Abstract 220: Comparison of 3 Cognitive Exams in Cardiac Arrest Survivors

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Allison Koller ◽  
Jon Rittenberger ◽  
Patrick Morgan ◽  
Melissa Repine ◽  
Jeffrey Kristan ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Cognitive Testing ◽  
Percentile Score ◽  
Pairwise Correlations ◽  
The Mean ◽  
Highly Correlated ◽  
Alpha Error

Background: Cognitive deficits may detract from quality of life after cardiac arrest (CA). The pattern and prevalence of these deficits are not well documented. We used the Computer Assessment of Mild Cognitive Impairment (CAMCI), the Montreal Cognitive Assessment (MOCA) and the 41 Cent Test to assess cognitive impairment in survivors of CA. We hypothesized that CAMCI subscales and other scores that were highly correlated could identify specific domains of impairment in CA survivors. Methods: Four researchers administered the CAMCI, MOCA, and/or the 41 Cent Test to CA survivors after discharge from the intensive care unit between 2010 and 2014. Physicians screened patients with the Mini-Mental State Exam to determine when this cognitive testing was feasible. We compared the distribution of scores between patients who presented with coma and those who awoke immediately after CA. Pairwise correlations between the different subscales and tests were considered significant with alpha error of 0.05. Results: Ninety-two participants completed the CAMCI, of which 18 participants completed the CAMCI, MOCA and 41 Cent Test. The mean (SD) percentile score for CAMCI was 32.2 (20.3) out of possible 100, for the MOCA was 20.3 (5.2) out of a possible 30 points and the 41 Cent Test was 5.4 (1.1) out of a possible 7 points. MOCA correlated strongly with the overall CAMCI score (r = 0.82) and with the executive accuracy subscale of the CAMCI (r = 0.75). The executive accuracy subscale and overall CAMCI score correlated with one another (r = 0.81) when all 92 CAMCI exams were considered. The MOCA and 41 Cent Test were correlated with each other (r = 0.63). Conclusion: The CAMCI detects cognitive impairment after CA; the MOCA correlates strongly with the overall CAMCI and the executive function subscale of the CAMCI. The 41 Cent Test may not be as effective as the MOCA in detecting cognitive deficits.

The Ten Point Clock Test: A Quick Screen and Grading Method for Cognitive Impairment in Medical and Surgical Patients

1994 ◽  
Vol 24 (3) ◽  
pp. 229-244 ◽  
Author(s):  
Peter J. Manos ◽  
Rae Wu
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Neuropsychological Tests ◽  
Medical Center ◽  
Neuropsychological Test ◽  
Hospitalized Patients ◽  
Surgical Patients ◽  
Tertiary Referral Center ◽  
The Mean ◽  
State Examination

Objective: The objective of this study was to evaluate the clinical utility of the ten point clock test in screening for and grading cognitive deficits in medical and surgical patients. Method: The setting was the hospital and clinics of Virginia Mason Medical Center, a tertiary referral center. Consecutive samples of hospitalized patients, and clinic outpatients—with and without a dementia—were administered the ten point clock test as well as a number of other neuropsychological tests and measures of cognitive impairment. Results: Clock scores correlated with neuropsychological test scores and with the mini-mental state examination. They were stable from rater to rater, and from day to day in stable patients. The mean clock score of elderly outpatient controls was 8.5, significantly different from the mean of 5.5 scored by patients with a dementia. A cut off score of seven identified 76 percent of outpatients with dementia and 78 percent of elderly controls. Clock scores correlated well with nurses' ratings of their inpatients' cognitive deficits (Spearman's rs = −0.61). The test was easy to administer, even to hospitalized patients. Conclusions: The ten point clock test is reliable, valid, and useful as a quick screen and grading method for cognitive deficits in medical and surgical patients.

