Screening for Dementia in Primary Care: A Comparison of the GPCOG and the MMSE

2016 ◽  
Vol 42 (5-6) ◽  
pp. 323-330 ◽  
Author(s):  
Henry Brodaty ◽  
Michael H. Connors ◽  
Clement Loy ◽  
Armando Teixeira-Pinto ◽  
Nigel Stocks ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Mental Disorders ◽  
Mini Mental State Examination ◽  
Screening Tool ◽  
The Elderly ◽  
Cognitive Test ◽  
Effective Screening ◽  
State Examination ◽  
Higher Sensitivity

Background/Aims: The General Practitioner Assessment of Cognition (GPCOG) is a brief cognitive test. This study compared the GPCOG to the Mini-Mental State Examination (MMSE), the most widely used test, in terms of their ability to detect likely dementia in primary care. Methods: General practitioners across three states in Australia recruited 2,028 elderly patients from the community. A research nurse administered the GPCOG and the MMSE, as well as the Cambridge Examination for Mental Disorders of the Elderly Cognitive Scale-Revised that we used to define likely dementia. Results: Overall, the GPCOG and the MMSE were similarly effective at detecting likely dementia. The GPCOG, however, had a higher sensitivity than the MMSE when using published cutpoints. Conclusion: The GPCOG is an effective screening tool for dementia in primary care. It appears to be a viable alternative to the MMSE, whilst also requiring less time to administer.

Mental Status and Neuropsychological Assessment: Discussion

1997 ◽  
Vol 9 (S1) ◽  
pp. 143-150
Author(s):  
Alistair Burns
Keyword(s):  
Primary Care ◽  
General Practitioner ◽  
Mini Mental State Examination ◽  
American Family ◽  
The Core ◽  
The Usa ◽  
The Individual ◽  
High Level ◽  
State Examination ◽  
Quantitative Assessments

Ham: There seems to be an astonishing range of expectation from this group as to what a general practitioner (GP) will do for his or her patients, ranging from screening only through to being the primary manager. I feel that we are expecting a fairly high level of sophistication from the GPs within an average British, Canadian, or American family practice. I think we need to be aware that, for some time, the core recommendation in the USA has been to assess the patient using the Mini-Mental State Examination (MMSE) or the Clock Test and perhaps two or three other quantitative assessments. Noncognitive features, such as behavior, are harder to quantify and the individual who assesses them must be the patient's primary manager. It will increasingly happen in the USA that as care becomes more managed, a greater emphasis will be put upon primary care.

Validity of the Elderly Behavior Assessment for Relatives (EBAR)

2000 ◽  
Vol 16 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Lina Pezzuti ◽  
Caterina Laicardi ◽  
Marco Lauriola
Keyword(s):  
Cognitive Functioning ◽  
Mini Mental State Examination ◽  
Rating Scale ◽  
Good Health ◽  
The Elderly ◽  
Behavior Assessment ◽  
Elderly Persons ◽  
Behavior Rating Scale ◽  
Components Analysis ◽  
State Examination

Summary: An Elderly Behavior Assessment for Relatives (EBAR), updating the GERRI ( Schwartz, 1983 ), was administered to relatives (or significant others) of 349 elderly persons, from 60 to over 80 years of age, living at home, in good health and without cognitive impairment. A trained psychologist administered subjects the Life Satisfaction for Elderly Scale (LSES), the Instrumental Activity of Daily Living (IADL), the Mini Mental State Examination (MMSE), and personally answered to an overall elderly behavior rating scale (RA). EBAR items were first examined. The more attractive and less discriminative statements were excluded. A principal components analysis was carried out on the remaining EBAR items. Three factors were extracted. After varimax rotation they were tentatively labeled: Everyday Cognitive Functioning, Depression, and Hostility. Factor-driven EBAR subscales were designed, taking into account simpler items in the factor matrix. Results provide evidence for EBAR construct validity. Everyday Cognitive Functioning is connected to the IADL and the RA scores; Depression is very highly related to the LSES; Hostility is weakly related to RA, IADL, and MMSE, indicating that the scale needs further investigation.

scholarly journals Can the MMSE help clinicians predict progression from mild cognitive impairment to dementia?

