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Berginström N, Andersson L. Remote neuropsychological assessment of patients with neurological disorders and injuries-a study protocol for a cross-sectional case-control validation study. BMJ Open 2024; 14:e080628. [PMID: 38653513 PMCID: PMC11043743 DOI: 10.1136/bmjopen-2023-080628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 04/11/2024] [Indexed: 04/25/2024] Open
Abstract
INTRODUCTION There are great potential benefits of being able to conduct neuropsychological assessments remotely, especially for hard-to-reach or less mobile patient groups. Such tools need to be equivalent to standard tests done in the clinic and also easy to use in a variety of clinical populations. METHODS AND ANALYSIS This study protocol describes a cross-sectional study aimed at validating the newly developed digitalized neuropsychological test battery Mindmore Remote in patients with neurological disorders and injuries. Diagnoses comprise traumatic brain injury, stroke, Parkinson's disease, multiple sclerosis, brain tumour and epilepsy. 50 patients in each patient group will be included. In addition, 50 healthy controls will be recruited. All participants will undergo both testing with Mindmore Remote at home and traditional neuropsychological assessment face-to-face in a randomised order. The primary outcome is the association between tests from the Mindmore Remote battery and their equivalent traditional neuropsychological tests. Further, bias between methods and differences between groups will also be investigated. ETHICS AND DISSEMINATION The study protocol has been approved by the Swedish Ethical Review Authority (2022-06230-01) and adheres to the declaration of Helsinki. All participants will be given oral and written information about the study and sign informed consent forms before entering the study. All participants are informed that they can terminate their participation in the study at any given time, without giving any explanation, and participating in the study or not will not affect their care at the clinic. Neither authors nor personnel involved in the research project are affiliated with Mindmore AB. The results from the study will be published in peer-reviewed scientific journals and presented at national and international conferences on the topic. TRIAL REGISTRATION NUMBER NCT05819008.
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Affiliation(s)
- Nils Berginström
- Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden
- Department of Psychology, Umeå University, Umeå, Sweden
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Sperling SA, Acheson SK, Fox-Fuller J, Colvin MK, Harder L, Cullum CM, Randolph JJ, Carter KR, Espe-Pfeifer P, Lacritz LH, Arnett PA, Gillaspy SR. Tele-Neuropsychology: From Science to Policy to Practice. Arch Clin Neuropsychol 2024; 39:227-248. [PMID: 37715508 DOI: 10.1093/arclin/acad066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE The primary aim of this paper is to accelerate the number of randomized experimental studies of the reliability and validity in-home tele-neuropsychological testing (tele-np-t). METHOD We conducted a critical review of the tele-neuropsychology literature. We discuss this research in the context of the United States' public and private healthcare payer systems, including the Centers for Medicare & Medicaid Services (CMS) and Current Procedural Terminology (CPT) coding system's telehealth lists, and existing disparities in healthcare access. RESULTS The number of tele-np publications has been stagnant since the onset of the COVID-19 pandemic. There are less published experimental studies of tele-neuropsychology (tele-np), and particularly in-home tele-np-t, than other tele-np publications. There is strong foundational evidence of the acceptability, feasibility, and reliability of tele-np-t, but relatively few studies of the reliability and validity of in-home tele-np-t using randomization methodology. CONCLUSIONS More studies of the reliability and validity of in-home tele-np-t using randomization methodology are necessary to support inclusion of tele-np-t codes on the CMS and CPT telehealth lists, and subsequently, the integration and delivery of in-home tele-np-t services across providers and institutions. These actions are needed to maintain equitable reimbursement of in-home tele-np-t services and address the widespread disparities in healthcare access.
