Cognitive Screening Instruments for Older Adults with Low Educational and Literacy Levels: A Systematic Review

2021 ◽  
pp. 073346482110562
Author(s):  
Isabel Pellicer-Espinosa ◽  
Unai Díaz-Orueta
Keyword(s):  
Systematic Review ◽  
Educational Level ◽  
The Elderly ◽  
Screening Tools ◽  
Cochrane Library ◽  
Cognitive Screening ◽  
Low Literacy ◽  
Frequent Use ◽  
Use Studies ◽  
State Examination

This study presents a systematic review on existing cognitive screening tools for mild cognitive impairment and dementia in populations with low education and literacy levels. Cochrane Library, PubMed and LILACS databases were examined for studies including adults aged 50 years old or older with low educational level. 61 articles were included. Despite its frequent use, studies on Mini-Mental State Examination (MMSE) revealed that educational level biased the score obtained, regardless of other factors. Separately, the Informant Questionnaire on Cognitive Decline in the Elderly, the Fototest, or the Eurotest, appear to minimize the effect of education and literacy. MMSE is unreliable for individuals with low literacy. Tasks involving reading, writing, arithmetics, drawing, praxis, visuospatial, and visuoconstructive skills have a greater educational bias than naming, orientation, or memory. An adequate determination of educational level and validation of instruments in populations with heterogeneous levels of literacy requires further research.

Can MoCA and MMSE Be Interchangeable Cognitive Screening Tools? A Systematic Review

2018 ◽  
Vol 59 (6) ◽  
pp. e743-e763 ◽  
Author(s):  
Glória S A Siqueira ◽  
Paula de M S Hagemann ◽  
Daniela de S Coelho ◽  
Flávia Heloísa Dos Santos ◽  
Paulo H F Bertolucci
Keyword(s):  
Systematic Review ◽  
Mental State ◽  
Cognitive Assessment ◽  
Mini Mental State Examination ◽  
Screening Tools ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Sensitive Tool ◽  
State Examination ◽  
Years Of Schooling

Abstract Background and Objectives Cognitive disorders may be an early sign of neuropsychiatric disorders; however, it remains unclear whether the screening measures are interchangeable. The aim of this study was to contrast the most commonly used screening tools—Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)—for early detection of neurocognitive disorder (NCD). Research Design and Methods This study presents a descriptive systematic review and informative literature according to the Cochrane Foundation’s guidelines. The keywords “Mini-Mental State Examination” and “Montreal Cognitive Assessment” were searched in the Web of Science, SciELO, and LILACS databases. Results Fifty-one studies were selected including a total sample of 11,870 participants (8,360 clinical patients and 3,510 healthy controls). Most studies were published in the past 5 years using a cross-sectional design, carried out across the world. They were organized by age ranges (18–69 years and 20–89 years), years of schooling, and mental status (with and without mental and behavior disorders). Sixteen of 18 studies had participants aged 18–69 years, and 21 out of 33 studies within the older set suggested that the MoCA is a more sensitive tool for detecting NCD. Discussion and Implications Thirty-seven studies suggested that the MoCA is a more sensitive tool for NCD detection because it assesses executive function and visuospatial abilities. Some individuals who demonstrated normal cognitive function on the MMSE had lower performance on the MoCA. However, it seems necessary to establish different cutoffs based on years of schooling to avoid false positives. Future studies should contrast MoCA with other screening tools designed for NCD assessment.

scholarly journals Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (7) ◽  
pp. 3471
Author(s):  
Hyeon-Ju Lee ◽  
Youn-Jung Son
Keyword(s):  
Systematic Review ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Associated Factors ◽  
Meta Analysis ◽  
Screening Tools ◽  
Cochrane Library ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Hemodialysis is the most common type of treatment for end-stage renal disease (ESRD). Frailty is associated with poor outcomes such as higher mortality. ESRD patients have a higher prevalence of frailty. This systematic review and meta-analysis aimed to identify the prevalence and associated factors of frailty and examine whether it is a predictor of mortality among ESRD patients undergoing hemodialysis. Five electronic databases including PubMed, Embase, CINAHL, Web of Science, and Cochrane Library were searched for relevant studies up to 30 November 2020. A total of 752 articles were found, and seven studies with 2604 participants in total were included in the final analysis. The pooled prevalence of frailty in patients with ESRD undergoing hemodialysis was 46% (95% Confidence interval (CI) 34.2−58.3%). Advanced age, female sex, and the presence of diabetes mellitus increased the risk of frailty in ESRD patients undergoing hemodialysis. Our main finding showed that patients with frailty had a greater risk of all-cause mortality compared with those without (hazard ratio (HR): 2.02, 95% CI: 1.65−2.48). To improve ESRD patient outcomes, healthcare professionals need to assess the frailty of older ESRD patients, particularly by considering gender and comorbidities. Comprehensive frailty screening tools for ESRD patients on hemodialysis need to be developed.

