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Malyutina S, Zabolotskaia A, Savilov V, Syunyakov T, Kurmyshev M, Kurmysheva E, Lobanova I, Osipova N, Karpenko O, Andriushchenko A. Are subjective language complaints in memory clinic patients informative? NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:795-822. [PMID: 37865966 DOI: 10.1080/13825585.2023.2270209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 10/08/2023] [Indexed: 10/24/2023]
Abstract
To diagnose mild cognitive impairment, it is crucial to understand whether subjective cognitive complaints reflect objective cognitive deficits. This question has mostly been investigated in the memory domain, with mixed results. Our study was one of the first to address it for language. Participants were 55-to-93-year-old memory clinic patients (n = 163). They filled in a questionnaire about subjective language and memory complaints and performed two language tasks (naming-by-definition and sentence comprehension). Greater language complaints were associated with two language measures, thus showing a moderate value in predicting language performance. Greater relative severity of language versus memory complaints was a better predictor, associated with three language performance measures. Surprisingly, greater memory complaints were associated with better naming, probably due to anosognosia in further disease progression or personality-related factors. Our findings highlight the importance of relative complaint severity across domains and, clinically, call for developing self-assessment questionnaires asking specific questions about multiple cognitive functions.
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Affiliation(s)
| | | | - Victor Savilov
- Day Hospital Memory Clinic, Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Timur Syunyakov
- Education Center, Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
- Republican Specialized Scientific and Practical Medical Center for Mental Health, Tashkent, Uzbekistan
- International Centre for Education and Research in Neuropsychiatry, Samara State Medical University, Samara, Russia
| | - Marat Kurmyshev
- Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Elena Kurmysheva
- Day Hospital Memory Clinic, Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Irina Lobanova
- Center for Language and Brain, HSE University, Moscow, Russia
| | - Natalia Osipova
- Day Hospital Memory Clinic, Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Olga Karpenko
- Scientific Сollaborations Department, Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
| | - Alisa Andriushchenko
- Department of Mental Disorders in Neurodegenerative Diseases of the Brain, Scientific Center of Neuropsychiatry, Mental Health Clinic No. 1 named after N.A. Alexeev, Moscow, Russia
- Department of Mental Health, Faculty of Psychology, Lomonosov Moscow State University, Moscow, Russia
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Teti SD, Murray LL, Orange JB, Kankam KS, Roberts AC. Telepractice Assessments for Individuals with Aphasia: A Systematic Review. Telemed J E Health 2024. [PMID: 39178126 DOI: 10.1089/tmj.2024.0268] [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: 08/25/2024] Open
Abstract
Purpose: Current literature broadly demonstrates the effectiveness and feasibility of telepractice services for people with aphasia. However, the examination of telepractice assessments for people with aphasia is limited. The purpose of this systematic review was to examine the current use of telepractice assessment protocols for people with aphasia. Specifically, the review sought to: (a) identify the assessments utilized in the aphasia telepractice literature; (b) appraise critically the quality of such investigations; and (c) evaluate critically the psychometric properties of the standardized tests used. Methods: A review of the literature published in English since 2000 was conducted in January 2023 by searching MEDLINE, EMBASE, PsychInfo, CINAHL, and Scopus databases. A total of 2,429 articles were screened. Two reviewers assessed records independently finding 11 articles eligible for inclusion. Data extraction was conducted once and validated by a second reviewer. Quality appraisal was carried out for the included studies as well as for the standardized testing measures used in these studies. Results: There was a lack of variation among the telepractice assessment protocols and aphasia tests used across all the included studies. That is, there was limited investigation of screening tests, discourse analysis, extralinguistic cognitive measures, and the use of patient-reported measures. Study characteristics lacked high-quality and free-of-bias examinations. Most standardized tests that were utilized exhibited poor validity and reliability properties. Conclusions: Overall, the current systematic review pointed to the need to investigate a wider range of aphasia assessment protocols that can be offered via telepractice. Moreover, more robust research designs are necessary to examine the variety of assessment tests and/or procedures that are available for in-person aphasia assessment services. Finally, given that many tests used in the included studies had psychometric property issues, the current review raised concerns regarding the use of these tests in research and clinical practices.
