scholarly journals Modifying the Mini-Cog to Screen for Cognitive Impairment in Nonliterate Individuals

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Shambhu P. Adhikari ◽  
Rubee Dev ◽  
Soo Borson
Keyword(s):  
Cognitive Impairment ◽  
Rating Scale ◽  
Family Members ◽  
Screening Tools ◽  
Word Recall ◽  
Group Differences ◽  
Chi Square ◽  
Clock Drawing Test ◽  
Severity Rating ◽  
Cultural Exposure

Objectives. The Mini-Cog, a rapid, valid, and reliable screening tool for cognitive impairment, consists of 3-word recall and an executive clock drawing test (CDT). However, CDT requires at least basic literacy and cultural exposure to analog clocks, conditions not met in many population groups around the world. We developed a modification of the Mini-Cog (MMC) for use with nonliterate and literate individuals. Methods. Participants were adults (≥60 years) with no neurological diagnosis, with known cognitive impairment due to stroke, Parkinsonism, traumatic brain injury, or Alzheimer’s disease, and whose family members were able to read and write. We replaced the CDT with two tasks of everyday life: a serial subtraction task or a multistep performance task. Family members rated the acceptability and feasibility of the Mini-Cog versions using a 6-point scale and completed a proxy-rated cognitive staging tool, the Dementia Severity Rating Scale (DSRS). Spearman’s rho, Mann-Whitney U , and chi-square tests were used to evaluate group differences and associations between measures. Results. Data were collected from 63 participants ( 75 % ≥ 60   years , 67% nonliterate). Literacy was associated with CDT (chi-square strength 0.9, p < 0.001 ). Both MMC versions correlated with DSRS in healthy adults and patients (rho 0.6-0.7, p < 0.05 ). In literate individuals, the acceptability and feasibility of CDT and both alternate distractors were similarly high (5/6). Conclusions. Two alternate distractor tasks may successfully replace CDT in the Mini-Cog. The MMC versions are promising and deserve further study as screening tools for cognitive impairment in larger and more fully characterized samples.

scholarly journals Modifying the Mini Cog to Screen for Cognitive Impairment in Non-literate Individuals

2021 ◽  
Author(s):  
Shambhu Prasad Adhikari ◽  
Rubee Dev ◽  
Soo Borson
Keyword(s):  
Cognitive Impairment ◽  
Rating Scale ◽  
Family Members ◽  
Screening Tools ◽  
Word Recall ◽  
Group Differences ◽  
Chi Square ◽  
Clock Drawing Test ◽  
Severity Rating ◽  
Cultural Exposure

Abstract Objectives: The Mini-Cog, a rapid, valid, and reliable screening tool for cognitive impairment, consists of 3-word recall and an executive Clock-Drawing Test (CDT). However, CDT requires at least basic literacy and cultural exposure to analog clocks, conditions not met in many population groups around the world. We developed a modification of the Mini-Cog (MMC) for use with non-literate and literate individuals. Methods: Participants were adults (≥ 60 years) with no neurological diagnosis, with known cognitive impairment due to stroke, Parkinsonism, traumatic brain injury or Alzheimer’s disease, and whose family members were able to read and write. We replaced the CDT with two tasks of everyday life: a serial subtraction task or a multistep performance task. Family members rated the acceptability and feasibility of the Mini-Cog versions using a 6-point scale, and completed a proxy-rated cognitive staging tool, the Dementia Severity Rating Scale (DSRS). Spearman’s rho, Mann- Whitney U and Chi-square tests were used to evaluate group differences and associations between measures. Results: Data were collected from 63 participants (75% ≥ 60 years, 67% non-literate). Literacy was associated with CDT (Chi-square strength 0.9, p < 0.001). Both MMC versions correlated with DSRS in healthy adults and patients (rho 0.6-0.7, p < 0.05). In literate individuals, the acceptability and feasibility of CDT and both alternate distractors were similarly high (5/6). Conclusions: Two alternate distractor tasks may successfully replace CDT in the Mini-Cog. The MMC versions are promising and deserve further study as screening tools for cognitive impairment in larger and more fully characterized samples.

