Development of a method for quantifying cognitive ability in the elderly through adaptive test administration

2011 ◽  
Vol 23 (7) ◽  
pp. 1116-1123 ◽  
Author(s):  
Susanna Konsztowicz ◽  
Haiqun Xie ◽  
Johanne Higgins ◽  
Nancy Mayo ◽  
Lisa Koski
Keyword(s):  
Cognitive Ability ◽  
Cognitive Assessment ◽  
Geriatric Medicine ◽  
Reliability And Validity ◽  
The Elderly ◽  
Adaptive Method ◽  
Adaptive Test ◽  
Wide Range ◽  
Testing Algorithm ◽  
Over Time

ABSTRACTBackground: The field of geriatric medicine has identified a need for an evaluative tool that can rapidly quantify global cognitive ability and accurately monitor change over time in patients with a wide range of impairments. We hypothesized that the development of an adaptive test approach to cognitive measurement would help to meet that need. This study aimed to provide evidence for the interpretability of scores obtained from a novel, adaptive approach to cognitive assessment, called the Geriatric Rapid Adaptive Cognitive Estimate (GRACE) method.Methods: An adaptive method for cognitive assessment was developed using data from 185 patients referred for geriatric cognitive assessment, and pilot tested in an additional 137 patients. Correlations between test scores and between rank orders of patients were computed to examine the reliability and validity of cognitive ability scores obtained by (1) administering test questions out of their usual order, (2) administering only a subset of questions, and (3) administering questions adaptively using simplified selection rules based on the most difficult question passed.Results: Cognitive ability scores obtained with the GRACE method correlated highly with the Montreal Cognitive Assessment (MoCA) scores (r = 0.93) and ranked patients similarly in order of ability (r > 0.87). A simplified adaptive testing algorithm for pencil-and-paper assessment demonstrated moderately high correlations with scores obtained from administering the full set of MMSE and MoCA items as well as the MoCA items alone.Conclusions: Scores from the GRACE method can be obtained easily in 5–10 minutes, reducing test burden. The resulting numeric score quantifies cognitive ability, allowing clinicians to compare patients and monitor change in global cognition over time. The adaptive nature of this method allows for evaluation of persons across a broader range of cognitive ability levels than currently available tests.

The Reliability and Validity of Two Assessment Scales in the Elderly Mentally Handicapped

1981 ◽  
Vol 138 (1) ◽  
pp. 15-16 ◽  
Author(s):  
A. H. W. Smith ◽  
B. R. Ballinger ◽  
A. S. Presly
Keyword(s):  
Cognitive Ability ◽  
Rating Scale ◽  
Reliability And Validity ◽  
The Elderly ◽  
Mentally Handicapped ◽  
Rater Reliability ◽  
Assessment Scales

SummaryThe Clifton Assessment Schedule and the Shortened Stockton Rating Scale were administered to 38 elderly, mentally handicapped patients. Inter-rater reliability was high and the CAS was found to be a useful measure of cognitive ability. The tests measure different features of patients, but both correlated significantly with estimated levels of independence.

scholarly journals Reliability and Validity of the Short Form of the Literacy-Independent Cognitive Assessment in the Elderly

2013 ◽  
Vol 9 (2) ◽  
pp. 111 ◽  
Author(s):  
Jungeun Kim ◽  
Jee H. Jeong ◽  
Seol-Heui Han ◽  
Hui Jin Ryu ◽  
Jun-Young Lee ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Short Form ◽  
Reliability And Validity ◽  
The Elderly

601 IMPROVING DELIRIUM ASSESSMENT IN A DISTRICT GENERAL HOSPITAL

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
C Finlow ◽  
L Azaden ◽  
C Abbott
Keyword(s):  
High Risk ◽  
Cognitive Assessment ◽  
Geriatric Medicine ◽  
District General Hospital ◽  
The Elderly ◽  
Ward Round ◽  
Risk Category ◽  
High Morbidity ◽  
Increased Risk ◽  
Service Redesign