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Affiliation(s)
- Selina D Teti
- Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Laura L Murray
- Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
- Canadian Center for Activity and Aging, Western University, London, Ontario, Canada
| | - J B Orange
- Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
- Canadian Center for Activity and Aging, Western University, London, Ontario, Canada
| | - Keren S Kankam
- Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Angela C Roberts
- Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
- Canadian Center for Activity and Aging, Western University, London, Ontario, Canada
- Department of Computer Science, Western University, London, Ontario, Canada
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Çoban O, Mutluay F. The effects of mechanical hippotherapy riding on postural control, balance, and quality of life (QoL) in patients with stroke. Disabil Rehabil 2024; 46:2338-2347. [PMID: 37303153 DOI: 10.1080/09638288.2023.2221458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/21/2023] [Accepted: 05/28/2023] [Indexed: 06/13/2023]
Abstract
PURPOSED This study aimed to investigate the effects of exercises by mechanical hippotherapy devices on postural control, balance, mobility, and Quality of Life in patients with stroke. MATERIAL AND METHODS This was a randomized controlled clinical trial with a total of 30 which were randomly divided into two groups. The participants in the mechanical hippotherapy group (MHG) (n = 15) were given exercises with a mechanical hippotherapy device for 15 min in addition to intensive conventional treatments (45 min), while the control group (CG) (n = 15) received additional 15 min of postural control and balance exercises for five days per week for four consecutive weeks. The primary outcome was The Berg Balance Scale (BBS). Secondary outcomes were the Fugl-Meyer (FM) Rating Scale, Biodex Balance Measurement (BBM), Trunk Impairment Scale (TIS), the Timed Up and Go Test (TUG) and quality of Life Short Form (SF-36). RESULTS In the MHG, FM-Lower extremity score (-6.4, p = 0.024), FM-Upper extremity score (-12.87, p = 0.013), TIS (-5.87, p = 0.04) and TUG (5.73, p = 0.027) improved statistically significant compared to CG. CONCLUSION Exercises using mechanical hippotherapy devices could improve postural control, functional mobility and balance in patients with stroke. It may also improve the quality of life. CLINICAL TRIAL REGISTRATION NUMBER NCT03528993IMPLICATIONS FOR REHABILITATIONNCT03528993It was concluded from our results that mechanical hippotherapy could be included in the treatment programs of stroke patients.
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Affiliation(s)
- Osman Çoban
- Department of Physical Therapy and Rehabilitation, Faculty of Health Science, Istanbul Uskudar University, Istanbul, Turkey
| | - Fatma Mutluay
- Department of Physical Therapy and Rehabilitation, Faculty of Health Science, Istanbul Medipol University, Istanbul, Turkey
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Andersson Hammar I, Westgård T, Dahlin-Ivanoff S, Wilhelmson K. Frail older people with decreased cognition can perceive reduced self-determination in self-care and social relationships. BMC Geriatr 2024; 24:7. [PMID: 38172750 PMCID: PMC10762990 DOI: 10.1186/s12877-023-04492-y] [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: 05/10/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Self-determination in old age is essential for people's experiences of good subjective health and quality of life. The knowledge concerning how frail older people with decreased cognition perceive their ability to be self-determined in the different dimension in daily life is, however, limited. The aim of this study was therefore to explore the relationship of self-determination and cognition in frail older people. METHODS This study was a cross-sectional secondary data analysis using baseline data with 119 frail people 75 ≥ from a larger randomized control trial. Self-determination was measured with the statements from the Impact on Participation and Autonomy-Older persons (IPA-O). Cognition was measured using the Mini Mental State Examination (MMSE), where decreased cognition was broadly defined as a score below 25 points. Fisher's exact test was used to test differences in proportions of perceiving self-determination in relation to cognition. The Relative Risk (RR) with a 95% Confidence Interval (CI) was used to explore the risk of perceiving reduced self-determination in relation to cognitive functioning. RESULTS Nearly the entire study population, regardless of cognitive functioning, perceived self-determination in Financial situation. For people with decreased cognition, the relative risk for perceiving reduced self-determination was statistically significant higher in activities related to Self-care and in Social relationships when comparing with the participants with intact cognition. CONCLUSION Perceiving self-determination when being old, frail and having decreased cognition is possible but is dependent upon which activities that are involved. Organizing healthcare needs according to the older people's wants and wishes is crucial regardless of people having a cognitive decline or not when the effort is to enable the people to be as self-determined as they want. The frail older people with decreased cognition should be treated as being experts in their own lives, and healthcare professionals should navigate the older people to get to their desired direction. TRIAL REGISTRATION ClinicalTrials.gov, NCT02773914. Retrospectively registered 16 May 2016.
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Affiliation(s)
- Isabelle Andersson Hammar
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Box 455, 405 30, Gothenburg, Sweden.
