will help to better identify and interpret symptoms and could also lead to a more adequate treatment for affected patients.
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Affiliation(s)
- Birgit Doeller
- Vienna Institute for Research in Ocular Surgery, Hanusch Hospital, Wien, Austria
| | | | - Lena Sifari
- Psychiatry and psychotherapy, Hanusch Hospital, Wien, Austria
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3
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Nolte CH, von Rennenberg R, Litmeier S, Scheitz JF, Leistner DM, Blankenberg S, Dichgans M, Katus H, Petzold GC, Pieske B, Regitz-Zagrosek V, Wegscheider K, Zeiher AM, Landmesser U, Endres M. PRediction of acute coronary syndrome in acute ischemic StrokE (PRAISE) - protocol of a prospective, multicenter trial with central reading and predefined endpoints. BMC Neurol 2020; 20:318. [PMID: 32854663 PMCID: PMC7450553 DOI: 10.1186/s12883-020-01903-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/23/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Current guidelines recommend measurement of troponin in acute ischemic stroke (AIS) patients. In AIS patients, troponin elevation is associated with increased mortality and worse outcome. However, uncertainty remains regarding the underlying pathophysiology of troponin elevation after stroke, particularly regarding diagnostic and therapeutic consequences. Troponin elevation may be caused by coronary artery disease (CAD) and more precisely acute coronary syndrome (ACS). Both have a high prevalence in stroke patients and contribute to poor outcome. Therefore, better diagnostic algorithms are needed to identify those AIS patients likely to have ACS or other manifestations of CAD. METHODS/DESIGN The primary goal of the "PRediction of Acute coronary syndrome in acute Ischemic StrokE" (PRAISE) study is to develop a diagnostic algorithm for prediction of ACS in AIS patients. The primary hypothesis will test whether dynamic high-sensitivity troponin levels determined by repeat measurements (i.e., "rise or fall-pattern") indicate presence of ACS when compared to stable (chronic) troponin elevation. PRAISE is a prospective, multicenter, observational trial with central reading and predefined endpoints guided by a steering committee. Clinical symptoms, troponin levels as well as findings on electrocardiogram, echocardiogram, and coronary angiogram will be recorded and assessed by central academic core laboratories. Diagnosis of ACS will be made by an endpoint adjudication committee. Severe adverse events will be evaluated by a critical event committee. Safety will be judged by a data and safety monitoring board. Follow-up will be conducted at three and twelve months and will record new vascular events (i.e., stroke and myocardial infarction) as well as death, functional and cognitive status. According to sample size calculation, 251 patients have to be included. DISCUSSION PRAISE will prospectively determine the frequency of ACS and characterize cardiac and coronary pathologies in a large, multicenter cohort of AIS patients with troponin elevation. The findings will elucidate the origin of troponin elevation, shed light on its impact on necessary diagnostic procedures and provide data on the safety and diagnostic yield of coronary angiography early after stroke. Thereby, PRAISE will help to refine algorithms and develop guidelines for the cardiac workup in AIS. TRIAL REGISTRATION NCT03609385 registered 1st August 2018.
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Affiliation(s)
- Christian H Nolte
- Klinik für Neurologie mit Experimentelle Neurologie, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany. .,Center for Stroke Research, Berlin, Germany. .,Berlin Institute of Health (BiH), Berlin, Germany. .,Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK), 10785, Berlin, Germany. .,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) - German Center for Neurodegenerative Diseases, 53127, Bonn, Germany.
