scholarly journals Cognitive Assessment Test: Validation of a Short Cognitive Test for the Detection of Mild Cognitive Disorder

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Kelly Estrada-Orozco ◽  
Kely Bonilla-Vargas ◽  
Francy Cruz ◽  
Oscar Mancera ◽  
Miguel Ruiz ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Cognitive Disorders ◽  
Roc Curves ◽  
Cognitive Disorder ◽  
Cognitive Test ◽  
Cognitive Domains ◽  
Time Of Application ◽  
Accuracy Study ◽  
Overall Performance ◽  
Research Challenge

Introduction.Cognitive disorders are a clinical and research challenge; in particular, the mild cognitive disorder (MiCD) requires diagnostic suspicion and tools with adequate performance for its detection. The objective of this study was the validation of a short cognitive test (CATest) for the detection of MiCD in population of 50 years or more.Methods.A diagnostic accuracy study was assembled and performed in a prospective cohort. A consecutive sample of 200 Colombian subjects who represented the whole spectrum of the condition of interest allowed us to reach the objective. Validity was determined by concurrent criteria. The cut points were determined by the ROC curves considering the best overall performance and accuracy of the test.Results.CATest was validated to detection of MiCD at a cut-off point of 18. As a result, scores lower than 18 classified the participants as MiCD. At this cut-off point, CATest showed sensitivity of 84.3% (CI 76 to 90.16), specificity of 71.4% (CI95% 61.8 to 79.43), positive predictive value of 75% ( 95% CI 66.79 to 82.42), and area under curve AUC 0.8518 (standard error SE 0.0265).Discussion.CATest has an adequate performance as a short cognitive test for the detection of MiCD. Its performance is superior to MiniMental and similar to Montreal Cognitive test (MoCA) according to the data reported in the literature. The advantages over other tests are the evaluation of all cognitive domains, time of application, and easy interpretation of results. CATest is a free use alternative for MiCD detection.

scholarly journals CogniSoft: A Platform for the Automation of Cognitive Assessment and Rehabilitation of Multiple Sclerosis

Computers ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 93
Author(s):  
Dessislava Petrova-Antonova ◽  
Ivaylo Spasov ◽  
Yanita Petkova ◽  
Ilina Manova ◽  
Sylvia Ilieva
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Assessment ◽  
Cognitive Rehabilitation ◽  
Large Scale ◽  
Cognitive Disorders ◽  
Cognitive Status ◽  
Machine Learning Algorithms ◽  
Cognitive Test ◽  
Economic Research ◽  
Medical Software

Cognitive disorders remain a major cause of disability in Multiple Sclerosis (MS). They lead to unemployment, the need for daily assistance, and a poor quality of life. The understanding of the origin, factors, processes, and consequences of cognitive disfunction is key to its prevention, early diagnosis, and rehabilitation. The neuropsychological testing and continuous monitoring of cognitive status as part of the overall evaluation of patients with MS in parallel with clinical and paraclinical examinations are highly recommended. In order to improve health and disease understanding, a close linkage between fundamental, clinical, epidemiological, and socio-economic research is required. The effective sharing of data, standardized data processing, and the linkage of such data with large-scale cohort studies is a prerequisite for the translation of research findings into the clinical setting. In this context, this paper proposes a software platform for the cognitive assessment and rehabilitation of patients with MS called CogniSoft. The platform automates the Beck Depression Inventory (BDI-II) test and diagnostic tests for the evaluation of memory and executive functions based on the nature of Brief International Cognitive Assessment for MS (BICAMS), as well as implementing a set of games for cognitive rehabilitation based on BICAMS. The software architecture, core modules, and technologies used for their implementation are presented. Special attention is given to the development of cognitive tests for diagnostics and rehabilitation. Their automation enables better perception, avoids bias as a result of conducting the classic paper tests of various neurophysiologists, provides easy administration, and allows data collection in a uniform manner, which further enables analysis using statistical and machine learning algorithms. The CogniSoft platform is registered as medical software by the Bulgarian Drug Agency and it is currently deployed in the Neurological Clinic of the National Hospital of Cardiology in Sofia, Bulgaria. The first experiments prove the feasibility of the platform, showing that it saves time and financial resources while providing subjectivity in the interpretation of the cognitive test results.

