Mental health among students with neurodevelopment disorders: case of dyslexic children and adolescents

ABSTRACT Several research studies have been devoted to study the links between emotional disorders and learning disabilities. However, very minimal of this research has focused on dyslexic students. Objective: The objectives of this study were as follows: (1) to assess self-esteem, anxiety, and depression in dyslexic Arabic-speaking children and adolescents and (2) to describe psychiatric comorbidities in these subjects by comparing them to their non-dyslexic peers. Methods: In total, 205 students (56 dyslexics and 149 good readers), pursuing their education in ordinary schools in the Beni Mellal-Khenifra region of Morocco responded to Taylor’s Self-Assessment Scale of Anxiety, Beck’s Depression Questionnaire, and the Coopersmith Self-Esteem Inventory (SEI). Results: Overall, dyslexics were more anxious, more depressed, and had disturbed self-esteem compared to their non-dyslexic peers. The percentage of psychiatric comorbidity was higher in the dyslexic group. Conclusions: The results of this study highlight the need for a multidisciplinary approach that integrates emotional needs assessment into the rehabilitation care of dyslexic children and adolescents.

Association between Apoϵ4 allele and cardiometabolic and social risk factors with cognitive impairment in elderly population from Bogota

ABSTRACT Being an ϵ4 carrier in the Apoϵ gene has been suggested as a modifying factor for the interaction between cardio-metabolic, social risk factors, and the development of cognitive impairment. Objective: The main objective of this study was to assess the existence of such interaction in a sample of Bogota’s elderly population. Methods: A cross-sectional study was conducted with 1,263 subjects older than 50 years. Each participant was diagnosed by consensus, after neuropsychological and neuropsychiatric evaluations, under a diagnosis of normal cognition, mild cognitive impairment (MCI) according to Petersen’s criteria, or dementia according to DSM-IV criteria. Apoϵ was typified and an analysis of MoCA test was performed in each group carrying or not ϵ4 allele. Results: Our study showed that 75% were women with a median age of 68 years (interquartile range 62–74 years) and a median schooling for 6 years (interquartile range 4–12 years). Dementia was related to low education level of ≤5 years OR=11.20 (95%CI 4.99–25.12), high blood pressure (HBP) OR=1.45 (95%CI 1.03–2.05), and age over 70 years OR=7.68 (95%CI 3.49–16.90), independently of being or not an ϵ4 allele carrier. Diabetic subjects with dementia carrying ϵ4 allele showed a tendency to exhibit lower scores on the MoCA test, when compared with noncarriers’ diabetic subjects with dementia. Conclusions: The presence of ϵ4 allele does not modify the relationship between cognitive impairment and the different cardio-metabolic and social risk factors, except in diabetic subjects ϵ4 carriers with dementia who showed a tendency to exhibit lower scores of the MoCA test, when compared with noncarriers’ diabetic subjects with dementia.

Cognitive screening instruments for dementia: comparing metrics of test limitation

ABSTRACT Cognitive screening instruments (CSIs) for dementia and mild cognitive impairment are usually characterized in terms of measures of discrimination such as sensitivity, specificity, and likelihood ratios, but these CSIs also have limitations. Objective: The aim of this study was to calculate various measures of test limitation for commonly used CSIs, namely, misclassification rate (MR), net harm/net benefit ratio (H/B), and the likelihood to be diagnosed or misdiagnosed (LDM). Methods: Data from several previously reported pragmatic test accuracy studies of CSIs (Mini-Mental State Examination, the Montreal Cognitive Assessment, Mini-Addenbrooke’s Cognitive Examination, Six-item Cognitive Impairment Test, informant Ascertain Dementia 8, Test Your Memory test, and Free-Cog) undertaken in a single clinic were reanalyzed to calculate and compare MR, H/B, and the LDM for each test. Results: Some CSIs with very high sensitivity but low specificity for dementia fared poorly on measures of limitation, with high MRs, low H/B, and low LDM; some had likelihoods favoring misdiagnosis over diagnosis. Tests with a better balance of sensitivity and specificity fared better on measures of limitation. Conclusions: When deciding which CSI to administer, measures of test limitation as well as measures of test discrimination should be considered. Identification of CSIs with high MR, low H/B, and low LDM, may have implications for their use in clinical practice.

