scholarly journals What Am I Measuring? Disentangling Cognitive Status From Sensory Impairment

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 822-822
Author(s):  
Emma Nichols ◽  
Bonnielin Swenor ◽  
Jennifer Deal ◽  
Alison Abraham ◽  
Michelle Carlson ◽  
...  
Keyword(s):  
Hearing Impairment ◽  
Test Performance ◽  
Cognitive Status ◽  
Vision Impairment ◽  
Cognitive Test ◽  
Sensory Impairment ◽  
Atherosclerosis Risk In Communities ◽  
Item Functioning ◽  
Baltimore Longitudinal Study ◽  
Cognitive Test Performance

Abstract Some studies have shown sensory impairment is associated with impaired cognitive test performance, however tests rely to varying degrees on hearing and vision. We hypothesized scores for cognitive tests whose administration depends on vision or hearing are biased among those with vision or hearing impairment, respectively, after controlling for underlying cognitive performance. We used item response theory methods to test for differential item functioning (DIF) by hearing and vision impairment in the Baltimore Longitudinal Study of Aging (BLSA) and the Atherosclerosis Risk in Communities study (ARIC). We identified DIF by hearing impairment for tests that do not rely on hearing and DIF by vision impairment for tests that do not rely on vision. We found no clinically meaningful differences between unadjusted and DIF-adjusted measures of cognition. Our finding that DIF by sensory domain was independent of administration modality suggests cognitive load may play a larger role than previously acknowledged.

scholarly journals Assessing Bias in Cognitive Testing for Older Adults with Sensory Impairment: An Analysis of Differential Item Functioning in the Baltimore Longitudinal Study on Aging (BLSA) and the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS)

2021 ◽  
pp. 1-12
Author(s):  
E. Nichols ◽  
J.A. Deal ◽  
B.K. Swenor ◽  
A.G. Abraham ◽  
N.M. Armstrong ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Differential Item Functioning ◽  
Test Performance ◽  
Vision Impairment ◽  
Sensory Impairment ◽  
Hearing Impairments ◽  
Atherosclerosis Risk In Communities ◽  
Item Functioning ◽  
Atherosclerosis Risk ◽  
Baltimore Longitudinal Study

Abstract Objectives: Vision and hearing impairments affect 55% of people aged 60+ years and are associated with lower cognitive test performance; however, tests rely on vision, hearing, or both. We hypothesized that scores on tests that depend on vision or hearing are different among those with vision or hearing impairments, respectively, controlling for underlying cognition. Methods: Leveraging cross-sectional data from the Baltimore Longitudinal Study of Aging (BLSA) and the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), we used item response theory to test for differential item functioning (DIF) by vision impairment (better eye presenting visual acuity worse than 20/40) and hearing impairment (better ear .5–4 kHz pure-tone average > 25 decibels). Results: We identified DIF by vision impairment for tests whose administrations do not rely on vision [e.g., Delayed Word Recall both in ARIC-NCS: .50 logit difference between impaired and unimpaired (p = .04) and in BLSA: .62 logits (p = .02)] and DIF by hearing impairment for tests whose administrations do not rely on hearing [Digit Symbol Substitution test in BLSA: 1.25 logits (p = .001) and Incidental Learning test in ARIC-NCS: .35 logits (p = .001)]. However, no individuals had differences between unadjusted and DIF-adjusted measures of greater than the standard error of measurement. Conclusions: DIF by sensory impairment in cognitive tests was independent of administration characteristics, which could indicate that elevated cognitive load among persons with sensory impairment plays a larger role in test performance than previously acknowledged. While these results were unexpected, neither of these samples are nationally representative and each has unique selection factors; thus, replication is critical.

scholarly journals Saliva RNA biomarkers predict concussion duration and detect symptom recovery: a comparison with balance and cognitive testing

2021 ◽  
Author(s):  
Gregory Fedorchak ◽  
Aakanksha Rangnekar ◽  
Cayce Onks ◽  
Andrea C. Loeffert ◽  
Jayson Loeffert ◽  
...  
Keyword(s):  
Test Performance ◽  
Area Under The Curve ◽  
Prediction Rule ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Clinical Tool ◽  
Post Injury ◽  
Symptom Recovery ◽  
Cognitive Test Performance

