Independent Older Adult’s IADL and Executive Function According to Cognitive Performance

2020 ◽  
Vol 40 (3) ◽  
pp. 183-189
Author(s):  
Orit Lahav ◽  
Noomi Katz
Keyword(s):  
Executive Function ◽  
Cognitive Assessment ◽  
Daily Living ◽  
Screening Tool ◽  
Cognitive Screening ◽  
Female Age ◽  
Gender And Age ◽  
Cognitive Levels ◽  
And Gender ◽  
Independent Elderly

Participation in Instrumental Activities of Daily Living (IADL) is essential in occupational therapy aiming to improve the life situation of elderly. Effective executive function (EF) is important to successful functioning in IADL. The purpose of this study was to examine EF and IADL performance differences according to cognitive levels as measured by the Montreal Cognitive Assessment (MoCA), age, and gender. In all, 80 elderly (49% female; age M = 73.4) were assessed at home, with Weekly Calendar Planning Activity (WCPA-10), IADL scale, and MoCA as a cognitive screening tool for dividing into normal cognitive (NC) level and mild cognitive impairment (MCI). The comparison between the MoCA groups on the WCPA-10 and IADL shows significant differences between the groups; gender and age differed only in IADL. IADL and WCPA-10 performance among independent elderly relates to their cognitive level. We suggest that intervention that will focus on EF may assist in improving performance and maintaining participation in occupation.

scholarly journals Assessing Capacity in the Elderly: Comparing the MoCA with a Novel Computerized Battery of Executive Function

2017 ◽  
Vol 7 (2) ◽  
pp. 249-256 ◽  
Author(s):  
Megan Brenkel ◽  
Kenneth Shulman ◽  
Elias Hazan ◽  
Nathan Herrmann ◽  
Adrian M. Owen
Keyword(s):  
Older Adults ◽  
Executive Function ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
The Elderly ◽  
Cognitively Impaired ◽  
Cognitive Screening ◽  
Decision Making Capacity ◽  
Brain Sciences ◽  
Cognitively Intact

Background/Aims: Clinicians are increasingly being asked to provide their opinion on the decision-making capacity of older adults, while validated and widely available tools are lacking. We sought to identify an online cognitive screening tool for assessing mental capacity through the measurement of executive function. Methods: A mixed elderly sample of 45 individuals, aged 65 years and older, were screened with the Montreal Cognitive Assessment (MoCA) and the modified Cambridge Brain Sciences Battery. Results: Two computerized tests from the Cambridge Brain Sciences Battery were shown to provide information over and above that obtained with a standard cognitive screening tool, correctly sorting the majority of individuals with borderline MoCA scores. Conclusions: The brief computerized battery should be used in conjunction with standard tests such as the MoCA in order to differentiate cognitively intact from cognitively impaired older adults.

The Colorado Cognitive Assessment (CoCA): Development of an Advanced Neuropsychological Screening Tool

2019 ◽  
Author(s):  
Ashita S. Gurnani ◽  
Shayne S.-H. Lin ◽  
Brandon E Gavett
Keyword(s):  
Construct Validity ◽  
Psychometric Properties ◽  
Cognitive Assessment ◽  
Screening Tool ◽  
Depression Scale ◽  
Internal Consistency Reliability ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Analysis Model ◽  
Factor Analysis Model

Objective: The Colorado Cognitive Assessment (CoCA) was designed to improve upon existing screening tests in a number of ways, including enhanced psychometric properties and minimization of bias across diverse groups. This paper describes the initial validation study of the CoCA, which seeks to describe the test; demonstrate its construct validity; measurement invariance to age, education, sex, and mood symptoms; and compare it to the Montreal Cognitive Assessment (MoCA). Method: Participants included 151 older adults (MAge = 71.21, SD = 8.05) who were administered the CoCA, MoCA, Judgment test from the Neuropsychological Assessment Battery (NAB), 15-item version of the Geriatric Depression Scale (GDS-15), and 10-item version of the Geriatric Anxiety Scale (GAS-10). Results: A single factor confirmatory factor analysis model of the CoCA fit the data well, CFI = 0.955; RMSEA = 0.033. The CoCA’s internal consistency reliability was .84, compared to .74 for the MoCA. The CoCA had stronger disattenuated correlations with the MoCA (r = .79) and NAB Judgment (r = .47) and weaker correlations with the GDS-15 (r = -.36) and GAS-10 (r = -.15), supporting its construct validity. Finally, when analyzed using multiple indicators, multiple causes (MIMIC) modeling, the CoCA showed no evidence of measurement non-invariance, unlike the MoCA. Conclusions: These results provide initial evidence to suggest that the CoCA is a valid cognitive screening tool that offers numerous advantages over the MoCA, including superior psychometric properties and measurement non-invariance. Additional validation and normative studies are warranted.