A Memory Clinic at a Geriatric Hospital: A Report on 577 Patients Assessed with the CAMDEX Over 9 Years

2003 ◽  
Vol 37 (3) ◽  
pp. 319-326 ◽  
Author(s):  
Joe A. Stratford ◽  
Dina Logiudice ◽  
Leon Flicker ◽  
Roslyn Cook ◽  
Wendy Waltrowicz ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
The Elderly ◽  
International Classification Of Diseases ◽  
Screening Tools ◽  
Cognitive Screening ◽  
Memory Clinic ◽  
Mental Test Score ◽  
Patient Demographics ◽  
Significant Difference ◽  
Icd 10

Objective: To report 9 years’ experience of an Australian memory clinic using the Cambridge Mental Disorders in the Elderly Examination (CAMDEX) assessment schedule, summarizing patient demographics, diagnoses at presentation and the utility of four instruments used in distinguishing patients with and without dementia. Methods: All patients seen at the clinic between December 1989 and September 1998 were assessed using the CAMDEX. Diagnoses were determined according to criteria of the International Classification of Diseases, tenth edition (ICD-10). Results: The mean age of 577 patients seen was 72.9 years and 60.8% were female. Over 40% fulfilled ICD-10 diagnostic criteria for dementia in Alzheimer's disease. A further 24% had another dementing illness. Only 28 patients were ‘normal’. There was no significant difference in the ability of the 107-item Cambridge cognitive examination, the 30-item mini-mental state examination, the 10-item abbreviated mental test score and the 26-item informant questionnaire on cognitive decline in the elderly to differentiate dementia patients from those who were normal or had functional psychiatric disorders. The four cognitive screening tools had high correlations with one another (r = −0.57 to 0.93). Conclusion: Patient demographics and diagnoses were similar to those found in other clinics. Most people who attended the memory clinic had significant cognitive or psychiatric disorders.

scholarly journals Employment of Patients With Kidney Failure Treated With Dialysis or Kidney Transplantation - A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Lilli Kirkeskov ◽  
Rasmus Carlsen ◽  
Thomas Lund ◽  
Niels-Henrik Buus
Keyword(s):  
Systematic Review ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Kidney Failure ◽  
Educational Level ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Employment Rate ◽  
Dialysis Patients ◽  
Post Transplant

Abstract Background: Patients with kidney failure treated with dialysis or kidney transplantation experience difficulties maintaining employ­­ment due to the condition itself as well as the treatment. We aimed to establish the rate of employment before and after initiation of dialysis and after kidney transplantation and to identify predictors of employment during dialysis and post-transplant.Methods: This systematic review and meta-analysis was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis, PRISMA, for studies that included employment rate in adults receiving dialysis or a kidney transplant. The literature search included cross sectional or cohort studies published in English in the period from January 1966 to August 2020 in the databases PubMed, Embase, and Cochrane Library. Data of employment rate, study population, age, gender, educational level, dialysis duration, kidney donor, ethnicity, dialysis modality, waiting time for transplantation, diabetes, and depression were extracted. Quality assessment was performed using the Newcastle-Ottawa Scale. Meta-analysis for predictors for employment and odds ratio; confidence intervals; and test for heterogeneity were calculated using Chi-squared statistics and I2. PROSPERO registration number: CRD42020188853.Results. 33 studies with 162,059 participants during dialysis and 31 studies with 137,742 participants receiving kidney transplantation. Dialysis patients were on average 52.6 years old (range 16-79), 60.3% males and kidney transplant patients 46.7 years old (range 18-78), 59.8% males. The employment rate (weighted mean) for dialysis patients was 26.3% (range 10.5-59.7%); pre-transplant 36.9% (range 25-86%), and post-transplant 38.2% (range 14.2-85%). Predictors for employment during dialysis and post-transplant were male, non-diabetic, peritoneal dialysis, and higher educational level, and post-transplant: pre-transplant employment, younger age, transplantation with a living donor kidney, and without depression.Conclusions: Patients with kidney failure had a low employment rate during dialysis, pre- and post-transplant. Kidney failure patients should be supported through a combination of clinical and social measures to ensure they remain in work.