The influence of cognitive impairment on health-related quality of life in neurological disease

2010 ◽  
Vol 22 (1) ◽  
pp. 2-13 ◽  
Author(s):  
Alex J. Mitchell ◽  
Steven Kemp ◽  
Julián Benito-León ◽  
Markus Reuber
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Neurological Disorders ◽  
Neurological Disease ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Mitchell AJ, Kemp S, Benito-León J, Reuber M. The influence of cognitive impairment on health-related quality of life in neurological disease.Background:Cognitive impairment is the most consistent neurological complication of acquired and degenerative brain disorders. Historically, most focus was on dementia but now has been broadened to include the important construct of mild cognitive impairment.Methods:Systematic search and review of articles linked quality of life (QoL) and cognitive complications of neurological disorders. We excluded QoL in dementia.Results:Our search identified 249 publications. Most research examined patients with brain tumours, stroke, epilepsy, head injury, Huntington's disease, motor neuron disease, multiple sclerosis and Parkinson's disease. Results suggested that the majority of patients with epilepsy, motor neuron disease, multiple sclerosis, Parkinson's disease, stroke and head injury have subtle cognitive deficits early in their disease course. These cognitive complaints are often overlooked by clinicians. In many cases, the cognitive impairment is progressive but it can also be relapsing-remitting and in some cases reversible. Despite the importance of severe cognitive impairment in the form of dementia, there is now increasing recognition of a broad spectrum of impairment, including those with subclinical or mild cognitive impairment. Even mild cognitive difficulties can have functional and psychiatric consequences–especially when they are persistent and untreated. Specific cognitive deficits such an inattention, dysexecutive function and processing speed may affect a number of quality of life (QoL) domains. For example, cognitive impairment influences return to work, interpersonal relationships and leisure activities. In addition, fear of future cognitive decline may also impact upon QoL.Conclusions:We recommend further development of simple tools to screen for cognitive impairments in each neurological condition. We also recommend that a thorough cognitive assessment should be a part of routine clinical practice in those caring for individuals with neurological disorders.

scholarly journals Nithsdale Schizophrenia Surveys 20

2000 ◽  
Vol 177 (4) ◽  
pp. 348-353 ◽  
Author(s):  
C. Kelly ◽  
V. Sharkey ◽  
G. Morrison ◽  
J. Allardyce ◽  
R. G. McCreadie
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Deficits ◽  
Verbal Fluency ◽  
Mini Mental State Examination ◽  
Community Based ◽  
Adult Reading ◽  
The Mean ◽  
National Adult Reading Test ◽  
State Examination

BackgroundCognitive deficits are a core aspect of schizophrenia but there has been no study of cognitive function in a catchment-area-based population of patients with schizophrenia.AimsTo assess cognitive function in a population of patients with schizophrenia, and relate it to community functioning.MethodAll patients with schizophrenia in Nithsdale, south-west Scotland, were identified (n=182). Measures of assessment were: National Adult Reading Test (NART), Mini-Mental State Examination (MMSE), Rivermead Behavioural Memory Test (RBMT), Executive Interview (EXIT), FAS Verbal Fluency and Health of the Nation Outcome Scales (HoNOS).ResultsWe assessed 138 patients, mean age 48 years (standard deviation (s.d.) 15). Only 14% were in-patients. The mean premorbid IQ as assessed by NART was 98 (s.d. 14); 15% of patients had significant global cognitive impairment (MMSE); 81% had impaired memory (RBMT); 25% had executive dyscontrol (EXIT); and 49% had impaired verbal fluency (FAS). Scores on the functional impairment sub-scale of HoNOS correlated with all measures of cognitive impairment.ConclusionsCognitive dysfunction is pervasive in a community-based population of patients with schizophrenia.

scholarly journals 207 - Cognitive deficits in specific settings: challenges for the assessment and disease management

2020 ◽  
Vol 32 (S1) ◽  
pp. 45-47
Keyword(s):  
Older Adults ◽  
Mental Illness ◽  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Cognitive Assessment ◽  
Cognitive Testing ◽  
Geriatric Syndrome ◽  
Clinical Scenarios ◽  
Status Assessment ◽  
Global Population

