scholarly journals Cross-Validation of the Financial Exploitation Vulnerability Scale

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1038-1038
Author(s):  
Juno Moray ◽  
Peter Lichtenberg
Keyword(s):  
Older Adults ◽  
Reading Ability ◽  
Cross Validation ◽  
Word Reading ◽  
Area Under The Curve ◽  
Initial Study ◽  
Contextual Risk ◽  
Financial Exploitation ◽  
Clinical Tools ◽  
Neurocognitive Measures

Abstract Most of the available clinical tools that detect the experience of financial exploitation (FE) are not practical for use by the many professionals who work with older adults. The available measures are often time-consuming, require specialized training to administer, or focus exclusively on the cognitive aspects of financial decision-making. The need for a brief, standardized measure of contextual risk prompted the development of the Financial Exploitation Vulnerability Scale (FEVS; Lichtenberg et al., 2020). The purpose of this study was to cross-validate the FEVS as a psychometrically sound measure of contextual risk for FE. Participants were recruited from the community (n=95), and through a financial coaching service for older adults who had experienced a financial scam (n=21). A total of 114 older adults were recruited for the study, 33 who had experienced FE and 81 who had not. An independent samples t-test demonstrated that the FEVS total score successfully differentiated older adults based on the experience of financial exploitation. The FEVS total score was correlated with age, but no other demographic factors or collected neurocognitive measures. A ROC curve detecting FE analysis revealed an area under the curve of 0.68. Internal consistency of the FEVS was a=0.80. In a logistic regression model, only the FEVS and word-reading ability were related to FE. The results of this cross-validation study are very similar to the initial study, demonstrating that the FEVS is an accessible, theory-based tool that detects the experience of FE.

scholarly journals REM sleep atonia loss distinguishes synucleinopathy in older adults with cognitive impairment

Neurology ◽  
2019 ◽  
Vol 94 (1) ◽  
pp. e15-e29 ◽  
Author(s):  
Stuart J. McCarter ◽  
Grace M. Tabatabai ◽  
Ho-Yann Jong ◽  
David J. Sandness ◽  
Paul C. Timm ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Rem Sleep ◽  
Area Under The Curve ◽  
Class Iii ◽  
Receiver Operating Characteristic Curves ◽  
Diagnostic Thresholds ◽  
Rem Atonia ◽  
Clinical Tools ◽  
Anterior Tibialis

ObjectiveTo determine whether quantitative polysomnographic REM sleep without atonia (RSWA) distinguishes between cognitive impairment phenotypes.BackgroundNeurodegenerative cognitive impairment in older adults predominantly correlates with tauopathy or synucleinopathy. Accurate antemortem phenotypic diagnosis has important prognostic and treatment implications; additional clinical tools might distinguish between dementia syndromes.MethodsWe quantitatively analyzed RSWA in 61 older adults who underwent polysomnography including 46 with cognitive impairment (20 probable synucleinopathy), 26 probable non-synucleinopathy (15 probable Alzheimer disease, 11 frontotemporal lobar dementia), and 15 age- and sex-matched controls. Submentalis and anterior tibialis RSWA metrics and automated REM atonia index were calculated. Group statistical comparisons and regression were performed, and receiver operating characteristic curves determined diagnostic RSWA thresholds that best distinguished synucleinopathy phenotype.ResultsSubmentalis—but not anterior tibialis RSWA—was greater in synucleinopathy than nonsynucleinopathy; several RSWA diagnostic thresholds distinguished synucleinopathy with excellent specificity including submentalis tonic, 5.6% (area under the curve [AUC] 0.791); submentalis any, 15.0% (AUC 0.871); submentalis phasic, 10.8% (AUC 0.863); and anterior tibialis phasic, 31.4% (AUC 0.694). In the subset of patients without dream enactment behaviors, submentalis RSWA was also greater in patients with synucleinopathy than in those without synucleinopathy. RSWA was detected more frequently by quantitative than qualitative methods (p = 0.0001).ConclusionElevated submentalis RSWA distinguishes probable synucleinopathy from probable nonsynucleinopathy in cognitively impaired older adults, even in the absence of clinical dream enactment symptoms.Classification of evidenceThis study provides Class III evidence that quantitative RSWA analysis is useful for distinguishing cognitive impairment phenotypes. Further studies with pathologic confirmation of dementia diagnoses are needed to confirm the diagnostic utility of RSWA in dementia.

