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.

scholarly journals Cognitive Skills Questionnaire: Comparative Results in Elderly Population without Cognitive Deficit, Mild Cognitive Impairment and Alzheimer's Disease

2020 ◽  
pp. 1-8
Author(s):  
Edith Labos ◽  
Edith Labos ◽  
Sofia Trojanowski ◽  
Karina Zabala ◽  
Miriam Del Rio ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Skills ◽  
Cognitive Disorders ◽  
Cognitive Disorder ◽  
Screening Tools ◽  
Control Group ◽  
Cognitive Complaint

The increase in consultations for changes and/or cognitive complaints in the elderly, together with the current interest in epidemiological research in this context creates the need for screening tools for cognitive assessment to enable the detection of early deficits. Evidence shows its predictive value in the development of dementia disease. This study aims at displaying the results of a Cognitive Skills Questionnaire (CSQ) in a patient population with mild cognitive impairment (MCI) and Alzheimer’s disease (AD), both compared with a control group (CG) with no cognitive disorder and verifying its sensitivity and specificity in order to identify risk patients with cognitive disorder. Participants and Methods: A total of 208 participants were evaluated, out of which 60 had MCI, 46 had AD and a remaining group of 102 subjects who had no cognitive disorder. All participants were administrated the CSQ and a battery of neuropsychological proofs. We analysed the statistical data using ANOVA, Student’s t-test, Tuckey test, ROC curve and principal components analysis. A multiple regression analysis was carried out so as to single out those questions which better differentiated the studied groups. Results: The CSQ showed significant differences between the CG and both groups of patients (AD p> 0.01 and MCI p> 0.05). It was established a cut-off point of 17.5 in the CSQ total score with a sensitivity of 93% and a specificity of 91.3%. Conclusion: The CSQ could eventually allow us to identify patients with cognitive disorders and those others with a cognitive complaint greater than expected. Thus, this questionnaire could be a useful testing and counselling tool in health primary attention.

scholarly journals C-33 Abnormal MoCA Scores in a Clinic-Referred Sample

2019 ◽  
Vol 34 (6) ◽  
pp. 1062-1062
Author(s):  
J Marceaux ◽  
K Bain ◽  
C Fullen
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Cognitive Assessment ◽  
Cognitive Disorder ◽  
Analysis Of Covariance ◽  
Cognitive Symptoms ◽  
Bonferroni Correction ◽  
Psychiatric Conditions

Abstract Objective To examine Montreal Cognitive Assessment (MoCA) performance and frequency of low scores among veterans with primary diagnoses of cognitive disorder, psychiatric disorder, or no disorder. Method A clinic-referred sample of veterans (n = 214; Mage = 66.1, SD = 15; Medu = 13.3, SD = 2.7) diagnosed with mild cognitive impairment (MCI; n = 97), dementia (n = 47), depression (n = 18), PTSD (n = 22), or no cognitive or psychiatric disorder (n = 30) were included. All participants were administered the MoCA as part of a larger battery of tests. Analysis of covariance (ANCOVA), controlling for age and education, was conducted (Bonferroni correction applied) to compare diagnostic groups on MoCA uncorrected total score. Results Across groups, mean MoCA scores were significantly different using ANCOVA, F(4, 207) = 31.5, p < .001. As expected, those with no diagnosis (M = 24.7, SD = 2.1) or psychiatric disorders (PTSD M = 24.4, SD = 4.1; Depression M = 23.9, SD = 3) scored higher than those with cognitive disorder (MCI M = 21.7, SD = 3.1; Dementia M = 17.4, SD = 4.1), p < .001. While both psychiatric groups scored higher than those with dementia (p < .001), the depression group did not significantly differ from those with MCI (p = .11). Examination of scores across all groups revealed a majority of participants scored below the recommended cutoff of < 26. Specifically, 100% of dementia cases, 89.7% of MCI cases, 63.3% of no diagnosis cases, 50% of PTSD cases, and 72.2% of depression cases scored < 26. Conclusion Abnormal MoCA scores are common, even in the absence of cognitive impairment. Individuals with PTSD or depression are likely to score below the publisher's recommend cutoff. While this may reflect cognitive symptoms of psychiatric conditions, it may also reflect normative limitations as identified in past studies.

