scholarly journals The Efficacy of General Practitioner Assessment of Cognition in Chinese Elders Aged 80 and Older

2019 ◽  
Vol 34 (7-8) ◽  
pp. 523-529
Author(s):  
Fang Xu ◽  
Juan Juan Ma ◽  
Fei Sun ◽  
Jaewon Lee ◽  
David W. Coon ◽  
...  
Keyword(s):  
General Practitioner ◽  
Mini Mental State Examination ◽  
Mainland China ◽  
University Hospital ◽  
Comparable Efficacy ◽  
Lower Sensitivity ◽  
Clinical Settings ◽  
Older Chinese ◽  
State Examination ◽  
Survey Questionnaires

Objectives: This study examined the efficacy of the General Practitioner Assessment of Cognition–Chinese version (GPCOG-C) in screening dementia and mild cognitive impairment (MCI) among older Chinese. Methods: Survey questionnaires were administered to 293 participants aged 80 or above from a university hospital in mainland China. Alzheimer disease and MCI were diagnosed in light of the National Institute on Aging and the Alzheimer’s Association (NIA/AA) criteria. The sensitivity and specificity of GPCOG-C and Mini-Mental State Examination (MMSE) in screening dementia and MCI were compared to the NIA/AA criteria. Results: The GPCOG-C had the sensitivity of 62.3% and specificity of 84.6% in screening MCI, which had comparable efficacy as the NIA/AA criteria. In screening dementia, GPCOG-C had a lower sensitivity (63.7%) than the MMSE and a higher specificity (82.6%) higher than the MMSE. Conclusions: The GPCOG-C is a useful and efficient tool to identify dementia and MCI in older Chinese in outpatient clinical settings.

scholarly journals Implementing SARS-CoV-2 Rapid Antigen Testing in the Emergency Ward of a Swiss University Hospital: The INCREASE Study

2021 ◽  
Vol 9 (4) ◽  
pp. 798
Author(s):  
Giorgia Caruana ◽  
Antony Croxatto ◽  
Eleftheria Kampouri ◽  
Antonios Kritikos ◽  
Onya Opota ◽  
...  
Keyword(s):  
Immunoglobulin A ◽  
University Hospital ◽  
Lower Sensitivity ◽  
Clinical Settings ◽  
Rt Pcr ◽  
Emergency Ward ◽  
Viral Loads ◽  
Asymptomatic Patients ◽  
Asymptomatic Subjects ◽  
Antigen Testing

Following the Swiss Federal Office of Public Health (FOPH) authorization of the rapid antigen test (RAT), we implemented the use of the RAT in the emergency ward of our university hospital for patients’ cohorting. RAT triaging in association with RT-PCR allowed us to promptly isolate positive patients and save resources. Among 532 patients, overall sensitivities were 48.3% for Exdia and 41.2% for Standard Q®, PanbioTM and BD Veritor™. All RATs exhibited specificity above 99%. Sensitivity increased to 74.6%, 66.2%, 66.2% and 64.8% for Exdia, Standard Q®, PanbioTM and BD Veritor™, respectively, for viral loads above 105 copies/mL, to 100%, 97.8%, 96.6% and 95.6% for viral loads above 106 copies/mL and 100% for viral loads above 107 copies/mL. Sensitivity was significantly higher for patients with symptoms onset within four days (74.3%, 69.2%, 69.2% and 64%, respectively) versus patients with the evolution of symptoms longer than four days (36.8%, 21.1%, 21.1% and 23.7%, respectively). Among COVID-19 asymptomatic patients, sensitivity was 33%. All Immunoglobulin-A-positive patients resulted negative for RAT. The RAT might represent a useful resource in selected clinical settings as a complementary tool in RT-PCR for rapid patient triaging, but the lower sensitivity, especially in late presenters and COVID-19 asymptomatic subjects, must be taken into account.

Medical Complications Predict Cognitive Decline in Nondemented Hip Fracture Patients—Results of a Prospective Observational Study

2018 ◽  
Vol 31 (2) ◽  
pp. 84-89 ◽  
Author(s):  
Juliana Hack ◽  
Daphne Eschbach ◽  
Rene Aigner ◽  
Ludwig Oberkircher ◽  
Steffen Ruchholtz ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Influencing Factors ◽  
Hip Fractures ◽  
Mental State ◽  
Mini Mental State Examination ◽  
University Hospital ◽  
Medical Complications ◽  
Consecutive Series ◽  
State Examination

