scholarly journals Psychometric Validation of The Cognitive Abilities Screening Instrument Using Rasch Analysis In People With Dementia

2022 ◽  
Author(s):  
Fang-Hsiao Hsu ◽  
Ya-Chen Lee ◽  
En-Chi Chiu
Keyword(s):  
Cognitive Function ◽  
Cognitive Abilities ◽  
Rasch Analysis ◽  
Principal Component ◽  
Screening Instrument ◽  
Screening Tools ◽  
Psychometric Validation ◽  
Residual Variance ◽  
Cognitive Screening ◽  
People With Dementia

Abstract Background: The Cognitive Abilities Screening Instrument (CASI) is one of the most commonly used cognitive screening tools to assess overall cognitive function in people with dementia. However, the unidimensionliaty of the CASI using Rasch analysis has not been evaluated in people with dementia, limiting its utility in clinical and research settings. Unidimensionality verifies whether all items of a measure reflect a single theoretical construct, which is necessary to determine whether clinicians and researchers can appropriately use the sum scores of the CASI to describe overall cognitive function. This study aimed to examine unidimensionality of the CASI using Rasch analysis and estimate Rasch person reliability in people with dementia. Methods: CASI data of people with dementia was collected from medical records of one general hospital in northern Taiwan. A total of 506 people with dementia were recruited from the Department of Neurology. Unidimensionality was confirmed through two assumptions: (1) the infit and outfit mean square (MnSq) were 0.6-1.4, and (2) residual variance of the first principal component in principal component analysis was ≤ 20%. Rasch person reliability was estimated after undimensionality was supported. Results: One item from the list-generating fluency dimension was misfitted (outfit MnSq=1.42) and was deleted. The unidimensionality of the remaining 45 items (referred to as the CASI-45) was supported with an infit and outfit MnSq (0.85-1.24 and 0.84-1.28, respectively) and low residual variance of the first principal component (12.8%). The Rasch person reliability of the CASI-45 was 0.62. Conclusion: The CASI-45 showed a unidimensional construct and had acceptable Rasch person reliability in people with dementia.

scholarly journals Cognitive function, disease burden and the structural connectome in systemic lupus erythematosus

Lupus ◽  
2018 ◽  
Vol 27 (8) ◽  
pp. 1329-1337 ◽  
Author(s):  
S J Wiseman ◽  
M E Bastin ◽  
E N Amft ◽  
J F F Belch ◽  
S H Ralston ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cognitive Function ◽  
Lupus Erythematosus ◽  
Cognitive Abilities ◽  
Structural Connectivity ◽  
Principal Component ◽  
Clustering Coefficient ◽  
Screening Tests ◽  
Systemic Lupus ◽  
Network Metrics

Objective To investigate brain structural connectivity in relation to cognitive abilities and systemic damage in systemic lupus erythematosus (SLE). Methods Structural and diffusion MRI data were acquired from 47 patients with SLE. Brains were segmented into 85 cortical and subcortical regions and combined with whole brain tractography to generate structural connectomes using graph theory. Global cognitive abilities were assessed using a composite variable g, derived from the first principal component of three common clinical screening tests of neurological function. SLE damage ( LD) was measured using a composite of a validated SLE damage score and disease duration. Relationships between network connectivity metrics, cognitive ability and systemic damage were investigated. Hub nodes were identified. Multiple linear regression, adjusting for covariates, was employed to model the outcomes g and LD as a function of network metrics. Results The network measures of density (standardised ß = 0.266, p = 0.025) and strength (standardised ß = 0.317, p = 0.022) were independently related to cognitive abilities. Strength (standardised ß = –0.330, p = 0.048), mean shortest path length (standardised ß = 0.401, p = 0.020), global efficiency (standardised ß = –0.355, p = 0.041) and clustering coefficient (standardised ß = –0.378, p = 0.030) were independently related to systemic damage. Network metrics were not related to current disease activity. Conclusion Better cognitive abilities and more SLE damage are related to brain topological network properties in this sample of SLE patients, even those without neuropsychiatric involvement and after correcting for important covariates. These data show that connectomics might be useful for understanding and monitoring cognitive function and white matter damage in SLE.