Frailty, with or without Cognitive Impairment, is a Strong Predictor of Recurrent Falls in a US Population-Representative Sample of Older Adults

2021 ◽  
Author(s):  
Mei-Ling Ge ◽  
Eleanor M Simonsick ◽  
Bi-Rong Dong ◽  
Judith D Kasper ◽  
Qian-Li Xue
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Strong Predictor ◽  
Word Recall ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Clock Drawing Test ◽  
Recurrent Falls ◽  
Health Aging ◽  
Marginal Means

Abstract Background Physical frailty and cognitive impairment have been separately associated with falls. The purpose of the study is to examine the associations of physical frailty and cognitive impairment separately and jointly with incident recurrent falls among older adults. Methods The analysis included 6000 older adults in community or non-nursing home residential care settings who were ≥65 years and participated in the National Health Aging Trends Study (NHATS). Frailty was assessed using the physical frailty phenotype; cognitive impairment was defined by bottom quintile of clock drawing test or immediate and delayed 10-word recall, or self/proxy-report of diagnosis of dementia, or AD8 score≥ 2. The marginal means/rates models were used to analyze the associations of frailty (by the physical frailty phenotype) and cognitive impairment with recurrent falls over 6 years follow-up (2012-2017). Results Of the 6000 older adults, 1,787 (29.8%) had cognitive impairment only, 334 (5.6%) had frailty only, 615 (10.3%) had both, and 3,264 (54.4%) had neither. After adjusting for age, sex, race, education, living alone, obesity, disease burden, and mobility disability, those with frailty (with or without cognitive impairment) at baseline had higher rates of recurrent falls than those without cognitive impairment and frailty (frailty only: Rate ratio (RR)=1.31, 95% confidence interval (CI)=1.18-1.44; both: RR=1.28, 95% CI=1.17-1.40). The association was marginally significant for those with cognitive impairment only (RR=1.07, 95% CI=1.00-1.13). Conclusions Frailty and cognitive impairment were independently associated with recurrent falls in non-institutionalized older adults. There was a lack of synergistic effect between frailty and cognitive impairment.

A Metabolic Imaging Severity Rating Scale for the Assessment of Cognitive Impairment

2003 ◽  
Vol 28 (7) ◽  
pp. 565-570 ◽  
Author(s):  
ANDREW NEWBERG ◽  
ADOLFO COTTER ◽  
MICHELLE UDESHI ◽  
ABASS ALAVI ◽  
CHRISTOPHER CLARK
Keyword(s):  
Cognitive Impairment ◽  
Rating Scale ◽  
Metabolic Imaging ◽  
Severity Rating

scholarly journals Test the Best: Classification Accuracies of Four Cognitive Rating Scales for Parkinson’s Disease Mild Cognitive Impairment

2020 ◽  
Vol 35 (7) ◽  
pp. 1069-1077
Author(s):  
Adela Fendrych Mazancova ◽  
Evžen Růžička ◽  
Robert Jech ◽  
Ondrej Bezdicek
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Rating Scales ◽  
Rating Scale ◽  
Screening Tools ◽  
Cutoff Score ◽  
Neuropsychological Battery ◽  
Mattis Dementia Rating Scale