Abstract Introduction Delirium affects a up to 20% of medical inpatients1. Patients in the high-risk category include those over 65, pre-existing cognitive impairment, current hip fracture and those with a serious illness 1,2. Often delirium goes undetected but is often related to high morbidity and motility rates with complications of insitionalisation, increased risk of dementia, high risk of falls and prolonged hospital stays1,2, recognition is the first step to reducing these risks. NICE guidance suggests that those patients showing indicators of delirium should have a formal cognitive assessment and a tailor-made plan should be documented within 24 hours 2. The detection of delirium can be sort using licensed tools including the 4AT score with the 4AT being the most sensitive, specific and practical1. Due to the ongoing risks of delirium, high risk patients on the Geriatric medicine firm and poor detection rate a quality improvement methodology was used to increase the rates of detection of delirium. The aim to have 90% of Geriatric medicine patients screened within 24 h admission and within 24 h of arrival to COTE ward/first consultant ward round within 4 months. Method 4 PDSA cycles were designed to trial changes including education of the Geriatric medicine team, lanyard cards, introduction of 4AT on the frailty proforma and a non-intervention cycle to see if these changes were sustained. Data was collected from the care of the elderly ward not including outliers of 27 patients. Any formal cognitive assessment that was documented either on admission or on arrival to the ward was included. Not included was those patients who were assessed for delirium or change in cognition after first consultant ward round or after 24 h of being on the ward. Results The uptake of 4AT improved by 50% after education and the lanyard cards. This was largely as a shift away from other assessments rather than more cognitive assessments done overall. During service redesign an Older Person’s Assessment Unit was formed with a Geriatrician based at the front door. This will improve the use of the 4AT for older patients admitted to hospital in the near future and is the subject of the next PDSA cycle. Conclusion Our journey to embed the 4AT is ongoing and we will continue to improve uptake using QI methodology.

DSM-5 alcohol use disorder features among treatment-seeking older adults

2018 ◽  
Vol 64 (4) ◽  
pp. 185-196 ◽  
Author(s):  
Silke Behrendt ◽  
Barbara Braun ◽  
Randi Bilberg ◽  
Gerhard Bühringer ◽  
Michael Bogenschutz ◽  
...  
Keyword(s):  
Older Adults ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
The Elderly ◽  
Treatment Seeking ◽  
Controlled Clinical Trial ◽  
Dsm 5 ◽  
Wide Range ◽  
And Gender ◽  
International Multicenter

Abstract. Background: The number of older adults with alcohol use disorder (AUD) is expected to rise. Adapted treatments for this group are lacking and information on AUD features in treatment seeking older adults is scarce. The international multicenter randomized-controlled clinical trial “ELDERLY-Study” with few exclusion criteria was conducted to investigate two outpatient AUD-treatments for adults aged 60+ with DSM-5 AUD. Aims: To add to 1) basic methodological information on the ELDERLY-Study by providing information on AUD features in ELDERLY-participants taking into account country and gender, and 2) knowledge on AUD features in older adults seeking outpatient treatment. Methods: baseline data from the German and Danish ELDERLY-sites (n=544) were used. AUD diagnoses were obtained with the Mini International Neuropsychiatric Interview, alcohol use information with Form 90. Results: Lost control, desired control, mental/physical problem, and craving were the most prevalent (> 70 %) AUD-symptoms. 54.9 % reported severe DSM-5 AUD (moderate: 28.2 %, mild: 16.9 %). Mean daily alcohol use was 6.3 drinks at 12 grams ethanol each. 93.9 % reported binging. More intense alcohol use was associated with greater AUD-severity and male gender. Country effects showed for alcohol use and AUD-severity. Conclusion: European ELDERLY-participants presented typical dependence symptoms, a wide range of severity, and intense alcohol use. This may underline the clinical significance of AUD in treatment-seeking seniors.

