scholarly journals Sepsis and Cognitive Assessment

2021 ◽  
Vol 10 (18) ◽  
pp. 4269
Author(s):  
Laura C. Jones ◽  
Catherine Dion ◽  
Philip A. Efron ◽  
Catherine C. Price

Sepsis disproportionally affects people over the age of 65, and with an exponentially increasing older population, sepsis poses additional risks for cognitive decline. This review summarizes published literature for (1) authorship qualification; (2) the type of cognitive domains most often assessed; (3) timelines for cognitive assessment; (4) the control group and analysis approach, and (5) sociodemographic reporting. Using key terms, a PubMed database review from January 2000 to January 2021 identified 3050 articles, and 234 qualified as full text reviews with 18 ultimately retained as summaries. More than half (61%) included an author with an expert in cognitive assessment. Seven (39%) relied on cognitive screening tools for assessment with the remaining using a combination of standard neuropsychological measures. Cognitive domains typically assessed were declarative memory, attention and working memory, processing speed, and executive function. Analytically, 35% reported on education, and 17% included baseline (pre-sepsis) data. Eight (44%) included a non-sepsis peer group. No study considered sex or race/diversity in the statistical model, and only five studies reported on race/ethnicity, with Caucasians making up the majority (74%). Of the articles with neuropsychological measures, researchers report acute with cognitive improvement over time for sepsis survivors. The findings suggest avenues for future study designs.

2017 ◽  
Vol 29 (11) ◽  
pp. 1771-1784 ◽  
Author(s):  
Annie Pye ◽  
Anna Pavlina Charalambous ◽  
Iracema Leroi ◽  
Chrysoulla Thodi ◽  
Piers Dawes

ABSTRACTBackground:Cognitive screening tests frequently rely on items being correctly heard or seen. We aimed to identify, describe, and evaluate the adaptation, validity, and availability of cognitive screening and assessment tools for dementia which have been developed or adapted for adults with acquired hearing and/or vision impairment.Method:Electronic databases were searched using subject terms “hearing disorders” OR “vision disorders” AND “cognitive assessment,” supplemented by exploring reference lists of included papers and via consultation with health professionals to identify additional literature.Results:1,551 papers were identified, of which 13 met inclusion criteria. Four papers related to tests adapted for hearing impairment; 11 papers related to tests adapted for vision impairment. Frequently adapted tests were the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MOCA). Adaptations for hearing impairment involved deleting or creating written versions for hearing-dependent items. Adaptations for vision impairment involved deleting vision-dependent items or spoken/tactile versions of visual tasks. No study reported validity of the test in relation to detection of dementia in people with hearing/vision impairment. Item deletion had a negative impact on the psychometric properties of the test.Conclusions:While attempts have been made to adapt cognitive tests for people with acquired hearing and/or vision impairment, the primary limitation of these adaptations is that their validity in accurately detecting dementia among those with acquired hearing or vision impairment is yet to be established. It is likely that the sensitivity and specificity of the adapted versions are poorer than the original, especially if the adaptation involved item deletion. One solution would involve item substitution in an alternative sensory modality followed by re-validation of the adapted test.


2019 ◽  
Vol 47 (4-6) ◽  
pp. 198-208 ◽  
Author(s):  
Vindika Suriyakumara ◽  
Srinivasan  Srikanth ◽  
Ruwani  Wijeyekoon ◽  
Harsha  Gunasekara ◽  
Chanaka  Muthukuda ◽  
...  

