scholarly journals Comparing performance on the Months of the Year Backwards test in hospitalised patients with delirium, dementia, and no cognitive impairment: an exploratory study

Author(s):  
Wolfgang Hasemann ◽  
Nikki Duncan ◽  
Caoimhe Clarke ◽  
Eva Nouzova ◽  
Lisa-Marie Süßenbach ◽  
...  

Abstract Purpose To investigate performance of the Months of the Year Backwards (MOTYB) test in older hospitalised patients with delirium, dementia, and no cognitive impairment. Methods Secondary analysis of data from a case–control study of 149 hospitalised patients aged ≥ 65 years with delirium [with or without dementia (N = 50)], dementia [without delirium (N = 46)], and no cognitive impairment (N = 53). Verbatim transcripts of MOTYB audio recordings were analysed to determine group differences in response patterns. Results In the total sample [median age 85y (IQR 80–88), 82% female], patients with delirium were more often unable to recite months backward to November (36/50 = 72%) than patients with dementia (21/46 = 46%; p < 0.01) and both differed significantly from patients without cognitive impairment (2/53 = 4%; p’s < 0.001). 121/149 (81%) of patients were able to engage with the test. Patients with delirium were more often unable to engage with MOTYB (23/50 = 46%; e.g., due to reduced arousal) than patients with dementia (5/46 = 11%; p < 0.001); both groups differed significantly (p’s < 0.001) from patients without cognitive impairment (0/53 = 0%). There was no statistically significant difference between patients with delirium (2/27 = 7%) and patients with dementia (8/41 = 20%) in completing MOTYB to January, but performance in both groups differed (p < 0.001 and p < 0.02, respectively) from patients without cognitive impairment (35/53 = 66%). Conclusion Delirium was associated with inability to engage with MOTYB and low rates of completion. In patients able to engage with the test, error-free completion rates were low in delirium and dementia. Recording of engagement and patterns of errors may add useful information to MOTYB scoring.

Author(s):  
Ali Alyahawi ◽  
Ali Alkaf ◽  
Taha Alnosary

The new fluoroquinolones have demonstrated enhanced activity against the most common bacteria involved in lower respiratory tract infection (LRTI). Moxifloxacin is the most commonly prescribed respiratory flouroquinolone drug in Yemen. Pneumonia is a major and an on-going public health problem globally. With the widely use of fluoroquinolones in the clinical practice, the potential for developing resistance has become a concern. The aim of present study was to determine the trend of moxifloxacin resistant and the distribution of resistant for different sample types among hospitalised patients in Sana'a, Yemen. The study was performed at a private hospital in Sana’a, Yemen. The records were taken from the microbiology department for hospitalised patients. Moxifloxacin susceptibility samples were collected from January, 2017 to December, 2017. The moxifloxacin susceptibility was studied against several isolates. Full ethical clearance was obtained from the qualified authorities who approved the study design. All data were analyzed using SPSS Statistics version 21. Out of 927 sample isolates, 580 (62.6%) were moxifloxacin resistant isolates and only 30.1% were sensitive. The Escherichia coli was observed in 24.4% of total sample isolates, followed by Pseudomonas aeruginosa (12.1%). From the study findings, 44.8% of total sample was isolated from sputum cultures.There was a statistically significant difference between bacteria type and culture results (P-value < 0.001). Moreover, 96.2% of Acinetobacter species and all Acinetobacter baumannii isolates were moxifloxacin resistant. The study findings reported that 70.4% of Escherichia coli isolates were resistant for moxifloaxin, followed by methicillin resistant staphylococcus aureus (64.7%), Klebsiella pneumonia (60.6%), and Pseudomonas aeruginosa (46.4%). However, 86.1% of staphylococcus aureus isolates were moxifloxacin resistant. Results in this study showed that there was high significantly relationship between culture results and sample type (P-value< 0.001).  Also 44.8% of sample isolates were from sputum cultures. Moreover, 74.2% of sputum cultures isolates were moxifloxacin resistant. There was a statistically significant difference between culture results with age groups (P-value = 0.02). Also 64.1% of males had moxifloxacin resistant and 36.9% of isolate resistant were aged > 60 years. This study reveals that varieties of pathogens are responsible for LRTI and moxifloxacin resistance has become a great public health issue. The possibility of reducing resistance by controlling the use of antibiotics is a reasonable approach. Inappropriate and irrational drug usage should be avoided. This study may help the government’s regulatory authority to develop a policy about rational prescription of antibiotics to minimize resistance of new antibiotics and also to ensure the maximum safety to the health of patients.  