2015 ◽  
Vol 21 (6) ◽  
pp. 363-366 ◽  
Author(s):  
Alex J. Mitchell
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Risk Prediction ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Case Finding ◽  
Cognitive Test ◽  
Prediction Tool ◽  
State Examination

SummaryThe Mini-Mental State Examination (MMSE) is the most widely used bedside cognitive test. It has previously been shown to be poor as a case-finding tool for both dementia and mild cognitive impairment (MCI). This month's Cochrane Corner review examines whether the MMSE might be used as a risk prediction tool for later dementia in those with established MCI. From 11 studies of modest quality, it appears that the MMSE alone should not be relied on to predict later deterioration in people with MCI. As this is the case, it is likely that only a combination of predictors would be able to accurately predict progression from MCI to dementia.

scholarly journals Impairments in balance and mobility identify delirium in patients with comorbid dementia

2018 ◽  
Vol 31 (5) ◽  
pp. 749-753 ◽  
Author(s):  
Neus Gual ◽  
Sarah J. Richardson ◽  
Daniel H. J. Davis ◽  
Giuseppe Bellelli ◽  
Wolfgang Hasemann ◽  
...  
Keyword(s):  
Motor Function ◽  
Mini Mental State Examination ◽  
The Elderly ◽  
Motor Dysfunction ◽  
Cross Sectional ◽  
Dsm 5 ◽  
Hierarchical Assessment ◽  
State Examination ◽  
Rehabilitation Hospitals ◽  
Delirium Superimposed On Dementia

ABSTRACTDiagnosing delirium superimposed on dementia (DSD) remains challenging because of a lack of specific tools, though motor dysfunction in delirium has been relatively under-explored. This study aimed to use dysfunction in balance and mobility (with the Hierarchical Assessment of Balance And Mobility: HABAM) to identify DSD. This is a cross-sectional multicenter study, recruiting consecutive patients ≥70 years admitted to five acute or rehabilitation hospitals in Ireland, Italy, Portugal, and Switzerland. Delirium was diagnosed using DSM-5 criteria; dementia was determined by the Mini-Mental State Examination and the Questionnaire of Cognitive Decline in the Elderly. HABAM score was recorded at admission. Out of 114 patients (mean age ± SD = 82 ± 7; 54% female), dementia alone was present in 24.6% (n = 28), delirium alone in 18.4% (n = 21) and DSD in 27.2% (n = 31). Patients with DSD had a mean HABAM score 7 points greater than those with dementia alone (19.8 ± 8.7 vs 12.5 ± 9.5; p < 0.001); 70% of participants with DSD were correctly identified using the HABAM at a cut off of 22 (sensitivity 61%, specificity 79%, AUC = 0.76). Individuals with delirium have worse motor function than those without delirium, even in the context of comorbid dementia. Measuring motor function using the HABAM in older people at admission may help to diagnose DSD.

The Elderly Expectations of the Caregiver’s Sociodemographic Preferences: a Qualitative Approach

2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Sharon Gondodiputro ◽  
Dahlia Santika Hutasoit ◽  
Lina Rahmiati
Keyword(s):  
Mental State ◽  
Mini Mental State Examination ◽  
Family Members ◽  
The Elderly ◽  
Health Issues ◽  
Inclusion Criteria ◽  
Community Volunteer ◽  
The Family ◽  
Interview Guide ◽  
State Examination