Cognitive assessment tools in Asia: a systematic review

2015 ◽  
Vol 28 (2) ◽  
pp. 189-210 ◽  
Author(s):  
Roshaslina Rosli ◽  
Maw Pin Tan ◽  
William Keith Gray ◽  
Pathmawathi Subramanian ◽  
Ai-Vyrn Chin
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
De Novo ◽  
Assessment Tools ◽  
Screening Tools ◽  
Cochrane Library ◽  
Future Research ◽  
Asian Populations ◽  
Keywords Dementia

ABSTRACTBackground:The prevalence of dementia is increasing in Asia than in any other continent. However, the applicability of the existing cognitive assessment tools is limited by differences in educational and cultural factors in this setting. We conducted a systematic review of published studies on cognitive assessments tools in Asia. We aimed to rationalize the results of available studies which evaluated the validity of cognitive tools for the detection of cognitive impairment and to identify the issues surrounding the available cognitive impairment screening tools in Asia.Methods:Five electronic databases (CINAHL, MEDLINE, Embase, Cochrane Library, and Science Direct) were searched using the keywords dementia Or Alzheimer Or cognitive impairment And screen Or measure Or test Or tool Or instrument Or assessment, and 2,381 articles were obtained.Results:Thirty-eight articles, evaluating 28 tools in seven Asian languages, were included. Twenty-nine (76%) of the studies had been conducted in East Asia with only four studies conducted in South Asia and no study from northern, western, or central Asia or Indochina. Local language translations of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were assessed in 15 and six studies respectively. Only three tools (the Korean Dementia Screening Questionnaire, the Picture-based Memory Intelligence Scale, and the revised Hasegawa Dementia Screen) were derivedde novofrom Asian populations. These tools were assessed in five studies. Highly variable cut-offs were reported for the MMSE (17–29/30) and MoCA (21–26/30), with 13/19 (68%) of studies reporting educational bias.Conclusions:Few cognitive assessment tools have been validated in Asia, with no published validation studies for many Asian nations and languages. In addition, many available tools display educational bias. Future research should include concerted efforts to develop culturally appropriate tools with minimal educational bias.

scholarly journals A Systematic Review of the Effectiveness of Telerehabilitation Interventions for Therapeutic Purposes in the Elderly

2020 ◽  
Vol 59 (02/03) ◽  
pp. 104-109
Author(s):  
Farnia Velayati ◽  
Haleh Ayatollahi ◽  
Morteza Hemmat
Keyword(s):  
Systematic Review ◽  
Elderly People ◽  
Data Extraction ◽  
The Elderly ◽  
Health Conditions ◽  
Cochrane Library ◽  
Chronic Obstructive ◽  
Mobility Limitations ◽  
Significant Difference

Abstract Background Many elderly people suffer from chronic health conditions and mobility limitations. Therefore, they may benefit from traditional rehabilitation or telerehabilitation interventions as an alternative for this type of services. Objective The purpose of this study was to compare the effectiveness of telerehabilitation interventions with traditional rehabilitation services for therapeutic purposes in the elderly. Methods This systematic review was conducted in 2018. The searched databases were Cochrane Library, PubMed, Scopus, Web of Science, Embase, and ProQuest. The search was conducted with no time or language limitation. The selected papers included the randomized clinical trial studies in which elderly people aged 60 and over used telerehabilitation services for treatment purposes. The quality of the studies was evaluated by using the physiotherapy evidence database (PEDro) scale. Data were extracted by using a data extraction form and findings were narratively synthesized. Results After screening the retrieved papers, eight articles were selected to be included in the study. According to the findings, telerehabilitation was used for the elderly after stroke, chronic obstructive pulmonary disease (COPD), total knee replacement, and in patients with the comorbidity of COPD and chronic heart failure. Overall, in most studies, there was no significant difference between the intervention and control groups and the level of improvements was similar for most outcomes. Conclusion Telerehabilitation services can be regarded as an alternative to traditional rehabilitation approaches to reduce outpatient resource utilization and improve quality of life. However, more rigorous studies are suggested to investigate the effectiveness of telerehabilitation services for specific diseases or health conditions.

scholarly journals The influence of schooling on cognitive screening test in the elderly

2007 ◽  
Vol 1 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Gustavo Christofoletti ◽  
Merlyn Mércia Oliani ◽  
Florindo Stella ◽  
Sebastião Gobbi ◽  
Lílian Teresa Bucken Gobbi
Keyword(s):  
Cognitive Decline ◽  
Educational Level ◽  
Screening Test ◽  
Neuropsychological Tests ◽  
Formal Education ◽  
The Elderly ◽  
Cognitive Status ◽  
Cognitive Screening ◽  
Screening Battery ◽  
Cognitive Screening Test

Abstract Introduction: Tests for screening cognitive functions are gaining importance with the increasing incidence and prevalence of demential syndromes. For our elderly population, the challenge is to develop neuropsychological tests independent from the influence of educational level. Objective: To compare the influence of education on the elderly with or without cognitive decline, on the Brief Cognitive Screening Battery (BCSB). Methods: We studied 176 elderly people: 60 with cognitive decline (aged 73.6±9.3 years and with 5.7±0.7 years of education) and 116 without cognitive impairments (aged 73.4±0.6 years and with 5.6±0.5 years of education). The BCSB was applied in all subjects. The data were submitted to descriptive statistics and analyzed by Independent Student test with 95% confidence intervals. Results: The data showed that the BCSB is an appropriate battery for identifying cognitive status in normal elderly individuals, as well as cognitive decline in our elderly sample. The BCSB items were not significantly influenced by schooling years, making this test favorable for different groups characterized by illiterate individuals, as well as by those with low or high levels of formal education. Conclusion: The BCSB proved to be a useful cognitive screening test for old people with or without cognitive decline independent of their educational level.

Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians

2015 ◽  
Vol 40 (1-2) ◽  
pp. 22-32 ◽  
Author(s):  
Kylie Radford ◽  
Holly A. Mack ◽  
Brian Draper ◽  
Simon Chalkley ◽  
Kim Delbaere ◽  
...  
Keyword(s):  
Characteristic Curve ◽  
Good Alternative ◽  
Screening Tools ◽  
Cognitive Screening ◽  
Community Based ◽  
Cross Sectional ◽  
Aboriginal Australians ◽  
Cultural Considerations ◽  
Aboriginal Populations ◽  
State Examination

Background: Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking. Methods: In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus. Results: All tests were culturally acceptable with good psychometric properties. Receiver operating characteristic curve analyses revealed that the MMSE and mKICA were the most accurate. Conclusion: The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population.

Cognitive screening tools for identification of dementia in illiterate and low-educated older adults, a systematic review and meta-analysis

2017 ◽  
Vol 29 (6) ◽  
pp. 897-929 ◽  
Author(s):  
Stella-Maria Paddick ◽  
William K. Gray ◽  
Jackie McGuire ◽  
Jenny Richardson ◽  
Catherine Dotchin ◽  
...  
Keyword(s):  
Older Adults ◽  
Validation Studies ◽  
Meta Analysis ◽  
Significant Proportion ◽  
Educational Background ◽  
Screening Tools ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Low Literacy ◽  
Prevalence Studies

ABSTRACTBackground:The majority of older adults with dementia live in low- and middle-income countries (LMICs). Illiteracy and low educational background are common in older LMIC populations, particularly in rural areas, and cognitive screening tools developed for this setting must reflect this. This study aimed to review published validation studies of cognitive screening tools for dementia in low-literacy settings in order to determine the most appropriate tools for use.Method:A systematic search of major databases was conducted according to PRISMA guidelines. Validation studies of brief cognitive screening tests including illiterate participants or those with elementary education were eligible. Studies were quality assessed using the QUADAS-2 tool. Good or fair quality studies were included in a bivariate random-effects meta-analysis and a hierarchical summary receiver operating characteristic (HSROC) curve constructed.Results:Forty-five eligible studies were quality assessed. A significant proportion utilized a case–control design, resulting in spectrum bias. The area under the ROC (AUROC) curve was 0.937 for community/low prevalence studies, 0.881 for clinic based/higher prevalence studies, and 0.869 for illiterate populations. For the Mini-Mental State Examination (MMSE) (and adaptations), the AUROC curve was 0.853.Conclusion:Numerous tools for assessment of cognitive impairment in low-literacy settings have been developed, and tools developed for use in high-income countries have also been validated in low-literacy settings. Most tools have been inadequately validated, with only MMSE, cognitive abilities screening instrument (CASI), Eurotest, and Fototest having more than one published good or fair quality study in an illiterate or low-literate setting. At present no screening test can be recommended.

scholarly journals Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) completion on an acute care ward for the elderly: a brief study of informant characteristics

2012 ◽  
Vol 24 (10) ◽  
pp. 1700-1701 ◽  
Author(s):  
K. Bloomfield ◽  
N. John
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
The Elderly ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Cognitive Screening ◽  
Screening Algorithm ◽  
Drawing Task ◽  
The Uk ◽  
State Examination

Over recent years in the UK, emphasis has been placed on appropriate diagnosis and referral of patients with dementia. In guidelines published by the British Geriatrics Society (BGS) and Faculty of Old Age Psychiatrists consensus group (Forsyth et al., 2006), a cognitive screening algorithm was developed, which consists of initial screening for cognitive impairment with the Mini-Mental State Examination (MMSE) and CLOX1 (an executive clock drawing task). If the scores meet cut-off points indicated in the algorithm (MMSE <24 or CLOX1 <11), further assessments with the Confusion Assessment Method (CAM) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) are applied with the aim to differentiate between delirium (CAM positive, IQCODE negative), delirium and chronic impairment (CAM positive, IQCODE positive), or chronic cognitive impairment (CAM negative, IQCODE positive).

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