2021 ◽  
pp. 204946372110411
Author(s):  
Raiyyan Aftab ◽  
Divyansh Dixit ◽  
Simon Williams ◽  
Laurence Baker ◽  
David Raindle Clarke ◽  
...  

Hip fractures represent a significant workload of both emergency and orthopaedic departments within the National Health Service (NHS). Pain relief is key in treating hip fractures as highlighted by both National Institute of Clinical Excellence (NICE) and British Orthopaedic Association Standards for Trauma (BOAST) guidelines. However, the literature shows that patients with cognitive impairment tend to have inconsistent pain management, leading to worse outcomes. We conducted a case–control study looking at 296 patients who presented with hip fractures to a major trauma centre between 1 December 2019 and 30 May 2020. Cognition was assessed using pre-recorded Abbreviated Mental Test Scores (AMTS). There was no significant difference between pain relief provided to patients with or without cognitive impairment in both the pre-hospital (p = 0.208) and Accident & Emergency (A&E) (p = 0.154) setting. A larger proportion of patients in A&E did not receive any pain relief (18.6% versus 42.2%). Pre-hospital, the higher the pain score, the stronger the analgesia given (R = 0.435, p = 0.000). This relationship was present in both the cognitively impaired (R = 0.572, p = 0.000) and cognitively intact groups (R = 0.390 p = 0.000). Strength of analgesia and pain scores did not correlate in A&E (R = 0.014, p = 0.826). Cognition did not impact the time to analgesia both pre-hospital (p = 0.291) and in A&E (p = 0.332); however, patients waited significantly longer to receive pain relief in A&E (29.61 minutes versus 150.28 minutes). Fascia-iliaca blocks were administered to 58.4% of the cohort, with no significant difference noted between cognition status. Overall, cognition does not impact pain management both pre-hospital and in A&E. There is still room for improvement, particularly in the assessment of pain in the cognitively impaired. A possible solution is the utilisation of the Bolton Pain Assessment Tool, a validated pain assessment tool for the cognitively impaired that has been utilised in the trauma setting with good effect.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Christine Marcotte ◽  
Olivier Potvin ◽  
D. Louis Collins ◽  
Sylvie Rheault ◽  
Simon Duchesne

Abstract It has been proposed that individuals developing Alzheimer’s disease (AD) first experience a phase expressing subjective complaints of cognitive decline (SCD) without objective cognitive impairment. Using magnetic resonance imaging (MRI), our objective was to verify whether SNIPE probability grading, a new MRI analysis technique, would distinguish between clinical dementia stage of AD: Cognitively healthy controls without complaint (CH), SCD, mild cognitive impairment, and AD. SNIPE score in the hippocampus and entorhinal cortex was applied to anatomical T1-weighted MRI of 143 participants from the Consortium pour l’identification précoce de la maladie Alzheimer - Québec (CIMA-Q) study and compared to standard atrophy measures (volumes and cortical thicknesses). Compared to standard atrophy measures, SNIPE score appeared more sensitive to differentiate clinical AD since differences between groups reached a higher level of significance and larger effect sizes. However, no significant difference was observed between SCD and CH groups. Combining both types of measures did not improve between-group differences. Further studies using a combination of biomarkers beyond anatomical MRI might be needed to identify individuals with SCD who are on the beginning of the clinical continuum of AD.


2021 ◽  
Vol 15 (6) ◽  
pp. 1876-1878
Author(s):  
Muhammad Hassan ◽  
Sajid Rashid ◽  
Rehan Ramzan Khan ◽  
Muhammad Usman Khalid ◽  
Haroon Mansha ◽  
...  