The applicability of the cognitive abilities screening instrument–short (CASI-S) in primary care in Brazil

2015 ◽  
Vol 28 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Glaucia Martins de Oliveira ◽  
Juliana Emy Yokomizo ◽  
Laís dos Santos Vinholi e Silva ◽  
Laura Ferreira Saran ◽  
Cássio M. C. Bottino ◽  
...  
Keyword(s):  
Primary Care ◽  
Internal Consistency ◽  
Cognitive Abilities ◽  
Temporal Stability ◽  
Screening Instrument ◽  
Eastern Region ◽  
Limited Information ◽  
Cognitive Screening ◽  
Dementia Patients ◽  
Normal Controls

ABSTRACTBackground:The Cognitive Abilities Screening Instrument – Short (CASI-S) is a brief cognitive screening test. However, there is limited information regarding its applicability in primary care.Objectives:To ascertain whether the CASI-S differentiates between dementia patients and normal controls in primary care; to examine its correlation with other cognitive instruments, to analyze its internal consistency, test-retest stability, and diagnostic accuracy.Methods:In a case-control study, carried out at two Primary Care Units (PCUs) in the eastern region of the city of São Paulo, 47 older adults were diagnosed with dementia according to DSM-IV criteria (mean age = 76.81 ± 7.03 years), and 55 were classified as normal controls (mean age = 72.78 ± 7.37 years), by a multidisciplinary panel which had access to results from a comprehensive cognitive battery and the patients’ health data. The present analyses included results from the Mini-Mental State Examination (MMSE). The CASI-S was not used to determine diagnostic status.Results:The CASI-S was easily applied in the primary care setting. There was a significant performance difference (p < 0.001) between dementia patients (15.57 ± 7.40) and normal controls (26.67 ± 3.52) on the CASI-S. CASI-S scores correlated with age (ρ = −0.410, p < 0.001), educational level (ρ = 0.373, p < 0.001), and MMSE score (ρ = 0.793, p < 0.001). The internal consistency of the CASI-S was high (α = 0.848) and the correlation between test and retest was 0.688, suggesting adequate temporal stability. In the ROC curve analyses, scores of 22/23 generated an area under the curve of 0.907, with sensitivity of 93% and specificity of 81%.Conclusions:The CASI-S can be useful for dementia screening in primary care in Brazil.

scholarly journals Virtual Reality for Screening of Cognitive Function in Older Persons: Comparative Study

10.2196/14821 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e14821 ◽  
Author(s):  
Sean Ing Loon Chua ◽  
Ngiap Chuan Tan ◽  
Wei Teen Wong ◽  
John Carson Allen Jr ◽  
Joanne Hui Min Quah ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Function ◽  
Older Persons ◽  
Screening Tools ◽  
Cognitive Screening ◽  
Performance Score ◽  
Total Performance ◽  
Group 2 ◽  
Cognitively Intact ◽  
Group 1

Background The prevalence of dementia, which presents as cognitive decline in one or more cognitive domains affecting function, is increasing worldwide. Traditional cognitive screening tools for dementia have their limitations, with emphasis on memory and, to a lesser extent, on the cognitive domain of executive function. The use of virtual reality (VR) in screening for cognitive function in older persons is promising, but evidence for its use is sparse. Objective The primary aim was to examine the feasibility and acceptability of using VR to screen for cognitive impairment in older persons in a primary care setting. The secondary aim was to assess the module’s ability to discriminate between cognitively intact and cognitively impaired participants. Methods A comparative study was conducted at a public primary care clinic in Singapore, where persons aged 65-85 years were recruited based on a cut-off score of 26 on the Montreal Cognitive Assessment (MoCA) scale. They participated in a VR module for assessment of their learning and memory, perceptual-motor function, and executive function. Each participant was evaluated by the total performance score (range: 0-700) upon completion of the study. A questionnaire was also administered to assess their perception of and attitude toward VR. Results A total of 37 participants in Group 1 (cognitively intact; MoCA score≥26) and 23 participants in Group 2 (cognitively impaired; MoCA score<26) were assessed. The mean time to completion of the study was 19.1 (SD 3.6) minutes in Group 1 and 20.4 (3.4) minutes in Group 2. Mean feedback scores ranged from 3.80 to 4.48 (max=5) in favor of VR. The total performance score in Group 1 (552.0, SD 57.2) was higher than that in Group 2 (476.1, SD 61.9; P<.001) and exhibited a moderate positive correlation with scores from other cognitive screening tools: Abbreviated Mental Test (0.312), Mini-Mental State Examination (0.373), and MoCA (0.427). A receiver operating characteristic curve analysis for the relationship between the total performance score and the presence of cognitive impairment showed an area under curve of 0.821 (95% CI 0.714-0.928). Conclusions We demonstrated the feasibility of using a VR-based screening tool for cognitive function in older persons in primary care, who were largely in favor of this tool.

