The Clinical Utility of the TYM and RBANS in a One-Stop Memory Clinic in Singapore: A Pilot Study

2019 ◽  
Vol 32 (2) ◽  
pp. 68-73 ◽  
Author(s):  
YanHong Dong ◽  
Melissa Tan Yi Ling ◽  
Kelly Ee Teng Ng ◽  
Aijing Wang ◽  
Esther Yee Shuang Wan ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Discriminant Validity ◽  
Neuropsychological Test ◽  
Area Under The Curve ◽  
Cognitive Screening ◽  
Memory Clinic ◽  
Boston Naming Test ◽  
Neuropsychological Status ◽  
Language Tests ◽  
One Stop

Background: We aimed to examine the discriminant validity of a brief self-administered cognitive screening test, the Test Your Memory (TYM) and a brief neuropsychological test, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), supplemented with executive and language tests (Color Trail Test [CTT] and modified Boston Naming Test [mBNT], respectively), in detecting cognitive impairment (CI) in a one-stop memory clinic in Singapore. Methods: Ninety patients ≥50 years old with a diagnosis of no cognitive impairment, mild cognitive impairment, and mild Alzheimer disease were recruited from memory clinic. They received the TYM, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), RBANS, CTT, mBNT, and a gold-standard formal neuropsychological test battery. Results: The TYM had a significantly larger area under the curve (AUC) than MMSE (0.96 vs 0.88, P = .03) and was equivalent to MoCA in detecting CI (0.96 vs 0.95, P = .80). At the optimal cutoff points, the TYM (<38) was significantly more sensitive than the MMSE (<24) and MoCA (<20; P < .001). The RBANS had an AUC equivalent to the RBANS supplemented with CTT and mBNT (0.92 vs 0.86, P = .22) in detecting CI. The RBANS supplemented with CTT and mBNT was more sensitive than RBANS alone in detecting CI (sensitivity: 0.98 vs 0.93, P = .016) among patients screened negative using TYM. Conclusion: The self-administered TYM is superior to MMSE and equivalent to MoCA in detecting CI and could be implemented routinely. The RBANS supplemented with CTT and mBNT is more sensitive in detecting CI than RBANS alone therefore could be used for diagnostic purposes.

scholarly journals B-13 Differences in Language Function Between Patients with Nonepileptic Seizures (NES) and Epilepsy on an Epilepsy Monitoring Unit

2019 ◽  
Vol 34 (6) ◽  
pp. 957-957
Author(s):  
R Garrett ◽  
R Gerkin ◽  
J Pardini
Keyword(s):  
Verbal Fluency ◽  
Right Hemisphere ◽  
Linear Trend ◽  
Neuropsychological Test ◽  
Retrospective Chart Review ◽  
Language Function ◽  
Boston Naming Test ◽  
Language Tests ◽  
Nonepileptic Seizures ◽  
Epilepsy Monitoring

Abstract Objective To examine potential differences in language function among nonepileptic seizures (NES) and epilepsy patients. Method Data were acquired via IRB approved retrospective chart review. Subjects were 60 patients who completed an inpatient stay in the Epilepsy Monitoring Unit of a southwestern hospital. 33 were diagnosed with NES, 13 were diagnosed with epilepsy originating in right hemisphere (ER), and 14 were diagnosed with epilepsy originating in the left hemisphere (EL). Patients were 65.9 % female, with a mean age of 40.5 (SD = 13.7). As part of a standard inpatient neuropsychological test battery, participants completed language tests that consisted of verbal fluency (FAS and Animals), Boston Naming Test, Wechsler Test of Adult Reading (WTAR), and Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-2) Similarities and Vocabulary subtests. Results ANOVA testing revealed significant between group differences in scores on the Animals verbal fluency test (F = 7.72, p = .008 for linear trend). Other measures did not achieve significance. NES participants had the highest Animal fluency scores (mean T = 49.28), followed by ER (47.73) then EL patients (43.27). WTAR score did not moderate this effect. Gender did moderate the effect, with male ER and EL subjects demonstrating lower Animal naming scores than their female counterparts (p = .037). Conclusion Animal naming was the only language-based variable found to differ in this sample of NES and epilepsy patients. Those with EL had the lowest scores on this measure, consistent with prior research that has found language deficits in this population.

scholarly journals Examination of Regression-based Discrepancy Scores for the RBANS in Detecting Cognitive Impairment from an Archival Sample