Abstract Objective The goals of this study were to assess the ability of salivary non-coding RNA (ncRNA) levels to predict post-concussion symptoms lasting ≥ 21 days, and to examine the ability of ncRNAs to identify recovery compared to cognition and balance. Methods RNA sequencing was performed on 505 saliva samples obtained longitudinally from 112 individuals (8–24-years-old) with mild traumatic brain injury (mTBI). Initial samples were obtained ≤ 14 days post-injury, and follow-up samples were obtained ≥ 21 days post-injury. Computerized balance and cognitive test performance were assessed at initial and follow-up time-points. Machine learning was used to define: (1) a model employing initial ncRNA levels to predict persistent post-concussion symptoms (PPCS) ≥ 21 days post-injury; and (2) a model employing follow-up ncRNA levels to identify symptom recovery. Performance of the models was compared against a validated clinical prediction rule, and balance/cognitive test performance, respectively. Results An algorithm using age and 16 ncRNAs predicted PPCS with greater accuracy than the validated clinical tool and demonstrated additive combined utility (area under the curve (AUC) 0.86; 95% CI 0.84–0.88). Initial balance and cognitive test performance did not differ between PPCS and non-PPCS groups (p > 0.05). Follow-up balance and cognitive test performance identified symptom recovery with similar accuracy to a model using 11 ncRNAs and age. A combined model (ncRNAs, balance, cognition) most accurately identified recovery (AUC 0.86; 95% CI 0.83–0.89). Conclusions ncRNA biomarkers show promise for tracking recovery from mTBI, and for predicting who will have prolonged symptoms. They could provide accurate expectations for recovery, stratify need for intervention, and guide safe return-to-activities.

scholarly journals Sensory Loss and the Healthcare System: Outcomes and Navigation

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 797-797
Author(s):  
Nicholas Reed ◽  
Charlotte Yeh
Keyword(s):  
Health Care ◽  
Hearing Impairment ◽  
Hearing Aids ◽  
Quality Care ◽  
Vision Impairment ◽  
Sensory Loss ◽  
Sensory Impairment ◽  
Age Related ◽  
Increased Risk ◽  
National Quality

Abstract Communication is fundamental to patient-centered care. However, sensory impairment limits communication among older adults. Specifically, hearing impairment strains communication via degraded auditory encoding while vision impairment distresses ability to read and interpret visual cues. The presence of dual sensory impairment, defined as concurrent hearing and vision impairment, may exacerbate these effects. The potential consequence s of age-related sensory loss on health care interactions and outcomes are beginning to surface in epidemiologic studies demonstrating poorer patient-provider communication, higher medical expenditures, increased risk of 30-day readmission, and longer length of stay when compared to individuals without sensory loss. Importantly, these associations may be amenable to intervention via sensory aids; however, uptake to sensory care is low. Notably, less than 20% of persons with hearing impairment have hearing aids and over 55% of Medicare Beneficiaries with reported vision problems have not had an eye examination in the prior year. Affordability and access may contribute to lack of sensory care uptake as Medicare explicitly excludes coverage of vision and hearing services. In this symposium, we will review current and new evidence for whether sensory loss affects health care outcomes, including satisfaction with care, incident delirium during hospitalization, navigation of Medicare, and present data on how persons with sensory loss are more likely to delay their care independent of cost and insurance factors suggesting fundamental changes in health care system interaction. We will place these results within the context of current national quality care and policy initiatives and review methods to address sensory loss.

Patterns of Cognitive Test Performance As Functions of the Lateral Localization of Cerebral Abnormalities in the Temporal Lobe

1957 ◽  
Vol 103 (433) ◽  
pp. 758-772 ◽  
Author(s):  
Victor Meyer ◽  
H. Gwynne Jones
Keyword(s):  
Test Performance ◽  
Right Hemisphere ◽  
Cognitive Test ◽  
Temporal Relationships ◽  
Verbal Tasks ◽  
Specific Locus ◽  
Left And Right ◽  
Spatio Temporal ◽  
Cognitive Test Performance ◽  
Lateral Localization

Various investigations into the effects of brain injury on psychological test performance (Weisenburg and McBride, 1935; Patterson and Zangwill, 1944; Anderson, 1951; McFie and Piercy, 1952; Bauer and Becka, 1954; Milner, 1954) suggest the overall conclusion that patients with left hemisphere lesions are relatively poor at verbal tasks, while those with right-sided lesions do worst at practical tasks, particularly the manipulation of spatial or spatio-temporal relationships. Heilbfun's (1956) study confirmed that verbal deficits result from left-sided lesions but his left and right hemisphere groups produced almost identical scores on spatial tests. In so far as these workers paid attention to the specific sites of the lesions, their findings indicate that the pattern of test performance is a function of the hemisphere in which the lesion occurs rather than of its specific locus.