scholarly journals ASSOCIATION OF 10-YEAR WALKING TRAJECTORIES WITH COGNITIVE FUNCTION IN OLDER ADULTS: ADULT CHANGES IN THOUGHT STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S20-S20
Author(s):  
Paul Gardiner ◽  
Barbara J Jefferis ◽  
KatieRose Richmere ◽  
Andrea Z LaCroix ◽  
Paul K Crane ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Abilities ◽  
Regression Models ◽  
Late Life ◽  
Screening Instrument ◽  
Function Data ◽  
Health Factors ◽  
Trajectory Group

Abstract We identified trajectories of older adults’ walking and their associations with cognitive function. Data on walking (days/week) were collected at baseline of the Adult Changes in Thought study and every two years for 10 years. Cognitive function was assessed by the Cognitive Abilities Screening Instrument (CASI) at year 12. Group-based trajectory analyses identified trajectories among 763 participants (baseline age 70±5 years, 60% female). Regression models, adjusted for baseline sociodemographic and health factors, examined associations with cognitive function. Five walking trajectories were identified: consistently inactive (18.1%), medium active (21.9%), early decline (15.8%), late decline (18.4%), and consistently active (25.8%). Mean CASI score was 92.0 (SD 6.9). CASI scores were lower in early b = -1.66 (95%CI: -2.97, -0.35) and late decline b = -1.89 (-3.26, -0.51) groups, with no difference in consistently active and inactive groups, compared to the medium active trajectory group. Ten-year walking trajectories may determine late-life cognitive function.

scholarly journals Integrating across neuroimaging modalities boosts prediction accuracy of cognitive ability

2021 ◽  
Vol 17 (3) ◽  
pp. e1008347 ◽  
Author(s):  
Javier Rasero ◽  
Amy Isabella Sentis ◽  
Fang-Cheng Yeh ◽  
Timothy Verstynen
Keyword(s):  
Individual Differences ◽  
Cognitive Function ◽  
Cognitive Ability ◽  
Cognitive Abilities ◽  
Predictive Power ◽  
Fluid Intelligence ◽  
Prediction Models ◽  
Principal Component ◽  
Individual Variability ◽  
Human Connectome Project

Variation in cognitive ability arises from subtle differences in underlying neural architecture. Understanding and predicting individual variability in cognition from the differences in brain networks requires harnessing the unique variance captured by different neuroimaging modalities. Here we adopted a multi-level machine learning approach that combines diffusion, functional, and structural MRI data from the Human Connectome Project (N = 1050) to provide unitary prediction models of various cognitive abilities: global cognitive function, fluid intelligence, crystallized intelligence, impulsivity, spatial orientation, verbal episodic memory and sustained attention. Out-of-sample predictions of each cognitive score were first generated using a sparsity-constrained principal component regression on individual neuroimaging modalities. These individual predictions were then aggregated and submitted to a LASSO estimator that removed redundant variability across channels. This stacked prediction led to a significant improvement in accuracy, relative to the best single modality predictions (approximately 1% to more than 3% boost in variance explained), across a majority of the cognitive abilities tested. Further analysis found that diffusion and brain surface properties contribute the most to the predictive power. Our findings establish a lower bound to predict individual differences in cognition using multiple neuroimaging measures of brain architecture, both structural and functional, quantify the relative predictive power of the different imaging modalities, and reveal how each modality provides unique and complementary information about individual differences in cognitive function.

scholarly journals Screening Tools and Assessment Methods of Cognitive Decline Associated With Age-Related Hearing Loss: A Review