Normative Data for the Spanish Version of the Addenbrooke's Cognitive Examination III

2016 ◽  
Vol 41 (5-6) ◽  
pp. 243-250 ◽  
Author(s):  
Jordi A. Matías-Guiu ◽  
Ramón Fernández-Bobadilla ◽  
Aníbal Fernández-Oliveira ◽  
María Valles-Salgado ◽  
Teresa Rognoni ◽  
...  
Keyword(s):  
Normative Data ◽  
Cognitive Disorders ◽  
Demographic Factors ◽  
Spanish Version ◽  
Cognitive Test ◽  
Test Results ◽  
Cognitive Domains ◽  
Visuospatial Skills ◽  
And Gender ◽  
Addenbrooke’S Cognitive Examination

Background: Addenbrooke's Cognitive Examination III (ACE-III) is a cognitive test that has been validated for the diagnosis of cognitive disorders. The aim of this study was to provide normative data for the ACE-III for age, education and gender. Methods: The Spanish version of the ACE-III was administered to a group of 273 healthy subjects in a multicenter study in Spain. Correlation and determination coefficients for age, education and gender were estimated. The overlapping interval strategy and linear regression analyses were used to provide adjusted norms for demographic factors and to explore the potential influence of these factors in the performance of the test. Results: Age and education correlated significantly with the total score and with all the domains. Gender correlated only with the domains of attention and visuospatial skills. Norms for the total score and for cognitive domains (attention, memory, fluency, language, and visuospatial skills) are provided. Conclusion: This study confirms the influence of demographic factors (especially age and education) on the performance in the ACE-III and provides normative data for the Spanish version of the ACE-III.

scholarly journals High occurrence of impaired emotion recognition after ischemic stroke

2020 ◽  
Vol 5 (3) ◽  
pp. 262-270
Author(s):  
Hugo P Aben ◽  
Johanna MA Visser-Meily ◽  
Geert Jan Biessels ◽  
Paul LM de Kort ◽  
Jacoba M Spikman ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Emotion Recognition ◽  
Cognitive Assessment ◽  
Reference Sample ◽  
Recognition Task ◽  
Cognitive Disorder ◽  
Cognitive Domains ◽  
A Prospective Study ◽  
Vascular Cognitive Disorder

Introduction Deficits of emotion recognition after ischemic stroke are often overlooked by clinicians, and are mostly not spontaneously reported by patients. However, impaired emotion recognition after stroke negatively affects the ability to return to work and the quality of life. It is still unknown how often impairments of emotion recognition occur shortly after ischemic stroke. We aimed to estimate the occurrence of impaired emotion recognition after ischemic stroke and to characterise these patients with impaired emotion recognition. Patients and methods Two hundred thirty patients were included, derived from a prospective study of cognitive recovery. Five weeks after ischemic stroke a neuropsychological assessment was performed, including an emotion recognition task (i.e. Ekman 60-faces test). Emotion recognition was regarded as impaired if the total score was below the fifth percentile for a large independent reference sample. Results Emotion recognition was impaired in 33.5% of patients. Patients with impaired emotion recognition were more likely to have an abnormal Montreal Cognitive Assessment during hospitalisation, and 5 weeks after their stroke, a higher proportion of them had a vascular cognitive disorder (VCD). Even 20% of patients without VCD had impaired emotion recognition. Discussion: Emotion recognition was often impaired after ischemic stroke. This is clinically relevant, since impaired emotion recognition negatively impacts social functioning. Conclusion: Even when there was no cognitive disorder in traditional cognitive domains, emotion recognition was impaired in 1 out of 5 patients. Clinicians should systematically ask patients and their caregivers about deficits in emotion recognition, and, if needed, test for these deficits.

Use of Receiver Operating Characteristic (ROC) Curves to Evaluate Computer Confidence Threshold and Clinical Performance in the Diagnosis of Appendicitis

1978 ◽  
Vol 17 (03) ◽  
pp. 157-161 ◽  
Author(s):  
F. T. De Dombal ◽  
Jane C. Horrocks
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Clinical Performance ◽  
Roc Curves ◽  
Final Diagnosis ◽  
Confidence Threshold ◽  
Computer Aided ◽  
Computer Confidence ◽  
Overall Performance ◽  
Receiver Operating