Objective: To evaluate the effects of structured resistance exercises on cognition level among patients with mild cognitive impairment. Methods: A quasi experimental trial was conducted on thirty patients with mild cognitive impairment (MCI) from September 2020 to February 2021 at Ibn e Siena hospital, Multan. The total sample was randomly divided into two equal groups containing fifteen patients each; Group-A (Conventional pharmacological treatment) and Group-B (Resisted exercises). Group-A participants were treated with conventional pharmacological treatment cholinesterase inhibitors along with regular physical exercise while Group-B participants were treated with resistance exercises along with conventional pharmacological treatment. The standardized tools were used for data collection including Standardized mini mental state examination (SMMSE), Montreal cognitive assessment (MOCA), Trial making test A (TMT-A) and Trial making test B (TMT-B). Data was entered and analyzed by using SPSS 21. Results: Independent samples T-test showed statistically significant difference after intervention for measures of cognitive performance. There was significant difference (p<0.01) between pre and post intervention score of SMMSE (20.60 ± 1.75 and 23.20 ± 1.69) and MOCA (17.60 ± 1.35 and 21.93 ± 1.57). There was also significant difference between (p<0.01) pre and post intervention score of TMT-A (1.47 ± 0.34 & 1.23 ± 0.04) and TMT-B (2.51 ± 0.04 and 2.08 ± 0.04). Conclusion: Resistance exercises increases the cognitive levels of Mild Cognitive impairment patients. Key Words: Cognitive dysfunction, Exercises, Dementia.


2014 ◽  
Vol 72 (6) ◽  
pp. 426-429 ◽  
Author(s):  
Marcos Hortes N. Chagas ◽  
Tais S. Moriyama ◽  
André C. Felício ◽  
Ana Luisa Sosa ◽  
Rodrigo A. Bressan ◽  
...  

Objective : To test the hypothesis that severity of cognitive impairment modifies the association between depression and Parkinson’s disease (PD). Method : One-phase population-based door-to-door surveys. This is a secondary analysis of 1,451 people aged 65 years and older with cognitive impairment living in defined catchment areas. Depression was estimated according to ICD-10, self-reported PD, disability according to WHODAS-II and cognitive status according to the CSI-D. Results : The mean age of the sample was 79.3 years old and most (69%) were women. Of the total sample, 16.1% had depression and it was significantly higher among participants with PD. There was an increase on the ORs of the association between depression and PD with decreased scores in the cognitive test (Adjusted OR from 0.98 to 8.04). Conclusion : The association between depression and PD increases with the severity of the cognitive impairment.


2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Saraswati Rani ◽  
Thiyam Kiran Singh

Labour is a social class of group comprises of those who do manual labour or work for wages. A thousand of labours every day migrate in Ranchi city and they work whole day at daily wages and back to home in evening. Here we see, there are many people who were well educated (6% male labour) like graduate or post graduate and they were working as a labour only because of lack of job and poor economical conditions. At present scenario money is important for every one’s life so everyone works for money. Labors worked mostly in unorganized sectors at daily wages and their rule is “no work no wages”. Method: A total sample of 87 normal populations (50 male and 37 female labours) were selected using purposive and consecutive based sampling method from the area of Morabadi Ground (Labour Market), Ranchi. Socio demographic data sheet and life satisfaction scale were used to find out significant difference in socio-demography and life satisfaction between male and female. Result- In the socio demographic profile, a significant group differences were found in age, education and Religion in both groups. Again, significant group difference was found in the total score of Life Satisfaction between both sex (male and female labourers) indicating male labourers had better life satisfaction in comparison to the female labourers. Conclusion: Some results showed that labourers (Male & Female) had poor life satisfaction and they are surviving with many problems like – poor education, poor health and dissatisfaction of job. Current finding shows that the male labourers have better life satisfaction in comparison to female labourers.