Background: Sri Lanka is a rapidly aging country, where dementia prevalence will increase significantly in the future. Thus, inexpensive and sensitive cognitive screening tools are crucial. Objectives: To assess the reliability, validity, and diagnostic accuracy of the Sinhalese version of the Addenbrooke’s Cognitive Examination-Revised (ACE-R s). Method: The ACE-R was translated into Sinhala with cultural and linguistic adaptations and administered, together with the Sinhala version of the Montreal Cognitive Assessment (MoCA), to 99 patients with dementia and 93 gender-matched controls. Results: The ACE-R s cutoff score for dementia was 80 (sensitivity 91.9%, specificity 76.3%). The areas under the curve for the ACE-R s, Mini-Mental State Examination (MMSE) and MoCA were 0.90, 0.86, and 0.86, respectively. The ­ACE-R s had good interrater reliability (intraclass correlation = 0.94), test-retest reliability (intraclass correlation = 0.99), and internal consistency (Cronbach’s α = 0.8442). Conclusions: The ACE-R s is sensitive, specific and reliable to detect dementia in persons aged ≥50 years in a Sinhala-speaking population and its diagnostic accuracy is superior to previously validated tools (MMSE and MoCA).


2020 ◽  
pp. 089198872091551
Author(s):  
Shanna L. Burke ◽  
Adrienne Grudzien ◽  
Aaron Burgess ◽  
Miriam J. Rodriguez ◽  
Yesenia Rivera ◽  
...  

Increasing rates of dementia spectrum disorders among Spanish-speaking geriatric populations necessitate the development of culturally appropriate cognitive screening tests that can identify neurodegenerative disorders in their earliest stages when emerging disease-modifying treatments are most likely to be effective. This scoping review identified 26 brief Spanish language cognitive screening tools (<20 minutes) by searching academic databases using a combination of search terms. Results suggest that the Mini-Mental Status Examination and Montreal Cognitive Assessment appear to be less valid than other screeners. Instruments such as the 7-Minute Screen and Mini-Cog evidence higher classification rates of dementia, while Phototest detected mild cognitive impairment at higher rates more consistently than other screeners. Different sensitivity and specificity outcomes and cutoffs were observed when the same cognitive screener was evaluated in different countries. Results indicate that it is imperative to increase nation-specific validation and normative data for these instruments to best serve diverse populations.


2015 ◽  
Vol 45 (15) ◽  
pp. 3147-3157 ◽  
Author(s):  
M. Bechi ◽  
M. Bosia ◽  
M. Spangaro ◽  
M. Buonocore ◽  
F. Cocchi ◽  
...  

BackgroundNeurocognitive and social cognitive impairments represent important treatment targets in schizophrenia, as they are significant predictors of functional outcome. Different rehabilitative interventions have recently been developed, addressing both cognitive and psychosocial domains. Although promising, results are still heterogeneous and predictors of treatment outcome are not yet identified. In this study we evaluated the efficacy of two newly developed social cognitive interventions, respectively based on the use of videotaped material and comic strips, combined with domain-specific Cognitive Remediation Therapy (CRT). We also analysed possible predictors of training outcome, including basal neurocognitive performance, the degree of cognitive improvement after CRT and psychopathological variables.MethodSeventy-five patients with schizophrenia treated with CRT, were randomly assigned to: social cognitive training (SCT) group, Theory of Mind Intervention (ToMI) group, and active control group (ACG).ResultsANOVAs showed that SCT and ToMI groups improved significantly in ToM measures, whereas the ACG did not. We reported no influences of neuropsychological measures and improvement after CRT on changes in ToM. Both paranoid and non-paranoid subjects improved significantly after ToMI and SCT, without differences between groups, despite the better performance in basal ToM found among paranoid patients. In the ACG only non-paranoid patients showed an improvement in non-verbal ToM.ConclusionResults showed that both ToMI and SCT are effective in improving ToM in schizophrenia with no influence of neuropsychological domains. Our data also suggest that paranoid symptoms may discriminate between different types of ToM difficulties in schizophrenia.


2020 ◽  
Vol 35 (4) ◽  
pp. 434-447 ◽  
Author(s):  
Anastasia Nousia ◽  
Maria Martzoukou ◽  
Zisis Tsouris ◽  
Vasileios Siokas ◽  
Athina-Maria Aloizou ◽  
...  

