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Chen Z, Meng B, Li X, Lu B, Zhai X, Wang R, Chen J. Boston Naming Test as a Screening Tool for Early Postoperative Cognitive Dysfunction in Elderly Patients After Major Noncardiac Surgery. Am Surg 2024:31348241260274. [PMID: 38848748 DOI: 10.1177/00031348241260274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
PURPOSE The Boston naming test (BNT), as a simple, fast, and easily administered neuropsychological test, was demonstrated to be useful in detecting language function. In this study, BNT was investigated whether it could be a screening tool for early postoperative cognitive dysfunction (POCD). METHODS This prospective observational cohort study included 132 major noncardiac surgery patients and 81 nonsurgical controls. All participants underwent a mini-mental state examination (MMSE) and BNT 1 day before and 7 days after surgery. Early POCD was assessed by reliable change index and control group results. RESULTS Seven days after surgery, among 132 patients, POCD was detected in 30 (22.7%) patients (95% CI, 15.5%-30.0%) based on MMSE, and 45 (34.1%) patients (95% CI, 26.3%-41.9%) were found with postoperative language function decline based on BNT and MMSE. Agreement between the BNT spontaneous naming and MMSE total scoring was moderate (Kappa .523), and the sensitivity of BNT spontaneous naming for detecting early POCD was .767. Further analysis showed that areas under receiver operating characteristics curves (AUC) did not show statistically significant differences when BNT spontaneous naming (AUC .862) was compared with MMSE language functional subtests (AUC .889), or non-language functional subtests (AUC .933). CONCLUSION This study indicates the feasibility of implementing the BNT spontaneous naming test to screen early POCD in elderly patients after major noncardiac surgery.
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Affiliation(s)
- Zhang Chen
- Department of Anesthesiology, Ningbo No.2 Hospital, Haishu District, Ningbo, China
| | - Bo Meng
- Department of Anesthesiology, Ningbo No.2 Hospital, Haishu District, Ningbo, China
| | - Xiaoyu Li
- Department of Anesthesiology, Ningbo No.2 Hospital, Haishu District, Ningbo, China
| | - Bo Lu
- Department of Anesthesiology, Ningbo No.2 Hospital, Haishu District, Ningbo, China
| | - Xiaojie Zhai
- Department of Anesthesiology, Ningbo No.2 Hospital, Haishu District, Ningbo, China
| | - Ruichun Wang
- Department of Anesthesiology, Ningbo No.2 Hospital, Haishu District, Ningbo, China
| | - Junping Chen
- Department of Anesthesiology, Ningbo No.2 Hospital, Haishu District, Ningbo, China
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Salis F, Pili D, Collu M, Serchisu L, Laconi R, Mandas A. Six-item cognitive impairment test (6-CIT)'s accuracy as a cognitive screening tool: best cut-off levels in emergency department setting. Front Med (Lausanne) 2023; 10:1186502. [PMID: 37547596 PMCID: PMC10401263 DOI: 10.3389/fmed.2023.1186502] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Background Nowadays, elderly patients represent a significant number of accesses to the Emergency Department (ED). Working rhythms do not allow to perform complete cognitive analysis, which would, however, be useful for the health care. This study aims to define the optimal cut-off values of the six-item Cognitive Impairment Test (6-CIT) as a cognitive screening tool in ED. Methods This study included 215 subjects, evaluated at the Emergency Department of the University Hospital of Monserrato, Cagliari, Italy, from July to December 2021. The accuracy of 6-CIT as a cognitive screening tool was assessed by comparison with Mini Mental State Examination (MMSE). Results The correlation coefficient between the two tests was -0.836 (CI: -0.87 to -0.79; p < 0.0001), and 6-CIT showed AUC = 0.947 (CI: 0.908-0.973; p < 0.0001). The 8/9 6-CIT cut-off score presented 86.76% sensitivity (CI: 76.4-93.8) and 91.84% specificity (CI: 86.2-95.7), and Youden index for this score was 0.786. Conclusion Our study demonstrates that 6-CIT is a reliable cognitive screening tool in ED, offering excellent sensitivity and specificity with a 8/9 points cut-off score.