scholarly journals P1508COGNITIVE IMPAIRMENT A RISK FACTOR FOR NON ADHERENCE TO MEDICAL MANAGEMENT AMONG PATIENTS ON MAINTENANCE HEMODIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Larisa Shehaj ◽  
Merita Rroji (Molla)
Keyword(s):  
Cognitive Assessment ◽  
Descriptive Analysis ◽  
Strong Association ◽  
Montreal Cognitive Assessment ◽  
Maintenance Hemodialysis ◽  
Medical Adherence ◽  
Cognitive Screening ◽  
High Prevalence ◽  
The Mean ◽  
And Gender

Abstract Background and Aims Patients with chronic kidney disease (CKD) are at substantially higher risk for developing cognitive impairment (CI) compared with the general population. Subtle changes can impact engagement with healthcare, comprehension, decision-making, and medication adherence. The Montreal Cognitive Assessment (MoCA) test was reported to represent a suitable cognitive screening tool for hemodialysis patients. Our study aimed to assess the prevalence of CI in CKD patients undergoing hemodialysis, socio-demographic and patient-related variables affecting CI and relationship with medical adherence. Method Out of 65 patients in the HD unit, 58 patients (mean age 59.16±10.61 years old and meantime in therapy 6.93±5.03 years) accepted to participate in the study. The Montreal Cognitive Assessment (MoCA) scale was administered to patients. Patients with a MoCA global score 24/30 were considered cognitively impaired. Descriptive analysis was done for the socio-demographic and clinical variables. Results The mean total MoCA score for all the patients were 22.77679±3.8. Thirty seven patient 63.7% were evaluated with CI where 67.5 % with Mild CI (MCI) and 32.5% with severe CI (SCI) under 20 points). MoCA subscale analysis revealed that the mean score for visuospatial/executive domain and attention were the lowest with 5.38±1.3 /8max and 2.82±1.67/6 max and scores for orientation were the highest 5.94±0.59/6 max. MCI was related to vintage to dialysis (p < .00001) and education years (p<0.05) but not with age (p>0.05) and gender (p>0.05) where severe CI was related to age and comorbidity ( p<0.05 and P<0.01, respectively. We found a strong association between low scores and medical adherence (p<0.001). Conclusion: In hemodialysis, we have a relatively high prevalence of CI and screening for impairment should be considered in all adults with ESRD. Older age, vintage on dialysis, and comorbidity were associated with lower scores. The visuospatial/executive domain and attention were mostly affected. The association between low scores and medical adherence show a high risk for this group of patients.

scholarly journals New Discovery of Left Atrial Macroreentry Tachycardia: Originating from the Spontaneous Scarring of Left Atrial Anterior Wall

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Xuefeng Zhu ◽  
Hongxia Chu ◽  
Jianping Li ◽  
Chunxiao Wang ◽  
Wenjing Li ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Left Atrial ◽  
Atrial Tachycardia ◽  
Low Voltage ◽  
Area Under The Curve ◽  
Anterior Wall ◽  
Female Age ◽  
Gender And Age ◽  
History Of ◽  
And Gender

Aims. This study sought to describe left atrial macroreentry tachycardia (LAMRT) originating from the spontaneous scarring of left atrial anterior wall (LAAW) and its clinical and electrophysiological characteristics, mechanisms, and the formation of substrates. Methods and Results. 9 of 123 patients (89% female, age 79.78 ± 5.59 years) had LAMRT originating from the LAAW with no cardiac surgery or prior left atrial (LA) ablation. The mean tachycardia cycle length (TCL) was 241.67 ± 38.00 milliseconds. Spontaneous scars areas and low voltage areas (LVAs) in the LAAW were found in all patients. Successful ablation of the critical isthmus caused termination of the LAMRT and was not inducible in all patients. Arrhythmogenic substrates of LAMRT were the spontaneous scars of LAAW, which matched with the aorta or/and pulmonary artery contact area. The area under the curve (AUC) of age and combination of gender and age for predicting the LAMRT originating from the LAAW were 0.918 and 0.951, respectively, with a cutoff value of ≥73.5 years of age and gender (female) predicting LAMRT with 88.9% sensitivity and 89% specificity. Conclusion. Combination of gender and age provides a simple and useful criterion to distinguish LAMRT from cavotricuspid isthmus- (CTI-) dependent atrial tachycardia in macroreentry atrial tachycardia (MRAT) in patients without a history of surgery or ablation. Aorta or/and pulmonary artery contacting LA may be related to spontaneous scars. Ablation the isthmus eliminated LAMRT in all patients.