scholarly journals How can automated linguistic analysis help to discern functional cognitive disorder from healthy controls and mild cognitive impairment?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S7-S7
Author(s):  
Lizzie Beavis ◽  
Ronan O'Malley ◽  
Bahman Mirheidari ◽  
Heidi Christensen ◽  
Daniel Blackburn
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Delayed Diagnosis ◽  
Age Of Acquisition ◽  
Linguistic Analysis ◽  
Cross Sectional Study ◽  
Cognitive Disorder ◽  
Remote Memory ◽  
Healthy Controls ◽  
Cross Sectional

AimsThe disease burden of cognitive impairment is significant and increasing. The aetiology of cognitive impairment can be structural, such as in mild cognitive impairment (MCI) due to early Alzheimer's disease (AD), or in functional cognitive disorder (FCD), where there is no structural pathology. Many people with FCD receive a delayed diagnosis following invasive or costly investigations. Accurate, timely diagnosis improves outcomes across all patients with cognitive impairment. Research suggests that analysis of linguistic features of speech may provide a non-invasive diagnostic tool. This study aimed to investigate the linguistic differences in conversations between people with early signs of cognitive impairment with and without structural pathology, with a view to developing a screening tool using linguistic analysis of conversations.MethodIn this explorative, cross-sectional study, we recruited 25 people with MCI considered likely due to AD, (diagnosed according to Petersen's criteria and referred to as PwMCI), 25 healthy controls (HCs) and 15 people with FCD (PwFCD). Participants’ responses to a standard questionnaire asked by an interactional virtual agent (Digital Doctor) were quantified using previously identified parameters. This paper presents statistical analyses of the responses and a discussion of the results.ResultPwMCI produced fewer words than PwFCD and HCs. The ratio of pauses to speech was generally lower for PwMCI and PwFCD than for HCs. PwMCI showed a greater pause to speech ratio for recent questions (such as ‘what did you do at the weekend?’) compared with the HCs. Those with FCD showed the greatest pause to speech ratio in remote memory questions (such as ‘what was your first job?’). The average age of acquisition of answers for verbal fluency questions was lower in the MCI group than HCs.ConclusionThe results and qualitative observations support the relative preservation of remote memory compared to recent memory in MCI due to AD and decreased spontaneous elaboration in MCI compared with healthy controls and patients with FCD. Word count, age of acquisition and pause to speech ratio could form part of a diagnostic toolkit in identifying those with structural and functional causes of cognitive impairment. Further investigation is required using a large sample.

The problem of cognitive impairment in neurological practice (reference review)

2014 ◽  
Vol 18 (4 (72)) ◽  
Author(s):  
T. I. Purdenko
Keyword(s):  
Cognitive Impairment ◽  
Early Diagnosis ◽  
Neurodegenerative Diseases ◽  
Old Age ◽  
Cognitive Disorders ◽  
Cerebral Diseases ◽  
Success Of Treatment ◽  
The Brain

The article presents an analysis of the literature on the problem of cognitive disorders. It is in old age, when vascular and neurodegenerative diseases of the brain are most frequently diagnosed, leading to cognitive disorders of varying severity: from mild to severe. Early diagnosis of cerebral diseases increases significantly the chances of success of treatment to the problem.

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.

scholarly journals Detection of Mild Cognitive Impairment in an At-Risk Group of Older Adults: Can a Novel Self-Administered Serious Game-Based Screening Test Improve Diagnostic Accuracy?