General synopsis of the Symposium: Cognitive impairment is an important geriatric syndrome. As the global population ages exponentially, the prevalence of cognitive impairment and dementia is increasing, and mental status assessment is key in the evaluation of older adults. However, there are several pitfalls during cognitive testing and special clinical situations that demands a more in-depth knowledge and attention from the examiner. The overall objective of this symposium is to show strategies and particularities of cognitive assessment in different settings (in the clinic, inside the hospital) and clinical scenarios (early onset impairment, mental illness comorbidity).

scholarly journals Executive, language and fluency dysfunction are markers of localised TDP-43 cerebral pathology in non-demented ALS

2019 ◽  
Vol 91 (2) ◽  
pp. 149-157 ◽  
Author(s):  
Jenna M Gregory ◽  
Karina McDade ◽  
Thomas H Bak ◽  
Suvankar Pal ◽  
Siddharthan Chandran ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Executive Functions ◽  
Cognitive Deficits ◽  
Regional Distribution ◽  
Brain Regions ◽  
Cognitive Testing ◽  
Functional Deficits ◽  
Language Functions ◽  
Cerebral Pathology ◽  
Lateral Sclerosis

ObjectiveApproximately 35% of patients with amyotrophic lateral sclerosis (ALS) exhibit mild cognitive deficits in executive functions, language and fluency, without dementia. The precise pathology of these extramotor symptoms has remained unknown. This study aimed to determine the pathological correlate of cognitive impairment in patients with non-demented ALS.MethodsIn-depth neuropathological analysis of 27 patients with non-demented ALS who had undergone cognitive testing (Edinburgh Cognitive and Behaviour ALS Screen (ECAS)) during life. Analysis involved assessing 43 kDa Tar-DNA binding protein (TDP-43) accumulation in brain regions specifically involved in executive functions, language functions and verbal fluency to ascertain whether functional deficits would relate to a specific regional distribution of pathology.ResultsAll patients with cognitive impairment had TDP-43 pathology in extramotor brain regions (positive predictive value of 100%). The ECAS also predicted TDP-43 pathology with 100% specificity in brain regions associated with executive, language and fluency domains. We also detected a subgroup with no cognitive dysfunction, despite having substantial TDP-43 pathology, so called mismatch cases.ConclusionsCognitive impairment as detected by the ECAS is a valid predictor of TDP-43 pathology in non-demented ALS. The profile of mild cognitive deficits specifically predicts regional cerebral involvement. These findings highlight the utility of the ECAS in accurately assessing the pathological burden of disease.

Measuring the Improving Quality of Outpatient Care in Medical Oncology Practices in the United States

2013 ◽  
Vol 31 (11) ◽  
pp. 1471-1477 ◽  
Author(s):  
Michael N. Neuss ◽  
Jennifer L. Malin ◽  
Stephanie Chan ◽  
Pamela J. Kadlubek ◽  
John L. Adams ◽  
...  
Keyword(s):  
Clinical Information ◽  
The United States ◽  
Measuring Process ◽  
The Past ◽  
The Mean ◽  
Highly Correlated ◽  
American Society ◽  
Oncology Practice ◽  
Over Time

Purpose The American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) has provided a method for measuring process-based practice quality since 2006. We sought to determine whether QOPI scores showed improvement in measured quality over time and, if change was demonstrated, which factors in either the measures or participants were associated with improvement. Methods The analysis included 156 practice groups from a larger group of 308 that submitted data from 2006 to 2010. One hundred fifty-two otherwise eligible practices were excluded, most commonly for insufficient data submission. A linear regression model that controlled for varied initial performance was used to estimate the effect of participation over time and evaluate participant and measure characteristics of improvement. Results Participants completed a mean of 5.06 (standard deviation, 1.94) rounds of data collection. Adjusted mean quality scores improved from 0.71 (95% CI, 0.42 to 0.91) to 0.85 (95% CI, 0.60 to 0.95). Overall odds ratio of improvement over time was 1.09 (P < .001). The greatest improvement was seen in measures that assessed newly introduced clinical information, in which the mean scores improved from 0.05 (95% CI, 0.01 to 0.17) to 0.69 (95% CI, 0.33 to 0.91; P < .001). Many measures showed no change over time. Conclusion Many US oncologists have participated in QOPI over the past 6 years. Participation over time was highly correlated with improvement in measured performance. Greater and faster improvement was seen in measures concerning newly introduced clinical information. Some measures showed no change despite opportunity for improvement.