2018 ◽  
Vol 34 (8) ◽  
pp. 1329-1339 ◽  
Author(s):  
William F Goette ◽  
Andrew L Schmitt
Keyword(s):  
Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Clinical Utility ◽  
Word Reading ◽  
Neuropsychological Test ◽  
Clinical Neuropsychology ◽  
Standard Score ◽  
Neuropsychological Status ◽  
Total Scale Score ◽  
Performance Results

Abstract Objective The purpose of this study was to evaluate the clinical utility of regression-based formulas for the RBANS indexes in screening for cognitive impairment. Method A database of neuropsychological test results was created from archival records in a memory assessment clinic. The sample consisted of 83 individuals (37 males/46 females) with an average age of 70.1 (SD = 9.8) and 14.6 years of education (SD = 2.8). Diagnostic accuracy of regression-based predictions provided by Duff and Ramezani (2015) (Duff, K., & Ramezani, A. (2015). Regression-based normative formulae for the Repeatable Battery for the Assessment of Neuropsychological Status for older adults. Archives of Clinical Neuropsychology, 30, 600–604.) and from regression of WTAR standard score were examined via receiver operator characteristic curves. Preliminary generalizability investigation was completed using two additional datasets. Results The WTAR was found to mediate the relationship between education and all RBANS index scores. The WTAR standard score was also found to contribute uniquely and significantly to the prediction of RBANS performance. Results of diagnostic accuracy analyses showed similar discriminating accuracy for all scores. There was limited support for using the WTAR over demographic variables alone in the estimation of RBANS performance; however, the WTAR was found to be more predictive than education, indicating potential clinical utility to using the word-reading score over just years of attained education. Conclusions Use of these derived Total Scale score variants is recommended for the screening of cognitive impairment, particularly in individuals with superior or poor educational quality. Further research is required to evaluate the utility of these variations in more diverse samples.

Short Montreal Cognitive Assessment

2016 ◽  
Vol 30 (2) ◽  
pp. 104-108 ◽  
Author(s):  
A. J. Larner
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Assessment ◽  
Computerized Adaptive Testing ◽  
Montreal Cognitive Assessment ◽  
Test Accuracy ◽  
Cognitive Screening ◽  
Memory Clinic ◽  
Subjective Memory ◽  
Index Study ◽  
Diagnosis Of Dementia

The diagnostic accuracy of the short Montreal Cognitive Assessment (s-MoCA), a cognitive screening instrument recently derived by item response theory and computerized adaptive testing from the original MoCA, for the diagnosis of dementia and mild cognitive impairment (MCI) was assessed in 2 patient cohorts referred to a dedicated memory clinic in order to examine the validity and reproducibility of s-MoCA. Diagnosis used standard clinical diagnostic criteria for dementia and MCI as reference standard (prevalence of cognitive impairment = 0.43 and 0.46 in each cohort, respectively). There were significant differences in s-MoCA test scores for dementia, MCI, and subjective memory impairment ( P ≤ .01), and s-MoCA effect sizes (Cohen d) were medium to large (range: 0.65-1.42) for the diagnosis of dementia and MCI. Using the cut-off for s-MoCA specified in the index study, it proved highly sensitive (>0.9) for diagnosis of dementia but with poor specificity (≤0.25), with moderate sensitivity (≥0.75) and specificity (≥0.60) for diagnosis of MCI. In conclusion, in these pragmatic diagnostic test accuracy studies, s-MoCA proved acceptable and sensitive for the diagnosis of cognitive impairment in a memory clinic setting, with a performance similar to that of the original MoCA.

scholarly journals Validation of ICMR Neurocognitive Toolbox for Dementia in the Linguistically Diverse Context of India

2021 ◽  
Vol 12 ◽  
Author(s):  
Mansi Verma ◽  
Manjari Tripathi ◽  
Ashima Nehra ◽  
Avanthi Paplikar ◽  
Feba Varghese ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Linguistic Diversity ◽  
Neuropsychological Test ◽  
Area Under The Curve ◽  
Cognitive Screening ◽  
Indian Languages ◽  
Middle Income ◽  
Significant Difference ◽  
Diagnosis Of Dementia