2020 ◽  
Vol 78 (1) ◽  
pp. 405-412
Author(s):  
Stelios Zygouris ◽  
Paraskevi Iliadou ◽  
Eftychia Lazarou ◽  
Dimitrios Giakoumis ◽  
Konstantinos Votis ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Neuropsychological Test ◽  
Cognitive Disorders ◽  
Assessment Method ◽  
Serious Game ◽  
Screening Instruments ◽  
Classification Rate ◽  
Healthy Older Adults

Background: Literature supports the use of serious games and virtual environments to assess cognitive functions and detect cognitive decline. This promising assessment method, however, has not yet been translated into self-administered screening instruments for pre-clinical dementia. Objective: The aim of this study is to assess the performance of a novel self-administered serious game-based test, namely the Virtual Supermarket Test (VST), in detecting mild cognitive impairment (MCI) in a sample of older adults with subjective memory complaints (SMC), in comparison with two well-established screening instruments, the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Methods: Two groups, one of healthy older adults with SMC (N = 48) and one of MCI patients (N = 47) were recruited from day centers for cognitive disorders and administered the VST, the MoCA, the MMSE, and an extended pencil and paper neuropsychological test battery. Results: The VST displayed a correct classification rate (CCR) of 81.91% when differentiating between MCI patients and older adults with SMC, while the MoCA displayed of CCR of 72.04% and the MMSE displayed a CCR of 64.89%. Conclusion: The three instruments assessed in this study displayed significantly different performances in differentiating between healthy older adults with SMC and MCI patients. The VST displayed a good CCR, while the MoCA displayed an average CCR and the MMSE displayed a poor CCR. The VST appears to be a robust tool for detecting MCI in a population of older adults with SMC.

scholarly journals The protocol of a clinical quality registry for dementia and mild cognitive impairment (MCI): the Australian dementia network (ADNeT) Registry

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaoping Lin ◽  
Kasey Wallis ◽  
Stephanie A. Ward ◽  
Henry Brodaty ◽  
Perminder S. Sachdev ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Clinical Practice ◽  
Mild Cognitive Impairment ◽  
Patient Outcomes ◽  
Steering Committee ◽  
Primary Objective ◽  
Clinical Quality ◽  
Quality Registry ◽  
People With Dementia ◽  
Diagnosis Of Dementia

Abstract Background Dementia was identified as a priority area for the development of a Clinical Quality Registry (CQR) in Australia in 2016. The Australian Dementia Network (ADNeT) Registry is being established as part of the ADNeT initiative, with the primary objective of collecting data to monitor and enhance the quality of care and patient outcomes for people diagnosed with either dementia or Mild Cognitive Impairment (MCI). A secondary aim is to facilitate the recruitment of participants into dementia research and trials. This paper describes the Registry protocol. Methods The ADNeT Registry is a prospective CQR of patients newly diagnosed with either dementia or MCI. Eligible patients will be identified initially from memory clinics and individual medical specialists (e.g., geriatricians, psychiatrists and neurologists) involved in the diagnosis of dementia. Participants will be recruited using either an opt-out approach or waiver of consent based on three key determinants (capacity, person responsible, and communication of diagnosis). Data will be collected from four sources: participating sites, registry participants, carers, and linkage with administrative datasets. It is anticipated that the Registry will recruit approximately 10,000 participants by the end of 2023. The ADNeT registry will be developed and implemented to comply with the national operating principles for CQRs and governed by the ADNeT Registry Steering Committee. Discussion The ADNeT Registry will provide important data on current clinical practice in the diagnosis, treatment and care of people with dementia and MCI in Australia as well as long-term outcomes among these people. These data will help to identify variations in clinical practice and patient outcomes and reasons underlying these variations, which in turn, will inform the development of interventions to improve care and outcomes for people with dementia and MCI.

scholarly journals Domain-specific cognitive effects of white matter pathology in old age, mild cognitive impairment and Alzheimer’s disease

2019 ◽  
Vol 27 (3) ◽  
pp. 453-470 ◽  
Author(s):  
Alar Kaskikallio ◽  
Mira Karrasch ◽  
Juha O. Rinne ◽  
Terhi Tuokkola ◽  
Riitta Parkkola ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
White Matter ◽  
Old Age ◽  
Cognitive Effects ◽  
Domain Specific ◽  
White Matter Pathology
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