Mental Status and Neuropsychological Assessment: Discussion

1997 ◽  
Vol 9 (S1) ◽  
pp. 143-150
Author(s):  
Alistair Burns
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Mini Mental State Examination ◽  
American Family ◽  
The Core ◽  
The Usa ◽  
The Individual ◽  
High Level ◽  
State Examination ◽  
Quantitative Assessments

Ham: There seems to be an astonishing range of expectation from this group as to what a general practitioner (GP) will do for his or her patients, ranging from screening only through to being the primary manager. I feel that we are expecting a fairly high level of sophistication from the GPs within an average British, Canadian, or American family practice. I think we need to be aware that, for some time, the core recommendation in the USA has been to assess the patient using the Mini-Mental State Examination (MMSE) or the Clock Test and perhaps two or three other quantitative assessments. Noncognitive features, such as behavior, are harder to quantify and the individual who assesses them must be the patient's primary manager. It will increasingly happen in the USA that as care becomes more managed, a greater emphasis will be put upon primary care.

Screening for Dementia in Primary Care: A Comparison of the GPCOG and the MMSE

2016 ◽  
Vol 42 (5-6) ◽  
pp. 323-330 ◽  
Author(s):  
Henry Brodaty ◽  
Michael H. Connors ◽  
Clement Loy ◽  
Armando Teixeira-Pinto ◽  
Nigel Stocks ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Mental Disorders ◽  
Mini Mental State Examination ◽  
Screening Tool ◽  
The Elderly ◽  
Cognitive Test ◽  
Effective Screening ◽  
State Examination ◽  
Higher Sensitivity

Background/Aims: The General Practitioner Assessment of Cognition (GPCOG) is a brief cognitive test. This study compared the GPCOG to the Mini-Mental State Examination (MMSE), the most widely used test, in terms of their ability to detect likely dementia in primary care. Methods: General practitioners across three states in Australia recruited 2,028 elderly patients from the community. A research nurse administered the GPCOG and the MMSE, as well as the Cambridge Examination for Mental Disorders of the Elderly Cognitive Scale-Revised that we used to define likely dementia. Results: Overall, the GPCOG and the MMSE were similarly effective at detecting likely dementia. The GPCOG, however, had a higher sensitivity than the MMSE when using published cutpoints. Conclusion: The GPCOG is an effective screening tool for dementia in primary care. It appears to be a viable alternative to the MMSE, whilst also requiring less time to administer.

Use of benzodiazepines and cognitive performance in primary care patients with first cognitive complaints

2017 ◽  
Vol 30 (4) ◽  
pp. 597-601 ◽  
Author(s):  
G. Grande ◽  
I. Tramacere ◽  
D. L. Vetrano ◽  
S. Pomati ◽  
C. Mariani ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Performance ◽  
Mini Mental State Examination ◽  
Cognitive Complaints ◽  
Logistic Regression Models ◽  
Benzodiazepine Use ◽  
Primary Care Patients ◽  
Long Acting ◽  
The Impact ◽  
State Examination

ABSTRACTThe aim of the present study is to investigate the impact of benzodiazepine use on cognitive performance in primary care patients with first cognitive complaints. The association between the exposition to benzodiazepines (short and long half-life) and cognitive performance, evaluated through the Mini Mental State Examination (MMSE), was tested through analysis of the covariance and logistic regression models. Within the 4,249 participants (mean age 77.0 ± 8.2, 66.4% women), 732 (17%) were on benzodiazepines. When compared with non-users, short- and long-acting benzodiazepine users presented overlapping adjusted MMSE mean scores (respectively, mean MMSE score: 25.3, 95%CI 25.2–25.5; 25.4, 95%CI 25.1–25.7, and 25.9, 95%CI 25.3–26.4; p = 0.156). When tested according to the logistical regression model, after adjusting for potential confounders, no association was found between short and long acting benzodiazepine use and a MMSE < 24 (respectively, OR 0.9, 95%CI 0.7–1.2; OR 0.8, 95%CI 0.7–1.3) as compared with non-users. In conclusion, according to the results of our study, benzodiazepine use seems not to impact on cognitive performance- as assessed with the MMSE- of primary care patients referring to GPs for first cognitive complaints.

scholarly journals The Efficacy of General Practitioner Assessment of Cognition in Chinese Elders Aged 80 and Older

2019 ◽  
Vol 34 (7-8) ◽  
pp. 523-529
Author(s):  
Fang Xu ◽  
Juan Juan Ma ◽  
Fei Sun ◽  
Jaewon Lee ◽  
David W. Coon ◽  
...  
Keyword(s):  
General Practitioner ◽  
Mini Mental State Examination ◽  
Mainland China ◽  
University Hospital ◽  
Comparable Efficacy ◽  
Lower Sensitivity ◽  
Clinical Settings ◽  
Older Chinese ◽  
State Examination ◽  
Survey Questionnaires