Objective: The aim of this study was to identify factors that are associated with cognitive decline in the long-term follow-up after hip fractures in previously nondemented patients. Methods: A consecutive series of 402 patients with hip fractures admitted to our university hospital were analyzed. After exclusion of all patients with preexisting dementia, 266 patients were included, of which 188 could be examined 6 months after surgery. Additional to several demographic data, cognitive ability was assessed using the Mini-Mental State Examination (MMSE). Patients with 19 or less points on the MMSE were considered demented. Furthermore, geriatric scores were recorded, as well as perioperative medical complications. Mini-Mental State Examination was performed again 6 months after surgery. Results: Of 188 previously nondemented patients, 12 (6.4%) patients showed a cognitive decline during the 6 months of follow-up. Multivariate regression analysis showed that age ( P = .040) and medical complications ( P = .048) were the only significant independent influencing factors for cognitive decline. Conclusions: In our patient population, the incidence of dementia exceeded the average age-appropriate cognitive decline. Significant independent influencing factors for cognitive decline were age and medical complications.

scholarly journals Synergistic influence of education and marriage on the risk for cognition loss among the older people in China

2020 ◽  
Author(s):  
ning sun ◽  
Rangcheng Jia ◽  
Chunyan Guo ◽  
Tongda Sun ◽  
Xiaoxin Dong ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Older People ◽  
Educational Level ◽  
Mini Mental State Examination ◽  
Educational Levels ◽  
Age Related ◽  
Related Risk ◽  
Older Chinese ◽  
Age Range ◽  
State Examination

Abstract Background The study was aim to prove that both rationality and emotion are indispensable for older people to maintain their ability to live independently during the twilight of their lives. Methods The resilience of older people to dementia were investigated by considering the interactions between educational levels and marriage status. Four sociodemographic variables (age, sex, educational level, and marital status) were collected from 1177 older Chinese participants, whose mini-mental state examination scores (MMSE scores) were measured. Results A lower educational level coupled with being widowed caused a greater risk for severe cognitive impairment (relative risk [RR] 1.48; 95% confidence interval [CI] 1.20–1.82; p < 0.001) for high-aged older participants (age range: ≥80) than for their low-aged counterparts (age range: ≥60 and < 80). In contrast, a higher educational level coupled with being married leveled this age-related risk for cognitive loss (RR 0.91; 95% CI 0.65–1.27; p = 0.62). Conclusions Further findings suggest that the synergistic influence of education and marriage was observed only among high-aged older people .Being both well-educated and married is associated with a delayed cognitive function for older people. However, longevity is a prerequisite for realizing this benefit.

scholarly journals ImplemeNting SARS-CoV-2 Rapid antigen testing in the Emergency wArd of a Swiss univErsity hospital: the INCREASE study

2021 ◽  
Author(s):  
Giorgia Caruana ◽  
Antony Croxatto ◽  
Eleftheria Kampouri ◽  
Antonios Kritikos ◽  
Onya Opota ◽  
...  
Keyword(s):  
University Hospital ◽  
Lower Sensitivity ◽  
Clinical Settings ◽  
Rt Pcr ◽  
Emergency Ward ◽  
Viral Loads ◽  
Molecular Tests ◽  
One Step ◽  
Antigen Tests ◽  
Second Wave

BackgroundWhile facing a second wave in SARS-CoV-2 pandemic, in November 2020 the Swiss Federal Office of Public Health (FOPH) authorized the use of rapid antigen tests (RATs) in addition to the gold-standard reverse transcription-polymerase chain reaction (RT-PCR).MethodsWe implemented the use of RAT in the emergency ward of our university hospital for rapid patients’ triaging and compared performances of four different antigen tests. All results were compared to SARS-CoV-2 specific RT-PCR (reference standard).ResultsTriaging patients using RAT in association with RT-PCR allowed us to isolate promptly positive patients and to save resources, in a context of rapid RT-PCR reagents shortage. Among 532 patients with valid results, overall sensitivities were 48.3% for One Step Exdia and 41.2% for Standard Q®, Panbio−and BD Veritor. All four antigen tests exhibited specificity above 99%. Sensitivity increased up to 74.6%, 66.2%, 66.2% and 64.8% for One Step Exdia, Standard Q, Panbio, and BD Veritor respectively, when considering viral loads above 105copies/ml, up to 100%, 97.8%, 96.6% and 95.6% for viral loads above 106 copies/ml and 100% (for all tests) when considering viral loads above 107 copies/ml. Sensitivity was significantly higher for patients presenting with symptoms onset within 4 days (74.3%, 69.2%, 69.2% and 64%, respectively) versus patients with evolution of symptoms for more than 4 days (36.8%, 21.1%, 21.1% and 23.7%, respectively). Sensitivities of all RAT assays were of only 33% among hospitalized patients without COVID-19 symptoms.ConclusionRAT might represent a useful epidemiological resource in selected clinical settings as a complementary tool to the molecular tests for rapid patients triaging, but the lower sensitivity compared to RT-PCR, especially in late presenters and subjects without COVID-19 symptoms, must be taken into account in order to correctly use RAT for triaging.