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Affiliation(s)
- Francesco Salis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniela Pili
- University Hospital “Azienda Ospedaliero-Universitaria” of Cagliari, Cagliari, Italy
| | - Manuel Collu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Luca Serchisu
- University Hospital “Azienda Ospedaliero-Universitaria” of Cagliari, Cagliari, Italy
| | - Rosanna Laconi
- University Hospital “Azienda Ospedaliero-Universitaria” of Cagliari, Cagliari, Italy
| | - Antonella Mandas
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- University Hospital “Azienda Ospedaliero-Universitaria” of Cagliari, Cagliari, Italy
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Conca F, Esposito V, Rundo F, Quaranta D, Muscio C, Manenti R, Caruso G, Lucca U, Galbussera AA, Di Tella S, Baglio F, L'Abbate F, Canu E, Catania V, Filippi M, Mattavelli G, Poletti B, Silani V, Lodi R, De Matteis M, Stanzani Maserati M, Arighi A, Rotondo E, Tanzilli A, Pace A, Garramone F, Cavaliere C, Pardini M, Rizzetto C, Sorbi S, Perri R, Tiraboschi P, Canessa N, Cotelli M, Ferri R, Weintraub S, Marra C, Tagliavini F, Catricalà E, Cappa SF. Italian adaptation of the Uniform Data Set Neuropsychological Test Battery (I-UDSNB 1.0): development and normative data. Alzheimers Res Ther 2022; 14:113. [PMID: 35982477 PMCID: PMC9389755 DOI: 10.1186/s13195-022-01056-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neuropsychological testing plays a cardinal role in the diagnosis and monitoring of Alzheimer's disease. A major concern is represented by the heterogeneity of the neuropsychological batteries currently adopted in memory clinics and healthcare centers. The current study aimed to solve this issue. METHODS Following the initiative of the University of Washington's National Alzheimer's Coordinating Center (NACC), we presented the Italian adaptation of the Neuropsychological Test Battery of the Uniform Data Set (I-UDSNB). We collected data from 433 healthy Italian individuals and employed regression models to evaluate the impact of demographic variables on the performance, deriving the reference norms. RESULTS Higher education and lower age were associated with a better performance in the majority of tests, while sex affected only fluency tests and Digit Span Forward. CONCLUSIONS The I-UDSNB offers a valuable and harmonized tool for neuropsychological testing in Italy, to be used in clinical and research settings.
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Affiliation(s)
| | | | - Francesco Rundo
- Department of Neurology IC, Oasi Research Institute - IRCCS, Troina, Italy
| | - Davide Quaranta
- Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Cristina Muscio
- Present address: ASST Bergamo Ovest, Treviglio, Italy
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Rosa Manenti
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giulia Caruso
- Laboratory of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ugo Lucca
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessia Antonella Galbussera
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | | | - Federica L'Abbate
- Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Valentina Catania
- Unit of Psychology I.C., Oasi Research Institute-IRCCS, Troina, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neurology Unit, Neurorehabilitation Unit, and Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Giulia Mattavelli
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Palazzo del Broletto, Piazza Vittoria 15, 27100, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, Pavia, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Università degli studi di Milano, Milan, Italy
- Department of Pathophysiology and Transplantation, "Dino Ferrari" Center, Università degli studi di Milano, Milan, Italy
| | - Raffaele Lodi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | | | - Andrea Arighi
- Fondazione IRCSS ca' Granda, Ospedale Policlinico, Milan, Italy
| | | | - Antonio Tanzilli
- Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Andrea Pace
- Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | | | - Matteo Pardini
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Cristiano Rizzetto
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Sandro Sorbi
- IRCCS Fondazione Don Carlo Gnocchi, ONLUS, Milan, Italy
| | - Roberta Perri
- Laboratory of Clinical and Behavioural Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Nicola Canessa
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Palazzo del Broletto, Piazza Vittoria 15, 27100, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, Pavia, Italy
| | - Maria Cotelli
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Raffaele Ferri
- Department of Neurology IC, Oasi Research Institute - IRCCS, Troina, Italy
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease and Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Department of Neurology, Northwestern University, Chicago, IL, USA
| | - Camillo Marra
- Neurology Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | | | - Eleonora Catricalà
- IRCCS Mondino Foundation, Pavia, Italy
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Palazzo del Broletto, Piazza Vittoria 15, 27100, Pavia, Italy
| | - Stefano Francesco Cappa
- IRCCS Mondino Foundation, Pavia, Italy.