Cognitive Impairment and Quality of Life among Stroke Survivors in Nigeria

2007 ◽  
Vol 100 (3) ◽  
pp. 876-882 ◽  
Author(s):  
Femi O. Fatoye ◽  
Morenikeji A. Komolafe ◽  
Benjamin A. Eegunranti ◽  
Abiodun O. Adewuya ◽  
Samuel K. Mosaku ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Poor Performance ◽  
Stroke Survivors ◽  
Life Questionnaire ◽  
Low Education ◽  
State Examination ◽  
Normal Controls

The study investigated cognitive impairment and quality of life (QOL) among 109 consecutive stroke survivors and 109 normal controls. Each group comprised 64 (58.7%) men and 45 (41.3%) women. The modified Mini Mental State Examination (mMMSE) and the WHO Quality of Life Questionnaire (WHOQOL-Bréf) indicated that 19 (17.4%) stroke survivors had cognitive deficits (mMMSE score < 16) compared with 5 (4.6%) control participants (χ12 = 4.27, p<.05). Control participants performed significantly better on orientation, language comprehension, laterality, and the WHOQOL-Bréf. Being GHQ-30 positive predicted poor performance on the mMMSE among the stroke survivors and reduced QOL on three of the four domains of the WHOQOL-Bréf. In addition, previous psychiatric illness, paresis, low education, and shorter time elapsed after a stroke predicted reduced QOL on one or more domains of the WHOQOL-Bréf but age and sex of the stroke survivors were not associated with quality of life, and not with cognitive function.

Hairiness in wool and a method for selection based on the nature of the fibres and the distribution of halo hairs of the lamb's tail

1957 ◽  
Vol 49 (1) ◽  
pp. 1-18 ◽  
Author(s):  
F. M. Labban
Keyword(s):  
Fibre Diameter ◽  
The Body ◽  
The Other ◽  
Significant Difference ◽  
Mean Diameter ◽  
Wide Variability ◽  
The Mean ◽  
Highly Correlated ◽  
Different Parts

Hairiness in wool of Suffolk sheep as a fault was found to be associated with other defects like coarseness of wool fibres, hairiness of the britch, and the occurrence of pigmented fibres. The presence of these various defects was studied in the lamb's tail at docking time, and subsequently evaluated and correlated with the fleece.The tails were graded according to the nature of the fibres and the spread of halo hairs from the tip to the base into four principal grades which by further subgrading could be made into seven grades. The results were as follows:(1) There was wide variability in grades of tails within each flock.(2) Average grade of tails followed in general the mean quality of the adult fleece.(3) When Border Leicester were crossed with Welsh Mountain the tails of the two reciprocal crosses were found to be of hairy type of tail and nearly like the Welsh Mountain type.(4) The percentage of coloured tails in the least hairy grades was found to be inversely related to the quality of the tail grade and indirectly to the fleece quality.(5) The diameter of the wool fibres on the base of the tail is highly correlated with the diameter of fibres from the britch regions or mean fibre diameter from four regions of the body (mid-shoulder, midside, hip and britch).(6) The mean diameter of the wool fibres obtained from four different parts of the tail was correlated with those of the britch regions only.(7) The diameter and variability of fibres increased from shoulder to britch in the body and from base to tip in the tails.(8) The britch and tails of two groups of sheep, one group characterized by coarse and the other by fine britch and tail wool, were studied histologically. There were significant or highly significant differences in the following characteristics in the britch of the two groups: (a) total number of follicles, (b) primary follicles with no medulla, (c) total number of secondary follicles, (d) secondaries with no medulla, (e) secondaries with large medulla. The only type of follicle where a significant difference was found in the tail was in the number of secondary follicles with no medulla.