Objectives: The growing prevalence of dementia, especially in low- and middle-income countries (LMICs), has raised the need for a unified cognitive screening tool that can aid its early detection. The linguistically and educationally diverse population in India contributes to challenges in diagnosis. The present study aimed to assess the validity and diagnostic accuracy of the Indian Council of Medical Research-Neurocognitive Toolbox (ICMR-NCTB), a comprehensive neuropsychological test battery adapted in five languages, for the diagnosis of dementia.Methods: A multidisciplinary group of experts developed the ICMR-NCTB based on reviewing the existing tools and incorporation of culturally appropriate modifications. The finalized tests of the major cognitive domains of attention, executive functions, memory, language, and visuospatial skills were then adapted and translated into five Indian languages: Hindi, Bengali, Telugu, Kannada, and Malayalam. Three hundred fifty-four participants were recruited, including 222 controls and 132 dementia patients. The sensitivity and specificity of the adapted tests were established for the diagnosis of dementia.Results: A significant difference in the mean (median) performance scores between healthy controls and patients with dementia was observed on all tests of ICMR-NCTB. The area under the curve for majority of the tests included in the ICMR-NCTB ranged from 0.73 to 1.00, and the sensitivity and specificity of the ICMR-NCTB tests ranged from 70 to 100% and 70.7 to 100%, respectively, to identify dementia across all five languages.Conclusions: The ICMR-NCTB is a valid instrument to diagnose dementia across five Indian languages, with good diagnostic accuracy. The toolbox was effective in overcoming the challenge of linguistic diversity. The study has wide implications to address the problem of a high disease burden and low diagnostic rate of dementia in LMICs like India.

scholarly journals Rapid Screening for Cognitive Impairment in Parkinson’s Disease: A Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
YanHong Dong ◽  
Way Inn Koay ◽  
Leonard Leong Litt Yeo ◽  
Christopher Li-Hsian Chen ◽  
Jing Xu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Discriminant Validity ◽  
Operating Characteristic ◽  
Mini Mental State Examination ◽  
Characteristic Curve ◽  
Rapid Screening ◽  
Cognitive Screening ◽  
Clinical Dementia Rating ◽  
Cognitive Screen ◽  
State Examination

Aim. This study sought to establish the discriminant validity of a rapid cognitive screen, that is, the National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute protocol, and compare its discriminant validity to the Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE) in detecting cognitive impairment (CI) in PD patients.Methods. One hundred and one PD patients were recruited from a movement disorders clinic in Singapore and they received the NINDS-CSN 5-minute protocol, MoCA, and MMSE. No cognitive impairment (NCI) was defined as Clinical Dementia Rating (CDR) = 0 and CI was defined as CDR ≥ 0.5.Results. Area under the receiver operating characteristic curve of NINDS-CSN 5-minute protocol was statistically equivalent to MoCA and larger than MMSE (0.86 versus 0.90,P=0.07; 0.86 versus 0.76,P=0.03). The sensitivity of NINDS-CSN 5-minute protocol (<9) was statistically equivalent to MoCA (<22) (0.77 versus 0.85,P=0.13) and superior to MMSE (<24) (0.77 versus 0.52,P<0.01) in detecting CI, while the specificity of NINDS-CSN 5-minute protocol (<9) was statistically equivalent to MoCA (<22) and MMSE (<24) (0.78 versus 0.88,P=0.34).Conclusion. The NINDS-CSN 5-minute protocol is time expeditious while remaining statistically equivalent to MoCA and superior to MMSE and therefore is suitable for rapid cognitive screening of CI in PD patients.

scholarly journals Clinical and Objective Cognitive Measures for the Diagnosis of Cognitive Frailty Subtypes: A Comparative Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Qingwei Ruan ◽  
Weibin Zhang ◽  
Jian Ruan ◽  
Jie Chen ◽  
Zhuowei Yu
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Neuropsychological Test ◽  
Community Dwelling ◽  
Subjective Cognitive Decline ◽  
Cognitive Screening ◽  
Cognitive Frailty ◽  
Clinical Criteria ◽  
Clinical Assessments ◽  
Normal Cognition

