Empirical weighting of the Standardized Mini Mental State Examination items among nursing home residents

Screaming and other types of disruptive vocalization are commonly observed among nursing home residents. Depressive symptoms are also frequently seen in this group, although the relationship between disruptive vocalization and depressive symptoms is unclear. Accordingly, we sought to examine this relationship in older nursing home residents. We undertook a controlled comparison of 41 vocally disruptive nursing home residents and 43 non-vocally-disruptive nursing home residents. All participants were selected to have Mini-Mental State Examination (MMSE) scores of at least 10. Participants had a mean age of 81.0 years (range 63-97 years) and had a mean MMSE score of 17.8 (range 10-29). Nurse ratings of disruptive vocalization according to a semioperationalized definition were validated against the noisy behavior subscale of the Cohen-Mansfield Agitation Inventory. Subjects were independently rated for depressive symptoms by a psychiatrist using the Dementia Mood Assessment Scale, the Cornell Scale for Depression in Dementia, and the Depressive Signs Scale. Vocally disruptive nursing home residents scored significantly higher than controls on each of these three depresion-in-dementia scales. These differences remained significant when the effects of possible confounding variables of cognitive impairment, age, and sex were removed. We conclude that depressive symptoms are associated with disruptive vocalization and may have an etiological role in the generation of disruptive vocalization behaviors in elderly nursing home residents.

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Correlates of agitation and depression in nursing home residents with dementia

International Psychogeriatrics ◽

10.1017/s104161021200066x ◽

2012 ◽

Vol 24 (11) ◽

pp. 1779-1789 ◽

Cited By ~ 22

Author(s):

Tomislav Majić ◽

Jan P. Pluta ◽

Thomas Mell ◽

Yvonne Treusch ◽

Hans Gutzmann ◽

...

Keyword(s):

Nursing Home ◽

Mini Mental State Examination ◽

Nursing Home Residents ◽

Regression Analyses ◽

Dementia Severity ◽

Advanced Stages ◽

Severity Of Depression ◽

And Gender ◽

The Relationship ◽

State Examination

ABSTRACTBackground:The purpose of this study was to investigate the relationship between dementia severity, age, gender, and prescription of psychotropics, and syndromes of agitation and depression in a sample of nursing home residents with dementia.Methods:The Cohen-Mansfield Agitation Inventory (CMAI) was administered to residents with dementia (N= 304) of 18 nursing homes. Agitation symptoms were clustered using factorial analysis. Depression was estimated using the Dementia Mood Assessment Scale (DMAS). Dementia severity was assessed categorically using predefined cut-off scores derived from the Mini-Mental State Examination (MMSE). The relationship between agitation and its sub-syndromes, depression, and dementia severity was calculated usingχ2-statistics. Linear regression analyses were used to calculate the effect of dementia severity and psychotropic prescriptions on agitation and depression, controlling for age and gender.Results:Increasing stages of dementia severity were associated with higher risk for physically aggressive (p< 0.001) and non-aggressive (p< 0.01) behaviors, verbally agitated behavior (p< 0.05), and depression (p< 0.001). Depressive symptoms were associated with physically aggressive (p< 0.001) and verbally agitated (p< 0.05) behaviors, beyond the effects of dementia severity. Prescription of antipsychotics was correlated with depression and all agitation sub-syndromes except hiding and hoarding.Conclusions:Dementia severity is a predictor for agitation and depression. Beyond that, depression increased with dementia severity, and the severity of depression was associated with both physically and verbally aggressive behaviors, indicating that, in advanced stages of dementia, depression in some patients might underlie aggressive behavior.

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Vocally disruptive behaviour in nursing home residents in Ireland: a descriptive study

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2020.124 ◽

2020 ◽

pp. 1-11

Author(s):

C. Nwogbunyama ◽

B. D. Kelly ◽

C. Cooney

Keyword(s):

