scholarly journals Assessing and disclosing test results for ‘mild cognitive impairment’: the perspective of old age psychiatrists in Scotland

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Stina Saunders ◽  
Craig W. Ritchie ◽  
Tom C. Russ ◽  
Graciela Muniz-Terrera ◽  
Richard Milne
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Old Age ◽  
Assessment Tool ◽  
Clinical History ◽  
Diagnostic Process ◽  
Test Results ◽  
Risk Disclosure ◽  
Therapy Assessment ◽  
The Individual

Abstract Background Mild cognitive impairment (MCI) is a condition that exists between normal healthy ageing and dementia with an uncertain aetiology and prognosis. This uncertainty creates a complex dynamic between the clinicians’ conception of MCI, what is communicated to the individual about their condition, and how the individual responds to the information conveyed to them. The aim of this study was to explore clinicians’ views around the assessment and communication of MCI in memory clinics. Method As part of a larger longitudinal study looking at patients’ adjustment to MCI disclosure, we interviewed Old Age Psychiatrists at the five participating sites across Scotland. The study obtained ethics approvals and the interviews (carried out between Nov 2020–Jan 2021) followed a semi-structured schedule focusing on [1] how likely clinicians are to use the term MCI with patients; [2] what tests clinicians rely on and how much utility they see in them; and [3] how clinicians communicate risk of progression to dementia. The interviews were voice recorded and were analysed using reflective thematic analysis. Results Initial results show that most clinicians interviewed (Total N = 19) considered MCI to have significant limitations as a diagnostic term. Nevertheless, most clinicians reported using the term MCI (n = 15/19). Clinical history was commonly described as the primary aid in the diagnostic process and also to rule out functional impairment (which was sometimes corroborated by Occupational Therapy assessment). All clinicians reported using the Addenbrooke’s Cognitive Examination-III as a primary assessment tool. Neuroimaging was frequently found to have minimal usefulness due to the neuroradiological reports being non-specific. Conclusion Our study revealed a mixture of approaches to assessing and disclosing test results for MCI. Some clinicians consider the condition as a separate entity among neurodegenerative disorders whereas others find the term unhelpful due to its uncertain prognosis. Clinicians report a lack of specific and sensitive assessment methods for identifying the aetiology of MCI in clinical practice. Our study demonstrates a broad range of views and therefore variability in MCI risk disclosure in memory assessment services which may impact the management of individuals with MCI.

A path to early diagnosis of mild cognitive impairment and dementia: validity and reliability of the myMemCheck® self-administered screening tool

2020 ◽  
Vol 37 (4) ◽  
pp. 561-567
Author(s):  
William E Mansbach ◽  
Ryan A Mace ◽  
Melissa A Tanner ◽  
Steven P Simmons
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Assessment Tool ◽  
Nursing Home Residents ◽  
Cognitive Status ◽  
Diagnostic Process ◽  
Validity And Reliability ◽  
Characteristic Analysis ◽  
Cross Sectional

Abstract Background Barriers to the early detection of mild cognitive impairment (MCI) and dementia can delay diagnosis and treatment. myMemCheck® was developed as a rapid free cognitive self-assessment tool that can be completed at home to identify older adults that would benefit from a more comprehensive cognitive evaluation. Objective Two prospective cross-sectional studies were conducted to examine the psychometric properties and clinical utility of myMemCheck®. Methods In Study 1, participants were independent living residents referred to an outpatient memory clinic (N = 59); older adults in the community and post-acute nursing home residents (N = 357) comprised Study 2. Results Psychometric analyses were performed on cognitive and psychological testing data, including myMemCheck®. myMemCheck® evidenced adequate reliability and strong construct validity. Receiver operating characteristic analysis evidenced an optional myMemCheck® cut score for identifying older adults at risk for MCI or dementia. myMemCheck® explained 25% of cognitive status beyond basic patient information. Conclusions myMemCheck® may help fast-track the diagnostic process, facilitate appropriate referrals for cognitive and neuropsychological evaluation, reduce assessment burden in health care and prevent negative outcomes associated with undetected cognitive impairment.

scholarly journals Use and understanding of functional cognitive disorder terminology in United Kingdom clinical practice - a survey

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S277-S277
Author(s):  
Alexandra Nash ◽  
Jon Stone ◽  
Alan Carson ◽  
Craig Ritchie ◽  
Laura McWhirter
Keyword(s):  
United Kingdom ◽  
Cognitive Impairment ◽  
Clinical Practice ◽  
Mild Cognitive Impairment ◽  
Old Age ◽  
Cognitive Disorders ◽  
Cognitive Disorder ◽  
Cognitive Symptoms ◽  
Case Study Methodology ◽  
Case Vignettes

