The applicability of the cognitive abilities screening instrument–short (CASI-S) in primary care in Brazil

2015 ◽  
Vol 28 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Glaucia Martins de Oliveira ◽  
Juliana Emy Yokomizo ◽  
Laís dos Santos Vinholi e Silva ◽  
Laura Ferreira Saran ◽  
Cássio M. C. Bottino ◽  
...  
Keyword(s):  
Primary Care ◽  
Internal Consistency ◽  
Cognitive Abilities ◽  
Temporal Stability ◽  
Screening Instrument ◽  
Eastern Region ◽  
Limited Information ◽  
Cognitive Screening ◽  
Dementia Patients ◽  
Normal Controls

ABSTRACTBackground:The Cognitive Abilities Screening Instrument – Short (CASI-S) is a brief cognitive screening test. However, there is limited information regarding its applicability in primary care.Objectives:To ascertain whether the CASI-S differentiates between dementia patients and normal controls in primary care; to examine its correlation with other cognitive instruments, to analyze its internal consistency, test-retest stability, and diagnostic accuracy.Methods:In a case-control study, carried out at two Primary Care Units (PCUs) in the eastern region of the city of São Paulo, 47 older adults were diagnosed with dementia according to DSM-IV criteria (mean age = 76.81 ± 7.03 years), and 55 were classified as normal controls (mean age = 72.78 ± 7.37 years), by a multidisciplinary panel which had access to results from a comprehensive cognitive battery and the patients’ health data. The present analyses included results from the Mini-Mental State Examination (MMSE). The CASI-S was not used to determine diagnostic status.Results:The CASI-S was easily applied in the primary care setting. There was a significant performance difference (p < 0.001) between dementia patients (15.57 ± 7.40) and normal controls (26.67 ± 3.52) on the CASI-S. CASI-S scores correlated with age (ρ = −0.410, p < 0.001), educational level (ρ = 0.373, p < 0.001), and MMSE score (ρ = 0.793, p < 0.001). The internal consistency of the CASI-S was high (α = 0.848) and the correlation between test and retest was 0.688, suggesting adequate temporal stability. In the ROC curve analyses, scores of 22/23 generated an area under the curve of 0.907, with sensitivity of 93% and specificity of 81%.Conclusions:The CASI-S can be useful for dementia screening in primary care in Brazil.

scholarly journals Psychometric Validation of The Cognitive Abilities Screening Instrument Using Rasch Analysis In People With Dementia

2022 ◽  
Author(s):  
Fang-Hsiao Hsu ◽  
Ya-Chen Lee ◽  
En-Chi Chiu
Keyword(s):  
Cognitive Function ◽  
Cognitive Abilities ◽  
Rasch Analysis ◽  
Principal Component ◽  
Screening Instrument ◽  
Screening Tools ◽  
Psychometric Validation ◽  
Residual Variance ◽  
Cognitive Screening ◽  
People With Dementia

Abstract Background: The Cognitive Abilities Screening Instrument (CASI) is one of the most commonly used cognitive screening tools to assess overall cognitive function in people with dementia. However, the unidimensionliaty of the CASI using Rasch analysis has not been evaluated in people with dementia, limiting its utility in clinical and research settings. Unidimensionality verifies whether all items of a measure reflect a single theoretical construct, which is necessary to determine whether clinicians and researchers can appropriately use the sum scores of the CASI to describe overall cognitive function. This study aimed to examine unidimensionality of the CASI using Rasch analysis and estimate Rasch person reliability in people with dementia. Methods: CASI data of people with dementia was collected from medical records of one general hospital in northern Taiwan. A total of 506 people with dementia were recruited from the Department of Neurology. Unidimensionality was confirmed through two assumptions: (1) the infit and outfit mean square (MnSq) were 0.6-1.4, and (2) residual variance of the first principal component in principal component analysis was ≤ 20%. Rasch person reliability was estimated after undimensionality was supported. Results: One item from the list-generating fluency dimension was misfitted (outfit MnSq=1.42) and was deleted. The unidimensionality of the remaining 45 items (referred to as the CASI-45) was supported with an infit and outfit MnSq (0.85-1.24 and 0.84-1.28, respectively) and low residual variance of the first principal component (12.8%). The Rasch person reliability of the CASI-45 was 0.62. Conclusion: The CASI-45 showed a unidimensional construct and had acceptable Rasch person reliability in people with dementia.