BackgroundCognitive frailty (CF) includes reversible and potentially reversible subtypes; the former is known as concurrent physical frailty (PF) and pre-mild cognitive impairment subjective cognitive decline (pre-MCI SCD), whereas the latter is known as concurrent PF and MCI. The diagnoses of pre-MCI SCD and MCI are based on clinical criteria and various subjective cognitive decline questionnaires. Heterogeneous assessment of cognitive impairment (CI) results in significant variability of CI, CF, and their subtype prevalence in various population-based studies.ObjectiveThis study aimed to compare the classification differences in CI and CF subtypes from PF and normal cognition by applying clinical and objective cognitive criteria. Clinical criteria comprised Fried PF and clinical MCI criteria combined with the SCD questionnaire, whereas objective criteria comprised Fried PF and objective cognitive criteria based on the norm-adjusted six neuropsychological test scores.MethodsOf the 335 volunteers (age ≥ 60 years) in this study, 191 were diagnosed with CI based on clinical cognitive diagnosis criteria, and 144 were identified as robust normal based on objective cognitive assessment from the community-dwelling older adult cohort. Individuals with clinical CI, including 94 with MCI and 97 with pre-MCI SCD, were reclassified into different z-score-derived MCI, pre-MCI SCD, and normal subgroups based on objective cognitive criteria. The classification diagnostic accuracy of normal cognition, PF, pre-MCI, MCI, CF, and CF subtypes based on clinical and objective criteria was compared before and after adjusting for age, sex, and education level.ResultsThe reclassification of objective assessments indicated better performance than that of clinical assessments in terms of discerning CI severity among different subgroups before adjusting for demographic factors. After covariate adjustment, clinical assessments significantly improved the ability to cognitively discriminate normal individuals from those with pre-MCI SCD and MCI but not the z-score-derived pre-MCI SCD and MCI groups from the robust normal group. Furthermore, the adjustment did not improve the ability to discriminate among individuals with reversible CF from those with potentially reversible CF and pre-MCI only SCD from MCI only SCD.ConclusionsObjective criteria showed better performance than clinical criteria in the diagnosis of individuals with CI or CF subtypes. Rapid clinical cognitive screening in combination with normative z-scores criteria is cost effective and sustainable in clinical practice.

The Montreal Cognitive Assessment is superior to the Mini–Mental State Examination in detecting patients at higher risk of dementia

2012 ◽  
Vol 24 (11) ◽  
pp. 1749-1755 ◽  
Author(s):  
YanHong Dong ◽  
Wah Yean Lee ◽  
Nur Adilah Basri ◽  
Simon Lowes Collinson ◽  
Reshma A. Merchant ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mental State ◽  
Cognitive Assessment ◽  
Discriminant Validity ◽  
Mini Mental State Examination ◽  
Montreal Cognitive Assessment ◽  
Memory Clinic ◽  
Clinic Setting ◽  
Incident Dementia ◽  
State Examination

ABSTRACTBackground: To examine the discriminant validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in detecting patients with cognitive impairment at higher risk for dementia at a memory clinic setting.Methods: Memory clinic patients were administered the MoCA, MMSE, and a comprehensive formal neuropsychological battery. Mild cognitive impairment (MCI) subtypes were dichotomized into two groups: single domain–MCI (sd–MCI) and multiple domain-MCI (md–MCI). Area under the receiver operating characteristic curve (ROC) analysis was used to compare the discriminatory ability of the MoCA and the MMSE.Results: Two hundred thirty patients were recruited, of which 136 (59.1%) were diagnosed with dementia, 61 (26.5%) with MCI, and 33 (14.3%) with no cognitive impairment (NCI). The majority of MCI patients had md–MCI (n = 36, 59%). The MoCA had significantly larger AUCs than the MMSE in discriminating md–MCI from the lower risk group for incident dementia (NCI and sd–MCI) [MoCA 0.92 (95% CI, 0.86–0.98) vs. MMSE 0.84 (95% CI, 0.75–0.92), p = 0.02). At their optimal cut-off points, the MoCA (19/20) remained superior to the MMSE (23/24) in detecting md–MCI [sensitivity: 0.83 vs. 0.72; specificity: 0.86 vs. 0.83; PPV: 0.79 vs. 0.72; NPV: 0.89 vs. 0.83; correctly classified: 85.1% vs. 78.7%].Conclusion: The MoCA is superior to the MMSE in the detection of patients with cognitive impairment at higher risk for incident dementia at a memory clinic setting.

scholarly journals Depressive Symptoms Negatively Impact Montreal Cognitive Assessment Performance: A Memory Clinic Experience

2016 ◽  
Vol 43 (4) ◽  
pp. 513-517 ◽  
Author(s):  
Mervin Blair ◽  
Kristy Coleman ◽  
Sarah Jesso ◽  
Véronique Desbeaumes Jodoin ◽  
Kathy Smolewska ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
Depressive Symptomatology ◽  
Negative Impact ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Memory Clinic ◽  
The Impact