Nursing Home ◽

Mini Mental State Examination ◽

Nursing Home Residents ◽

Target Population ◽

Care Plan ◽

Disruptive Behaviour ◽

Two Factors ◽

Randomised Controlled ◽

State Examination ◽

Study Inclusion

Background: Vocally disruptive behaviour (VDB) is relatively common in nursing home residents but difficult to treat. There is limited study on prevalence and treatment of VDB. We hypothesise that VDB is a result of complex interaction between patient factors and environmental contributors. Methods: Residents of nursing homes in south Dublin were the target population for this study. Inclusion criteria were that the residents were 65 years or over and exhibited VDB significant enough for consideration in the resident’s care plan. Information on typology and frequency of VDB, Interventions employed and their efficacy, diagnoses, Cohen-Mansfield Agitation Inventory scores, Mini-Mental State Examination scores, and Barthel Index scores were obtained. Results: Eight percent of nursing home residents were reported to display VDB, most commonly screaming (in 39.4% of vocally disruptive residents). VDB was associated with physical agitation and dementia; together, these two factors accounted for almost two-thirds of the variation in VDB between residents. One-to-one attention, engaging in conversation, redirecting behaviour, and use of psychotropic medication were reported by nurses as the most useful interventions. Analgesics were the medications most commonly used (65.7%) followed by quetiapine (62.9%), and these were reportedly effective in 82.6% and 77.2% of residents respectively. Conclusions: VDB is common, challenging, and difficult to manage. The study of VDB is limited by a variety of factors that both contribute to this behaviour and make its treatment challenging. Issues relating to capacity and ethics make it difficult to conduct randomised controlled trials of treatments for VDB in the population affected.

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Feasibility of a Geriatric Assessment to Detect and Quantify Sarcopenia and Physical Functioning in German Nursing Home Residents—A Pilot Study

Geriatrics ◽

10.3390/geriatrics6030069 ◽

2021 ◽

Vol 6 (3) ◽

pp. 69

Author(s):

Daniel Haigis ◽

Rebekka Pomiersky ◽

Dorotheé Altmeier ◽

Annika Frahsa ◽

Gorden Sudeck ◽

...

Keyword(s):

Nursing Home ◽

Pilot Study ◽

Physical Functioning ◽

Mini Mental State Examination ◽

Nursing Home Residents ◽

Anthropometric Data ◽

Timed Up And Go ◽

Home Setting ◽

Nursing Home Setting ◽

State Examination

Background: Entering into a nursing home leads to increased immobility and further reductions in physical and cognitive functioning. As a result, there is a risk of sarcopenia, which is characterized by loss of muscle strength, muscle mass and physical functioning. To our knowledge, the feasibility of sarcopenia screening has not yet been performed in the German nursing home setting. Methods: For sarcopenia screening, the specifications of EWGSOP2 were applied. The quantification of sarcopenia was performed according to the corresponding cut-off values. The collection of anthropometric data and the morbidity status were recorded. SARC-F, mini-mental state examination, Barthel Index, Short Physical Performance Battery and Timed Up and Go tests were implemented. Results: In one participant, severe sarcopenia could be identified. The quantification was not possible for four participants. A suspicion of sarcopenia was not confirmed in five participants. Only one person was able to perform all assessments. Conclusions: Sarcopenia screening according to EWGSOP2 presented satisfactory feasibility by nursing home residents. However, further tests to assess the physical functioning of the participants often could not be performed. Moreover, inconsistencies in individual assessments became apparent, leading to inconclusive analyses. The recording of sarcopenia prevalence in German nursing homes should be the goal of further research.

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Mini-Mental-State

Zeitschrift für Gerontopsychologie & -psychiatrie ◽

10.1024/1011-6877.22.1.11 ◽

2009 ◽

Vol 22 (1) ◽

pp. 11-16 ◽

Cited By ~ 5

Author(s):

Andreas Kaiser ◽

Renate Gusner-Pfeiffer ◽

Hermann Griessenberger ◽

Bernhard Iglseder

Keyword(s):

Mental State ◽

Mini Mental State Examination ◽

Oder Nicht ◽

State Examination

Im folgenden Artikel werden fünf verschiedene Versionen der Mini-Mental-State-Examination dargestellt, die alle auf der Grundlage des Originals von Folstein erstellt wurden, sich jedoch deutlich voneinander unterscheiden und zu unterschiedlichen Ergebnissen kommen, unabhängig davon, ob das Screening von erfahrenen Untersuchern durchgeführt wird oder nicht. Besonders auffällig ist, dass Frauen die Aufgaben «Wort rückwärts» hoch signifikant besser lösten als das «Reihenrechnen». An Hand von Beispielen werden Punkteunterschiede aufgezeigt.