Abstract Background Cognitive dysfunction is one of the most prevalent non-motor aspects of Parkinson’s disease (PD). The present review focuses on published studies investigating the effect of computer-based cognitive training (CT) on neuropsychological performance in PD. Methods A systematic search of the PubMed database and Google Scholar was carried out. Randomized controlled studies published before September 2019, investigating the effect of computer-based CT (regardless of the comparator, active or placebo) on PD patients were included. Literature search, data extraction, and Risk of Bias (RoB) evaluation (based on the RoB Cochrane tool for Randomized Trials) were performed by two authors (A.N. and M.M), independently. Results Among 30 full-texts assessed for eligibility, seven articles fulfilled the inclusion criteria and were involved in the qualitative analysis. The main outcomes of the retrieved studies (all studies used similar cognitive rehabilitation methodologies) were indicative of cognitive improvement in most cognitive domains, particularly memory, executive function, processing speed, and attention, that is, the domains primarily impaired in the disease. Conclusion Multidomain CT, which is exclusively based on computer software, leads to measurable improvements in most cognitive domains affected in patients with PD. The present review is the first to include studies assessing the effect of computer-based CT techniques without deploying CT with paper-pencil techniques. Limitations originate mainly due to the heterogeneity among included studies (differences in CT softwares, PD stages, number, and duration of training sessions.


2019 ◽  
pp. 1357633X1989078 ◽  
Author(s):  
Jodie E Chapman ◽  
Dominique A Cadilhac ◽  
Betina Gardner ◽  
Jennie Ponsford ◽  
Ruchi Bhalla ◽  
...  

Introduction Videoconferencing may help address barriers associated with poor access to post-stroke cognitive screening. However, the equivalence of videoconference and face-to-face administrations of appropriate cognitive screening tools needs to be established. We compared face-to-face and videoconference administrations of the Montreal Cognitive Assessment (MoCA) in community-based survivors of stroke. We also evaluated whether participant characteristics (e.g. age) influenced equivalence. Methods We used a randomised crossover design (two-week interval). Participants were recruited through community advertising and use of a stroke-specific database. Both sessions were conducted by the same researcher in the same location. Videoconference sessions were conducted using Zoom. A repeated-measures t-test, intraclass correlation coefficient (ICC), Bland–Altman plot and multivariate regression modelling were used to establish equivalence. Results Forty-eight participants (26 men, Mage = 64.6 years, standard deviation ( SD) = 10.1; Mtime since stroke = 5.2 years, SD = 4.0) completed the MoCA face-to-face and via videoconference on average 15.8 ( SD = 9.7) days apart. Participants did not perform systematically better in a particular condition, and no participant variable predicted difference in MoCA performance. However, the ICC was low (0.615), and the Bland–Altman plot indicated wide limits of agreement, indicating variability between sessions. Discussion Our findings provide preliminary evidence to support the use of videoconference to administer the MoCA following stroke. However, further research into the test–retest reliability of scores derived from the MoCA is needed in this population. Administering the MoCA via videoconference holds potential to ensure that all stroke survivors undergo cognitive screening, in line with recommended clinical practice.


2018 ◽  
Vol 46 (5-6) ◽  
pp. 310-321 ◽  
Author(s):  
Leila Sellami ◽  
Synthia Meilleur-Durand ◽  
Anne-Marie Chouinard ◽  
David Bergeron ◽  
Louis Verret ◽  
...  