AimsThis study aimed to explore the terms used by old-age psychiatrists and psychologists to describe subjective and mild cognitive impairment and functional cognitive disorders (FCD) in clinical practice.MethodParticipants were selected from across the United Kingdom based on their clinical involvement in the assessment of cognitive complaints. 9 old-age psychiatrists and 4 psychologists were interviewed about their use of terminology in clinical practice and their awareness and understanding of FCD terminology via semi-structured interview questions and case vignettes. Interviews were conducted between December 2020 and February 2021 using online platforms Zoom and Microsoft Teams. Participants were recruited by email and Twitter. All questions were asked verbally; however, the four case vignettes were displayed via screen-share. All discussions and answers were transcribed and transcripts were coded manually using the exploratory case study methodology in order to identify themes in participants’ responses.ResultThis study has highlighted the variable use of terms used to describe and diagnose patients presenting with symptoms of cognitive disorders. The terms ‘mild cognitive impairment’, ‘subjective cognitive decline’ and ‘functional cognitive disorder’ were used most commonly amongst participants, though the terms ‘subjective cognitive impairment’ and ‘pseudodementia’ were also presented. This theme of language discontinuity is underscored by participants’ varying use of terminology when describing or presenting their diagnoses for the case vignettes. The data also reveals a sub-theme of variability in application of the term FCD. Whilst all participants gave similar definitions for this term, the application of FCD as a diagnosis in practice was inconsistent. Six participants described FCD as associated with or secondary to other functional or psychiatric conditions, four participants viewed FCD as an isolated diagnosis, and one participant considered FCD to be either part of another illness or a separate diagnosis. Two participants neither used nor recognised the term FCD.ConclusionIt is evident that there is varied use of terms describing or diagnosing forms of cognitive symptoms. The findings of this study highlight the need for a clear, adoptable definition of FCD in practice as well as implementable management plans for FCD patients. This is critical in order to avoid misdiagnosis and mismanagement, which may have harmful effects on patients living with debilitating cognitive symptoms.

Living Longer Better

2021 ◽  
pp. 1-14
Author(s):  
Charles Alessi ◽  
Larry W. Chambers ◽  
Muir Gray
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Physical Fitness ◽  
Vascular Dementia ◽  
Old Age ◽  
Social Activity ◽  
Cognitive Ageing ◽  
Brain Reserve ◽  
Lay People ◽  
Age Limit

Ageing is not a cause of major problems till the later nineties. The problems we fear—dementia, disability, and dependency are due to three other processes: loss of physical fitness, which starts long before old age, diseases, many of which are preventable, and pessimistic attitudes. Both lay people and our professional colleagues have difficulty with the meanings of dementia, Alzheimer’s disease, vascular dementia, and cognitive ageing and use these terms in different ways, often incorrectly. Now is the time to use your assets—preserving and increasing your brain reserve to reduce your risk of dementia. The fitness gap can be closed at any age by increasing both physical and social activity. There is no upper age limit for prevention. The steps we recommend for reducing the risk of dementia will also help you reduce the risk of other diseases, keep you fitter, and help you feel better, and are equally relevant for people who have already developed mild cognitive impairment or dementia.

P3-164: Profile of neuropsychological test results of mild cognitive impairment associated with presence of depression

2008 ◽  
Vol 4 ◽  
pp. T568-T568
Author(s):  
Ja-Young Oh ◽  
Chan-Seung Chung ◽  
Jae-Hong Lee ◽  
Duk-Lyul Na ◽  
Doh Kwan Kim ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Neuropsychological Test ◽  
Test Results

scholarly journals Negative social interactions and risk of mild cognitive impairment in old age.

2015 ◽  
Vol 29 (4) ◽  
pp. 561-570 ◽  
Author(s):  
Robert S. Wilson ◽  
Patricia A. Boyle ◽  
Bryan D. James ◽  
Sue E. Leurgans ◽  
Aron S. Buchman ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Social Interactions ◽  
Old Age ◽  
Negative Social Interactions

scholarly journals Memory in Old Age: Current Scenario in India

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. K. Lalitha ◽  
Dr. D. Jamuna
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Old Age ◽  
Empirical Studies ◽  
Transitional Stage ◽  
Memory Problems ◽  
Early Dementia ◽  
Current Scenario ◽  
Objective Tests ◽  
The Common