2021 ◽  
Vol 13 ◽  
Author(s):  
Tao Yue ◽  
Yu Chen ◽  
Qi Zheng ◽  
Zihao Xu ◽  
Wei Wang ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Clinical Manifestations ◽  
Assessment Methods ◽  
Screening Tools ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Age Related ◽  
Age Related Hearing Loss

Strong links between hearing and cognitive function have been confirmed by a growing number of cross-sectional and longitudinal studies. Seniors with age-related hearing loss (ARHL) have a significantly higher cognitive impairment incidence than those with normal hearing. The correlation mechanism between ARHL and cognitive decline is not fully elucidated to date. However, auditory intervention for patients with ARHL may reduce the risk of cognitive decline, as early cognitive screening may improve related treatment strategies. Currently, clinical audiology examinations rarely include cognitive screening tests, partly due to the lack of objective quantitative indicators with high sensitivity and specificity. Questionnaires are currently widely used as a cognitive screening tool, but the subject’s performance may be negatively affected by hearing loss. Numerous electroencephalogram (EEG) and magnetic resonance imaging (MRI) studies analyzed brain structure and function changes in patients with ARHL. These objective electrophysiological tools can be employed to reveal the association mechanism between auditory and cognitive functions, which may also find biological markers to be more extensively applied in assessing the progression towards cognitive decline and observing the effects of rehabilitation training for patients with ARHL. In this study, we reviewed clinical manifestations, pathological changes, and causes of ARHL and discussed their cognitive function effects. Specifically, we focused on current cognitive screening tools and assessment methods and analyzed their limitations and potential integration.

scholarly journals Virtual Reality for Screening of Cognitive Function in Older Persons: Comparative Study (Preprint)

2019 ◽  
Author(s):  
Sean Ing Loon Chua ◽  
Ngiap Chuan Tan ◽  
Wei Teen Wong ◽  
John Carson Allen Jr ◽  
Joanne Hui Min Quah ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Function ◽  
Older Persons ◽  
Screening Tools ◽  
Cognitively Impaired ◽  
Cognitive Screening ◽  
Performance Score ◽  
Total Performance ◽  
Group 2 ◽  
Group 1

BACKGROUND Dementia, which presents as cognitive decline in one or more cognitive domains affecting function, is becoming more prevalent. Traditional cognitive screening tools for dementia have their limitations, with emphasis on memory and to a lesser extent on the cognitive domain of executive function. The use of virtual reality (VR) in screening for cognitive function in older person is promising but evidence for its use is sparse. OBJECTIVE The primary aim is to examine the feasibility and acceptability of using VR to screen for cognitive impairment in older person in a primary care setting, through a VR module. The secondary aim is to assess the module’s ability to discriminate between cognitively normal and cognitively impaired participants. METHODS A comparative study was conducted at a public primary care clinic in Singapore, where 60 older persons were recruited based on a cut-off score of 26 using the Montreal Cognitive Assessment (MoCA) scale. They participated in the VR module to assess their learning and memory, perceptual-motor function and executive function. Each participant was evaluated by a total performance score (range: 0 – 700) upon completion. An assisted questionnaire was also administered to assess their perception of and attitude towards VR. RESULTS 37 participants in Group 1 (cognitively normal; MoCA >= 26) and 23 participants in Group 2 (cognitively impaired; MoCA < 26) were assessed. All participants completed the study with a mean total time of 19.1±3.6 minutes in Group 1 and 20.4±3.4 minutes in Group 2. Mean feedback scores ranged from 3.80 to 4.48 (max=5) in favour of VR. The total performance score in Group 1 (552.0±57.2) was higher than in Group 2 (476.1±61.9) (P < .001), and exhibited moderate positive correlation with scores from other cognitive screening tools: Abbreviated Mental Test (AMT) (0.312), Mini-Mental State Examination (MMSE) (0.373) and MoCA (0.427). A ROC curve analysis, relating total performance score to the presence of cognitive impairment, showed an area under curve of 0.821 (95% confidence interval: 0.714 to 0.928). CONCLUSIONS We demonstrated the feasibility of using an VR-based screening tool for cognitive function in older persons in primary care, who were largely in favour of this tool.

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