scholarly journals Context Matters: Financial, Psychological, and Relationship Insecurity Around Personal Finance Is Associated With Financial Exploitation

2020 ◽  
Vol 60 (6) ◽  
pp. 1040-1049 ◽  
Author(s):  
Peter A Lichtenberg ◽  
Rebecca Campbell ◽  
LaToya Hall ◽  
Evan Z Gross
Keyword(s):  
Decision Making ◽  
Construct Validity ◽  
Area Under The Curve ◽  
Financial Decision Making ◽  
Financial Exploitation ◽  
Final Sample ◽  
Financial Decision ◽  
Current Sample ◽  
Neurocognitive Measures ◽  
Financial Awareness

Abstract Background and Objectives Context can influence or overwhelm the intellectual and cognitive aspects of financial decision making but has only recently received increased attention. The construct validity of conceptual subscales from a financial decision-making scale was examined in the context of their relationship to financial exploitation. Research Design and Methods Two hundred forty-two community-based participants were recruited into the study. The final sample contained 242 participants. Measures included demographic variables, conceptually derived contextual items, and neurocognitive measures. Seventeen of the 34 contextual items investigated differentiated financially exploited and nonexploited older adults. Combining these 17 contextual items led to the creation of a new scale: the Financial Exploitation Vulnerability Scale (FEVS). Correlational analyses and area under the curve analyses were used to examine the relationship between this new scale of contextual items and other measures and to determine how clinically meaningful the scale was in the current sample. Results Contextual items were powerful discriminators between those who were exploited and those who were not. The new scale of contextual items (the FEVS) demonstrated good internal consistency (Cronbach’s alpha = 0.82) and a strong area under the curve (receiver operating characteristic = 0.80), thereby indicating good clinical significance and evidence for construct validity. Discussion and Implications We examined the conceptually derived subscales of financial awareness, psychological vulnerability, and relationship strain and how these relate to financial exploitation. Our major finding is that contextual items differentiated between exploited and nonexploited adults, which demonstrate the importance of measuring context in financial decision making and exploitation. A new scale for measuring contextual items was introduced.

scholarly journals Calibration and Cross-Validation of Accelerometer Cut-Points to Classify Sedentary Time and Physical Activity from Hip and Non-Dominant and Dominant Wrists in Older Adults

Sensors ◽  
2021 ◽  
Vol 21 (10) ◽  
pp. 3326
Author(s):  
Jairo H. Migueles ◽  
Cristina Cadenas-Sanchez ◽  
Juan M. A. Alcantara ◽  
Javier Leal-Martín ◽  
Asier Mañas ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cross Validation ◽  
Sedentary Time ◽  
Vigorous Physical Activity ◽  
Area Under The Curve ◽  
Cut Points ◽  
Metabolic Equivalents ◽  
Sample Characteristics ◽  
Accelerometer Cut Points

Accelerometers’ accuracy for sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) classification depends on accelerometer placement, data processing, activities, and sample characteristics. As intensities differ by age, this study sought to determine intensity cut-points at various wear locations people more than 70 years old. Data from 59 older adults were used for calibration and from 21 independent participants for cross-validation purposes. Participants wore accelerometers on their hip and wrists while performing activities and having their energy expenditure measured with portable calorimetry. ST and MVPA were defined as ≤1.5 metabolic equivalents (METs) and ≥3 METs (1 MET = 2.8 mL/kg/min), respectively. Receiver operator characteristic (ROC) analyses showed fair-to-good accuracy (area under the curve [AUC] = 0.62–0.89). ST cut-points were 7 mg (cross-validation: sensitivity = 0.88, specificity = 0.80) and 1 count/5 s (cross-validation: sensitivity = 0.91, specificity = 0.96) for the hip; 18 mg (cross-validation: sensitivity = 0.86, specificity = 0.86) and 102 counts/5 s (cross-validation: sensitivity = 0.91, specificity = 0.92) for the non-dominant wrist; and 22 mg and 175 counts/5 s (not cross-validated) for the dominant wrist. MVPA cut-points were 14 mg (cross-validation: sensitivity = 0.70, specificity = 0.99) and 54 count/5 s (cross-validation: sensitivity = 1.00, specificity = 0.96) for the hip; 60 mg (cross-validation: sensitivity = 0.83, specificity = 0.99) and 182 counts/5 s (cross-validation: sensitivity = 1.00, specificity = 0.89) for the non-dominant wrist; and 64 mg and 268 counts/5 s (not cross-validated) for the dominant wrist. These cut-points can classify ST and MVPA in older adults from hip- and wrist-worn accelerometers.