2017 ◽  
Vol 63 (6) ◽  
pp. 926-932
Author(s):  
Lyudmila Belskaya ◽  
Viktor Kosenok ◽  
Ж. Массард

So far optimization problems for diagnostics and prognostication aids remained relevant for lung cancer as a leader in the structure of cancers. Objective: a search for regularities of changes in the saliva enzyme activity in patients with nonsmall cell lung cancer. In the case-control study, 505 people took part, divided into 2 groups: primary (lung cancer, n=290) and control (conventionally healthy, n=215). All the participants went through a questionnaire survey, saliva biochemical counts, and a histological verification of their diagnosis. The enzyme activity was measured with spectrophotometry. Between-group differences were measured with the nonparametric test. It was shown that in terms of lung cancer, we observe metabolic changes, described with the decreased de Ritis coefficient (p


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 292-293
Author(s):  
Lydia Nguyen ◽  
Shraddha Shende ◽  
Daniel Llano ◽  
Raksha Mudar

Abstract Value-directed strategic processing is important for daily functioning. It allows selective processing of important information and inhibition of irrelevant information. This ability is relatively preserved in normal cognitive aging, but it is unclear if mild cognitive impairment (MCI) affects strategic processing and its underlying neurophysiological mechanisms. The current study examined behavioral and EEG spectral power differences between 16 cognitively normal older adults (CNOA; mean age: 74.5 ± 4.0 years) and 16 individuals with MCI (mean age: 77.1 ± 4.3 years) linked to a value-directed strategic processing task. The task used five unique word lists where words were assigned high- or low-value based on letter case and were presented sequentially while EEG was recorded. Participants were instructed to recall as many words as possible after each list to maximize their score. Results revealed no group differences in recall of low-value words, but individuals with MCI recalled significantly fewer high-value words and total number of words relative to CNOA. Group differences were observed in theta and alpha bands for low-value words, with greater synchronized theta power for CNOA than MCI and greater desynchronized alpha power for MCI than CNOA. Collectively, these findings demonstrate that more effortful neural processing of low-value words in the MCI group, relative to the CNOA group, allowed them to match their behavioral performance to the CNOA group. Individuals with MCI appear to utilize more cognitive resources to inhibit low-value information and might show memory-related benefits if taught strategies to focus on high-value information processing.


Author(s):  
Hamdy N. El-Tallawy ◽  
Tahia H. Saleem ◽  
Wafaa M. Farghaly ◽  
Heba Mohamed Saad Eldien ◽  
Ashraf Khodaery ◽  
...  

Abstract Background Parkinson’s disease is one of the neurodegenerative disorders that is caused by genetic and environmental factors or interaction between them. Solute carrier family 41 member 1 within the PARK16 locus has been reported to be associated with Parkinson’s disease. Cognitive impairment is one of the non-motor symptoms that is considered a challenge in Parkinson’s disease patients. This study aimed to investigate the association of rs11240569 polymorphism; a synonymous coding variant in SLC41A1 in Parkinson’s disease patients in addition to the assessment of cognitive impairment in those patients. Results In a case -control study, rs11240569 single nucleotide polymorphisms in SLC41A1, genes were genotyped in 48 Parkinson’s disease patients and 48 controls. Motor and non-motor performance in Parkinson's disease patients were assessed by using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). The genotype and allele frequencies were compared between the two groups and revealed no significant differences between case and control groups for rs11240569 in SLC41A1 gene with P value .523 and .54, respectively. Cognition was evaluated and showed the mean ± standard deviation (SD) of WAIS score of PD patients 80.4 ± 9.13 and the range was from 61 to 105, in addition to MMSE that showed mean ± SD 21.96 ± 3.8. Conclusion Genetic testing of the present study showed that rs11240569 polymorphism of SLC41A1 gene has no significant differences in distributions of alleles and genotypes between cases and control group, in addition to cognitive impairment that is present in a large proportion of PD patients and in addition to the strong correlation between cognitive impairment and motor and non-motor symptoms progression.


Sign in / Sign up

Export Citation Format

Share Document