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Affiliation(s)
- Scott A Sperling
- Department of Neurology, Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA
| | | | - Joshua Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lana Harder
- Children's Health, Children's Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | | | - Patricia Espe-Pfeifer
- Department of Psychiatry and Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Laura H Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Peter A Arnett
- Department of Psychology, The Pennsylvania State University, State College, PA, USA
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Amirpour A, Eckerblad J, Bergman L, Nilsson U. Comparing analog and digital neurocognitive tests with older adults: a study of the ISPOCD battery vs. a digital test battery from Mindmore. BMC Geriatr 2024; 24:34. [PMID: 38191318 PMCID: PMC10775484 DOI: 10.1186/s12877-023-04648-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/29/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Delayed neurocognitive recovery and neurocognitive disorder are common postoperative complications among older adults. The assessment of these complications traditionally relies on analog neurocognitive tests, predominantly using the test battery from the ISPOCD-study as the standard approach. However, analog tests are time-consuming and necessitate trained staff which poses limitations. The potential availability of a digital neurocognitive test as an alternative to the ISPOCD remains unknown. We conducted a comparative study between the analog test battery from ISPOCD and the self-administrated digital test battery developed by Mindmore. METHODS We conducted a crossover study with 50 cognitively healthy older adults ≥ 60 years of age recruited in Stockholm Sweden, between February and April 2022. The primary outcome focused on measuring comparability between the two test batteries. Our secondary outcomes included assessing participants' perceptions and attitudes about the tests with qualitative interviews and their usability experiences. RESULTS Fifty older adults, mean age 76, female 56%, with a university or college degree 48% participated in the study. The sub tests in two test batteries demonstrated a medium-large correlation (r = 0.3-0.5), except for one measure. For four out of six measures, significant differences were found with medium to large effect sizes, ranging from 0.57-1.43. Two categories were recognized in the qualitative analysis: self-competing in a safe environment, and experience with technology. Participants expressed feeling safe and at ease during the assessment, with some preferring the digital test over the analog. Participants reported a high level of usability with the digital test and a majority participants (n = 47) reported they would undergo the digital test for a potential future surgery. CONCLUSIONS The digital test battery developed by Mindmore offers several advantages, including rapid access to test results, easy comprehension, and use for participants, thereby increased accessibility of cognitive screening. TRIAL REGISTRATION NUMBER NCT05253612; ClinicalTrials.gov, 24/02/2022.
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Affiliation(s)
- Anahita Amirpour
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, C4, 141 83, Stockholm, Sweden.
| | - Jeanette Eckerblad
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, C4, 141 83, Stockholm, Sweden
| | - Lina Bergman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, C4, 141 83, Stockholm, Sweden
| | - Ulrica Nilsson
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, C4, 141 83, Stockholm, Sweden
- Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
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Roca-Ventura A, Solana-Sánchez J, Heras E, Anglada M, Missé J, Ulloa E, García-Molina A, Opisso E, Bartrés-Faz D, Pascual-Leone A, Tormos-Muñoz JM, Cattaneo G. "Guttmann Cognitest ®," a digital solution for assessing cognitive performance in adult population: A feasibility and usability pilot study. Digit Health 2024; 10:20552076231224246. [PMID: 38188861 PMCID: PMC10768632 DOI: 10.1177/20552076231224246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 12/15/2023] [Indexed: 01/09/2024] Open
Abstract
Background As the world population continues to age, the prevalence of neurological diseases, such as dementia, poses a significant challenge to society. Detecting cognitive impairment at an early stage is vital in preserving and enhancing cognitive function. Digital tools, particularly mHealth, offer a practical solution for large-scale population screening and prompt follow-up assessments of cognitive function, thus overcoming economic and time limitations. Objective In this work, two versions of a digital solution called Guttmann Cognitest® were tested. Methods Two hundred and one middle-aged adults used the first version (Group A), while 132 used the second one, which included improved tutorials and practice screens (Group B). This second version was also validated in an older age group (Group C). Results This digital solution was found to be highly satisfactory in terms of usability and feasibility, with good acceptability among all three groups. Specifically for Group B, the system usability scale score obtained classifies the solution as the best imaginable in terms of usability. Conclusions Guttmann Cognitest® has been shown to be effective and well-perceived, with a high potential for sustained engagement in tracking changes in cognitive function.