AbstractObjective:The Montreal Cognitive Assessment (MoCA) is a general cognitive screening tool that has shown sensitivity in detecting mild levels of cognitive impairment in various clinical populations. Although mood dysfunction is common in referrals to memory clinics, the influence of mood on the MoCA has to date been largely unexplored.Method:In this study, we examined the impact of mood dysfunction on the MoCA using a memory clinic sample of individuals with depressive symptoms who did not meet criteria for a neurodegenerative disease.Results:Half of the group with depressive symptoms scored below the MoCA-suggested cutoff for cognitive impairment. As a group, they scored below healthy controls, but above individuals with Alzheimer’s disease and frontotemporal dementia. A MoCA subtask analysis revealed a pattern of executive/attentional dysfunction in those with depressive symptoms.Conclusions:This observed negative impact of depressive symptomatology on the MoCA has interpretative implications for its utility as a cognitive screening tool in a memory clinic setting.

scholarly journals Screening for cognition in amyotrophic lateral sclerosis: test characteristics of a new screen

2021 ◽  
Author(s):  
Emma Beeldman ◽  
Rosanne Govaarts ◽  
Marianne de Visser ◽  
Michael A. van Es ◽  
Yolande A. L. Pijnenburg ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Cognitive Impairment ◽  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Screening Methods ◽  
Cognitive Screening ◽  
Test Characteristics ◽  
Lateral Sclerosis

AbstractCognitive and behavioural impairment in amyotrophic lateral sclerosis (ALS) negatively influences the quality of life and survival, and, therefore, screening for these impairments is recommended. We developed a cognitive screening tool, the amyotrophic lateral sclerosis–frontotemporal dementia–cognitive screen (ALS–FTD–Cog) and aimed to validate it in patients with ALS. During the current study, the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) was published and we, therefore, decided to compare these two cognitive screening methods. The ALS–FTD–Cog was administered to 72 patients with ALS, 21 patients with behavioural variant FTD (bvFTD) and 34 healthy controls. Twenty-nine patients with ALS underwent the ECAS. ROC curve analyses were performed and sensitivity and specificity of the ALS–FTD–Cog and ECAS were calculated, with a neuropsychological examination (NPE) as the gold standard. Cognitive impairment was present in 28% of patients with ALS. ROC curve analyses of the ALS–FTD–Cog and ECAS showed an area under the curve (AUC) of 0.72 (95% CI 0.58–0.86) and 0.95 (95% CI 0.86–1.03), respectively. Compared to a full NPE, sensitivity and specificity of the ALS–FTD–Cog were 65.0% and 63.5% and of the ECAS 83.3% and 91.3%, respectively. The sensitivity and specificity of the ALS–FTD–Cog in patients with bvFTD were 94.4% and 100%, respectively. Test characteristics of the ALS–FTD–Cog were moderate, suggesting restricted practical value, as compared to a comprehensive NPE. The ECAS had an excellent AUC and high sensitivity and specificity, indicating that it is a valid screening instrument for cognitive impairment in ALS.

Spontaneous Speech of Patients With Dementia of the Alzheimer Type and Mild Cognitive Impairment

2001 ◽  
Vol 13 (3) ◽  
pp. 289-298 ◽  
Author(s):  
Tom Bschor ◽  
Klaus-Peter Kühl ◽  
Friedel M. Reischies
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Spontaneous Speech ◽  
Alzheimer Type ◽  
Boston Naming Test ◽  
Global Deterioration Scale ◽  
Language Tests ◽  
Picture Description ◽  
Description Task ◽  
Naming Test

This article discusses the potential of three assessments of language function in the diagnosis of Alzheimer-type dementia (DAT). A total of 115 patients (mean age 65.9 years) attending a memory clinic were assessed using three language tests: a picture description task (Boston Cookie-Theft picture), the Boston Naming Test, and a semantic and phonemic word fluency measure. Results of these assessments were compared with those of clinical diagnosis including the Global Deterioration Scale (GDS). The patients were classified by ICD-10 diagnosis and GDS stage as without cognitive impairment (n = 40), mild cognitive impairment (n = 34), mild DAT (n = 21), and moderate to severe DAT (n = 20). Hypotheses were (a) that the complex task of a picture description could more readily identify language disturbances than specific language tests and that (b) examination of spontaneous speech could help to identify patients with even mild forms of DAT. In the picture description task, all diagnostic groups produced an equal number of words. However, patients with mild or moderate to severe DAT described significantly fewer objects and persons, actions, features, and localizations than patients without or with mild cognitive impairment. Persons with mild cognitive impairment had results similar to those without cognitive impairment. The Boston Naming Test and both fluency measures were superior to the picture description task in differentiating the diagnostic groups. In sum, both hypotheses had to be rejected. Our results confirm that DAT patients have distinct semantic speech disturbances whereas they are not impaired in the amount of produced speech.

Sign in / Sign up

Export Citation Format

Share Document