- The Gothenburg University Centre for Ageing and Health (AgeCap), Gothenburg, Sweden.
| | - Theresa Westgård
- The Gothenburg University Centre for Ageing and Health (AgeCap), Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden
| | - Synneve Dahlin-Ivanoff
- The Gothenburg University Centre for Ageing and Health (AgeCap), Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Katarina Wilhelmson
- The Gothenburg University Centre for Ageing and Health (AgeCap), Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Gothenburg, Region Västra Götaland, Sweden
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Xiang LS, Zhang Y, Xie F, Fei X, Wang Y, Shi Y. Reliability and validity of the Cognitive Assessment for Stroke Patients (Chinese version) for patients with nonaphasic stroke. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-7. [PMID: 38104350 DOI: 10.1080/23279095.2023.2292236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
This study aimed to preliminarily explore the reliability and validity of the Chinese version of the Cognitive Assessment for Stroke Patients (CASP) in patients with nonaphasic stroke and provide a reliable basis for its clinical application in China. The original French version of the CASP was translated into Mandarin Chinese. The study enrolled 58 patients in the neurological center. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and CASP were used to evaluate cognitive function. Content validity, structural validity, and concurrent validity, internal consistency, interrater consistency, and retesting reliability were used to evaluate the results. The Spearman correlation coefficient of each item and the total CASP score was between 0.320 and 0.905 (p < .05), showing good content validity. Two initial factors were extracted using principal component analysis and the orthogonal rotation method, with a cumulative contribution rate of 70.100%. Except for the subitem reproducing a copy of a cube, the factor loading of all subitems was >0.5, indicating good construct validity. The total CASP score significantly correlated with the total MMSE (r = 0.796, p < .001) and total MoCA (r = 0.816, p < .001) scores, indicating good concurrent validity. Cronbach's α of the CASP was 0.812, showing good internal consistency. The interrater consistency (ICC > 0.85) and retesting reliability (ICC = 0.7-0.951) were good. The Chinese version of the CASP has good reliability and validity and can play a good auxiliary role in evaluating cognitive dysfunction in patients with stroke.
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Affiliation(s)
- Li-Sha Xiang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Department of Rehabilitation Medicine, School of Clinical Medicine, Soochow University, Soochow, China
| | - Yi Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Fan Xie
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiao Fei
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ya Wang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yue Shi
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
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Das SS, Gopal PM, Thomas JV, Mohan MC, Thomas SC, Maliakel BP, Krishnakumar IM, Pulikkaparambil Sasidharan BC. Influence of CurQfen ®-curcumin on cognitive impairment: a randomized, double-blinded, placebo-controlled, 3-arm, 3-sequence comparative study. FRONTIERS IN DEMENTIA 2023; 2:1222708. [PMID: 39081970 PMCID: PMC11285547 DOI: 10.3389/frdem.2023.1222708] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2024]
Abstract
Background Although curcumin is a blood-brain-barrier permeable molecule with the ability to bind and segregate β-amyloid plaques and neurofibrillary tangles of hyperphosphorylated tau proteins, its poor oral bioavailability, rapid biotransformation to inactive metabolites, fast elimination from the systemic circulation, and hence the poor neuronal uptake has been limiting its clinical efficacy under neurodegenerative conditions. Objective We hypothesized that the highly bioavailable CurQfen-curcumin (CGM), which has been shown to possess significant blood-brain-barrier permeability and brain bioavailability, would ameliorate dementia in neurodegenerative conditions. Methods In the present double-blinded placebo-controlled 3-arm 3-sequence comparative study, 48 subjects characterized with moderate dementia due to the onset of Alzheimer's disease were randomized into three groups (N = 16/group) and supplemented with 400 mg × 2/day of either placebo (MCC), unformulated standard curcumin complex with 95% purity (USC), or CGM as a sachet for six months. The relative changes in cognitive and locomotor functions and biochemical markers were compared. Results Supplementation with CGM produced significant (P < 0.05) improvement in the Mini-Mental State Examination (MMSE) and the Geriatric Locomotive Function Scale (GLFS) scores in both intra- and inter-group comparison by 2 × 2 repeated measures (RM) ANOVA. Further, analysis of the serum levels of specific biomarkers (BDNF, Aβ42, tau protein, IL-6, and TNF-α) also revealed a significant (P < 0.05) improvement among CGM subjects as compared to placebo and the USC groups. Conclusion Supplementation with CGM as sachet was found to offer significant delay in the progress of Alzheimer's disease, as evident from the improvements in locomotive and cognitive functions related to dementia. Clinical trial registration http://ctri.nic.in, identifier: CTRI/2018/03/012410.