Anti-corruption in History

2017 ◽  
Keyword(s):  
Financial Institutions ◽  
Global Media ◽  
Policy Makers ◽  
The Past ◽  
Human Wellbeing ◽  
Modern Period ◽  
Legitimate Power ◽  
Wide Range ◽  
Scant Attention ◽  
Over Time

Anticorruption in History is the first major collection of case studies on how past societies and polities, in and beyond Europe, defined legitimate power in terms of fighting corruption and designed specific mechanisms to pursue that agenda. It is a timely book: corruption is widely seen today as a major problem, undermining trust in government, financial institutions, economic efficiency, the principle of equality before the law and human wellbeing in general. Corruption, in short, is a major hurdle on the “path to Denmark”—a feted blueprint for stable and successful statebuilding. The resonance of this view explains why efforts to promote anticorruption policies have proliferated in recent years. But while the subjects of corruption and anticorruption have captured the attention of politicians, scholars, NGOs and the global media, scant attention has been paid to the link between corruption and the change of anticorruption policies over time and place. Such a historical approach could help explain major moments of change in the past as well as reasons for the success and failure of specific anticorruption policies and their relation to a country’s image (of itself or as construed from outside) as being more or less corrupt. It is precisely this scholarly lacuna that the present volume intends to begin to fill. A wide range of historical contexts are addressed, ranging from the ancient to the modern period, with specific insights for policy makers offered throughout.

scholarly journals Personality dynamics at work: The effects of form, time, and context of variability

2021 ◽  
pp. 089020702110173
Author(s):  
Nadin Beckmann ◽  
Damian P Birney ◽  
Amirali Minbashian ◽  
Jens F Beckmann
Keyword(s):  
Individual Differences ◽  
Cognitive Ability ◽  
Temporal Stability ◽  
Limited Evidence ◽  
Short Term ◽  
State Data ◽  
The Status ◽  
Over Time ◽  
Trait Variability

The study aimed to investigate the status of within-person state variability in neuroticism and conscientiousness as individual differences constructs by exploring their (a) temporal stability, (b) cross-context consistency, (c) empirical links to selected antecedents, and (d) empirical links to longer term trait variability. Employing a sample of professionals ( N = 346) from Australian organisations, personality state data together with situation appraisals were collected using experience sampling methodology in field and repeatedly in lab-like settings. Data on personality traits, cognitive ability, and motivational mindsets were collected at baseline and after two years. Contingent (situation contingencies) and non-contingent (relative SD) state variability indices were relatively stable over time and across contexts. Only a small number of predictive effects of state variability were observed, and these differed across contexts. Cognitive ability appeared to be associated with state variability under lab-like conditions. There was limited evidence of links between short-term state and long-term trait variability, except for a small effect for neuroticism. Some evidence of positive manifold was found for non-contingent variability. Systematic efforts are required to further elucidate the complex pattern of results regarding the antecedents, correlates and outcomes of individual differences in state variability.

Knowledge assessment and barriers to cancer screening among Ghanaian community pharmacists

2021 ◽  
pp. 107815522098341
Author(s):  
Kofi B Mensah ◽  
Adwoa Bemah Boamah Mensah ◽  
Peter Yamoah ◽  
Joseph Attakorah ◽  
Varsha Bangalee ◽  
...  
Keyword(s):  
Cancer Screening ◽  
Reliability And Validity ◽  
Community Pharmacists ◽  
Online Questionnaire ◽  
Screening Guidelines ◽  
Validity Assessment ◽  
Wide Range ◽  
Chi Squared ◽  
Primary Healthcare Provider ◽  
To Come