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.

scholarly journals GENDER DIFFERENCES IN THE PREVALENCE AND INCIDENCE OF COGNITIVE IMPAIRMENT: DOES IMMIGRATION MATTER?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S814-S815
Author(s):  
Fengyan Tang ◽  
Fengyan Tang ◽  
Ke Li ◽  
Iris Chi ◽  
XinQi Dong
Keyword(s):  
Cognitive Impairment ◽  
Mini Mental State Examination ◽  
Chinese Women ◽  
Future Research ◽  
Research Needs ◽  
Related Factors ◽  
Men And Women ◽  
Baseline Incidence ◽  
Older Chinese ◽  
State Examination

Abstract Using two waves of the PINE data, this study examined gender difference in the associations between immigration-related factors and cognitive impairment (CI). CI was assessed by the Chinese Mini-Mental State Examination (C-MMSE). CI prevalence was determined by C-MMSE &lt; 18 at baseline; incidence was the percentage of the respondents whose C-MMSE &gt; 18 at baseline but dropped below 18 at Wave 2. We found 7.62% CI prevalence and 5.12% incidence rate. Women were more likely than men to have CI, consisting of 77.06% and 75.20% among persons with CI at two time points. Older Chinese women were generally disadvantaged in cognition and overall health compared with older men. Yet immigration experience does not link to CI for both men and women after controlling the well-established effects of age and education. Future research needs to investigate what biological and contextual factors earlier in life are predictive of late-life CI risk.

scholarly journals PHYSICAL FUNCTION AND LONGITUDINAL CHANGES IN COGNITIVE FUNCTION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S815-S815
Author(s):  
Jinjiao Wang ◽  
Jinjiao Wang ◽  
Dexia Kong ◽  
XinQi Dong
Keyword(s):  
Cognitive Function ◽  
Physical Function ◽  
Mini Mental State Examination ◽  
Digit Span ◽  
Chinese Adults ◽  
Older Chinese ◽  
Older Chinese Adults ◽  
The Relationship ◽  
State Examination

Abstract Among 2,038 older Chinese adults in the U.S., we examined the relationship between physical function (Short Performance Physical Battery [SPPB], [instrumental] activities of daily living [ADL/IADL] limitations) at baseline (2011-2013) and changes in cognitive function in the two-year follow-up (2013-2015). Cognitive function was measured by the East Boston Memory Test (EBMT), the Digit Span Backwards assessment (DSB), the Symbol Digit Modalities Test (SDMT), and the Mini-Mental State Examination (MMSE). During the two-year follow-up, 41.8%-50.88% of the participants decreased in cognitive function and 32.88%-44.8% increased. In linear regression that adjusted for baseline cognitive function, education, age, and other covariates, baseline SPPB and ADL/IADL limitations were significantly associated with changes in cognitive function in the two-year follow-up (SPPB: βEBMT=0.0149, p&lt;0.05; βDSB=0.0253, p&gt;0.05; βSDMT=0.2742, p&lt;0.01; βMMSE=0.1070, p&lt;0.001; ADL/IADL limitations: βEBMT= -0.0401, p&lt;0.0001; βDSB= -0.0410, p&lt;0.05; βSDMT= -0.3027, p&lt;0.01; βMMSE= -0.2566, p&lt;0.0001). This suggests that better physical function predicts positive changes in cognitive function.

Dimensions of the Mini-Mental State Examination among community dwelling older adults

2000 ◽  
Vol 30 (3) ◽  
pp. 605-618 ◽  
Author(s):  
RICHARD N. JONES ◽  
JOSEPH J. GALLO
Keyword(s):  
Older Adults ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Field Research ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Assessment Instrument ◽  
Clinical Settings ◽  
Community Dwelling Older Adults ◽  
State Examination

Background. Little work has been published on the internal structure of the Mini-Mental State Examination (MMSE), one of the most widely used instruments for grading cognitive status in clinical settings and field research.Methods. MMSE responses from a sample of older adults (50–98 years) in five US sites (N = 8556) were analysed.Results. A five-factor solution was found to be most appropriate. The first factor (concentration) had large loadings with serial sevens and spell world backwards items. The second factor (language and praxis) had large loadings with naming, follow command and praxis items. The third factor (orientation) had loadings with orientation to time and place items. The fourth factor (memory) had large loadings with delayed recall items and the fifth (attention) had large loadings with immediate registration items.Conclusions. We found that the MMSE is essentially unidimensional; nevertheless, evidence was revealed suggesting that the MMSE is a multidimensional assessment instrument. Dimensions revealed in this sample correspond directly to MMSE sections articulated by the developers of the instrument. These findings have not been reported in previous factor analyses of the MMSE. The findings support the construct validity of the MMSE as a measure of cognitive mental state among community dwelling older adults.

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