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Affiliation(s)
- S. Syam Das
- Akay Natural Ingredients, Kochi, Kerala, India
| | - Prasad M. Gopal
- Alzheimer's and Related Disorders Society of India, Kochi, Kerala, India
- Centre for Neuroscience, Cochin University of Science and Technology, Kochi, Kerala, India
| | - Jestin V. Thomas
- Leads Clinical Research & Bio Services Private Limited, Bengaluru, India
| | - Mohind C. Mohan
- Centre for Neuroscience, Cochin University of Science and Technology, Kochi, Kerala, India
- Department of Biotechnology, Cochin University of Science and Technology, Kochi, Kerala, India
| | - Siju C. Thomas
- Alzheimer's and Related Disorders Society of India, Kochi, Kerala, India
| | | | | | - Baby Chakrapani Pulikkaparambil Sasidharan
- Centre for Neuroscience, Cochin University of Science and Technology, Kochi, Kerala, India
- Department of Biotechnology, Cochin University of Science and Technology, Kochi, Kerala, India
- Centre for Excellence in Neurodegeneration and Brain Health, Kochi, Kerala, India
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Baudouin R, Lechien JR, Carpentier L, Gurruchaga JM, Lisan Q, Hans S. Deep Brain Stimulation Impact on Voice and Speech Quality in Parkinson's Disease: A Systematic Review. Otolaryngol Head Neck Surg 2023; 168:307-318. [PMID: 36040825 DOI: 10.1177/01945998221120189] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Deep brain stimulation (DBS) has considerable efficacy for the motor dysfunction of idiopathic Parkinson's disease (PD) on patient quality of life. However, the benefit of DBS on voice and speech quality remains controversial. We carried out a systematic review to understand the influence of DBS on parkinsonian dysphonia and dysarthria. DATA SOURCES A PubMed/MEDLINE and Cochrane systematic review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Population, Intervention, Comparison, Outcome, Timing, and Setting (PICOTS) statements. REVIEW METHODS Three investigators screened studies published in the literature from inception to May 2022. The following data were retrieved: age, demographic, sex, disease duration, DBS duration, DBS location, speech, and voice quality measurements. RESULTS From the 180 studies identified, 44 publications met the inclusion criteria, accounting for 866 patients. Twenty-nine studies focused on voice/speech quality in subthalamic DBS patients, and 6 included patients with stimulation of pallidal, thalamic, and zona incerta regions. Most studies (4/6) reported a deterioration of the vocal parameters on subjective voice quality evaluation. For speech, the findings were more contrasted. There was an important heterogeneity between studies regarding the voice and speech quality outcomes used to evaluate the impact of DBS on voice/speech quality. CONCLUSION The impact of DBS on voice and speech quality significantly varies between studies. The stimulated anatomical region may have a significant role since the stimulation of the pallidal area was mainly associated with voice quality improvement, in contrast with other regions. Future controlled studies comparing all region stimulation are needed to get reliable findings. LEVEL OF EVIDENCE Level III: evidence from evidence summaries developed from systematic reviews.
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Affiliation(s)
- Robin Baudouin
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Versailles, France
| | - Jérôme R Lechien
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Versailles, France
- Department of Otolaryngology, Elsan Hospital, Paris, France
- Department of Otolaryngology-Head Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Brussels, Belgium
| | | | - Jean-Marc Gurruchaga
- Department of Neurosurgery, Henri Mondor Hospital, Université Paris-Est Créteil, Créteil, France
| | - Quentin Lisan
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Versailles, France
| | - Stéphane Hans
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Versailles, France
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Ghoreyshi Z, Nilipour R, Bayat N, Nejad SS, Mehrpour M, Azimi T. The Incidence of Aphasia, Cognitive Deficits, Apraxia, Dysarthria, and Dysphagia in Acute Post Stroke Persian Speaking Adults. Indian J Otolaryngol Head Neck Surg 2022; 74:5685-5695. [PMID: 36742896 PMCID: PMC9895668 DOI: 10.1007/s12070-021-03006-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 11/18/2021] [Indexed: 02/07/2023] Open
Abstract
Stroke is a major cause of serious disabilities in adults. While communication deficits post stroke are prevalent and disabling, early detection of them is important during acute phase. There is limited data published on the incidence of communication disorders in Persian speaking adults following post stroke to our knowledge. The present study aims to determine the incidence and associated factors of aphasia, cognitive deficits, motor speech disorders (apraxia and dysarthria) as well as dysphagia following acute post stroke in Persian speaking adults. 100 stroke patients were assessed using P-WAB, MMSE, Oral Apraxia test, Informal Dysarthria assessment, and MASA. The data was collected from 2 hospitals in Tehran using convenient sampling for the duration of 1 year. Based on our findings, the incidence of aphasia, cognitive deficits, oral apraxia, dysarthria, and dysphagia was in respectively 61.8%, 76%, 30%, 61%, and 39% of stroke patients during the acute phase. Patients with aphasia were significantly older (mean age, 59.29 vs. 64.95), and had fewer education years (9.21 vs. 5.45) compared to individuals without aphasia (p < .05). Co-occurrence of aphasia and dysarthria, dysphasia, cognitive deficits, and apraxia was in respectively 40%, 31%, 55%, and 25%. Due to the high incidence of neurogenic communication disorders and dysphagia during the acute post stroke, especially in the elderly and the less educated patients, prompt and rapid detection of these deficits and rehabilitation is essential to ameliorate patients' quality of life and social participation, and reduce the comorbidities risk.