Cognitive screening instrument use in primary care: is it changing?

2014 ◽  
Vol 11 (4) ◽  
pp. 425-429 ◽  
Author(s):  
Mona Ghadiri-Sani ◽  
Andrew J Larner
Keyword(s):  
Primary Care ◽  
Screening Instrument ◽  
Cognitive Screening

Internal Structure of the Spanish Adaptation of the Eating Disorder Inventory-3

2012 ◽  
Vol 28 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Paula Elosua ◽  
Alicia López-Jáuregui
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Internal Structure ◽  
Internal Consistency ◽  
Clinical Sample ◽  
Temporal Stability ◽  
Second Order ◽  
Order Structure ◽  
Eating Disorder Inventory ◽  
High Internal Consistency

In this study the Eating Disorder Inventory-3 was adapted to Spanish and analyzed the internal psychometric properties of the test in a clinical sample of females with eating disorders. The results showed a high internal consistency of the scores as well as high temporal stability. The factor structure of the scale composites was analyzed using confirmatory factor analysis. The results supported the existence of a second-order structure beyond the psychological composites. The second-order factor showed high correlation with the factor related to eating disorders. Overall, the Spanish version of the EDI-3 showed good psychometric qualities in terms of internal consistency, temporal stability and internal structure.

Cognitive Screening Instrument

2020 ◽  
Author(s):  
Jaqueline de Carvalho Rodrigues ◽  
Denise Ruschel Bandeira ◽  
Jerusa Fumagalli de Salles
Keyword(s):  
Screening Instrument ◽  
Cognitive Screening

scholarly journals Cerebrospinal Fluid Hypocretin and Nightmares in Dementia Syndromes

2021 ◽  
pp. 19-25
Author(s):  
Lynn Marie Trotti ◽  
Donald L. Bliwise ◽  
Glenda L. Keating ◽  
David B. Rye ◽  
William T. Hu
Keyword(s):  
Cerebrospinal Fluid ◽  
Alzheimer Disease ◽  
Cholinesterase Inhibitor ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Cognitively Normal ◽  
Dementia Patients ◽  
Sleep Questionnaires ◽  
Sleep Alterations ◽  
Normal Controls

Background/Aims: Hypocretin promotes wakefulness and modulates REM sleep. Alterations in the hypocretin system are increasingly implicated in dementia. We evaluated relationships among hypocretin, dementia biomarkers, and sleep symptoms in elderly participants, most of whom had dementia. Methods: One-hundred twenty-six adults (mean age 66.2 ± 8.4 years) were recruited from the Emory Cognitive Clinic. Diagnoses were Alzheimer disease (AD; n = 60), frontotemporal dementia (FTD; n = 21), and dementia with Lewy bodies (DLB; n = 20). We also included cognitively normal controls (n = 25). Participants and/or caregivers completed sleep questionnaires and lumbar puncture was performed for cerebrospinal fluid (CSF) assessments. Results: Except for sleepiness (worst in DLB) and nocturia (worse in DLB and FTD) sleep symptoms did not differ by diagnosis. CSF hypocretin concentrations were available for 87 participants and normal in 70, intermediate in 16, and low in 1. Hypocretin levels did not differ by diagnosis. Hypocretin levels correlated with CSF total τ levels only in men (r = 0.34; p = 0.02). Lower hypocretin levels were related to frequency of nightmares (203.9 ± 29.8 pg/mL in those with frequent nightmares vs. 240.4 ± 46.1 pg/mL in those without; p = 0.05) and vivid dreams (209.1 ± 28.3 vs. 239.5 ± 47.8 pg/mL; p = 0.014). Cholinesterase inhibitor use was not associated with nightmares or vivid dreaming. Conclusion: Hypocretin levels did not distinguish between dementia syndromes. Disturbing dreams in dementia patients may be related to lower hypocretin concentrations in CSF.

scholarly journals 463 - Evaluating the Implementation of a Memory Clinic using the RE-AIM model. The experience of the “Memory and Neuropsychiatry Clinic” in Hospital del Salvador, Chile

2020 ◽  
Vol 32 (S1) ◽  
pp. 184-185
Author(s):  
T. Leon ◽  
L. Castro ◽  
F. Mascayano ◽  
BA. Lawlor ◽  
A. Slachevsky
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Latin American ◽  
Care Service ◽  
Care Center ◽  
Health Care Service ◽  
Multidisciplinary Teams ◽  
Outpatient Services ◽  
Health Care Center ◽  
Dementia Patients