Abstract Objective A progressive cognitive impairment is one of the frequent non-motor symptoms during Parkinson’s disease (PD) course. A short and valid screening tool is needed to detect an incipient cognitive deficit at the mild cognitive impairment stage in Parkinson’s disease (PD–MCI). Method The present study aims to evaluate the classification accuracies of four cognitive screenings: Montreal Cognitive Assessment (MoCA), Mattis Dementia Rating Scale second edition (DRS–2), Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) in a cohort of PD patients (PD–MCI, n = 46; and Parkinson’s disease with normal cognition, PD-NC, n = 95) and Controls (n = 66). All subjects underwent a standard neuropsychological battery as recommended by the International Parkinson and Movement Disorder Society and underwent all four screening tools. Results In the detection of PD-MCI versus PD-NC, the MoCA showed a sensitivity of 84% and a specificity of 66% with a screening cutoff score at ≤25 points. The MoCA’s AUC was 86% (95% CI 78.7–93.1). In the detection of PD-MCI versus Controls, the FAB displayed 84% sensitivity and 79% specificity with a cutoff ≤16 points, to screen. The FAB’s AUC was 87% (79.0–95.0). Conclusions Our results show that the MoCA is the most discriminative tool for screening MCI in the PD population.

scholarly journals Correlation Between Aphasia in Stroke Patients and Severe Depression of Family Members as Primary Caregivers.

Medicinus ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 94
Author(s):  
Pricilla Yani Gunawan ◽  
Kalista Ardelia Iswara
Keyword(s):  
Major Depression ◽  
Rating Scale ◽  
Family Members ◽  
Depression Scale ◽  
Severe Depression ◽  
Stroke Patients ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Analysis ◽  
Taking Care

<p><strong>Background and Objective: </strong>Stroke is a disease with an increasing annual prevalence. One of the most frequent clinical manifestation seen in stroke patients is aphasia which greatly affects the patient’s ability to communicate. The burden and the pressure of taking care of the patient placed on the family members often results in psychological impacts such as depression.  We intend to know the association between aphasia in stroke patients with severe depression on family members. </p><p><strong>Methodology:</strong> This was a cross sectional study, using an unpaired categorical comparative analysis. Inclusion criteria were family members of patients with and without aphasia. Patients and caregivers who gave their consent verbally were guided to fill in the Hamilton Depression Rating Scale questionnaire. The association between aphasia status and the depression scale was analyzed using Chi-Square.</p><p><strong>Results:  </strong>Out of 54 respondents included in the study, there were 25 caregivers (46,3%) taking care stroke patients without aphasia, and 29 caregivers (53,7) taking care stroke patients with aphasia. As much as35 (64.8%) were categorized as normal- moderate level of depression and 19 (35.2%) categorized as major depression. From those with major depression, 14 (73.7%) were found in the aphasic group and 5 were in the non-aphasia group. Chi-Square analysis shows a significant correlation [P=0.03; OR=3.73 (1.1-12.7)] between aphasia in stroke patients and severe depression of the caregivers.</p><p><strong>Conclusion: </strong>There is a significant association between aphasia in stroke patients and the incidence of severe depression on their caregivers.</p>

A 2-min cognitive screener for predicting 1-year functional recovery and survival in older adults after hip fracture repair

2021 ◽  
Author(s):  
Sileno de Queiroz Fortes-Filho ◽  
Márlon Juliano Romero Aliberti ◽  
Juliana de Araújo Melo ◽  
Daniel Apolinario ◽  
Maria do Carmo Sitta ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Hip Fracture ◽  
Functional Recovery ◽  
Cognitive Assessment ◽  
Older Patients ◽  
Fracture Repair ◽  
Screening Tools ◽  
Hip Surgery ◽  
Word Recall ◽  
Risk Of Death

