Short IQCODE as a screening tool for MCI and dementia: preliminary results

Abstract Reaching a diagnosis may be difficult in the initial stages of dementia, especially in low educated individuals, when informant reports may be useful. Objectives: To compare the sensitivity and specificity of the IQCODE against cognitive tests applied in clinical practice and to evaluate the possible cut-off points in Brazil. Methods: Individuals without dementia (CDR=0; N=5), with Mild Cognitive Impairment (MCI) (CDR=0.5; N=15) and demented (CDR³1; N=29) were evaluated using the Short IQCODE, a 16-item questionnaire applied to an informant, and on standard cognitive and functional scales. Diagnosis was reached by a consensus team with expertise in dementia, according to DSM-IV criteria, which was blind to the IQCODE results. Results: IQCODE scores were positively correlated to the CDR (r=0.65, p<0.001) and negatively correlated with years of schooling (r= -0.33, p=0.021). IQCODE scores were positively correlated with CDR controlled by age and education (r=0.61, p<0.001). Linear regression showed that age was associated with the IQCODE (p=0.016) whereas education was not associated (p=0.078). IQCODE means according to the CDR classification were: CDR 0-3.37; CDR 0.5-3.75; CDR 1-4.32; CDR 2-4.61; CDR 3-5.00. The area under the ROC curve for dementia vs. controls was 0.869 (p<0.001), MCI vs. controls, 0.821 (p<0.001); and according to the groups classified by the CDR was: CDR 0.5 vs. CDR 1=0.649 (p=0.089), CDR 1 vs. CDR 2=0.779 (p=0.009), and CDR 2 vs. CDR 3=0.979 (p=0.023). Conclusions: These preliminary findings suggest that the short IQCODE can be used for the screening of MCI and dementia in Brazil.

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Feasibility study of assessing the Preclinical Alzheimer Cognitive Composite (PACC) score via videoconferencing

Journal of Neurology ◽

10.1007/s00415-021-10403-1 ◽

2021 ◽

Author(s):

Giulia Seghezzo ◽

Yvonne Van Hoecke ◽

Laura James ◽

Donna Davoren ◽

Elizabeth Williamson ◽

...

Keyword(s):

Cognitive Impairment ◽

Clinical Practice ◽

Linear Regression ◽

Multiple Linear Regression ◽

Pearson Correlation ◽

Cognitive Tests ◽

Strong Positive Correlation ◽

Pearson Correlation Coefficient ◽

Face To Face ◽

The Difference

Abstract Background The Preclinical Alzheimer Cognitive Composite (PACC) is a composite score which can detect the first signs of cognitive impairment, which can be of importance for research and clinical practice. It is designed to be administered in person; however, in-person assessments are costly, and are difficult during the current COVID-19 pandemic. Objective To assess the feasibility of performing the PACC assessment with videoconferencing, and to compare the validity of this remote PACC with the in-person PACC obtained previously. Methods Participants from the HEalth and Ageing Data IN the Game of football (HEADING) Study who had already undergone an in-person assessment were re-contacted and re-assessed remotely. The correlation between the two PACC scores was estimated. The difference between the two PACC scores was calculated and used in multiple linear regression to assess which variables were associated with a difference in PACC scores. Findings Of the 43 participants who were invited to this external study, 28 were re-assessed. The median duration in days between the in-person and the remote assessments was 236.5 days (7.9 months) (IQR 62.5). There was a strong positive correlation between the two assessments for the PACC score, with a Pearson correlation coefficient of 0·82 (95% CI 0·66, 0·98). The multiple linear regression found that the only predictor of the PACC difference was the time between assessments. Interpretation This study provides evidence on the feasibility of performing cognitive tests online, with the PACC tests being successfully administered through videoconferencing. This is relevant, especially during times when face-to-face assessments cannot be performed.

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A model of cognitive evaluation battery for diagnosis of mild cognitive impairment and dementia in educated and illiterate Egyptian elderly people

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00223-x ◽

2020 ◽

Vol 56 (1) ◽

Author(s):

Nehal ElKholy ◽

Heba Mohamed Tawfik ◽

Somaia Ebeid ◽

Omaima Refat Elsayed Madkor ◽

Sarah Ahmed Hamza

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Elderly People ◽

Digit Span ◽

Statistical Significance ◽

Test Reliability ◽

Eastern Region ◽

Cognitive Evaluation ◽

Dsm Iv ◽

Low Educated

Abstract Background The high illiteracy rates in the North African and Middle Eastern region make direct cognitive testing challenging. Validated instruments for dementia in Arabic language are lacking specially those targeting low-educated subjects. Objectives The aim of this study was to develop a cognitive evaluation battery suitable for both educated and illiterate Egyptian elderly people. Design A cross-sectional study was conducted. Setting: Ain-Shams University geriatric and ophthalmology wards, geriatrics outpatient clinic, and geriatric clubs. Participants: 159 male and female participants aged ≥ 60 years were recruited. Measurements Cut-off points were determined according to DSM-IV criteria for dementia and MMSE scores which divided the participants into 3 quadrants as normal, having mild cognitive impairment and having dementia then application of the new battery test was done. Results Test re-test reliability ranged from adequate to high in most of its tests with r ≥ 0.7. There was a statistical significance between all battery tests when divided into normal and dementia according to DSM IV criteria except in digit span forward length, digit span backward length, stimulus cue of confrontation naming and judgment. Means and standard deviations were calculated for each battery subset, for the whole sample, for low-educated group and group with > 9 years education according to three quadrants of MMSE. Conclusion A new valid and reliable neurocognitive evaluation battery that can differentiate between normal, mild cognitive impairment, and dementia in both educated and illiterate subjects under the name of Ain Shams Cognitive Assessment (ASCA) scale is now available.

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The Montreal Cognitive Assessment-Basic: A Screening Tool for Mild Cognitive Impairment in Illiterate and Low-Educated Elderly Adults

Journal of the American Geriatrics Society ◽

10.1111/jgs.13820 ◽

2015 ◽

Vol 63 (12) ◽

pp. 2550-2554 ◽

Cited By ~ 67

Author(s):

Parunyou Julayanont ◽

Sookjaroen Tangwongchai ◽

Solaphat Hemrungrojn ◽

Chawit Tunvirachaisakul ◽

Kammant Phanthumchinda ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Assessment ◽

Screening Tool ◽

Montreal Cognitive Assessment ◽

Elderly Adults ◽

Low Educated

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Faculty Opinions recommendation of Brief Cognitive Tests for Distinguishing Clinical Alzheimer-Type Dementia From Mild Cognitive Impairment or Normal Cognition in Older Adults With Suspected Cognitive Impairment.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.737835968.793574049 ◽

2020 ◽

Author(s):

Martha Twaddle

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Tests ◽

Alzheimer Type ◽

Alzheimer Type Dementia ◽

Normal Cognition

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

BJPsych Open ◽

10.1192/bjo.2021.737 ◽

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.

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