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Palazzo del Broletto, Piazza Vittoria 15, 27100, Pavia, Italy.
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Outcomes of clinical utility in amyloid-PET studies: state of art and future perspectives. Eur J Nucl Med Mol Imaging 2021; 48:2157-2168. [PMID: 33594474 PMCID: PMC8175294 DOI: 10.1007/s00259-020-05187-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/28/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To review how outcomes of clinical utility are operationalized in current amyloid-PET validation studies, to prepare for formal assessment of clinical utility of amyloid-PET-based diagnosis. METHODS Systematic review of amyloid-PET research studies published up to April 2020 that included outcomes of clinical utility. We extracted and analyzed (a) outcome categories, (b) their definition, and (c) their methods of assessment. RESULTS Thirty-two studies were eligible. (a) Outcome categories were clinician-centered (found in 25/32 studies, 78%), patient-/caregiver-centered (in 9/32 studies, 28%), and health economics-centered (5/32, 16%). (b) Definition: Outcomes were mainly defined by clinical researchers; only the ABIDE study expressly included stakeholders in group discussions. Clinician-centered outcomes mainly consisted of incremental diagnostic value (25/32, 78%) and change in patient management (17/32, 53%); patient-/caregiver-centered outcomes considered distress after amyloid-pet-based diagnosis disclosure (8/32, 25%), including quantified burden of procedure for patients' outcomes (n = 8) (1/8, 12.5%), impact of disclosure of results (6/8, 75%), and psychological implications of biomarker-based diagnosis (75%); and health economics outcomes focused on costs to achieve a high-confidence etiological diagnosis (5/32, 16%) and impact on quality of life (1/32, 3%). (c) Assessment: all outcome categories were operationalized inconsistently across studies, employing 26 different tools without formal rationale for selection. CONCLUSION Current studies validating amyloid-PET already assessed outcomes for clinical utility, although non-clinician-based outcomes were inconsistent. A wider participation of stakeholders may help produce a more thorough and systematic definition and assessment of outcomes of clinical utility and help collect evidence informing decisions on reimbursement of amyloid-PET.
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Kratzer A, Scheel J, Wolf-Ostermann K, Schmidt A, Ratz K, Donath C, Graessel E. The DemWG study: reducing the risk of hospitalisation through a complex intervention for people with dementia and mild cognitive impairment (MCI) in German shared-housing arrangements: study protocol of a prospective, mixed-methods, multicentre, cluster-randomised controlled trial. BMJ Open 2020; 10:e041891. [PMID: 33268431 PMCID: PMC7713202 DOI: 10.1136/bmjopen-2020-041891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Shared-housing arrangements (SHAs) are small, home-like care environments in Germany. Residents are predominantly people with dementia. The risk for all-cause hospitalisation is consistently higher for people with dementia compared with people without dementia and there is currently no evidence-based intervention to reduce the risk of hospitalisation. Thus, the DemWG study investigates whether a complex intervention is effective in reducing hospitalisation (primary outcome), behavioural and psychological symptoms of dementia and falls and for stabilising cognitive functioning and quality of life in people with dementia and mild cognitive impairment (MCI) in German SHAs. METHODS AND ANALYSIS Based on the UK Medical Research Council framework 'Developing and evaluating complex interventions', a prospective, mixed-methods, multicentre, cluster-randomised controlled trial combining primary and secondary data analyses as well as quantitative and qualitative research methods is being conducted. The intervention consists of three parts: (A) education of nursing staff in SHAs; (B) awareness raising and continuing medical education (CME) of general practitioners; (C) multicomponent non-pharmacological group intervention MAKS-mk+ ('m'=motor training; 'k'=cognitive training; '+'=fall prevention) for people with dementia and MCI. Randomisation is stratified by the German federal states and type of setting (rural vs urban). Neither the trained professionals nor the participants are blinded. Data are collected at baseline and after 6, 12 and 18 months with standardised instruments. Quantitative data will be analysed by multivariate analyses according to the general linear model, qualitative data using qualitative content analysis. Recruitment is still ongoing until 31 December 2020. ETHICS AND DISSEMINATION All procedures were approved by the Ethics Committee of the University of Bremen (Ref. 2019-18-06-3). Informed consent will be obtained before enrolment of participants. Due to findings of previous randomised controlled trials, serious adverse events are not expected. Results will be disseminated in peer-reviewed journal publications and conference presentations. TRIAL REGISTRATION NUMBER ISRCTN89825211.