Physical Activity Level and Motor Aptitude: Motor Domains and Identification Capacity of Brazilian Insufficiently Active Older Adults

2020 ◽  
Vol 13 ◽  
Author(s):  
Lucia Maria Andreis ◽  
Fernando de Aguiar Lemos ◽  
Lorenna Walesca de Lima Silva ◽  
Cassiana Luiza Pistorello Garcia ◽  
Gabrielli Veras ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Activity Level ◽  
Area Under The Curve ◽  
The Elderly ◽  
Activity Level ◽  
General Motor ◽  
Body Scheme ◽  
Significant Difference ◽  
Global Coordination

Background: A decrease in the physical activity level in old age is common, which results in an increase in the number of falls and chronic conditions. Associated with that occurs the decline in motor skills as a result of the deficit in the interaction of cognitive and motor processes. Physical activity level can be associated differently with each motor domains. Objective: We analyzed the relationship between physical activity level and motor aptitude, and to identify which motor domains were most sensitive to detect insufficiently active level in older adults. Methods: Participated in the study 385 elderly people of both sexes. For the evaluation of the subjects were adopted the International Questionnaire on Physical Activity and the Motor Scale for Older Adults. Results: The majority of the elderly were active. In the comparison of motor aptitude between active and insufficiently active (IAC) elders a significant difference was found in the Global Coordination, Balance, Body Scheme and General Motor Aptitude. From the analysis of the area under the curve (AUC), we verified that these domains also were the ones that presented adequate diagnostic accuracy to identify IAC elderly. Besides that active elderly have presented the General Motor Aptitude classified within normality while the IAC below the normal. Conclusion: Our data suggest that IAC older adults present lower motor aptitude than the active elderly, especially in the domains of Global Coordination, Balance, Body Scheme and General Motor Aptitude, and that these domains were sensitive to indicate IAC older adults.

scholarly journals Comparing the characteristics and predicting the survival of patients with head and neck melanoma versus body melanoma: a population-based study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuxin Ding ◽  
Runyi Jiang ◽  
Yuhong Chen ◽  
Jing Jing ◽  
Xiaoshuang Yang ◽  
...  
Keyword(s):  
Head And Neck ◽  
Health Management ◽  
External Validation ◽  
Area Under The Curve ◽  
Population Based ◽  
Survival Prediction ◽  
Cancer Specific Survival ◽  
Cox Models ◽  
Lentigo Maligna Melanoma ◽  
Clinical Tools

Abstract Background Previous studies reported cutaneous melanoma in head and neck (HNM) differed from those in other regions (body melanoma, BM). Individualized tools to predict the survival of patients with HNM or BM remain insufficient. We aimed at comparing the characteristics of HNM and BM, developing and validating nomograms for predicting the survival of patients with HNM or BM. Methods The information of patients with HNM or BM from 2004 to 2015 was obtained from the Surveillance, Epidemiology, and End Results (SEER) database. The HNM group and BM group were randomly divided into training and validation cohorts. We used the Kaplan-Meier method and multivariate Cox models to identify independent prognostic factors. Nomograms were developed via the rms and dynnom packages, and were measured by the concordance index (C-index), the area under the curve (AUC) of the receiver operating characteristic (ROC) curve and calibration plots. Results Of 70,605 patients acquired, 21% had HNM and 79% had BM. The HNM group contained more older patients, male sex and lentigo maligna melanoma, and more frequently had thicker tumors and metastases than the BM group. The 5-year cancer-specific survival (CSS) and overall survival (OS) rates were 88.1 ± 0.3% and 74.4 ± 0.4% in the HNM group and 92.5 ± 0.1% and 85.8 ± 0.2% in the BM group, respectively. Eight variables (age, sex, histology, thickness, ulceration, stage, metastases, and surgery) were identified to construct nomograms of CSS and OS for patients with HNM or BM. Additionally, four dynamic nomograms were available on web. The internal and external validation of each nomogram showed high C-index values (0.785–0.896) and AUC values (0.81–0.925), and the calibration plots showed great consistency. Conclusions The characteristics of HNM and BM are heterogeneous. We constructed and validated four nomograms for predicting the 3-, 5- and 10-year CSS and OS probabilities of patients with HNM or BM. These nomograms can serve as practical clinical tools for survival prediction and individual health management.