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Zur Anwendung der CES-D bei älteren Menschen: Dimensionsstruktur und Meßartefakte

Diagnostica ◽

10.1026//0012-1924.46.1.29 ◽

2000 ◽

Vol 46 (1) ◽

pp. 29-37 ◽

Cited By ~ 7

Author(s):

Herbert Matschinger ◽

Astrid Schork ◽

Steffi G. Riedel-Heller ◽

Matthias C. Angermeyer

Keyword(s):

Mental State ◽

Latent Class ◽

Mini Mental State Examination ◽

Depression Scale ◽

Epidemiological Studies ◽

Partial Credit ◽

Examination Score ◽

State Examination

Zusammenfassung. Beim Einsatz der Center for Epidemiological Studies Depression Scale (CES-D) stellt sich das Problem der Dimensionalität des Instruments, dessen Lösung durch die Konfundierung eines Teilkonstruktes (“Wohlbefinden”) mit Besonderheiten der Itemformulierung Schwierigkeiten bereitet, da Antwortartefakte zu erwarten sind. Dimensionsstruktur und Eignung der CES-D zur Erfassung der Depression bei älteren Menschen wurden an einer Stichprobe von 663 über 75-jährigen Teilnehmern der “Leipziger Langzeitstudie in der Altenbevölkerung” untersucht. Da sich die Annahme der Gültigkeit eines partial-credit-Rasch-Modells sowohl für die Gesamtstichprobe als auch für eine Teilpopulation als zu restriktiv erwies, wurde ein 3- bzw. 4-Klassen-latent-class-Modell für geordnete Kategorien berechnet und die 4-Klassen-Lösung als den Daten angemessen interpretiert: Drei Klassen zeigten sich im Sinne des Konstrukts “Depression” geordnet, eine Klasse enthielt jene Respondenten, deren Antwortmuster auf ein Antwortartefakt hinwiesen. In dieser Befragtenklasse wird der Depressionsgrad offensichtlich überschätzt. Zusammenhänge mit Alter und Mini-Mental-State-Examination-Score werden dargestellt. Nach unseren Ergebnissen muß die CES-D in einer Altenbevölkerung mit Vorsicht eingesetzt werden, der Summenscore sollte nicht verwendet werden.

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Prediction of Probable Alzheimer Disease in Patients With Symptoms Suggestive of Memory Impairment: Value of the Mini-Mental State Examination

Archives of Family Medicine ◽

10.1001/archfami.9.6.527 ◽

2000 ◽

Vol 9 (6) ◽

pp. 527-532 ◽

Cited By ~ 56

Author(s):

M. C. Tierney

Keyword(s):

Alzheimer Disease ◽

Mental State ◽

Memory Impairment ◽

Mini Mental State Examination ◽

State Examination

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Validation of the Hungarian version of Alzheimer’s Disease Assessment Scale – Cognitive Subscale

Orvosi Hetilap ◽

10.1556/oh.2012.29332 ◽

2012 ◽

Vol 153 (12) ◽

pp. 461-466 ◽

Cited By ~ 5

Author(s):

Magdolna Pákáski ◽

Gergely Drótos ◽

Zoltán Janka ◽

János Kálmán

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Mental State ◽

Mini Mental State Examination ◽

Assessment Scale ◽

Disease Assessment ◽

Control Subjects ◽

Cognitive Subscale ◽

State Examination ◽

Hungarian Version

The cognitive subscale of the Alzheimer’s Disease Assessment Scale is the most widely used test in the diagnostic and research work of Alzheimer’s disease. Aims: The aim of this study was to validate and investigate reliability of the Hungarian version of the Alzheimer’s Disease Assessment Scale in patients with Alzheimer’s disease and healthy control subjects. Methods: syxty-six patients with mild and moderate Alzheimer’s disease and 47 non-demented control subjects were recruited for the study. The cognitive status was established by the Hungarian version of the Alzheimer’s Disease Assessment Scale and Mini Mental State Examination. Discriminative validity, the relation between age and education and Alzheimer’s Disease Assessment Scale, and the sensitivity and specificity of the test were determined. Results: Both the Mini Mental State Examination and the Alzheimer’s Disease Assessment Scale had significant potential in differentiating between patients with mild and moderate stages of Alzheimer’s disease and control subjects. A very strong negative correlation was established between the scores of the Mini Mental State Examination and the Alzheimer’s Disease Assessment Scale in the Alzheimer’s disease group. The Alzheimer’s Disease Assessment Scale showed slightly negative relationship between education and cognitive performance, whereas a positive correlation between age and Alzheimer’s Disease Assessment Scale scores was detected only in the control group. According to the analysis of the ROC curve, the values of sensitivity and specificity of the Alzheimer’s Disease Assessment Scale were high. Conclusions: The Hungarian version of the Alzheimer’s Disease Assessment Scale was found to be highly reliable and valid and, therefore, the application of this scale can be recommended for the establishment of the clinical stage and follow-up of patients with Alzheimer’s disease. However, the current Hungarian version of the Alzheimer’s Disease Assessment Scale is not sufficient; the list of words and linguistic elements should be selected according to the Hungarian standard in the future. Orv. Hetil., 2012, 153, 461–466.

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