This paper uses simple receiver operating characteristic (ROC) curves (i) to study the effect of varying computer confidence of threshold levels and (ii) to evaluate clinical performance in the diagnosis of acute appendicitis. Over 1300 patients presenting to five centres with abdominal pain of short duration were studied in varying detail. Clinical and computer-aided diagnostic predictions were compared with the »final« diagnosis. From these studies it is concluded the simplistic setting of a 50/50 confidence threshold for the computer program is as »good« as any other. The proximity of a computer-aided system changed clinical behaviour patterns; a higher overall performance level was achieved and clinicians performance levels became associated with the »mildly conservative« end of the computers ROC curve. Prior forecasts of over-confidence or ultra-caution amongst clinicians using the computer-aided system have not been fulfilled.

scholarly journals Patient and provider perceptions of a novel cognitive functioning report for patients with systemic lupus erythematosus: a qualitative study

2021 ◽  
Vol 8 (1) ◽  
pp. e000476
Author(s):  
Laura Plantinga ◽  
Ann Vandenberg ◽  
Felicia Goldstein ◽  
Brian Jones ◽  
Jeremy Johnson ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Cognitive Assessment ◽  
Exploratory Study ◽  
Cognitive Test ◽  
Test Results ◽  
Assessment Data ◽  
Provider Perceptions ◽  
Potential Barriers ◽  
Cognitive Information ◽  
Multiple Domains

ObjectiveTo determine whether and how cognitive assessment data should be included in a report for patients with SLE and their providers.MethodsLeveraging experiences from prior studies, we created a cognitive report that included a hypothetical patient’s results on tests of multiple domains based on the NIH Toolbox Fluid Cognition Battery. In focus groups that comprised patients with SLE (two groups) and their providers (two groups), feedback was sought on the presentation of results as well as the potential value of the report in the clinical setting.ResultsFeedback regarding the presentation of the report was generally positive. Both patients with SLE and their providers liked its simple graphics and use of a colour-gradated scale to indicate performance. However, both groups stressed the importance of using non-stigmatising language in describing results. Several potential purposes of the report, including distinguishing cognitive versus other issues, explaining cognitive challenges, improving patient–provider interactions, guiding decision-making, improving functioning or preventing impairment and tracking cognitive function over time, were noted by the participants. Potential barriers, such as inadequate clinical staffing or time and lack of potential treatments for identified issues, were also discussed.ConclusionIn this exploratory study, we found that both patients with SLE and their providers were receptive to the idea of a patient-friendly report of cognitive test results. This study provides important information to guide future pragmatic research to optimise the delivery of cognitive information to patients with SLE.

scholarly journals 12-month incidence, prevalence, persistence, and treatment of mental disorders among individuals recently admitted to assisted living facilities in Maryland

2013 ◽  
Vol 25 (5) ◽  
pp. 721-731 ◽  
Author(s):  
Quincy M. Samus ◽  
Chiadi U. Onyike ◽  
Deirdre Johnston ◽  
Lawrence Mayer ◽  
Matthew McNabney ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Assisted Living ◽  
Cognitive Disorders ◽  
Cognitive Disorder ◽  
Incidence Rates ◽  
Direct Care ◽  
Care Staff ◽  
Care Practice ◽  
Longitudinal Impact ◽  
Incidence Prevalence

ABSTRACTBackground: To estimate the 12-month incidence, prevalence, and persistence of mental disorders among recently admitted assisted living (AL) residents and to describe the recognition and treatment of these disorders.Methods: Two hundred recently admitted AL residents in 21 randomly selected AL facilities in Maryland received comprehensive physician-based cognitive and neuropsychiatric evaluations at baseline and 12 months later. An expert consensus panel adjudicated psychiatric diagnoses (using DSM-IV-TR criteria) and completeness of workup and treatment. Incidence, prevalence, and persistence were derived from the panel's assessment. Family and direct care staff recognition of mental disorders was also assessed.Results: At baseline, three-quarters suffered from a cognitive disorder (56% dementia, 19% Cognitive Disorders Not Otherwise Specified) and 15% from an active non-cognitive mental disorder. Twelve-month incidence rates for dementia and non-cognitive psychiatric disorders were 17% and 3% respectively, and persistence rates were 89% and 41% respectively. Staff recognition rates for persistent dementias increased over the 12-month period but 25% of cases were still unrecognized at 12 months. Treatment was complete at 12 months for 71% of persistent dementia cases and 43% of persistent non-cognitive psychiatric disorder cases.Conclusions: Individuals recently admitted to AL are at high risk for having or developing mental disorders and a high proportion of cases, both persistent and incident, go unrecognized or untreated. Routine dementia and psychiatric screening and reassessment should be considered a standard care practice. Further study is needed to determine the longitudinal impact of psychiatric care on resident outcomes and use of facility resources.