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Affiliation(s)
- Zahra Ghoreyshi
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Second Floor, Building No 2, Koodakyar Ave., Daneshjo Blvd, 1985713834 Tehran, Iran
| | - Reza Nilipour
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Second Floor, Building No 2, Koodakyar Ave., Daneshjo Blvd, 1985713834 Tehran, Iran
| | - Narges Bayat
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Second Floor, Building No 2, Koodakyar Ave., Daneshjo Blvd, 1985713834 Tehran, Iran
| | - Samaneh Sazegar Nejad
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Second Floor, Building No 2, Koodakyar Ave., Daneshjo Blvd, 1985713834 Tehran, Iran
| | - Masoud Mehrpour
- Department of Neurology, Iran University of Medical Sciences, Hemat Highway, 1449614535 Tehran, Iran
| | - Tabassom Azimi
- Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Ganj Afrouz Ave., 47176-47745 Babol, Iran
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Reiss AB, de Levante Raphael D, Chin NA, Sinha V. The physician's Alzheimer's disease management guide: Early detection and diagnosis of cognitive impairment, Alzheimer's disease and related dementia. AIMS Public Health 2022; 9:661-689. [PMID: 36636148 PMCID: PMC9807411 DOI: 10.3934/publichealth.2022047] [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: 07/19/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 01/16/2023] Open
Abstract
Primary care professionals play a critical role in the care of their patients. In clinical practice, early detection and diagnosis of Mild Cognitive Impairment, Alzheimer's disease and related dementia are often missed or delayed. Disclosure of diagnosis is not timely or not revealed. Though the methods that could improve early detection and diagnosis have remained the same over the decades with little change, they provide opportunities for early intervention, treatment and improvement in patient care. Emerging research suggests that though the disease process begins years prior to the clinical diagnosis, the healthcare system and health care professionals remain distant and reluctant to provide the service of annual cognitive assessment, which has been recommended by the Medicare program for older adults aged 65 years and older. Findings support that Alzheimer's disease and related cognitive impairments have gone under detected, underdiagnosed and undertreated. This article seeks to provide valuable and equitable information in the form of a clinician's guide for removing the barriers to early detection and diagnosis of cognitive impairments and offers an unprecedented opportunity to improve the clinical outcomes and care of older adults with various levels of cognitive decline, including mild cognitive impairment, Alzheimer's disease, and related dementias. This article provides information on understanding and addressing the challenges faced by health care professionals, including primary care clinicians; removing the barriers to cognitive assessments; educating this professional group on the importance of brain health, early detection, and diagnosis for their older adult patients; and providing these professionals with the ability to transfer their knowledge into more defined care planning. Until cognitive screening has been fully accepted and implemented for the optimal the care of older adults, health-related efforts should include the promotion and education of brain health, early detection, and diagnosis in the education of health care providers.