Prevalence of chronic diseases and disability will increase at the advancing age. In the future, the need for the caregiver will increase. Only few studies about the expectations of the elderly towards the sociodemographics status of the caregiver found. Unfulfilled expectations of the elderly towards their caregivers may cause both health and non-health issues. The purpose of this study was to explore the elderly expectations of the caregiver’s sociodemographic preferences. A qualitative study was carried out to 7 elderly aged 64–77 years old from July to August 2018 in Bandung city. These elderly selected from 7 integrated care posts (pos pembinaan terpadu/posbindu) that met the inclusion criteria: aged 60 years old and above; male or female; capable of communicating adeptly, and no dementia by undergoing the mini-mental state examination (MMSE). A one-on-one interview was conducted at the residence of the elderly using an interview guide consisted of several opened questions related to the caregiver’s sociodemographic preferences. A content analysis was carried out. This study discovered that the elderly preferred their family members or relatives whom they can trust to become their caregivers (their children and grandchildren). Most of these elderly also preferred daughters who live with them and has a decent income. If the family members could not become their caregiver then their neighbor or a community volunteer/cadre, they knew well, and trust to be their caregiver. It concluded that the elderly prefer their daughters who live with them and has a decent income to be their caregivers. EKSPEKTASI USIA LANJUT TERHADAP STATUS SOSIODEMOGRAFI CAREGIVER: SUATU PENDEKATAN KUALITATIFPrevalensi penyakit kronis dan disablilitas akan meningkat dengan pertambahan usia. Hal ini berdampak pada kebutuhan terhadap caregiver akan meningkat pula. Penelitian tentang ekspektasi usia lanjut terhadap status sosiodemografi caregiver belum banyak dilakukan. Ekspektasi usia lanjut merupakan faktor penting karena bila ekspektasi tersebut tidak terpenuhi maka akan berisiko timbul masalah kesehatan dan nonkesehatan. Tujuan penelitian ini mengeksplorasi ekspektasi usia lanjut terhadap status sosiodemografi caregiver. Studi kualitatif dilakukan terhadap 7 orang usia lanjut berusia 64–77 tahun pada Juli hingga Agustus 2018 di Kota Bandung. Para usia lanjut berasal dari 7 pos pembinaan terpadu (posbindu) yang memenuhi kriteria inklusi, yaitu usia ≥60 tahun, laki-laki atau perempuan, dapat berkomunikasi dengan baik, dan tidak demensia dengan dilakukan mini-mental state examination (MMSE). Wawancara dilakukan di kediaman informan masing-masing menggunakan panduan wawancara terkait pertanyaan dengan preferensi sosiodemografi caregiver. Analisis konten dilakukan. Studi ini menemukan bahwa usia lanjut lebih memilih anggota keluarga mereka yang dapat dipercaya untuk menjadi caregiver terutama anak dan cucu. Anak perempuan yang tinggal bersama usia lanjut dan memiliki penghasilan layak menjadi pilihan utama. Jika anggota keluarga tidak dapat menjadi caregiver maka tetangga atau kader yang mereka kenal baik dan dipercaya menjadi pilihan. Simpulan, pilihan utama caregiver bagi usia lanjut, yaitu anak perempuan mereka yang tinggal bersama dan memiliki penghasilan layak.

Prestroke Physical Activity and Poststroke Cognitive Performance

2020 ◽  
Vol 49 (6) ◽  
pp. 632-638
Author(s):  
Andreas Gammelgaard Damsbo ◽  
Janne Kaergaard Mortensen ◽  
Kristian Lundsgaard Kraglund ◽  
Søren Paaske Johnsen ◽  
Grethe Andersen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cognitive Impairment ◽  
Functional Outcome ◽  
Cognitive Performance ◽  
Mini Mental State Examination ◽  
The Elderly ◽  
Protective Measure ◽  
Multivariable Analyses ◽  
State Examination ◽  
Physical Activity Scale

<b><i>Introduction:</i></b> Physical activity (PA) is associated with a lower risk of stroke and stroke mortality as well as a favorable stroke outcome. PA may also prevent general cognitive decline. Poststroke cognitive impairment is both common and disabling, and focusing on all possible preventive measures is important. Studies on the effect of PA on poststroke cognitive performance are sparse, however. We therefore aimed to examine the association between prestroke PA and poststroke cognitive performance. <b><i>Methods:</i></b> We studied the correlation between prestroke PA and poststroke cognitive performance in a prespecified analysis in The Efficacy of Citalopram Treatment in Acute Ischemic Stroke (TALOS) trial. We used the Physical Activity Scale for the Elderly (PASE) to collect information on PA during the 7-day period before stroke. PA was quantified, and patients were stratified into quartiles based on their PASE score. Cognitive performance was measured using the Symbol Digit Modalities Test (SDMT) at 1 and 6 months and the Mini-Mental State Examination (MMSE) at 6 months. The functional outcome was assessed using the modified Rankin Scale (mRS). <b><i>Results:</i></b> In total, 625 of 642 patients (97%) completed the PASE questionnaire. The median age was 69 (interquartile range [IQR]: 60–77), and the median PASE score was 137 (82–205). Higher prestroke PASE quartiles (2nd, 3rd, and 4th, each compared to the 1st) were independently associated with a higher SDMT score at 1 month in the both the univariable and multivariable analyses (2nd: 3.99 points, 95% confidence interval [CI]: 1.01–6.97; 3rd: 3.6, CI: 0.6–6.61; 4th: 4.1, CI: 0.95–7.24). This association remained at 6 months. PA was not statistically associated with the MMSE score or mRS. <b><i>Conclusion:</i></b> Higher prestroke PA was associated with a better cognitive performance as measured by the SDMT at 1 and 6 months poststroke. We found no significant association between prestroke PA and functional outcome. Our results are encouraging and support further investigations of PA as a protective measure against poststroke cognitive impairment.

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