| | - Regina von Rennenberg
- Klinik für Neurologie mit Experimentelle Neurologie, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.,Center for Stroke Research, Berlin, Germany.,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) - German Center for Neurodegenerative Diseases, 53127, Bonn, Germany
| | - Simon Litmeier
- Klinik für Neurologie mit Experimentelle Neurologie, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.,Center for Stroke Research, Berlin, Germany.,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) - German Center for Neurodegenerative Diseases, 53127, Bonn, Germany
| | - Jan F Scheitz
- Klinik für Neurologie mit Experimentelle Neurologie, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.,Center for Stroke Research, Berlin, Germany.,Berlin Institute of Health (BiH), Berlin, Germany.,Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK), 10785, Berlin, Germany
| | - David M Leistner
- Berlin Institute of Health (BiH), Berlin, Germany.,Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK), 10785, Berlin, Germany.,Medizinische Klinik für Kardiologie, Campus Benjamin-Franklin, Charite-Universitätsmedizin, 12203, Berlin, Germany
| | - Stephan Blankenberg
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK), 10785, Berlin, Germany.,Klinik und Poliklinik für Kardiologe, Universitäres Herz- und Gefäßzentrum, Universitätsklinikum, 20246, Hamburg, Germany
| | - Martin Dichgans
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) - German Center for Neurodegenerative Diseases, 53127, Bonn, Germany.,Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, 81377, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE, Munich) Partnersite, 81377, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), 81377, Munich, Germany
| | - Hugo Katus
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK), 10785, Berlin, Germany.,Klinik für Kardiologie, Angiologie, Pneumologie, Universitätsklinikum Heidelberg, 69120, Heidelberg, Germany
| | - Gabor C Petzold
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) - German Center for Neurodegenerative Diseases, 53127, Bonn, Germany.,Sektion für Vaskuläre Neurologie, Klinik und Poliklinik für Neurologie, Universitätsklinikum Bonn, 53105, Bonn, Germany
| | - Burkert Pieske
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK), 10785, Berlin, Germany.,Medizinische Klinik mit Schwerpunkt Kardiologie, Campus Virchow-Klinikum, Charite-Universitätsmedizin, 13353, Berlin, Germany
| | - Vera Regitz-Zagrosek
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK), 10785, Berlin, Germany.,Institut für Geschlechterforschung in der Medizin (Gender in Medicine, GiM), Charite-Universitätsmedizin, 10115, Berlin, Germany
| | - Karl Wegscheider
- Institut für Medizinische Biometrie und Epidemiologie, Universitätsklinikum Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Andreas M Zeiher
- Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK), 10785, Berlin, Germany.,Klinik für Kardiologie, Angiologie, Nephrologie, Uniklinik Frankfurt, 60590, Frankfurt am Main, Germany
| | - Ulf Landmesser
- Berlin Institute of Health (BiH), Berlin, Germany.,Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK), 10785, Berlin, Germany.,Medizinische Klinik für Kardiologie, Campus Benjamin-Franklin, Charite-Universitätsmedizin, 12203, Berlin, Germany
| | - Matthias Endres
- Klinik für Neurologie mit Experimentelle Neurologie, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.,Center for Stroke Research, Berlin, Germany.,Berlin Institute of Health (BiH), Berlin, Germany.,Deutsches Zentrum für Herz-Kreislauf-Forschung e.V. (DZHK), 10785, Berlin, Germany.,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) - German Center for Neurodegenerative Diseases, 53127, Bonn, Germany.,Medizinische Klinik für Kardiologie, Campus Benjamin-Franklin, Charite-Universitätsmedizin, 12203, Berlin, Germany.,Excellence Cluster NeuroCure, 10117, Berlin, Germany
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Naharci MI, Celebi F, Oguz EO, Yilmaz O, Tasci I. The Turkish Version of the Telephone Cognitive Screen for Detecting Cognitive Impairment in Older Adults. Am J Alzheimers Dis Other Demen 2020; 35:1533317519889810. [PMID: 31755298 PMCID: PMC10624096 DOI: 10.1177/1533317519889810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The ability to screen Turkish-speaking older adults for cognitive impairment by phone is lacking. The aim of this study was to translate the existing version of the telephone cognitive screen (T-CogS) into Turkish version (T-CogS-TR) and evaluate its reliability and validity in community-dwelling older adults. We prospectively recruited 104 community-dwelling participants with mild to moderate Alzheimer's disease (AD) and healthy controls. The T-CogS-TR was administered twice via telephone at home, first within 3 days of an in-person administration and again 4 weeks later. We observed acceptable internal consistency (Cronbach α coefficient = 0.738) and internal reliability. The test-retest reliability was excellent. The T-CogS-TR demonstrated significant correlations with Instrumental Activities of Daily Living, Mini-Mental State Examination, Clock-Drawing Test, and Clinician Dementia Rating (P's < .0001). The cutoff value of ≤22 exhibited sensitivity of 96.8%, specificity of 90.2%, positive predictive value of 93.9%, and negative predictive value of 94.9%. The T-CogS-TR can be useful as a valid and reliable tool for detecting AD in Turkish elderly patients. Also, this tool may be considered suitable for patients who need more frequent follow-up and cannot easily return to in-person visits.