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Affiliation(s)
- André Kratzer
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Jennifer Scheel
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Karin Wolf-Ostermann
- Department of Health Care Research, Institute of Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Annika Schmidt
- Department of Health Care Research, Institute of Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Katrin Ratz
- Department of Health Care Research, Institute of Public Health and Nursing Research (IPP), University of Bremen, Bremen, Germany
| | - Carolin Donath
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Elmar Graessel
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Jones D, Wilkinson R, Jackson C, Drew P. Variation and Interactional Non-Standardization in Neuropsychological Tests: The Case of the Addenbrooke's Cognitive Examination. QUALITATIVE HEALTH RESEARCH 2020; 30:458-470. [PMID: 31550997 PMCID: PMC7322939 DOI: 10.1177/1049732319873052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The Addenbrooke's Cognitive Examination (ACE-111) is a neuropsychological test used in clinical practice to inform a dementia diagnosis. The ACE-111 relies on standardized administration so that patients' scores can be interpreted by comparison with normative scores. The test is delivered and responded to in interaction between clinicians and patients, which places talk-in-interaction at the heart of its administration. In this article, conversation analysis (CA) is used to investigate how the ACE-111 is delivered in clinical practice. Based on analysis of 40 video/audio-recorded memory clinic consultations in which the ACE-111 was used, we have found that administrative standardization is rarely achieved in practice. There was evidence of both (a) interactional variation in the way the clinicians introduce the test and (b) interactional non-standardization during its implementation. We show that variation and interactional non-standardization have implications for patients' understanding and how they might respond to particular questions.
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Affiliation(s)
- Danielle Jones
- University of Bradford, Bradford, UK
- Danielle Jones, Lecturer in Dementia Studies, Centre for Applied Dementia Studies, Faculty of Health Studies, University of Bradford, Richmond Road, Bradford BD7 1DP, UK.
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Aerts L, Cations M, Harrison F, Jessop T, Shell A, Chenoweth L, Brodaty H. Why deprescribing antipsychotics in older people with dementia in long-term care is not always successful: Insights from the HALT study. Int J Geriatr Psychiatry 2019; 34:1572-1581. [PMID: 31276255 DOI: 10.1002/gps.5167] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 06/29/2019] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Antipsychotic medications are commonly used to manage behavioural and psychological symptoms of dementia despite their side effects and harms. While the Halting Antipsychotic Use in Long-Term care (HALT) deprescribing trial was successful at reducing antipsychotic use, 19% of participants had their antipsychotics represcribed or never reached a dose of zero. The aim of this study was to investigate the reasons for represcription of antipsychotic medication and factors associated with ongoing antipsychotic use, relating to care staff requests and perceived behavioural changes. MATERIALS AND METHODS Thirty-nine of 133 HALT participants never ceased their antipsychotic medication or were represcribed a regular or pro re nata (PRN) antipsychotic after initial deprescribing. The views of nursing staff, general practitioner, and family on the circumstances leading up to these outcomes were collected via a questionnaire-based approach. This information was triangulated with observation and detailed file audit (including progress notes, medical notes, medication charts, incident reports, and hospital discharge summaries). A consensus panel reconstructed the represcribing context. RESULTS Nurses were the most common drivers of represcribing (63.2%), followed by family members (39.5%), GPs (23.7%), specialists (13.2%), and hospital staff (10.5%). There were multiple drivers for antipsychotic use in 46.2% of participants. Increased agitated and aggressive behaviours were the most commonly reported reasons for represcribing even though these changes were not identified over time on objective measures. Consent and dosage practices remained poor despite education. DISCUSSION Nursing staff are the key drivers of deprescribing particularly in response to perceived worsening agitation and aggression among male residents. The train-the-trainer model used in the HALT trial may have been insufficient on its own to improve staff competence and confidence in applying nonpharmacological approaches when responding to behaviour change.