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Affiliation(s)
| | - Donna de Levante Raphael
- National Memory Screening Program, Alzheimer's Foundation of America, 322 Eighth Avenue, New York, NY 10001, USA
| | - Nathaniel A. Chin
- Wisconsin Alzheimer's Disease Research Center (ADRC), Madison, WI 53726
| | - Vivek Sinha
- Belleview Medical Partners, Alexandria, VA 22314 USA,* Correspondence: ; Tel: +19176888518; Fax: +16466381546
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10
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Wu M, Lin L, Wu Y, Zheng Y, Chen H. Correlation between 5-HTTLPR gene polymorphism and cognitive function of traumatic stress in Chinese Han children. Transl Pediatr 2022; 11:1251-1260. [PMID: 35958016 PMCID: PMC9360820 DOI: 10.21037/tp-22-289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/13/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a trauma-related psychological disorder with serious social and familial impacts. The involvement of 5-hydroxytryptamine transporter gene-linked polymorphic region (5-HTTLPR) in numerous mental disorders has been documented. This study explored the correlation between 5-HTTLPR gene polymorphism and cognitive function in Chinese Han children with PTSD. METHODS A total of 60 PTSD children treated from December 2019 to December 2021 were selected as study participants, with another 60 healthy children selected as controls. We assessed the cognitive function of participants using the Mini-Mental State Examination (MMSE). Additionally, the PTSD level was estimated by the Children's Revised Impact of Event Scale (CRIES). The 5-HTTLPR gene polymorphism was detected by reverse transcription quantitative polymerase chain reaction (RT-qPCR). The genotype and allele frequency were evaluated via case-control association analysis. RESULTS Children in the PTSD group showed low MMSE scores and high CRIES scores. In terms of genotype, cases of LL, LS, and SS in PTSD children were 4 (6.67%), 20 (33.3%), and 36 (60.00%), and 18 (30.00%), 28 (46.67%), and 14 (23.33%) cases in healthy controls. In terms of allele gene frequency, incidences of L and S were 23.33% and 76.67% in PTSD children, respectively, and were 53.33% and 46.67% in healthy controls, respectively. Moreover, the CRIES and MMSE scores of LS and SS genotypes were evidently different from those of LL genotype in PTSD children. CONCLUSIONS Polymorphism of the 5-HTTLPR gene is correlated with cognitive dysfunction in Chinese Han children with PTSD.
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Affiliation(s)
- Ming Wu
- Department of Pediatrics, The Fourth People's Hospital of Haikou, Haikou, China
| | - Lufei Lin
- Department of Pediatrics, The Fourth People's Hospital of Haikou, Haikou, China
| | - Yuebiao Wu
- Department of Pediatrics, The Fourth People's Hospital of Haikou, Haikou, China
| | - Yu Zheng
- Department of Pediatrics, The Fourth People's Hospital of Haikou, Haikou, China
| | - Haidan Chen
- Department of Pediatrics, Sanya Central Hospital (Hainan Third People's Hospital), Sanya, China
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Tsai YIP, Browne G, Inder KJ. Documented nursing practices of pain assessment and management when communicating about pain in dementia care. J Adv Nurs 2022; 78:3174-3186. [PMID: 35436007 PMCID: PMC9545301 DOI: 10.1111/jan.15251] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/16/2022] [Accepted: 03/09/2022] [Indexed: 11/29/2022]
Abstract
AIM To evaluate nurses' documented practice when communicating about pain for people with dementia in hospital. DESIGN Retrospective medical record review. METHOD Medical records were retrieved from four inpatient units in a district and a tertiary teaching hospital of people aged 65 years and over with documented dementia. Data were extracted on nurses' documented pain assessment and management. Pain frequency and association between patient self-report, pain scores, cognition levels and analgesics used during hospitalization were analysed using descriptive and inferential statistics. Multivariate regression examined patient characteristics, pain characteristics and length of hospital stay. RESULTS One-hundred patient records met the inclusion criteria between 1 January and 31 August 2017. Sixty-six percent of patients with dementia had pain documented at least once during hospitalization with 58% reported as moderate to severe pain intensity. Patients' pain severity during admission was associated with their length of hospital stay. Ninety-three percent of nurses used a self-reporting pain tool and 7% used an observational pain tool. Pain scores were not associated with patients' cognition level, nurses' pain reports or analgesic management. CONCLUSION Pain frequently occurs in people with dementia during hospitalization. Fragmented pain reporting influences the translation of pain messages. Disproportionate pain tool application and non-association between pain scores and analgesic management suggest a potential knowledge gap among nurses about the practical use of pain tools and practice gap between pain assessment and management in dementia care. IMPACT Pain was regularly assessed by nurses and implemented as a fifth vital sign for people with dementia in hospitals. However, the high frequency of pain affects care outcomes. Areas for improvement include nursing practice of pain assessment and management in dementia care in hospitals. Further understanding of the usefulness of pain tools and the efficacy of pain scores when communicating about pain in dementia care in hospitals is required.