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Affiliation(s)
- Alba Roca-Ventura
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Javier Solana-Sánchez
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Eva Heras
- Servei Envelliment i Salut Servei Andorrà d’Atenció Sanitària, Escaldes-Engordany, Andorra
| | - Maria Anglada
- Servei Envelliment i Salut Servei Andorrà d’Atenció Sanitària, Escaldes-Engordany, Andorra
| | - Jan Missé
- Servei Envelliment i Salut Servei Andorrà d’Atenció Sanitària, Escaldes-Engordany, Andorra
| | - Encarnació Ulloa
- Servei Envelliment i Salut Servei Andorrà d’Atenció Sanitària, Escaldes-Engordany, Andorra
| | - Alberto García-Molina
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Eloy Opisso
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - David Bartrés-Faz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Alvaro Pascual-Leone
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Josep M. Tormos-Muñoz
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Gabriele Cattaneo
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Spain
- Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra, Spain
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Revert-Alcántara N, Funes-Molina MJ, Porcel C, Sáez-Zea C. Cross-Cultural Adaptation and Spanish Validation of the Computerized Information Processing Assessment Battery (COGNITO). Arch Clin Neuropsychol 2023:acad075. [PMID: 37769198 DOI: 10.1093/arclin/acad075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION Mild cognitive impairment (CI) has an exponential increase in its prevalence and causes functional deficits and dependence. Its early detection allows for timely treatment and greater therapeutic efficacy. However, mild cognitive impairment (MCI) is currently underdiagnosed. Although recent decades have seen a rise in computerized instruments for the detection and early diagnosis of MCI, showing numerous advantages over the classic paper-and-pencil methods, such as standardized stimulus presentation. However, their limitations include the use of self-administered application without professional supervision. Few of these instruments have Spanish-adapted versions. OBJECTIVE To translate, adapt, and validate the computerized Information Processing Assessment Battery (COGNITO) battery in the Spanish population and to develop a portable administration system that facilitates its application in different settings. COGNITO was then administered to 232 Spanish participants (18-89 years) without cognitive impairment, after which preliminary normative data were obtained. RESULTS Strong positive correlations were found between the main cognitive domains assessed by COGNITO and the variables of age, educational level, and MEC score. The gender variable only correlated with visuospatial skills, with men outperforming women. The test-retest correlations conducted after 4 weeks with 89 participants revealed adequate reliability coefficients ranging between.63 and.66 (visuospatial skills = 0.35). Internal consistency coefficients were satisfactory in Attention-Executive Functions and Memory domains. CONCLUSIONS The Spanish adaptation of COGNITO shows adequate psychometric characteristics of validity and reliability. The preliminary normative data provided may contribute to the early detection of cognitive impairments associated with both normal aging and various types of neurological pathology. This tool has great utility and versatility for neuropsychological practice.