Pharmacologic manipulation of complement receptor 3 prevents dendritic spine loss and cognitive impairment after acute cranial radiation

2020 ◽  
Author(s):  
Joshua J. Hinkle ◽  
John A. Olschowka ◽  
Jacqueline P. Williams ◽  
M. Kerry O’Banion
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Dendritic Spine ◽  
Cranial Irradiation ◽  
Complement Receptor ◽  
Spine Density ◽  
Male Mice ◽  
Complement Receptor 3

AbstractCranial irradiation induces healthy tissue damage that can lead to neurocognitive complications and negatively impact patient quality of life. One type of damage associated with cognitive impairment is loss of neuronal spine density. Based on developmental and disease studies implicating microglia and complement in dendritic spine loss, we hypothesized that irradiation-mediated spine loss is microglial complement receptor 3 (CR3)-dependent, and associated with late-delayed cognitive deficits. Utilizing a model of cranial irradiation (acute, 10 Gy gamma) in C57BL/6 mice we found that male mice demonstrate irradiation-mediated spine loss and cognitive deficits whereas female mice and CR3 knockout mice do not. Moreover, pharmacological blockade of CR3 with leukadherin-1 (LA1) prevented these changes in irradiated male mice. Interestingly, CR3 KO mice showed reduced behavioral task performance suggesting that CR3 is important for normal learning and memory. Improving our understanding of irradiation-mediated mechanisms and sexual dimorphic responses is essential for the identification of novel therapeutics to reduce irradiation-induced cognitive decline and improve patient quality of life.

scholarly journals LO73: Long-term functional outcome and health-related quality of life of elderly out-of-hospital cardiac arrest survivors

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S53
Author(s):  
E. Mercier ◽  
E. Andrew ◽  
Z. Nehme ◽  
M. Lijovic ◽  
S. Bernard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cardiac Arrest ◽  
Functional Outcome ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Mean ◽  
Hospital Cardiac Arrest

Introduction: This study aims to describe the long-term functional outcome and health-related quality of life of elderly (≥65 years old) out-of-hospital cardiac arrest (OHCA) survivors in Victoria, Australia. Methods: Elderly OHCA patients who arrested between January 1st, 2010 and December 31st, 2014 were identified from the Victorian Ambulance Cardiac Arrest Registry (VACAR). Living status, Glasgow Outcome Scale-Extended (GOS-E), Euro-QoL (EQ-5D) and Twelve-item Short Form (SF-12) Health Survey were collected by telephone 12 months following the OHCA. Results: Emergency medical services attended on 14,678 elderly OHCA during the study period, 6,851 (46.7%) of which received a resuscitation attempt. Of these, 668 patients (9.8%) survived to hospital discharge. The mean age of the survivors was 75 (standard deviation (SD) 7.4) years and 504 (75.4%) were male. Eighty-five patients subsequently died within 12 months of their OHCA. A total of 483 patients were interviewed (response rate 82.9%). At 12 months, 313 responders (64.9%) were living at home without care. Most responders (n=324 (67.2%)) had a good long-term functional recovery with a GOS-E ≥7. The proportion of patients with a GOS-E≥7 progressively decreased with increasing age (65-74 years: 66.1%, 75-84 years: 53.0%,≥85 years: 27.3%). On the EQ-5D, the majority of survivors reported no problem with mobility (n=266 (55.1%)), self-care (n=403 (83.4%)), activity (n=293 (60.6%)), pain (n=335 (69.3%)) and anxiety (n=358 (74.1%)). On the SF-12, the mean mental component summary was 56.3 (SD 6.6) while the mean physical component summary was 44.7 (SD 11.4) (both measures range from 0-100). Among the 1,951 patients who arrested in a supported accommodation, 849 (43.5%) had a resuscitation attempt, and of these, 21 survived to hospital discharge (2.5%). Only eight (1.0%) of these patients were still alive 12 months after the OHCA and one survivor (0.12%) had a good functional outcome (GOS-E≥7). Conclusion: Most elderly OHCA survivors have an adequate long-term functional status and health-related quality of life. However, the likelihood of having a good functional recovery decreases with increasing age, and is rare for patients arresting in a supported accommodation.

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