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Affiliation(s)
- Yvette I-Pei Tsai
- School of Nursing & Midwifery, University of Newcastle, Newcastle, Australia
| | - Graeme Browne
- School of Nursing & Midwifery, University of Newcastle, Newcastle, Australia
| | - Kerry Jill Inder
- School of Nursing & Midwifery, University of Newcastle, Newcastle, Australia
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12
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Maxwell R, O’Brien M, O’Donnell D, Christophers L, Kroll T. Using a multidisciplinary approach to reveal decision-making capacity within acute care for an individual with aphasia. SAGE Open Med Case Rep 2021; 9:2050313X211027098. [PMID: 34290868 PMCID: PMC8273517 DOI: 10.1177/2050313x211027098] [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: 11/24/2020] [Accepted: 06/01/2021] [Indexed: 11/30/2022] Open
Abstract
Formal assessments of cognition that rely on language may conceal the non-linguistic cognitive function of people with aphasia. This may have detrimental consequences for how people with aphasia are supported to reveal communicative and decision-making competence. This case report demonstrates a multidisciplinary team approach to supporting the health and social care decision-making of people with aphasia. The case is a 67-year-old woman with Wernicke's type aphasia. As the issue of long-term care arose, the speech and language therapist used a supported communication approach with the patient who expressed her wish to go home. A multidisciplinary team functional assessment of capacity was undertaken which involved functional assessments and observations of everyday tasks by allied health, nursing, catering and medical staff. In this way, the patient's decision-making capacity was revealed and she was discharged home. A collaborative multidisciplinary team approach using supported communication and functional capacity assessments may be essential for scaffolding the decision-making capacity of people with aphasia.
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Affiliation(s)
- Ruth Maxwell
- St Vincent’s University Hospital, Elm Park, Dublin, Ireland
| | | | - Deirdre O’Donnell
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS), University College Dublin, Dublin, Ireland
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Lauren Christophers
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Thilo Kroll
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS), University College Dublin, Dublin, Ireland
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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13
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Domingos C, Costa PS, Santos NC, Pêgo JM. European Portuguese Version of the User Satisfaction Evaluation Questionnaire (USEQ): Transcultural Adaptation and Validation Study. JMIR Mhealth Uhealth 2021; 9:e19245. [PMID: 34185018 PMCID: PMC8278297 DOI: 10.2196/19245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/24/2020] [Accepted: 10/10/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Wearable activity trackers have the potential to encourage users to adopt healthier lifestyles by tracking daily health information. However, usability is a critical factor in technology adoption. Older adults may be more resistant to accepting novel technologies. Understanding the difficulties that older adults face when using activity trackers may be useful for implementing strategies to promote their use. OBJECTIVE The purpose of this study was to conduct a transcultural adaptation of the User Satisfaction Evaluation Questionnaire (USEQ) into European Portuguese and validate the adapted questionnaire. Additionally, we aimed to provide information about older adults' satisfaction regarding the use of an activity tracker (Xiaomi Mi Band 2). METHODS The USEQ was translated following internationally accepted guidelines. The psychometric evaluation of the final version of the translated USEQ was assessed based on structural validity using exploratory and confirmatory factor analyses. Construct validity was examined using divergent and discriminant validity analysis, and internal consistency was evaluated using Cronbach α and McDonald ω coefficients. RESULTS A total of 110 older adults completed the questionnaire. Confirmatory factor analysis supported the conceptual unidimensionality of the USEQ (χ24=7.313, P=.12, comparative fit index=0.973, Tucker-Lewis index=0.931, goodness of fit index=0.977, root mean square error of approximation=0.087, standardized root mean square residual=0.038). The internal consistency showed acceptable reliability (Cronbach α=.677, McDonald ω=0.722). Overall, 90% of the participants reported excellent satisfaction with the Xiaomi Mi Band 2. CONCLUSIONS The findings support the use of this translated USEQ as a valid and reliable tool for measuring user satisfaction with wearable activity trackers in older adults, with psychometric properties consistent with the original version.