Objectives: This study examined the efficacy of the General Practitioner Assessment of Cognition–Chinese version (GPCOG-C) in screening dementia and mild cognitive impairment (MCI) among older Chinese. Methods: Survey questionnaires were administered to 293 participants aged 80 or above from a university hospital in mainland China. Alzheimer disease and MCI were diagnosed in light of the National Institute on Aging and the Alzheimer’s Association (NIA/AA) criteria. The sensitivity and specificity of GPCOG-C and Mini-Mental State Examination (MMSE) in screening dementia and MCI were compared to the NIA/AA criteria. Results: The GPCOG-C had the sensitivity of 62.3% and specificity of 84.6% in screening MCI, which had comparable efficacy as the NIA/AA criteria. In screening dementia, GPCOG-C had a lower sensitivity (63.7%) than the MMSE and a higher specificity (82.6%) higher than the MMSE. Conclusions: The GPCOG-C is a useful and efficient tool to identify dementia and MCI in older Chinese in outpatient clinical settings.

A meta-analysis of the accuracy of the Addenbrooke's Cognitive Examination (ACE) and the Addenbrooke's Cognitive Examination-Revised (ACE-R) in the detection of dementia

2013 ◽  
Vol 26 (4) ◽  
pp. 555-563 ◽  
Author(s):  
Andrew J. Larner ◽  
Alex J. Mitchell
Keyword(s):  
Primary Care ◽  
Diagnostic Accuracy ◽  
Mini Mental State Examination ◽  
Meta Analysis ◽  
Screening Tools ◽  
High Prevalence ◽  
Memory Clinics ◽  
State Examination ◽  
Addenbrooke’S Cognitive Examination ◽  
Prevalence Of Dementia

ABSTRACTBackground:The Addenbrooke's Cognitive Examination (ACE) and its Revised version (ACE-R) are relatively new screening tools for cognitive impairment that may improve upon the well-known Mini-Mental State Examination (MMSE) and other brief batteries. We systematically reviewed diagnostic accuracy studies of ACE and ACE-R.Methods:Published studies comparing ACE, ACE-R and MMSE were comprehensively sought and critically appraised. A meta-analysis of suitable studies was conducted.Results:Of 61 possible publications identified, meta-analysis of qualifying studies encompassed 5 for ACE (1,090 participants) and 5 for ACE-R (1156 participants); of these, 9 made direct comparisons with the MMSE. Sensitivity and specificity of the ACE were 96.9% (95% CI = 92.7% to 99.4%) and 77.4% (95% CI = 58.3% to 91.8%); and for the ACE-R were 95.7% (95% CI = 92.2% to 98.2%) and 87.5% (95% CI = 63.8% to 99.4%). In a modest prevalence setting, such as primary care or general hospital settings where the prevalence of dementia may be approximately 25%, overall accuracy of the ACE (0.823) was inferior to ACE-R (0.895) and MMSE (0.882). In high prevalence settings such as memory clinics where the prevalence of dementia may be 50% or higher, overall accuracy again favored ACE-R (0.916) over ACE (0.872) and MMSE (0.895).Conclusions:The ACE-R has somewhat superior diagnostic accuracy to the MMSE while the ACE appears to have inferior accuracy. The ACE-R is recommended in both modest and high prevalence settings. Accuracy of newer versions of the ACE remain to be determined.

scholarly journals A Conformation Variant of p53 Combined with Machine Learning Identifies Alzheimer Disease in Preclinical and Prodromal Stages

2020 ◽  
Vol 11 (1) ◽  
pp. 14
Author(s):  
Giulia Abate ◽  
Marika Vezzoli ◽  
Letizia Polito ◽  
Antonio Guaita ◽  
Diego Albani ◽  
...  
Keyword(s):  
Machine Learning ◽  
Primary Care ◽  
Mini Mental State Examination ◽  
Amnestic Mild Cognitive Impairment ◽  
Learning Approach ◽  
Plasma Samples ◽  
Primary Care Settings ◽  
Starting Point ◽  
Machine Learning Approach ◽  
State Examination

Early diagnosis of Alzheimer’s disease (AD) is a crucial starting point in disease management. Blood-based biomarkers could represent a considerable advantage in providing AD-risk information in primary care settings. Here, we report new data for a relatively unknown blood-based biomarker that holds promise for AD diagnosis. We evaluate a p53-misfolding conformation recognized by the antibody 2D3A8, also named Unfolded p53 (U-p532D3A8+), in 375 plasma samples derived from InveCe.Ab and PharmaCog/E-ADNI longitudinal studies. A machine learning approach is used to combine U-p532D3A8+ plasma levels with Mini-Mental State Examination (MMSE) and apolipoprotein E epsilon-4 (APOEε4) and is able to predict AD likelihood risk in InveCe.Ab with an overall 86.67% agreement with clinical diagnosis. These algorithms also accurately classify (AUC = 0.92) Aβ+—amnestic Mild Cognitive Impairment (aMCI) patients who will develop AD in PharmaCog/E-ADNI, where subjects were stratified according to Cerebrospinal fluid (CSF) AD markers (Aβ42 and p-Tau). Results support U-p532D3A8+ plasma level as a promising additional candidate blood-based biomarker for AD.

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