scholarly journals Glioma surgery under awake condition can lead to good independence and functional outcome excluding deep sensation and visuospatial cognition

2018 ◽  
Vol 6 (5) ◽  
pp. 354-363 ◽  
Author(s):  
Riho Nakajima ◽  
Masashi Kinoshita ◽  
Hirokazu Okita ◽  
Tetsutaro Yahata ◽  
Mitsutoshi Nakada
Keyword(s):  
Functional Outcome ◽  
Cognitive Disorders ◽  
Chronic Phase ◽  
Recovery Process ◽  
Cognitive Disorder ◽  
Awake Surgery ◽  
Lower Grade ◽  
Glioma Surgery ◽  
Visuospatial Cognition ◽  
Neuropsychological Functions

Abstract Background Awake surgery for the eloquent cortex is a common strategy for glioma surgery. Although a recent emphasis has been placed on awake surgery both for dominant and nondominant cerebral hemispheres to preserve neurological/neuropsychological functions, those functional outcomes are not well investigated because few studies have focused on the longitudinal recovery process. This study explored the outcome of neurological/neuropsychological functions following awake surgery until the chronic phase. Methods A total of 87 patients with glioma who underwent awake surgery were included, and of these 66 patients matched our inclusion criteria. Each patient was assessed for neurological/neuropsychological functions before surgery, as well as acute and chronic phase. Additionally, scores for the KPS were collected. Results Almost all functions recovered within 3 months postoperatively, even when transient deficits were observed in the acute phase; however, deep sensory perception deficits and visuospatial cognitive disorders persisted into the chronic phase (15.4% of patients with parietal lesions, 14.3% of patients with right cerebral hemispheric lesion, respectively). KPS score ≥90 was achieved in 86.0% of patients with lower-grade glioma, whereas only 52.2% of glioblastoma patients scored ≥90. Primary causes of declined KPS were disorder of visuospatial cognition, sensorimotor function including deep sensation, aphasia, and emotional function. Conclusions Awake surgery leads to good functional outcome at the chronic phase of neurological/neuropsychological functions, except for deep sensory and visuospatial cognition. Because sensation and visuospatial cognitive disorder have major impacts on patients’ independence level, further importance should be placed on preserving these functions during surgery.

scholarly journals Digital Screening for Cognitive Impairment – A Proof of Concept Study

2021 ◽  
pp. 1-8
Author(s):  
V. Bloniecki ◽  
G. Hagman ◽  
M. Ryden ◽  
M. Kivipelto
Keyword(s):  
Cognitive Impairment ◽  
Neurodegenerative Disorder ◽  
Early Stage ◽  
Roc Curves ◽  
University Hospital ◽  
Cognitive Test ◽  
Test Time ◽  
Proof Of Concept ◽  
Cognitive Screening ◽  
Disease Modifying Drugs

Background: Due to an ageing demographic and rapid increase of cognitive impairment and dementia, combined with potential disease-modifying drugs and other interventions in the pipeline, there is a need for the development of accurate, accessible and efficient cognitive screening instruments, focused on early-stage detection of neurodegenerative disorders. Objective: In this proof of concept report, we examine the validity of a newly developed digital cognitive test, the Geras Solutions Cognitive Test (GCST) and compare its accuracy against the Montreal Cognitive Assessment (MoCA). Methods: 106 patients, referred to the memory clinic, Karolinska University Hospital, due to memory complaints were included. All patients were assessed for presence of neurodegenerative disorder in accordance with standard investigative procedures. 66% were diagnosed with subjective cognitive impairment (SCI), 25% with mild cognitive impairment (MCI) and 9% fulfilled criteria for dementia. All patients were administered both MoCA and GSCT. Descriptive statistics and specificity, sensitivity and ROC curves were established for both test. Results: Mean score differed significantly between all diagnostic subgroups for both GSCT and MoCA (p<0.05). GSCT total test time differed significantly between all diagnostic subgroups (p<0.05). Overall, MoCA showed a sensitivity of 0.88 and specificity of 0.54 at a cut-off of <=26 while GSCT displayed 0.91 and 0.55 in sensitivity and specificity respectively at a cut-off of <=45. Conclusion: This report suggests that GSCT is a viable cognitive screening instrument for both MCI and dementia.

scholarly journals Use and understanding of functional cognitive disorder terminology in United Kingdom clinical practice - a survey