scholarly journals ONE-LEGGED STANCE BALANCE OF OLDER ADULTS WITH AND WITHOUT FALLS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S470-S470
Author(s):  
Edgar R Vieira ◽  
Márcio Oliveira ◽  
Andre Gil ◽  
Karen Fernandes ◽  
Denilson Teixeira ◽  
...  
Keyword(s):  
Older Adults ◽  
Fear Of Falling ◽  
Center Of Pressure ◽  
Area Under The Curve ◽  
Test Duration ◽  
Mobility Impairments ◽  
Eyes Open ◽  
Falls In Older Adults ◽  
Elliptical Area ◽  
Age Range

Abstract Balance impairment is a common problem among older adults. Poor balance in older adults is often associated with mobility impairments, activity limitations and fear of falling in older adults. Thus, balance assessment is useful for early detection of postural control deficits to prevent mobility impairments and falls in older adults. The aim of this study was to assess if balance measures based in center of pressure (COP) parameters during one-legged stance could differentiate between older adults with and without falls in the past 12 months. One-hundred and seventy older adults (50 fallers and 120 non-fallers, age range: 63-72 years) performed three 30s one-legged stance trials with eyes open on a force platform with 30s of rest between each trial. The following variables were evaluated: COP 95% elliptical area, COP velocity in the anterior-posterior and medio-lateral directions, and test duration (how long the participant was able to stay in one-legged stance, up to 30s). Fallers had poorer balance than non-fallers (P ≤0.004). The COP parameters presented an area under the curve between 0.65-0.72, with sensitivity varying from 66 to 78% and specificity from 54 to 68%. There were no significant differences between fallers and non-fallers on test duration (17 vs. 18s, respectively). The findings showed that the fallers had similar duration time, but poorer balance than the non-fallers during one-legged stance. The COP parameters were able to differentiate the balance between fallers and non-fallers with acceptable area under curve, sensitivity and specificity.

scholarly journals Diagnostic Power of Circulatory Metabolic Biomarkers as Metabolic Syndrome Risk Predictors in Community-Dwelling Older Adults in Northwest of England (A Feasibility Study)

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2275
Author(s):  
Razieh Hassannejad ◽  
Hamsa Sharrouf ◽  
Fahimeh Haghighatdoost ◽  
Ben Kirk ◽  
Farzad Amirabdollahian
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Metabolic Syndrome ◽  
Roc Analysis ◽  
Cross Validation ◽  
Community Dwelling ◽  
Tnf Α ◽  
Diagnostic Power ◽  
Metabolic Biomarkers ◽  
Community Dwelling Older Adults