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Affiliation(s)
- Liesbeth Aerts
- Dementia Centre for Research Collaboration, School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
| | - Monica Cations
- Dementia Centre for Research Collaboration, School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
| | - Fleur Harrison
- Dementia Centre for Research Collaboration, School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia.,Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
| | - Tiffany Jessop
- Dementia Centre for Research Collaboration, School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
| | - Allan Shell
- Dementia Centre for Research Collaboration, School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
| | - Lynn Chenoweth
- Dementia Centre for Research Collaboration, School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
| | - Henry Brodaty
- Dementia Centre for Research Collaboration, School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia.,Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
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Chua KC, Böhnke JR, Prince M, Banerjee S. Health-related quality-of-life assessment in dementia: Evidence of cross-cultural validity in Latin America. Psychol Assess 2019; 31:1264-1277. [PMID: 31282701 PMCID: PMC6818683 DOI: 10.1037/pas0000743] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 04/24/2019] [Accepted: 05/16/2019] [Indexed: 11/17/2022]
Abstract
All health-related quality-of-life (HRQL) measures for dementia have been developed in high-income countries and none were validated for cross-cultural use. Yet, the global majority of people living with dementia reside in low- and middle-income countries. We therefore investigated the measurement invariance of a set of self- and informant-report HRQL measures developed in the United Kingdom when used in Latin America. Self-reported HRQL was obtained using (DEMQOL) at a memory assessment service in the United Kingdom (n = 868) and a population cohort study in Latin America (n = 417). Informant reports were collected using DEMQOL-Proxy at both sites (n = 909 and n = 495). Multiple-group confirmatory bifactor models for ordered categorical item responses were estimated to evaluate measurement invariance. Results support configural, metric, and scalar invariance for the concept of general HRQL in DEMQOL and DEMQOL-Proxy. The dominant impact of general HRQL on item responses was evident across U.K. English and Ibero American Spanish versions of DEMQOL (ωh = 0.87-0.90) and DEMQOL-Proxy (ωh = 0.88-0.89). Ratings of "positive emotion" did not show a major impact on general HRQL appraisal, particularly for Latin American respondents. Item information curves show that self- and informant-reports were highly informative about the presence rather than the absence of HRQL impairment. We found no major difference in conceptual meaning, sensitivity, and relevance of DEMQOL and DEMQOL-Proxy for older adults in the United Kingdom and Latin America. Further replication is needed for consensus over which HRQL measures are appropriate for making cross-national comparisons in global dementia research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Kia-Chong Chua
- Centre for Implementation Science, Institute of Psychiatry, Psychology, and Neuroscience
| | - Jan R Böhnke
- School of Nursing and Health Sciences, University of Dundee
| | - Martin Prince
- King's Global Health Institute, Institute of Psychiatry, Psychology, and Neuroscience, King's College London
| | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, University of Sussex
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Rashedi V, Foroughan M, Nazari H, Seeher K, Brodaty H. Validity and reliability of the Persian version of general practitioner assessment of cognition (P-GPCOG). Aging Ment Health 2019; 23:961-965. [PMID: 29781711 DOI: 10.1080/13607863.2018.1473840] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objectives: The study aimed to examine the validity, reliability, and practicality of the Persian version of the General Practitioner Assessment of Cognition (P-GPCOG) as a brief, efficient cognitive assessment instrument in Iranian older adults. Method: The sample comprised 151 community-dwelling older adults and 79 nursing home residents (aged ≥60 years). The English GPCOG was translated, back-translated, and revised to prepare the final P-GPCOG. The Abbreviated Mental Test score (AMTs) and the Depression in Old Age Scale (DIA-S) were administered to the two different samples to establish the convergent and