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S277-S277
Author(s):  
Alexandra Nash ◽  
Jon Stone ◽  
Alan Carson ◽  
Craig Ritchie ◽  
Laura McWhirter
Keyword(s):  
United Kingdom ◽  
Cognitive Impairment ◽  
Clinical Practice ◽  
Mild Cognitive Impairment ◽  
Old Age ◽  
Cognitive Disorders ◽  
Cognitive Disorder ◽  
Cognitive Symptoms ◽  
Case Study Methodology ◽  
Case Vignettes

AimsThis study aimed to explore the terms used by old-age psychiatrists and psychologists to describe subjective and mild cognitive impairment and functional cognitive disorders (FCD) in clinical practice.MethodParticipants were selected from across the United Kingdom based on their clinical involvement in the assessment of cognitive complaints. 9 old-age psychiatrists and 4 psychologists were interviewed about their use of terminology in clinical practice and their awareness and understanding of FCD terminology via semi-structured interview questions and case vignettes. Interviews were conducted between December 2020 and February 2021 using online platforms Zoom and Microsoft Teams. Participants were recruited by email and Twitter. All questions were asked verbally; however, the four case vignettes were displayed via screen-share. All discussions and answers were transcribed and transcripts were coded manually using the exploratory case study methodology in order to identify themes in participants’ responses.ResultThis study has highlighted the variable use of terms used to describe and diagnose patients presenting with symptoms of cognitive disorders. The terms ‘mild cognitive impairment’, ‘subjective cognitive decline’ and ‘functional cognitive disorder’ were used most commonly amongst participants, though the terms ‘subjective cognitive impairment’ and ‘pseudodementia’ were also presented. This theme of language discontinuity is underscored by participants’ varying use of terminology when describing or presenting their diagnoses for the case vignettes. The data also reveals a sub-theme of variability in application of the term FCD. Whilst all participants gave similar definitions for this term, the application of FCD as a diagnosis in practice was inconsistent. Six participants described FCD as associated with or secondary to other functional or psychiatric conditions, four participants viewed FCD as an isolated diagnosis, and one participant considered FCD to be either part of another illness or a separate diagnosis. Two participants neither used nor recognised the term FCD.ConclusionIt is evident that there is varied use of terms describing or diagnosing forms of cognitive symptoms. The findings of this study highlight the need for a clear, adoptable definition of FCD in practice as well as implementable management plans for FCD patients. This is critical in order to avoid misdiagnosis and mismanagement, which may have harmful effects on patients living with debilitating cognitive symptoms.

Assessment of cognitive impairment with the cognitive assessment interview (CAI) was useful for identifying poor psychosocial functioning outcome in patients with psychosis

2016 ◽  
Vol 33 (S1) ◽  
pp. S106-S107
Author(s):  
A. Sánchez-Torres ◽  
M.R. Elosúa ◽  
R. Lorente-Omeñaca ◽  
L. Moreno-Izco ◽  
V. Peralta ◽  
...  
Keyword(s):  
Social Cognition ◽  
Cognitive Functioning ◽  
Verbal Memory ◽  
Psychosocial Functioning ◽  
Cognitive Assessment ◽  
Daily Functioning ◽  
Everyday Functioning ◽  
Cognitive Domains ◽  
Assessment Interview ◽  
Competing Interest

IntroductionCognitive impairments clearly impact the daily functioning of patients with psychosis.ObjectivesTo assess cross-sectionally whether there are differences in the cognitive domains assessed with the CAI, for considering the real-world functioning of a sample of patients with psychosis.MethodsThe sample consisted of 76 patients with a DSM-IV psychotic disorder. Patients were assessed with the cognitive assessment interview (CAI), which is an interview-based measure of cognitive functioning that is intermediate between cognitive functioning and daily functioning, and three subscales of the specific levels of functioning (SLOF), an informant-rated measure of functioning. The CAI was used to assess the patient and an informant, and these scores were integrated into a rater composite score. We divided the sample by a median-split procedure for each of the three functional domains, and then applied ANOVAs to compare the two groups (impaired/not impaired) in the six cognitive domains of the CAI: working memory, attention, verbal memory, problem solving, processing speed, and social cognition.ResultsWe found significant differences between the impaired vs. non-impaired groups in most of the cognitive domains assessed with the CAI (Fig. 1).ConclusionsInterview-based assessment of cognition with the CAI allows for the prediction of everyday functioning in patients with psychosis. Impairment in almost all CAI cognitive domains, except for social cognition, was associated with poorer psychosocial functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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