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Affiliation(s)
- Mehmet Ilkin Naharci
- Division of Geriatrics, Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Fatih Celebi
- Division of Geriatrics, Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ekin Oktay Oguz
- Division of Geriatrics, Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Osman Yilmaz
- Division of Geriatrics, Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ilker Tasci
- Department of Internal Medicine, Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Muñoz-García M, Cervantes S, Razquin C, Guillén-Grima F, Toledo JB, Martínez-González MÁ, Toledo E. Validation study of a Spanish version of the modified Telephone Interview for Cognitive Status (STICS-m). GACETA SANITARIA 2018; 33:415-420. [PMID: 30054168 DOI: 10.1016/j.gaceta.2018.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/24/2018] [Accepted: 05/02/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To compare the Spanish version of the modified Telephone Interview of Cognitive Status (STICS-m) with the Mini-Mental State Examination (MMSE) and predict its ability to detect the development of dementia. METHOD 106 participants in a dietary intervention trial underwent face-to-face evaluation with the MMSE, and phone interview with the STICS-m. The correlation between STICS-m and MMSE was assessed with the intraclass correlation coefficient (ICC) of consistency. Secondly, 932 participants over 55 years old from the "Seguimiento Universidad de Navarra" cohort were evaluated with the STICS-m and data on dementia diagnosis were gathered (median follow-up time of 6.5 years). A logistic regression model evaluated the association between STICS-m score or 2-year changes in STICS-m score and risk of developing dementia, adjusting for ApoE, age and years of university education. RESULTS The ICC between the MMSE and the STICS-m was 0.31 (95% confidence interval [95%CI]: 0.13-0.48). The adjusted odds ratio (OR) for the development of dementia for each additional point in the baseline STICS-m score was 0.85 (95%CI: 0.72-1.02; p=0.084). When considering the 2-year change in the STICS-m score as exposure, the OR for the development of dementia was 0.79 (95%CI: 0.67-0.93; p=0.006). CONCLUSIONS The weak correlation between the STICS-m and the MMSE reflects moderate-low concurrent validity. Even so, the STICS-m can be regarded as an useful tool in the epidemiological setting since increasing scores appear to be able to predict a lower risk of developing dementia.
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Affiliation(s)
- Mariana Muñoz-García
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra and University of Navarra Clinic, Pamplona, Spain
| | - Sebastián Cervantes
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra and University of Navarra Clinic, Pamplona, Spain; Complejo Hospitalario de Navarra, Osasunbidea-Servicio Navarro de Salud, Pamplona, Spain
| | - Cristina Razquin
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra and University of Navarra Clinic, Pamplona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Francisco Guillén-Grima
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra and University of Navarra Clinic, Pamplona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | | | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra and University of Navarra Clinic, Pamplona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra and University of Navarra Clinic, Pamplona, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.