AbstractThe prevalence of dementia in Chile is 1.06 %, meaning that over 200,000 people are affected. In 2017, the Ministry of Health launched the National Plan of Dementia, which proposed establishing a range of health-care services from primary care to Memory Units (MU).MUs have emerged as a new health care service composed of multidisciplinary teams with the goal of improving diagnosis and management of dementia patients.The creation and implementation of a MU should take into consideration the organization of a particular healthcare system. In this context, the evaluation of a Chilean MU might provide information for the standardization and replication of such a health service on a regional basis.The objective of this paper was to evaluate the implementation processes of a MU using the RE-AIM model, a multi-component model aimed to assist the evaluation of the implementation of ongoing programs.Regarding “R” (Reach): from March 2018 up to June 2019, a total of 510 patients were referred and assessed at the Hospital del Salvador. Most patients came from primary care (51.9 %) and from outpatient services at the Hospital (39.2 %), particularly from the Neurology (63.3%) and Psychiatry (16.0 %) departments. We estimated that the MU assessed 5.39% of dementia patients living in the area of referral.In relationship with “E” (Effectiveness): of patients evaluated by the MU, 60 (11%) were discharged. Of these, 41 (66%) were referred to primary health care, 9 (17%) to other outpatient services, 6 (10%) to a specialized mental health care center, and 4 (7%) to a daycare center.Due to the short lifespan of our MU, no other RE-AIM dimensions could be evaluated yet.This was the first evaluation of the implementation of a MU in Chile as part of the Chilean Dementia Plan. It showed that it is possible to implement a MU in a Latin American country and improve access to dementia diagnosis, management, and treatment. Ongoing challenges include continuing to collect clinical data, creating research projects as part of the MU, and developing a MU protocol that can be adopted elsewhere in Chile and other Latin American countries.

scholarly journals 404 - Effect of Psychoeducation Modul on the Administration of Psychotropic Drugs for Patients with Behavioral and Psychological Symptoms of Dementia at the RS Dr. H. Marzoeki Mahdi Bogor on Caregivers

2020 ◽  
Vol 32 (S1) ◽  
pp. 120-120
Keyword(s):  
Psychotropic Drugs ◽  
Cognitive Abilities ◽  
Health Workers ◽  
Psychological Symptoms ◽  
Clinical Syndrome ◽  
List Type ◽  
Study Program ◽  
Dementia Patients ◽  
Patients Experience ◽  
Behavioral And Psychological Symptoms

Name : Yuniar Pukuk KesumaStudy program : Psychiatry, Specialist II Geriatric PsychiatryCounsellor : Dr.dr. Martina Wiwie S. Nasrun, Sp.KJ(K)Background:Dementia is a clinical syndrome characterized by a decline in cognitive abilities and memory deficits globally. About 90% of patients experience behavioral and psychological symptoms. The use of psychotropic drugs is influenced by the patient symptoms, burden of the caregiver, and the habit of health workers.Objective:To determine the effect of psychoeducation modules to caregivers to increase knowledge, decrease of psychotropic drugs, reduce symptoms and burden of caregivers.Methods:There are 2 steps of studies. The first was a qualitative study to create psychoeducation module and the second was to conduct a pre-experimental study (one group pretest-posttest study). Psychoeducation is given in 2 consecutive weeks.Results:Fourty caregivers of dementia patients aged 41.3 (± 9.72) years. The psychoeducation modules is associated with decreasing symptoms and the use of psychotropic drugs, increasing knowledge and decreasing the burden of caregivers. At the end, 23% of patients were able to stop using psychotropic drugs and 62% of patients reduced their dose and/or the amount of psychotropic drugs.Conclusion:The psychoeducation modules to caregivers is associated with a decrease of patient symptoms and the use of psychotropic drugs. Psychoeducation also increases the knowledge of the caregiver and decreases the burden of the caregiver so that this psychoeducation module can be an additional therapy for patients with dementia.

scholarly journals Outcomes of Primary Care for People With Dementia: What’s Important?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 164-165
Author(s):  
Laura Wray ◽  
Bonnie Vest ◽  
Laura Brady ◽  
Christina Vair ◽  
Gregory Beehler ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health And Safety ◽  
Limited Attention ◽  
Veterans Health ◽  
Cognitive Screening ◽  
Health Administration ◽  
People With Dementia ◽  
Primary Care Teams ◽  
Care Outcomes