discriminant validity of the P-GPCOG. Results: The mean age of the sample was 70.67 (SD = 9.51); 57.4% were male. The mean P-GPCOG scores for the total, cognitive and informant subscales were 7.67 (SD = 4.59), 4.18 (SD = 2.73), and 3.49 (SD = 2.24), respectively. Cognitive (P < 0.001), informant (P < 0.001) and total scores (P < 0.001) differed significantly between community-dwelling participants and nursing home residents. Worse cognitive performance on the P-GPCOG correlated significantly with worse scores on the AMTs (r = 0.61, P < 0.001) and less so with depressive symptoms as measured with the DIA-S (r = -0.20, P < 0.05). Cronbach's alpha for the P-GPCOG cognitive and informant subscales were 0.90 and 0.83 respectively, indicating a high degree of internal consistency and homogeneity between items. The test-retest correlation for the total P-GPCOG score was 0.82 in 30 participants after 19 days. P-GPCOG cognitive scores correlated significantly with education. Conclusion: The P-GPCOG displayed strong psychometric properties, offering healthcare professionals a quick and efficient cognitive instrument for older Persian speakers. As with other cognitive assessment tools, the P-GPCOG cognitive score is affected by a person's level of education.
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Affiliation(s)
- Vahid Rashedi
- a Tehran Psychiatric Institute, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences , Tehran , Iran
| | - Mahshid Foroughan
- b Iranian Research Center On Aging , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran
| | - Heiman Nazari
- c Student Research Committee , Hamadan University of Medical Sciences & Health Services , Hamadan , Iran
| | - Katrin Seeher
- d Dementia Collaborative Research Centre , School of Psychiatry, University of New South Wales , Sydney , Australia
| | - Henry Brodaty
- d Dementia Collaborative Research Centre , School of Psychiatry, University of New South Wales , Sydney , Australia.,e Centre For Healthy Brain Ageing , School of Psychiatry, University of New South Wales , Sydney , Australia
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Abstract
There are many instruments for screening cognitive impairment. The common tools for screening cognitive impairment are categorized into 4 groups (very brief, brief, self-administered, and test batteries) in geriatrics. There are some tests used for specific tests of 6 cognitive domains (learning and memory, language, executive function, complex attention, and social cognition) by following the DSM-V criteria. Different settings, stages, conditions, and specific people need some specific tools for screening cognitive impairment. It must be noted that there is some harm in screening for cognitive impairment in geriatrics.
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Affiliation(s)
- Ziqi Wang
- Department of Neurology, Chengdu Fifth People's Hospital, No. 33 Mashi Street, Chengdu, Sichuan, China 611130
| | - Birong Dong
- The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, Sichuan, China 610041.
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11
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Kok JS, Nielen MMA, Scherder EJA. Quality of life in small-scaled homelike nursing homes: an 8-month controlled trial. Health Qual Life Outcomes 2018; 16:38. [PMID: 29486788 PMCID: PMC5830070 DOI: 10.1186/s12955-018-0853-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 01/24/2018] [Indexed: 01/20/2023] Open
Abstract
Background Quality of life is a clinical highly relevant outcome for residents with dementia. The question arises whether small scaled homelike facilities are associated with better quality of life than regular larger scale nursing homes do. Methods A sample of 145 residents living in a large scale care facility were followed over 8 months. Half of the sample (N = 77) subsequently moved to a small scaled facility. Quality of life aspects were measured with the QUALIDEM and GIP before and after relocation. Results We found a significant Group x Time interaction on measures of anxiety meaning that residents who moved to small scale units became less anxious than residents who stayed on the regular care large-scale units. No significant differences were found on other aspects of quality of life. Conclusions This study demonstrates that residents who move from a large scale facility to a small scale environment can improve an aspect of quality of life by showing a reduction in anxiety. Trial registration Current Controlled Trials ISRCTN11151241. registration date: 21–06-2017. Retrospectively registered.