Introduction: Early recognition of atypical dementia remains challenging partly because of lack of cognitive screening instruments precisely tailored for this purpose. Methods: We assessed the validity and reliability of the Dépistage Cognitif de Québec (DCQ; www.dcqtest.org), a newly developed cognitive screening test, to detect atypical dementia using a multicenter cohort of 628 participants. Sensitivity and specificity were compared to the Montreal Cognitive Assessment (MoCA). A predictive diagnostic algorithm for atypical dementia was determined using classification tree analysis. Results: The DCQ showed excellent psychometric properties. It was significantly more accurate than the MoCA to detect atypical dementia. All correlations between DCQ indexes and standard neuropsychological measures were significant. A statistical model distinguished typical from atypical dementia with a predictive power of 79%. Discussion: The DCQ is a better tool to detect atypical dementia than standard cognitive screening tests. Expanding the clinician’s tool kit with the DCQ could reduce missed/delayed identification of atypical dementia and accelerate therapeutic intervention.


2019 ◽  
Vol 34 (6) ◽  
pp. 1030-1030
Author(s):  
N Hawley ◽  
L Bennett ◽  
A Ritter

Abstract Objective The Montreal Cognitive Assessment (MoCA) is a widely-used screening tool for neurodegenerative disorders. Despite widespread use, there have been few investigations into correlations between MoCA and biomarkers of Alzheimer's disease pathology. This study examined the relationship between MoCA performance and the presence of amyloid as detected by positron emission tomography (PET). Methods Sensitivity and specificity for the total MoCA score were determined for 76 individuals (26 amyloid-negative, 50 amyloid- positive) who were between the ages of 55 and 90 and diagnosed with MCI or mild dementia with a CDR score of 0-1 and were participating in a longitudinal, observational study at the Cleveland Clinic Lou Ruvo Center for Brain Health. All individuals underwent an amyloid PET scan and cognitive screening. Results Sensitivity and specificity for the total score were determined using amyloid positivity as the standard. A cutpoint of 25 yielded the best balance between sensitivity and specificity (74% and 74%, respectively). A total score of 27 was required to achieve 90% sensitivity to identify amyloid positive individuals (i.e. only a 10% risk that individuals with a score of 28-30 have a positive scan). A score of 26 was required in individuals over the age of 75. Conclusions With the emergence of new diagnostic biomarkers, there is need to define the utility of affordable, widely-available screening tools. In this mixed clinical sample, the MoCA score showed good sensitivity for detecting amyloid pathology but with low specificity. Thus a total MoCA score of 28 is needed to confidently rule out risk for AD pathology.


2018 ◽  
Vol 59 (6) ◽  
pp. e743-e763 ◽  
Author(s):  
Glória S A Siqueira ◽  
Paula de M S Hagemann ◽  
Daniela de S Coelho ◽  
Flávia Heloísa Dos Santos ◽  
Paulo H F Bertolucci

Abstract Background and Objectives Cognitive disorders may be an early sign of neuropsychiatric disorders; however, it remains unclear whether the screening measures are interchangeable. The aim of this study was to contrast the most commonly used screening tools—Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)—for early detection of neurocognitive disorder (NCD). Research Design and Methods This study presents a descriptive systematic review and informative literature according to the Cochrane Foundation’s guidelines. The keywords “Mini-Mental State Examination” and “Montreal Cognitive Assessment” were searched in the Web of Science, SciELO, and LILACS databases. Results Fifty-one studies were selected including a total sample of 11,870 participants (8,360 clinical patients and 3,510 healthy controls). Most studies were published in the past 5 years using a cross-sectional design, carried out across the world. They were organized by age ranges (18–69 years and 20–89 years), years of schooling, and mental status (with and without mental and behavior disorders). Sixteen of 18 studies had participants aged 18–69 years, and 21 out of 33 studies within the older set suggested that the MoCA is a more sensitive tool for detecting NCD. Discussion and Implications Thirty-seven studies suggested that the MoCA is a more sensitive tool for NCD detection because it assesses executive function and visuospatial abilities. Some individuals who demonstrated normal cognitive function on the MMSE had lower performance on the MoCA. However, it seems necessary to establish different cutoffs based on years of schooling to avoid false positives. Future studies should contrast MoCA with other screening tools designed for NCD assessment.


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