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Affiliation(s)
| | | | - Carlos Porcel
- Department of Computer Science and Artificial Intelligence, University of Granada, Granada, Spain
| | - Carmen Sáez-Zea
- Department of Psychobiology, University of Granada, Granada, Spain
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Zegers C, Offermann C, Dijkstra J, Compter I, Hoebers F, de Ruysscher D, Anten M, Broen M, Postma A, Hoeben A, Hovinga K, Van Elmpt W, Eekers D. Clinical implementation of standardized neurocognitive assessment before and after radiation to the brain. Clin Transl Radiat Oncol 2023; 42:100664. [PMID: 37576068 PMCID: PMC10413416 DOI: 10.1016/j.ctro.2023.100664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/19/2023] [Accepted: 07/20/2023] [Indexed: 08/15/2023] Open
Abstract
Background Radiotherapy induced impairment of cognitive function can lead to a reduced quality of life. The aim of this study was to describe the implementation and compliance of standardized neurocognitive assessment. In addition, the first results of cognitive changes for patients receiving a radiation dose to the brain are described. Materials and methods Patients that received radiation dose to the brain (neuro, head and neck and prophylactic cranial irradiation between April-2019 and Dec-2021 were included. Three neuro cognitive tests were performed a verbal learning and memory test, the Hopkins Verbal Learning Test; a verbal fluency test, the Controlled Oral Word Association Test and a speed and cognitive flexibility test, the Trail Making Test A&B. Tests were performed before the start of radiation, 6 months (6 m) and 1 year (1y) after irradiation. The Reliable Change Index (RCI) between baseline and follow-up was calculated using reference data from literature. Results 644 patients performed the neurocognitive tests at baseline, 346 at 6 months and 205 at 1y after RT, with compliance rates of 90.4%, 85.6%, and 75.3%, respectively. Reasons for non-compliance were: 1. Patient did not attend appointment (49%), 2. Patient was unable to perform the test due to illness (12%), 3. Patient refused the test (8 %), 4. Various causes, (31%). A semi-automated analysis was developed to evaluate the test results. In total, 26% of patients showed a significant decline in at least one of variables at 1y and 11% on at least 2 variables at 1y. However, an increase in cognitive performance was observed in 49% (≥1 variable) and 22% (≥2 variables). Conclusion Standardized neurocognitive testing within the radiotherapy clinic was successfully implemented, with a high patient compliance. A semi-automatic method to evaluate cognitive changes after treatment was defined. Data collection is ongoing, long term follow-up (up to 5 years after treatment) and dose-effect analysis will be performed.
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Affiliation(s)
- C.M.L. Zegers
- Department of Radiation Oncology (Maastro), Maastricht University Medical Center+, GROW-School for Oncology and Reproduction, Maastricht, the Netherlands
| | - C. Offermann
- Department of Radiation Oncology (Maastro), Maastricht University Medical Center+, GROW-School for Oncology and Reproduction, Maastricht, the Netherlands
| | - J. Dijkstra
- Department of Medical Psychology Maastricht University Medical Center+, MHeNs School for Mental Health and Neuroscience, Maastricht, the Netherlands
| | - I. Compter
- Department of Radiation Oncology (Maastro), Maastricht University Medical Center+, GROW-School for Oncology and Reproduction, Maastricht, the Netherlands
| | - F.J.P. Hoebers
- Department of Radiation Oncology (Maastro), Maastricht University Medical Center+, GROW-School for Oncology and Reproduction, Maastricht, the Netherlands
| | - D. de Ruysscher
- Department of Radiation Oncology (Maastro), Maastricht University Medical Center+, GROW-School for Oncology and Reproduction, Maastricht, the Netherlands
| | - M.M. Anten
- Department of Neurology, GROW – School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, Netherlands
| | - M.P.G. Broen
- Department of Neurology, GROW – School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, Netherlands
| | - A.A. Postma
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, MHeNs School for Mental Health and Neuroscience, Maastricht, the Netherlands
| | - A. Hoeben
- Dept of Medical Oncology, GROW-School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - K.E. Hovinga
- Department of Neurosurgery, Maastricht University Medical Center+, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands
| | - W. Van Elmpt
- Department of Radiation Oncology (Maastro), Maastricht University Medical Center+, GROW-School for Oncology and Reproduction, Maastricht, the Netherlands
| | - D.B.P. Eekers
- Department of Radiation Oncology (Maastro), Maastricht University Medical Center+, GROW-School for Oncology and Reproduction, Maastricht, the Netherlands