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Affiliation(s)
- Jeroen S Kok
- Lentis
- Dignis, Mental Health Care Institute, PO Box 128, 9470 AC, Zuidlaren, The Netherlands.
| | - Marjan M A Nielen
- ZINN, Mental Health Care Institute, PO Box 51, 9750 AB, Haren, The Netherlands
| | - Erik J A Scherder
- Department of Clinical Neuropsychology, VU University Amsterdam, van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands
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12
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Bateman DR, Srinivas B, Emmett TW, Schleyer TK, Holden RJ, Hendrie HC, Callahan CM. Categorizing Health Outcomes and Efficacy of mHealth Apps for Persons With Cognitive Impairment: A Systematic Review. J Med Internet Res 2017; 19:e301. [PMID: 28855146 PMCID: PMC5597798 DOI: 10.2196/jmir.7814] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 07/15/2017] [Accepted: 08/01/2017] [Indexed: 01/18/2023] Open
Abstract
Background Use of mobile health (mHealth) apps is growing at an exponential rate in the United States and around the world. Mild cognitive impairment (MCI), Alzheimer disease, and related dementias are a global health problem. Numerous mHealth interventions exist for this population, yet the effect of these interventions on health has not been systematically described. Objective The aim of this study is to catalog the types of health outcomes used to measure effectiveness of mHealth interventions and assess which mHealth interventions have been shown to improve the health of persons with MCI, Alzheimer disease, and dementia. Methods We searched 13 databases, including Ovid MEDLINE, PubMed, EMBASE, the full Cochrane Library, CINAHL, PsycINFO, Ei Compendex, IEEE Xplore, Applied Science & Technology Source, Scopus, Web of Science, ClinicalTrials.gov, and Google Scholar from inception through May 2017 for mHealth studies involving persons with cognitive impairment that were evaluated using at least one quantitative health outcome. Proceedings of the Annual ACM Conferences on Human Factors in Computing Systems, the ACM User Interface Software and Technology Symposium, and the IEEE International Symposium on Wearable Computers were searched in the ACM Digital Library from 2012 to 2016. A hand search of JMIR Publications journals was also completed in July 2017. Results After removal of duplicates, our initial search returned 3955 records. Of these articles, 24 met final inclusion criteria as studies involving mHealth interventions that measured at least one quantitative health outcome for persons with MCI, Alzheimer disease, and dementia. Common quantitative health outcomes included cognition, function, mood, and quality of life. We found that 21.2% (101/476) of the fully reviewed articles were excluded because of a lack of health outcomes. The health outcomes selected were observed to be inconsistent between studies. For those studies with quantitative health outcomes, more than half (58%) reported postintervention improvements in outcomes. Conclusions Results showed that many mHealth app interventions targeting those with cognitive impairment lack quantitative health outcomes as a part of their evaluation process and that there is a lack of consensus as to which outcomes to use. The majority of mHealth app interventions that incorporated health outcomes into their evaluation noted improvements in the health of persons with MCI, Alzheimer disease, and dementia. However, these studies were of low quality, leading to a grade C level of evidence. Clarification of the benefits of mHealth interventions for people with cognitive impairment requires more randomized controlled trials, larger numbers of participants, and trial designs that minimize bias. Trial Registration PROSPERO Registration: PROSPERO 2016:CRD42016033846; http://www.crd.york.ac.uk/PROSPERO/ display_record.asp?ID=CRD42016033846 (Archived by WebCite at http://www.webcitation.org/6sjjwnv1M)
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Affiliation(s)
- Daniel R Bateman
- Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, United States.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Bhavana Srinivas
- Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, United States.,School of Informatics and Computing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Thomas W Emmett
- Ruth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Titus K Schleyer
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States.,Center for Biomedical Informatics, Regenstrief Institute, Inc, Indianapolis, IN, United States
| | - Richard J Holden
- Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, United States.,School of Informatics and Computing, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States.,Center for Biomedical Informatics, Regenstrief Institute, Inc, Indianapolis, IN, United States
| | - Hugh C Hendrie
- Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, United States.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Christopher M Callahan
- Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, United States.,Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
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