Improvement of cognitive test performance in patients undergoing primary CABG and other CPB-assisted cardiac procedures

Perfusion ◽  
2008 ◽  
Vol 23 (5) ◽  
pp. 267-273 ◽  
Author(s):  
JM van den Goor ◽  
BK Saxby ◽  
JG Tijssen ◽  
KA Wesnes ◽  
BA de Mol ◽  
...  
Keyword(s):  
Cognitive Functions ◽  
Test Performance ◽  
Artery Bypass ◽  
Cardiac Surgical Procedures ◽  
Cognitive Test ◽  
Cardiac Procedures ◽  
Patient Groups ◽  
Cognitive Test Performance ◽  
Composite Scores ◽  
Cabg Patients

Cardiac surgical procedures assisted by cardiopulmonary bypass (CPB) impair cognitive functions. Several studies, however, showed that cognitive functions were unaffected in patients undergoing either primary coronary artery bypass grafting (CABG) or more complex surgery assisted by CPB. Therefore, we conducted a straightforward study to compare patient groups who differed significantly in terms of risk factors such as prolonged CPB times. Consecutive patients (n = 54) were included, undergoing either non-primary CABG, e.g. valve and/or CABG, (n = 30) or primary CABG (n = 24), assisted by CPB. Cognitive function was determined pre-operatively on the day of hospital admission, and post-operatively after one and six months using the Cognitive Drug Research computerized assessment battery. Data from the fourteen individual task variables were summarized in four composite scores: Power of Attention (PoA), Continuity of Attention (CoA), Quality of Episodic Memory (QoEM), and Speed of Memory (SoM). In the non-primary CABG patients, both CoA and QoEM improved after 1 month (p = 0.001 and p = 0.016, respectively), whereas, after 6 months, CoA (p = 0.002), QoEM (p = 0.002) and SoM (p < 0.001) were improved. In primary CABG patients, CoA improved at one month after surgery (p = 0.002) and, after six months, not only CoA (p = 0.003), but also QoEM and SoM were improved (p = 0.001 and p = 0.030, respectively). The test performance was similar in non-primary and primary CABG patients after surgery. Our present study shows a post-operative improvement of cognitive composite scores after cardiac surgery assisted by CPB in both non-primary CABG and in primary CABG patients.

Mental Health and Well-Being Among Individuals With a Sensory Loss During COVID-19 Lockdown Measures

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 409-409
Author(s):  
Natascha Merten ◽  
Amy Schultz ◽  
Matthew Walsh ◽  
Suzanne van Landingham ◽  
Paul Peppard ◽  
...  
Keyword(s):  
Mental Health ◽  
Hearing Impairment ◽  
Mental Health Problems ◽  
Well Being ◽  
Vision Impairment ◽  
Sensory Loss ◽  
Future Research ◽  
Sensory Impairment ◽  
Psychological Well Being ◽  
Health And Well Being

Abstract Hearing and vision impairment are highly prevalent chronic conditions and are associated with poorer mental health and well-being. Mental health problems may be exacerbated by COVID-19-related lockdown measures and limitations of in-person contacts may affect those with sensory impairments more severely. We aimed to determine whether hearing and/or visual impairment were associated with worse mental health and psychological well-being during lockdown measures in Spring/Summer 2020 in Wisconsin. We included 1341 (64% women, aged 20-92 years) Survey of the Health of Wisconsin participants of a COVID-19 survey (May-June, 2020). We assessed self-reported current mental health and psychological well-being and vision and hearing impairment. Logistic regression models with vision and hearing impairments as determinants and multiple mental health and well-being outcomes were used and adjusted for age, gender, race, education, heart disease, hypertension, hyperlipidemia and diabetes. In preliminary analyses, we found associations of vision impairment with increased odds of generalized anxiety disorder (odds ratio=2.10; 95% confidence interval=1.32-3.29) and depression (2.57; 1.58-4.11). Individuals with a vision impairment were more likely to be taking medication for depression (1.75; 1.13-2.68), report being lonely (1.65; 1.00-2.64) and report hopelessness (1.45; 1.01-2.08). Individuals with a hearing impairment were more likely to be taking depression medications (1.72; 1.07-2.73) and to report being lonely (1.80; 1.05-2.98). Sensory impairment was not associated with stress levels or sense of purpose in life. Individuals with sensory impairment may represent a particularly vulnerable population during the COVID-19 pandemic. Future research should determine underlying reasons and interventions to mitigate this populations’ disadvantages.

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