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Franke Föyen L, Sennerstam V, Kontio E, Lekander M, Hedman-Lagerlöf E, Lindsäter E. Objective cognitive functioning in patients with stress-related disorders: a cross-sectional study using remote digital cognitive testing. BMC Psychiatry 2023; 23:565. [PMID: 37550693 PMCID: PMC10405463 DOI: 10.1186/s12888-023-05048-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/24/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Patients with stress-related mental disorders often report cognitive impairment, but studies investigating objective cognitive impairment in patients with stress-related disorders have produced inconsistent findings. AIM The primary aim of this study was to investigate objective cognitive functioning in patients diagnosed with the stress-related disorders adjustment disorder or exhaustion disorder, compared to a healthy normative group. Secondary aims were to conduct subgroup analyses of cognitive functioning between the diagnostic groups and explore associations between self-reported symptoms and cognitive functioning. METHODS Cognitive test results on a digitally self-administered cognitive test battery from 266 patients (adjustment disorder, n = 131; exhaustion disorder, n = 135) were cross-sectionally compared with results from a healthy normative group (N = 184 to 692) using one-tailed t-tests. ANOVAs were conducted for subgroup analyses, and regression analyses for associations between self-reported symptoms and cognitive functioning. Effect sizes were calculated. RESULTS Patients performed significantly worse than the normative group on all measures with small to moderate effect sizes ranging from d = -.13 to -.57. Those diagnosed with exhaustion disorder performed worse than norms on more measures than did patients with adjustment disorder, but no significant differences between diagnostic groups were found on any measure. Self-reported memory impairment was weakly associated with one of two memory measures. No clear associations between self-reported burnout symptoms and objective cognitive functioning were found. CONCLUSIONS This study adds to the literature indicative of small to moderate objective cognitive impairments in patients diagnosed with stress-related mental disorders. Further exploration into mechanisms of cognitive functioning in different populations is needed for development of theoretical models that may explain the weak correlation between self-reported symptoms and objective measures. TRIAL REGISTRATION ClinicalTrial.gov: NCT04797273. Trial registration date 15 March 2021. This study was also pre-registered on Open Science Framework (osf.io) with https://doi.org/10.17605/OSF.IO/TQXZV .
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Affiliation(s)
- Ludwig Franke Föyen
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden.
- Gustavsberg University Primary Care Center, Stockholm Health Care Services, Region Stockholm, Sweden.
| | - Victoria Sennerstam
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Gustavsberg University Primary Care Center, Stockholm Health Care Services, Region Stockholm, Sweden
- Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Evelina Kontio
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Gustavsberg University Primary Care Center, Stockholm Health Care Services, Region Stockholm, Sweden
| | - Mats Lekander
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
- Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Erik Hedman-Lagerlöf
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Gustavsberg University Primary Care Center, Stockholm Health Care Services, Region Stockholm, Sweden
- Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Elin Lindsäter
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Gustavsberg University Primary Care Center, Stockholm Health Care Services, Region Stockholm, Sweden
- Osher Center for Integrative Health, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
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Amirpour A, Eckerblad J, Thorell A, Bergman L, Nilsson U. Usability and feasibility of a digital cognitive screening tool measuring older adults' early postoperative neurocognitive recovery: a protocol for a pilot study. BMJ Open 2023; 13:e070404. [PMID: 37479514 PMCID: PMC10364180 DOI: 10.1136/bmjopen-2022-070404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/23/2023] Open
Abstract