Abstract People with dementia (PWD) typically receive most of their healthcare in primary care (PC), but neurocognitive disorders can be challenging to recognize, assess, and manage in that setting. As a result, cognitive impairment in older adults is often missed or not addressed until later stages. The result is poor management of comorbid health conditions, increased healthcare utilization, and negative outcomes for the patient and family. Further, strategies for improvement and barriers to high quality PC for PWD have received limited attention. To improve PC for PWD, it is essential to understand what care outcomes should be targeted. To address this gap, we used a qualitative approach to examine potential outcomes of PC from the perspectives of older adults, family caregivers, primary care teams, and geriatrics specialists (n=79) from two Veterans Health Administration healthcare systems. Participants were interviewed individually or in focus groups. A directed content analysis based on the adapted Donabedian model was employed and expanded to fully capture transcript content. Three main categories of outcomes were identified: Personhood (i.e., independence), Physical Health and Safety, and Quality of Life. Regardless of participant type, respondents focused on similar desired outcomes and, notably, identified outcomes as important for both patients and their broader social context (i.e., caregivers, family). Discussion will: show how findings align with work conducted in specialty and residential care; describe how challenges to attaining these outcomes in PC can be overcome; and, challenge cognitive screening recommendations for PC that are based primarily on risk/benefit analysis of medication-focused outcomes.

Cross-cultural linguistic adaptation of Arabic version of four dimensional symptom questionnaire (4DSQ) for assessing distress, anxiety, depression and somatization in Egyptian primary care attendees

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nour Muhammad Raouf Elmessiri ◽  
Hussien Ahmed Elkholy ◽  
Mohamed Farouk Allam ◽  
Diaa Marzouk Abd el-Hamid
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Internal Consistency ◽  
English Language ◽  
Expert Committee ◽  
Arabic Version ◽  
English Version ◽  
Final Version ◽  
Symptom Questionnaire ◽  
Back Translation

Abstract Background The four-dimensional symptom questionnaire (4DSQ) is a Dutch self-administered screening tool that has been developed in primary care to differentiate non pathologic general distress from depression, anxiety and somatization. It has been validated in the English language as well as other languages yet it has not been validated in Arabic. For the sake of developing the appropriate Arabic version, linguistic validation has been sought with the guidance of crosscultural adaptation guidelines. Objective To design the appropriate Arabic version of the 4DSQ that has linguistic and conceptual equivalence to its validated English version and that is appropriate for administration to Egyptian primary care attendees. Methods The validated English version of the 4DSQ was translated by 5 translators (including specialist psychiatrist, internists and English language specialist) into Arabic (Egyptian spoken dialect) without mutual consultation. An expert committee that consisted of 2 professors of public health and family medicine and an associate professor of neuropsychiatry was formed. The consensus version was created after expert committee modification and approval of each questionnaire item using DELPHI method. After that the back translation to English was carried out by two independent bilingual physicians whose English is their mother tongue. A pilot study was carried out on 17 bilingual participants after answering the questionnaire in both languages to test its equivalence. The consensus Arabic version was updated based on the pilot study and the final version was developed. The final version was then tested on 278 Egyptian primary care attendees. Results After the course of forward and back translation, expert committee’s review and developer’s comments, the final version of Arabic 4DSQ was developed for assessment of distress, depression, anxiety and somatization. There was no significant difference between results of Arabic and English questionnaire using paired T test. Final testing showed very good internal consistency of each of the 4 scales of the questionnaire. Conclusion The Arabic 4DSQ linguistically and conceptually corresponds to the validated English 4DSQ. It has good structural validity and internal consistency reliability and thus could be used in primary care after further psychometric validation.

A Comparative ID Migraine™ Screener Study in Ophthalmology, ENT and Neurology Out-Patient Clinics

Cephalalgia ◽  
2009 ◽  
Vol 29 (1) ◽  
pp. 68-75 ◽  
Author(s):  
M Ertaş ◽  
B Baykan ◽  
D Tuncel ◽  
M Gökçe ◽  
F Gökçay ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Screening Instrument ◽  
Headache Diagnosis ◽  
Id Migraine ◽  
Study Sites ◽  
Sensitivity Specificity ◽  
Test Result ◽  
Simple Screening ◽  
Nose And Throat

Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument.

Sign in / Sign up

Export Citation Format

Share Document