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Affiliation(s)
- Célia Domingos
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,iCognitus4ALL - IT Solutions, Braga, Portugal.,Clinical Academic Center - Braga, Braga, Portugal
| | - Patrício Soares Costa
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,Faculty of Psychology and Education Sciences, University of Porto, Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,Associação Centro de Medicina Digital P5, Braga, Portugal
| | - José Miguel Pêgo
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,iCognitus4ALL - IT Solutions, Braga, Portugal.,Clinical Academic Center - Braga, Braga, Portugal
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14
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Zeng LN, Zong QQ, Xu SW, An FR, Ungvari GS, Bressington DT, Cheung T, Qin MZ, Chen LG, Xiang YT. Oral health in patients with dementia: A meta-analysis of comparative and observational studies. Int J Geriatr Psychiatry 2021; 36:467-478. [PMID: 33105039 DOI: 10.1002/gps.5453] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 10/08/2020] [Accepted: 10/18/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Poor oral health is common in dementia, but findings of epidemiological studies have been inconsistent. This meta-analysis examined oral health in patients with dementia diagnosed according to standardized diagnostic criteria. METHODS Six international databases (PubMed, EMBASE, PsycINFO, Medline, Cochrane Library, and Web of Science) were searched from their commencement date until 8 November 2018. Oral health was measured by the Remaining Teeth (RT) and Decayed, Missing, and Filled Teeth (DMFT) Index. The mean differences (MD) and 95% confidence intervals (CI) of DMFT Index total and component scores were calculated using a random-effect model. RESULTS Twenty-four studies were included for analyses. The pooled DMFT Index was 23.48 (95% CI: 22.34, 24.62), while the pooled score for each component was 2.38 (95% CI: 1.56, 3.20) in decayed teeth (DT), 18.39 (95% CI: 15.92, 20.87) in missing teeth (MT), 2.29 (95% CI: 0.62, 3.95) in filled teeth (FT), and 11.59 (95% CI: 9.14, 14.05) in RT. Compared to controls, people with dementia had significantly a higher DMFT Index total score (MD = 3.80, 95% CI: 2.21, 5.39, p < 0.00,001), and significantly lower number of RT (MD = -3.15, 95% CI: -4.23, -2.06, p < 0.00,001). Subgroup analyses revealed that higher DMFT Index score was significantly associated with year of survey (>2010), study design (case-control study), percentage of females (≤54.3), and the Mini Mental State Examination score (≤18.2). Higher MT score was significantly associated with study design (cross-sectional study), and lower FT score was significantly associated with year of survey (>2010). CONCLUSIONS Oral health was significantly poorer in people with dementia compared with controls. Regular screening and effective treatment should be implemented for this population.
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Affiliation(s)
- Liang-Nan Zeng
- Center for Cognition and Brain Sciences, Faculty of Health Sciences, University of Macau, Macao SAR, China.,Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Medical Research Center for Neurosurgery, Academician (Expert) Workstation of Sichuan Province, Neurological Diseases and Brain Function Laboratory, Luzhou, Sichuan, China
| | - Qian-Qian Zong
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,School of Nursing, Capital Medical University, Beijing, China
| | - Shi-Wei Xu
- Faculty of Medicine, Changsha Medical University, Changsha, Hunan Province, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Gabor S Ungvari
- University of Notre Dame Australia, Fremantle, Western Australia, Australia.,Division of Psychiatry, School of Medicine, University of Western Australia Graylands Hospital, Perth, Western Australia, Australia
| | | | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ming-Zhao Qin
- Department of Geriatric Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Li-Gang Chen
- Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Sichuan Clinical Medical Research Center for Neurosurgery, Academician (Expert) Workstation of Sichuan Province, Neurological Diseases and Brain Function Laboratory, Luzhou, Sichuan, China
| | - Yu-Tao Xiang
- Center for Cognition and Brain Sciences, Faculty of Health Sciences, University of Macau, Macao SAR, China
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15
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Schrauf RW. Epistemic Responsibility - Labored, Loosened, and Lost: Staging Alzheimer's Disease. JOURNAL OF PRAGMATICS 2020; 168:56-68. [PMID: 32943809 PMCID: PMC7491752 DOI: 10.1016/j.pragma.2020.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Interlocutors hold one another accountable for knowing certain information about themselves (their roles, activities, and memories) and for keeping track of information in the current conversational exchange. When speakers have trouble with this expectation, they themselves work to repair the breach, often doing a memory search, or when unsuccessful they provide an account (e.g. "I don't remember"). Memory searches (like word searches) are observable, interactional accomplishments. Speakers disengage with their interlocutors (look away), produce hesitation markers, take repeated pauses, engage in pre-positioned and post-positioned repairs, make epistemic assessments, and on finding an answer, re-engage with their interlocutors (look back). For their part, interlocutors comply with the search by not interrupting and continuing to yield the floor. At progressively severe stages of Alzheimer's disease, individuals exhibit increasingly labored memory searches that often trail off into non-answers, until at the latest stages, they eschew the search and (almost smoothly) provide either grammatically appropriate but wrong and improbable answers or give answers to previous questions on now closed topics. With data from the clinical administration of a disease staging instrument (Clinical Dementia Rating) this article examines the inexorable loss of epistemic responsibility as a key discursive dynamic in the progression of the disease.
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