INTRODUCTION Delayed neurocognitive recovery, also identified as early postoperative cognitive decline (POCD), is a common complication after surgery, with advanced age being the most important risk factor. As the geriatric population is increasing worldwide, and number of older adults undergoing surgery continues to rise, so will the incidence of POCD. Only a small proportion use digital cognitive tests for measuring postoperative neurocognitive performance compared with analogue tests. This study aims to evaluate a digital cognitive screening tool, Mindmore Postoperative version (Mindmore-P), in a perioperative setting to determine its feasibility and usability, and to compare preoperative cognition with early postoperative neurocognitive performance. Further, to determine associations between neurocognitive performance and perioperative factors as well as to explore patients' experiences of early neurocognitive recovery. METHODS AND ANALYSIS We will include 50 patients (aged ≥60 years) undergoing elective abdominal surgery under general anaesthesia. Cognitive functions will be measured with Mindmore-P preoperatively and on postoperative day (POD) 1 or 2 as well as 2-3 weeks after surgery. Preoperatively, frailty, (Clinical Frailty Scale), depression (Geriatric Depression Scale-15), functional status (12-item WHO Disability Assessment Schedule 2.0) and pre-recovery status (Swedish web version Quality of Recovery Scale, SwQoR) will be measured. Delirium will be assessed by Nu-DESC (Nursing Delirium Screening Scale) twice a day, with start on POD 1 and until the patient is discharged from the hospital. Outcomes at 2-3 weeks postoperatively are postoperative recovery (SwQoR), depression, functional status and usability (System Usability Scale) of Mindmore-P. Postoperative recovery will also be measured POD 1 or 2. We will also explore feasibility and experience of early postoperative neurocognitive recovery with interviews approximately 1 month after surgery. ETHICS AND DISSEMINATION This study is approved by the Swedish Ethical Review Authority (REC Reference: 2022-03593-01) and will follow the principles outlined in the 1964 Helsinki Declaration and its later amendments. Results from this study will be disseminated in peer-reviewed journals, scientific conferences and in social media. TRIAL REGISTRATION NUMBER NCT05564195.
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Affiliation(s)
- Anahita Amirpour
- Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Jeanette Eckerblad
- Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anders Thorell
- Department of Clinical Sciences Intervention and Technology, Karolinska institutet, Huddinge, Sweden
| | - Lina Bergman
- Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ulrica Nilsson
- Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Perioperative Medicine and Intensive Care, Karolinska Universitetssjukhuset, Stockholm, Sweden
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Giaquinto F, Battista P, Angelelli P. Touchscreen Cognitive Tools for Mild Cognitive Impairment and Dementia Used in Primary Care Across Diverse Cultural and Literacy Populations: A Systematic Review. J Alzheimers Dis 2022; 90:1359-1380. [PMID: 36245376 DOI: 10.3233/jad-220547] [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: 12/14/2022]
Abstract
BACKGROUND Touchscreen cognitive tools opened new promising opportunities for the early detection of cognitive impairment; however, most research studies are conducted in English-speaking populations and high-income countries, with a gap in knowledge about their use in populations with cultural, linguistic, and educational diversity. OBJECTIVE To review the touchscreen tools used in primary care settings for the cognitive assessment of mild cognitive impairment (MCI) and dementia, with a focus on populations of different cultures, languages, and literacy. METHODS This systematic review was conducted following the PRISMA guidelines. Studies were identified by searching across MEDLINE, EMBASE, EBSCO, OVID, SCOPUS, SCIELO, LILACS, and by cross-referencing. All studies that provide a first-level cognitive assessment for MCI and dementia with any touchscreen tools suitable to be used in the context of primary care were included. RESULTS Forty-two studies reporting on 30 tools and batteries were identified. Substantial differences among the tools emerged, in terms of theoretical framework, clinical validity, and features related to the application in clinical practice. A small proportion of the tools are available in multiple languages. Only 7 out of the 30 tools have a multiple languages validation. Only two tools are validated in low-educated samples, e.g., IDEA and mSTS-MCI. CONCLUSION General practitioners can benefit from touchscreen cognitive tools. However, easy requirements of the device, low dependence on the examiner, fast administration, and adaptation to different cultures and languages are some of the main features that we need to take into consideration when implementing touchscreen cognitive tools in the culture and language of underrepresented populations.
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Affiliation(s)
- Francesco Giaquinto
- Department of History, Laboratory of Applied Psychology and Intervention, Society and Human Studies, University of Salento, Lecce, Italy
| | - Petronilla Battista
- Clinical and Scientific Institutes Maugeri Pavia, Scientific Institute of Bari, IRCCS, Italy
| | - Paola Angelelli
- Department of History, Laboratory of Applied Psychology and Intervention, Society and Human Studies, University of Salento, Lecce, Italy
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