One of the common concerns of older people is the complaint that their memory was not as good as it was. Empirical studies on memory have highlighted that memory losses are not uncommon in any age. According to statistics, 70% of older adults report that they have memory problems, but objective tests are needed to determine if they have mild cognitive impairment, which is also known as benign senescent forgetfulness (AAMD) and early dementia. Mild cognitive impairment is basically a transitional stage between normal aging and Alzheimer’s disease. Studies show that 17% to 34% of elderly people have mild cognitive impairment. One of the significant areas of contemporary gerontological researches is planning of systematic interventions in improving memory. This article focuses on the research carried out on memory and old age in India and discusses the need for further research.

scholarly journals A Path to Early Diagnosis of MCI and Dementia: Integrating myMemCheck Into the Primary Care Workflow

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 261-262
Author(s):  
William Mansbach ◽  
Ryan Mace ◽  
Theresa Frangiosa ◽  
Virginia Biggar ◽  
Meryl Comer ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Predictive Value ◽  
Healthcare Professionals ◽  
Assessment Tool ◽  
Cognitive Status ◽  
Diagnostic Process ◽  
Characteristic Analysis ◽  
Self Assessment ◽  
Study Results

Abstract Barriers to the early detection of mild cognitive impairment (MCI) and dementia can delay diagnosis and treatment. myMemCheck® was developed as a rapid free cognitive self-assessment tool that can be completed in the practice setting or at home to identify older adults that would benefit from a more comprehensive cognitive evaluation for MCI and dementia. Two prospective cross-sectional studies (N = 59; N = 357) were conducted to examine the psychometric properties and clinical utility of myMemCheck®. myMemCheck® evidenced adequate reliability (test-retest, r = 0.67) and strong construct validity (η2 = 0.29, discriminating normal, MCI, dementia). Receiver operating characteristic analysis evidenced an optional myMemCheck® cut score for identifying older adults with MCI or dementia (sensitivity = 0.80, specificity = 0.67, positive predictive value = 0.91, negative predictive value = 0.43). myMemCheck® explained 25% of cognitive status beyond basic patient information. We provide specific suggestions for integrating myMemCheck® into practice to optimize workflow. Study results are further interpreted in the context of two national online surveys (healthcare professionals, N = 181; consumers, N = 1740). Healthcare professionals widely agreed on the need (94%) and importance (86%) of cognitive self-assessments. Public demand for cognitive self-assessment was confirmed by consumers who trialed myMemCheck® as part of their survey participation—86% agreed on the need for a tool like myMemCheck®. Mixed methods findings suggest that myMemCheck® could fast- track the diagnostic process, facilitate appropriate referrals for cognitive and neuropsychological evaluation, reduce assessment burden in healthcare, and prevent negative outcomes associated with undetected cognitive impairment.

scholarly journals Utility of a Screening Test (MoCa) to Predict Amyloid Physiopathology in Mild Cognitive Impairment

2020 ◽  
Vol 1 (1) ◽  
pp. 87-91
Author(s):  
María Florencia Clarens ◽  
Ismael Calandri ◽  
María Belen Helou ◽  
María Eugenia Martín ◽  
Patricio Chrem Méndez ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Biological Markers ◽  
Cognitive Assessment ◽  
Screening Test ◽  
Test Results ◽  
Clinical Practices ◽  
Future Studies ◽  
Orientation Score ◽  
The Relationship

Introduction: The MoCa (Montreal Cognitive Assessment) Screening test has become relevant in recent years in the screening of patients with Mild Cognitive Impairment (MCI). It is important to seek and study simple and reliable tools in clinical practices that correlate with biological markers that have been used to predict conversion from MCI to AD. Objective: To analyze the MOCA and its cognitive sub-scores and the relationship with Amyloid pathophysiology in Alzheimer’s Disease. Methodology: 32 patients with MCI were studied, they were separated according positive (n: 20) and negative (n: 12) underlying amyloid pathology. The patients performed a extensive cognitive assessment that included MoCa Test. Results: MoCa Total Scores showed significantly different results between groups (p <0.001) as well as the Memory Score (MoCa MIS), the Executive (MoCa EIS), the Attentional Score (MoCa AIS)) (p < 0.001) and the Orientation Score (MoCa OIS)) (p < 0.05) with worse performance of patients with amyloid pathophysiology. Score of MoCa a cut-off point of < 24 was established, since the diagnostic sensitivity at this point was 83% and the specificity 70%. Conclusions: The MoCa is a useful tool to differentiate biomarker status in MCI. Future studies should study this tool in the prodromal phases of the disease.

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