Abstract Background Implementing cognitive assessment in older people admitted to hospital with hip fracture – lying in bed, experiencing pain – is challenging. We investigated the value of a quick and easy-to-administer 10-point cognitive screener (10-CS) in predicting 1-year functional recovery and survival after hip surgery. Methods Prospective cohort study comprising 304 older patients (mean age=80.3±9.1 years; women=72%) with hip fracture consecutively admitted to a specialized academic medical center that supports secondary hospitals in Sao Paulo Metropolitan Area, Brazil. The 10-CS, a 2-minute bedside tool including temporal orientation, verbal fluency, and three-word recall, classified patients as having normal cognition, possible cognitive impairment, or probable cognitive impairment on admission. Outcomes were time-to-recovery activities of daily living (ADLs; Katz index) and mobility (New Mobility Score), and survival during 1-year after hip surgery. Hazard models, considering death as a competing risk, were used to associate the 10-CS categories with outcomes after adjusting for sociodemographic and clinical measures. Results On admission, 144 (47%) patients had probable cognitive impairment. Compared to those cognitively normal, patients with probable cognitive impairment presented less postsurgical recovery of ADLs (77% vs. 40%; adjusted sub-hazard ratio [HR]=0.44; 95%CI=0.32-0.62) and mobility (50% vs. 30%; adjusted sub-HR=0.52; 95%CI=0.34-0.79), and higher risk of death (15% vs. 40%; adjusted HR=2.08; 95%CI=1.03-4.20) over 1-year follow-up. Conclusions The 10-CS is a strong predictor of functional recovery and survival after hip fracture repair. Cognitive assessment using quick and easy-to-administer screening tools like 10-CS can help clinicians make better decisions and offer tailored care for older patients admitted with hip fracture.

Nonlinguistic Cognitive Impairment in Poststroke Aphasia

2013 ◽  
Vol 28 (3) ◽  
pp. 273-281 ◽  
Author(s):  
Hanane El Hachioui ◽  
Evy G. Visch-Brink ◽  
Hester F. Lingsma ◽  
Mieke W. M. E. van de Sandt-Koenderman ◽  
Diederik W. J. Dippel ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Visual Perception ◽  
Functional Outcome ◽  
Visual Memory ◽  
Rating Scale ◽  
Cognitive Impairments ◽  
Cognitive Domain ◽  
First Year ◽  
Abstract Reasoning ◽  
Severity Rating

Background and objectives. Information on cognitive impairment in aphasic patients is limited. Our aim was to investigate the prevalence and course of nonlinguistic cognitive impairments in the first year after stroke and their association with aphasia and functional outcome. Methods. We included 147 patients with acute aphasia. At 3 months and 1 year, we assessed cognition with a nonlinguistic cognitive examination including abstract reasoning, visual memory, visual perception and construction, and executive functioning. We assessed language with a verbal communication rating (Aphasia Severity Rating Scale), the ScreeLing (a linguistic-level screening test), and the Token Test. We evaluated functional outcome with the modified Rankin scale and registered the use of antidepressants. Results. In total, 107 (88%) patients had impairments in at least one nonlinguistic cognitive domain at 3 months and 91 (80%) at 1 year. The most frequently observed impairment concerned visual memory (83% at 3 months; 78% at 1 year) and the least frequent visual perception and construction (19% at 3 months; 14% at 1 year). There was improvement on all cognitive domains including language, except for abstract reasoning. Patients with persisting aphasia had lower cognitive domain scores, worse functional outcome, and were more often depressed than patients who had recovered from aphasia. Conclusions. Standard nonlinguistic cognitive examination is recommended in aphasic stroke patients. Nonlinguistic cognitive impairments are common and associated with poor functional outcome and depression, especially in patients with persisting aphasia.

scholarly journals Evaluating the Validity of the Columbia-Suicide Severity Rating Scale for Lonely Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 925-925
Author(s):  
Jacqueline Mai ◽  
Emily Bower ◽  
Kimberly Van Orden
Keyword(s):  
Older Adults ◽  
Suicide Attempt ◽  
Suicide Risk ◽  
Suicide Ideation ◽  
Rating Scale ◽  
Controlled Trial ◽  
Screening Tools ◽  
Exclusion Criteria ◽  
Severity Rating ◽  
The Past