Background: Metabolic Syndrome (MetS) is a cluster of risk factors for diabetes and cardiovascular diseases with pathophysiology strongly linked to aging. A range of circulatory metabolic biomarkers such as inflammatory adipokines have been associated with MetS; however, the diagnostic power of these markers as MetS risk correlates in elderly has yet to be elucidated. This cross-sectional study investigated the diagnostic power of circulatory metabolic biomarkers as MetS risk correlates in older adults. Methods: Hundred community dwelling older adults (mean age: 68.7 years) were recruited in a study, where their blood pressure, body composition and Pulse Wave Velocity (PWV) were measured; and their fasting capillary and venous blood were collected. The components of the MetS; and the serum concentrations of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Plasminogen Activator Inhibitor-I (PAI-I), Leptin, Adiponectin, Resistin, Cystatin-C, C-Reactive Protein (CRP), insulin and ferritin were measured within the laboratory, and the HOMA1-IR and Atherogenic Index of Plasma (AIP) were calculated. Results: Apart from other markers which were related with some cardiometabolic (CM) risk, after Bonferroni correction insulin had significant association with all components of Mets and AIP. These associations also remained significant in multivariate regression. The multivariate odds ratio (OR with 95% confidence interval (CI)) showed a statistically significant association between IL-6 (OR: 1.32 (1.06–1.64)), TNF-α (OR: 1.37 (1.02–1.84)), Resistin (OR: 1.27 (1.04–1.54)) and CRP (OR: 1.29 (1.09–1.54)) with MetS risk; however, these associations were not found when the model was adjusted for age, dietary intake and adiposity. In unadjusted models, insulin was consistently statistically associated with at least two CM risk factors (OR: 1.33 (1.16–1.53)) and MetS risk (OR: 1.24 (1.12–1.37)) and in adjusted models it was found to be associated with at least two CM risk factors and MetS risk (OR: 1.87 (1.24–2.83) and OR: 1.25 (1.09–1.43)) respectively. Area under curve (AUC) for receiver operating characteristics (ROC) demonstrated a good discriminatory diagnostics power of insulin with AUC: 0.775 (0.683–0.866) and 0.785 by cross validation and bootstrapping samples for at least two CM risk factors and AUC: 0.773 (0.653–0.893) and 0.783 by cross validation and bootstrapping samples for MetS risk. This was superior to all other AUC reported from the ROC analysis of other biomarkers. Area under precision-recall curve for insulin was also superior to all other markers (0.839 and 0.586 for at least two CM risk factors and MetS, respectively). Conclusion: Fasting serum insulin concentration was statistically linked with MetS and its risk, and this link is stronger than all other biomarkers. Our ROC analysis confirmed the discriminatory diagnostic power of insulin as CM and MetS risk correlate in older adults.

scholarly journals Multiple biomarker panel to screen for severe aortic stenosis: results from the CASABLANCA study

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000916 ◽  
Author(s):  
Sammy Elmariah ◽  
Cian McCarthy ◽  
Nasrien Ibrahim ◽  
Deborah Furman ◽  
Renata Mukai ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Predictive Value ◽  
Cross Validation ◽  
Severe Aortic Stenosis ◽  
Area Under The Curve ◽  
Diagnostic Model ◽  
Aortic Valve Area ◽  
Academic Medical Centre ◽  
Diagnostic Score ◽  
Biomarker Panel

ObjectiveSevere aortic valve stenosis (AS) develops via insidious processes and can be challenging to correctly diagnose. We sought to develop a circulating biomarker panel to identify patients with severe AS.MethodsWe enrolled study participants undergoing coronary or peripheral angiography for a variety of cardiovascular diseases at a single academic medical centre. A panel of 109 proteins were measured in blood obtained at the time of the procedure. Statistical learning methods were used to identify biomarkers and clinical parameters that associate with severe AS. A diagnostic model incorporating clinical and biomarker results was developed and evaluated using Monte Carlo cross-validation.ResultsOf 1244 subjects (age 66.4±11.5  years, 28.7% female), 80 (6.4%) had severe AS (defined as aortic valve area (AVA) <1.0  cm2). A final model included age, N-terminal pro-B-type natriuretic peptide, von Willebrand factor and fetuin-A. The model had good discrimination for severe AS (OR=5.9, 95% CI 3.5 to 10.1, p<0.001) with an area under the curve of 0.76 insample and 0.74 with cross-validation. A diagnostic score was generated. Higher prevalence of severe AS was noted in those with higher scores, such that 1.6% of those with a score of 1 had severe AS compared with 15.3% with a score of 5 (p<0.001), and score values were inversely correlated with AVA (r=−0.35; p<0.001). At optimal model cut-off, we found 76% sensitivity, 65% specificity, 13% positive predictive value and 98% negative predictive value.ConclusionsWe describe a novel, multiple biomarker approach for diagnostic evaluation of severe AS.Trial registration numberNCT00842868.

Sign in / Sign up

Export Citation Format

Share Document