The AVERT MoCA Data: Scoring Reliability in a Large Multicenter Trial

Assessment ◽  
2018 ◽  
Vol 27 (5) ◽  
pp. 976-981 ◽  
Author(s):  
Toby B. Cumming ◽  
Danielle Lowe ◽  
Thomas Linden ◽  
Julie Bernhardt
Keyword(s):  
Cognitive Assessment ◽  
Interrater Reliability ◽  
Screening Tool ◽  
Multicenter Trial ◽  
Scoring Rules ◽  
Independent Data ◽  
Cognitive Screening ◽  
Subjective Judgement ◽  
Trail Making ◽  
Data Checking

The Montreal Cognitive Assessment (MoCA) is a widely used cognitive screening tool in stroke. As scoring the visuospatial/executive MoCA items involves subjective judgement, reliability is important. Analyzing data on these items from A Very Early Rehabilitation Trial (AVERT), we compared the original scoring of assessors ( n = 102) to blind scoring by a single, independent rater. In a sample of scoresheets from 1,119 participants, we found variable interrater reliability. The match between original assessors and the independent rater was the following: trail-making 97% (κ = 0.94), cube copy 90% (κ = 0.80), clock contour 92% (κ = 0.49), clock numbers 89% (κ = 0.67), and clock hands 72% (κ = 0.46). For all items except clock contour, the independent rater was “stricter” than the original assessors. Discrepancies were typically errors in original scoring, rather than borderline differences in subjective judgement. In trials that include the MoCA, researchers should emphasize scoring rules to assessors and implement independent data checking, especially for clock hands, to maximize accuracy.

scholarly journals A-021 Normative Data on Montreal Cognitive Assessment Total Scores in Healthy Controls

2020 ◽  
Vol 35 (6) ◽  
pp. 811-811
Author(s):  
Ratcliffe L ◽  
Marker C
Keyword(s):  
Cognitive Assessment ◽  
Normative Data ◽  
Screening Tool ◽  
Geographical Location ◽  
Healthy Adults ◽  
Montreal Cognitive Assessment ◽  
Healthy Controls ◽  
Strongly Correlated ◽  
Cognitive Screening ◽  
Cutoff Scores

Abstract The Montreal Cognitive Assessment (MoCA) is considered to be a suitable, sensitive, and specific cognitive screening tool for detecting mild cognitive impairment. Research has reported variable cutoff scores for the MoCA based upon geographical location. The aim of the present study is to provide normative data in a sample of cognitively healthy adults. Data was collected through the National Alzheimer’s Coordinating Center (NACC). A population of healthy adults (N = 3610) was examined (66% female, 78% Caucasian, 16% African American, 6% Other). MoCA normative data were derived from age and education, which were found to be weakly but significantly associated with age (r = −.203, p = .000) and more strongly correlated with education (r = .402, p = .000). Total scores (M = 26.25, SD = 2.75) were at the suggested cutoff for impairment (< 26). Based on an ANOVA, age had a significant effect on MoCA scores (F (6, 3603) = 25.30, p < .001). A second ANOVA revealed that education also had a significant effect on MoCA scores (F (2, 3582) = 290.56, p < .001). Individuals with higher levels of education obtained higher MoCA scores. Performance was also found to decrease slightly with age. Therefore, clinicians should use caution when applying the recommended cutoff scores.

scholarly journals The Montreal Cognitive Assessment as a Cognitive Screening Tool in Athletes

2019 ◽  
Vol 46 (3) ◽  
pp. 311-318 ◽  
Author(s):  
Chantel Teresa Debert ◽  
Joan Stilling ◽  
Meng Wang ◽  
Tolulope Sajobi ◽  
Kristina Kowalski ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Sports Medicine ◽  
High Performance ◽  
Screening Tool ◽  
Sport Participation ◽  
Clinical Care ◽  
Montreal Cognitive Assessment ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
National Team

ABSTRACT:Background: The Montreal Cognitive Assessment (MoCA) is a cognitive screening tool known to accurately measure mild cognitive impairment (MCI) in many different neurological populations. Objective: We aimed to determine whether a sport-related concussion (SRC) history and other concussion modifiers influence global cognitive function in high-performance athletes. Methods: A cross-sectional study of 326 varsity and national team athletes aged 18–36 years was completed at the University of Calgary Sports Medicine Clinic, Calgary, Alberta, Canada. Logistic regression analysis was used to examine the association between the total MoCA score, MoCA subscales, and number of previous SRC, adjusting for age, sex, sport participation (SP), and concussion modifiers. Results: Athletes with a history of three or more SRC were 5.36 times more likely to score less than 26/30 on the MoCA (the cutoff for MCI) compared to athletes with two or less SRC (p = 0.02). Males were 2.23 times more likely to have MCI than females (p = 0.0004). There was a significant relationship between the number of previous concussions and the MoCA subscales of attention (p = 0.05) and abstraction (p = 0.003). Age, SP, and concussion modifiers (migraine, depression, anxiety, and attention deficit and hyperactivity disorder) did not influence the relationship between MoCA and previous concussion history. Conclusion: In the appropriate clinical context, cognitive screening with the MoCA may benefit clinical care in athletes with multiple previous SRC, but should not replace a full neuropsychological assessment. Thus, further research is needed to compare the MoCA to full neuropsychological assessments in this population.

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