Abstract The risk of suicide death represents a significant problem facing older adults. They are less likely to disclose suicidal ideation (SI) and more likely to die from a suicide attempt compared to younger populations. Accurate screening tools for suicide risk are necessary to identify high-risk individuals who could benefit from intervention. The Columbia-Suicide Severity Rating Scale (C-SSRS), considered the gold standard for clinician-administered suicide risk assessments, was not developed for use with older adults. The purpose of this investigation is to evaluate the C-SSRS’s sensitivity in capturing previous suicidal behavior (behavior subscale) and current intent (severity subscale), both of which are highly predictive of suicide in older adults. 105 adults 60 years and older (M=72.10, SD=9.16; 68.6% female) who endorsed loneliness or feeling like a burden in the past two weeks were enrolled in a larger controlled trial and completed baseline C-SSRS, Quick Inventory of Depressive Symptoms (QIDS), and Geriatric Suicide Ideation Scale (GSIS). Exclusion criteria included significant cognitive impairment. Concurrent validity will be evaluated using random-effects mixed linear regression to test associations between C-SSRS scores and GSIS and QIDS scores, respectively. Baseline responses indicate that 14.9% of participants reported at least one lifetime suicide attempt. Within the last month, 66.7% wished to be dead, 20% had active SI without a plan, 6.7% had active SI with some intent to act, and 6.7% had active SI with a specific plan and intent. Findings from this project will help guide safety assessment recommendations and inform interventions targeting older adult suicide risk.

scholarly journals Diffusion MRI Indices and their Relation to Cognitive Impairment in Brain Aging: The updated multi-protocol approach in ADNI3

2018 ◽  
Author(s):  
Artemis Zavaliangos-Petropulu ◽  
Talia M. Nir ◽  
Sophia I. Thomopoulos ◽  
Robert I. Reid ◽  
Matt A. Bernstein ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
White Matter ◽  
Rating Scale ◽  
Brain Aging ◽  
Screening Tools ◽  
Disease Assessment ◽  
Clinical Impairment ◽  
Clinical Measures

AbstractBrain imaging with diffusion-weighted MRI (dMRI) is sensitive to microstructural white matter changes associated with brain aging and neurodegeneration. In its third phase, the Alzheimer’s Disease Neuroimaging Initiative (ADNI3) is collecting data across multiple sites and scanners using different dMRI acquisition protocols, to better understand disease effects. It is vital to understand when data can be pooled across scanners, and how the choice of dMRI protocol affects the sensitivity of extracted measures to differences in clinical impairment. Here, we analyzed ADNI3 data from 317 participants (mean age: 75.4±7.9 years; 143 men/174 women), who were each scanned at one of 47 sites with one of six dMRI protocols using scanners from three different manufacturers. We computed four standard diffusion tensor imaging (DTI) indices including fractional anisotropy (FADTI) and mean, radial, and axial diffusivity, and one FA index based on the tensor distribution function (FATDF), in 24 bilaterally averaged white matter regions of interest. We found that protocol differences significantly affected dMRI indices, in particular FADTI. We ranked the diffusion indices for their strength of association with four clinical assessments. In addition to diagnosis, we evaluated cognitive impairment as indexed by three commonly used screening tools for detecting dementia and Alzheimer’s disease: the Alzheimer’s Disease Assessment Scale (ADAS-cog), the Mini-Mental State Examination (MMSE), and the Clinical Dementia Rating scale sum-of-boxes (CDR-sob). Using a nested random-effects model to account for protocol and site, we found that across all dMRI indices and clinical measures, the hippocampal-cingulum and fornix (crus) / stria terminalis regions most consistently showed strong associations with clinical impairment. Overall, the greatest effect sizes were detected in the hippocampal-cingulum and uncinate fasciculus for associations between axial or mean diffusivity and CDR-sob. FATDF detected robust widespread associations with clinical measures, while FADTI was the weakest of the five indices for detecting associations. Ultimately, we were able to successfully pool dMRI data from multiple acquisition protocols from ADNI3 and detect consistent and robust associations with clinical impairment and age.

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