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Georgakis MK, Papadopoulos FC, Beratis I, Michelakos T, Kanavidis P, Dafermos V, Tousoulis D, Papageorgiou SG, Petridou ET. Validation of TICS for detection of dementia and mild cognitive impairment among individuals characterized by low levels of education or illiteracy: a population-based study in rural Greece. Clin Neuropsychol 2017; 31:61-71. [DOI: 10.1080/13854046.2017.1334827] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Marios K. Georgakis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens , Athens, Greece
| | | | - Ion Beratis
- Second Department of Neurology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens , Athens, Greece
| | - Theodoros Michelakos
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens , Athens, Greece
| | - Prodromos Kanavidis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens , Athens, Greece
| | - Vasilios Dafermos
- Department of Political Sciences, University of Crete , Rethymno, Greece
| | - Dimitrios Tousoulis
- First Department of Cardiology, Hippokrateion Hospital, School of Medicine, National and Kapodistrian University of Athens , Athens, Greece
| | - Sokratis G. Papageorgiou
- Second Department of Neurology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens , Athens, Greece
| | - Eleni Th. Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens , Athens, Greece
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Lacruz M, Emeny R, Bickel H, Linkohr B, Ladwig K. Feasibility, internal consistency and covariates of TICS-m (telephone interview for cognitive status-modified) in a population-based sample: findings from the KORA-Age study. Int J Geriatr Psychiatry 2013; 28:971-8. [PMID: 23242951 DOI: 10.1002/gps.3916] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 11/02/2012] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Test the feasibility of the modified telephone interview for cognitive status (TICS-m) as a screening tool to detect cognitive impairment in a population-based sample of older subjects. METHODS Data were collected from 3,578 participants, age 65-94 years, of the KORA-Age study. We used analysis of covariance to test for significant sex, age and educational differences in raw TICS-m scores. Internal consistency was analysed by assessing Cronbach's alpha. Correction for education years was undertaken, and participants were divided in three subgroups following validated cut-offs. Finally, a logistic regression was performed to determine the impact of sex on cognition subgroups. RESULTS Internal consistency of the TICS-m was 0.78. Study participants needed approximately 5.4 min to complete the interview. Lower raw TICS-m scores were associated with male sex, older age and lower education (all p < 0.0001). After correction for education years, 2,851 (79%) had a non-impaired cognitive status (score >31). Male sex was independently associated with having a score equal to or below 27 and 31 (OR = 1.9, 95% CI 1.4-2.5 and OR = 1.5, 95% CI 1.2-1.7, respectively). CONCLUSIONS The TICS-m is a feasible questionnaire for community-dwelling older adults with normal cognitive function or moderate cognitive impairment. Lower cognitive performance was associated with being a man, being older, and having fewer years of formal education.
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Affiliation(s)
- Me Lacruz
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
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Wollenweber FA, Zietemann V, Rominger A, Opherk C, Bayer-Karpinska A, Gschwendtner A, Coloma Andrews L, Bürger K, Duering M, Dichgans M. The Determinants of Dementia After Stroke (DEDEMAS) Study: protocol and pilot data. Int J Stroke 2013; 9:387-92. [PMID: 23834337 DOI: 10.1111/ijs.12092] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 01/30/2013] [Indexed: 11/29/2022]
Abstract
RATIONALE About 20% of stroke patients develop dementia within a few months after their event, but the determinants and mechanisms of poststroke dementia are insufficiently understood. AIMS To identify and characterize the determinants of cognitive impairment poststroke. DESIGN Observational prospective study in patients with acute stroke and no prior dementia. Six hundred subjects will be characterized by detailed interview, standardized clinical examinations, biometric measures (intima-media thickness, waist-hip ratio, and ankle-brachial index), multimodal imaging (magnetic resonance imaging, fluorodeoxyglucose-positron emission tomography (FDG-PET), amyloid-positron emission tomography (amyloid-PET), and retinal imaging), analysis of biomarkers derived from blood and cerebrospinal fluid, and detailed cognitive testing at repeat time points. Patients will be followed for five-years with a total of five personal visits and three telephone interviews. STUDY OUTCOMES Primary end-point is the occurrence of poststroke dementia. Secondary end-points include poststroke cognitive impairment-no dementia, stroke recurrence, and death. Predictive factors for poststroke dementia will be identified by multiple Cox proportional-hazards model. RESULTS Baseline characteristics of the first 71 patients (study inclusion between May 2011 and August 2012) are as follows: median age, 70 years (interquartile range, 65-75); female gender, 25 (35%); median National Institutes of Health Stroke Scale at admission, 2 (1-4); and etiological stroke subtypes according to TOAST classification, 15% large artery disease, 18% small vessel disease, 35% cardioembolic, and 32% undetermined or multiple competing etiologies. DISCUSSION This study will provide insights into the mechanisms of poststroke dementia and hold the potential to identify novel diagnostic markers and targets for preventive therapies. The study is registered at http://www.clinicaltrials.gov (NCT01334749) and will be extended as a multicenter study starting 2013.
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Affiliation(s)
- Frank A Wollenweber
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany
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