Introduction Though there are controversies, cancer screening has been suggested to decrease mortality. Over the years, the most accessible primary healthcare provider; the community pharmacist, has developed an interest in being part of cancer screening activities and prevention of a wide range of other non-communicable diseases. To achieve this, community pharmacists need a working knowledge of the basic screening test and recommendations. Also, it’s important to acknowledge the barriers that may prevent the implementation of cancer-screening efforts at the community pharmacy. This study aims to determine the knowledge and barriers to cancer screening among Ghanaian community pharmacists. Methodology Knowledge and barriers to cancer screening was assessed using an online questionnaire in 435 community pharmacists. Descriptive statistics and Pearson's chi-squared tests were used to analyze the data. Results The reliability and validity assessment of the questionnaire after data collection revealed a Cronbach’s alpha value of 0.82 for knowledge on cancer screening. The SD and mean age of study participants were 2.48 ± 20.08. Only 25.7% of the participants had good knowledge. The most identified barrier was the lack of established guidelines (60.9%). There was no association between participants' demographics and their knowledge scores. Conclusions Community pharmacists can potentially have a large impact on early detection of cancer through screening. However, they have to improve their knowledge on general screening guidelines and be aware of available educational resources to increase their knowledge. It is also important for all stakeholders to come together to establish local screening modalities and recommendations for the country.

scholarly journals A Newfangled Collagenase Inhibitor Topical Formulation Based on Ethosomes with Sambucus nigra L. Extract

2021 ◽  
Vol 14 (5) ◽  
pp. 467
Author(s):  
Ana Henriques Mota ◽  
Inês Prazeres ◽  
Henrique Mestre ◽  
Andreia Bento-Silva ◽  
Maria João Rodrigues ◽  
...  
Keyword(s):  
Biological Activities ◽  
Scientific Evidence ◽  
Release Profile ◽  
Health Claims ◽  
Topical Formulation ◽  
Sambucus Nigra ◽  
Western Asia ◽  
Wide Range ◽  
The Impact ◽  
Over Time

Sambucus nigra L. (S. nigra) is a shrub widespread in Europe and western Asia, traditionally used in medicine, that has become popular in recent years as a potential source of a wide range of interesting bioactive compounds. The aim of the present work was to develop a topical S. nigra extract formulation based on ethosomes and thus to support its health claims with scientific evidence. S. nigra extract was prepared by an ultrasound-assisted method and then included in ethosomes. The ethosomes were analyzed in terms of their size, stability over time, morphology, entrapment capacity (EC), extract release profile, stability over time and several biological activities. The prepared ethosomes were indicated to be well defined, presenting sizes around 600 nm. The extract entrapment capacity in ethosomes was 73.9 ± 24.8%, with an interesting slow extract release profile over 24 h. The extract-loaded ethosomes presented collagenase inhibition activity and a very good skin compatibility after human application. This study demonstrates the potential use of S. nigra extract incorporated in ethosomes as a potential cosmeceutical ingredient and on further studies should be performed to better understand the impact of S. nigra compounds on skin care over the time.

ExpanDrogram: Dynamic Visualization of Big Data Segmentation over Time

2021 ◽  
Vol 13 (2) ◽  
pp. 1-27
Author(s):  
A. Khalemsky ◽  
R. Gelbard
Keyword(s):  
Big Data ◽  
Visual Presentation ◽  
Trend Detection ◽  
Dynamic Visualization ◽  
Segmentation Process ◽  
Key Points ◽  
Wide Range ◽  
History Of ◽  
The Individual ◽  
Over Time

In dynamic and big data environments the visualization of a segmentation process over time often does not enable the user to simultaneously track entire pieces. The key points are sometimes incomparable, and the user is limited to a static visual presentation of a certain point. The proposed visualization concept, called ExpanDrogram, is designed to support dynamic classifiers that run in a big data environment subject to changes in data characteristics. It offers a wide range of features that seek to maximize the customization of a segmentation problem. The main goal of the ExpanDrogram visualization is to improve comprehensiveness by combining both the individual and segment levels, illustrating the dynamics of the segmentation process over time, providing “version control” that enables the user to observe the history of changes, and more. The method is illustrated using different datasets, with which we demonstrate multiple segmentation parameters, as well as multiple display layers, to highlight points such as new trend detection, outlier detection, tracking changes in original segments, and zoom in/out for more/less detail. The datasets vary in size from a small one to one of more than 12 million records.

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