Cognitive profile of patients with facioscapulohumeral muscular dystrophy

ABSTRACT Although it is predominantly a muscular disease, impairments in the central nervous system in patients with facioscapulohumeral muscular dystrophy (FSHD) have been described in the literature. Objective: To describe the cognitive profile of patients with FSHD and to correlate the impairments found with clinical variables and quality of life. Methods: Cross-sectional and case–control study that evaluated FSHD patients using a series of cognitive assessments (Mini-Mental State Examination — MMSE, Montreal Cognitive Assessment — MoCA, verbal fluency with phonological restriction — FAS, categorical verbal fluency — FAS-cat, trail-making test — TMT, and Rey’s Verbal Auditory Learning Test); a neurological severity scale (Gardner–Medwin–Walton — GMWS); and a quality of life measurement tool (Medical Outcomes Study 36-Item Short-Form Health Survey). Results: Individuals with FSHD (13) and healthy controls (26) were paired by gender and age. Significant differences between case and control groups were found in MMSE, TMT A, and A7 (p≤0.05) and MOCA (p≤0.001) performances. A positive correlation was verified in long-term memory impairments and the age in which symptoms appear (r=-0.593, p=0.033). Regarding quality of life assessment, the emotional domain correlated to MEEM (r=0.657, p=0.015), TMT A (r=-0.601, p=0.030), and A7 (r=0.617, p=0.025) performances. Conclusions: Individuals with FSHD presented mild impairments in the performance of tasks that involve attention, planning, and long-term memory functions. Those impairments were associated neither with the disease duration nor with its neurological severity.

Clock drawing test: comparison between the Pfizer and the Shulman systems

ABSTRACT Cognitive decline can be screened by the clock drawing test (CDT), which has several versions. Objective: This survey aimed to analyze the correlation between two simple methods for scoring the CDT. Methods: This cross-sectional study was nested in the Elo-Creati cohort from Passo Fundo, Brazil and comprised 404 subjects. Two raters underwent previous training and scored the subjects’ CDT according to both the Pfizer and Shulman systems. The inter-observer and intra-observer concordance within each method was analyzed with the Spearman’s rank correlation coefficient, as well as the concordance of the scores between the two methods. Age and scholarity were also correlated with the scores. Results: Most of the participants were women (93.8%) and Caucasian (84.6%), with a mean age of 66.9 (±7.8) years and a scholarity of 10.9 years (±5.6). There was significant inter-observer (Pfizer: r=0.739, p£0.001; Shulman: r=0.727, p£0.001) and intra-observer correlation (Pfizer: rater 1, r=0.628, p≤0.001; rater 2, r=0.821, p≤0.001; Shulman: rater 1, r=0.843, p≤0.001; rater 2: r=0.819; p≤0.001). Intra-observer correlation was also observed comparing Pfizer and Shulman methods (rater 1: r=0.744; p≤0.001; rater 2: r=0.702; p≤0.001). There was weak correlation of the scores with scholarity (Pfizer: r=0.283, p£0.001; Shulman: r=0.244, p£0.001) and age (Pfizer: r=-0.174, p£0.001; Shulman: r=-0.170, p£0.001). More participants were classified with decreased cognition through the Pfizer system (rater 1: 44.3 vs. 26.5%; rater 2: 42.1 vs. 16.3%; p≤0.001). Conclusions: For this population, our results suggest that the Pfizer system of scoring CDT is more suitable for screening cognitive decline.

Cognitive interventions in mature and older adults, benefits for psychological well-being and quality of life: a systematic review study

ABSTRACT Few recently published studies investigating the benefits of educational and cognitive interventions on quality of life (QoL), psychological well-being, and depressive symptoms are available. Objective: The aim of this study was to investigate the effects of educational and cognitive interventions on psychological well-being, QoL, and mood in mature and older adults without dementia and/or with mild cognitive impairment (MCI). Methods: The systematic review took place from September to October 2020 and the following databases were used to select the studies: SciELO, LILACS, PubMed, and Medline. The search terms used were idos* AND “treino cognitivo” AND “bem-estar psicológico” AND “qualidade de vida” and their corresponding translations in English and Spanish. Results: Of the 241 articles retrieved, 26 primary studies were included in the review. Of these, 18 showed improvement in QoL, psychological well-being, or cognition. Conclusions: The studies reported beneficial effects of educational and cognitive interventions for QoL, psychological well-being, and depressive symptoms of mature and older adults without dementia or depression.

Environmental interventions to support orientation and social engagement of people with Alzheimer’s disease

ABSTRACT The built environment can be a home to compensatory strategies aimed at increasing the independence of elderly people with Alzheimer’s disease, by mitigating the cognitive impairment caused by it. Objective: The aim of this study was to find out which interventions were performed in indoor environments and observe their impacts on the relief of behavioral symptoms related to the disorientation of elderly people with probable Alzheimer’s disease. Methods: A systematic review was carried out using the preferred reporting items for systematic review and meta-analyses criteria in the MEDLINE/PubMed database. Two researchers carried out the selection of the studies, following the same methodology. The third author contributed during the writing process and in the decision-making. Results: Of note, 375 studies were identified and 20 studies were included in this systematic review. The identified interventions were classified into environmental communications and environmental characteristics. Conclusions: Environmental communications had positive results in guiding and reducing agitation. In contrast, while reducing behavioral symptoms related to orientation, environmental characteristics showed improvements mainly in social engagement and functional capacity.

Virtual day center for people with dementia and their caregivers during the COVID-19 pandemic

ABSTRACT The coronavirus disease 2019 (COVID-19) pandemic suspended face-to-face assistance offered by community spaces, such as day centers (DCs). People with dementia (PwD) and their families were faced with the risks posed by social detachment and suspension of treatments. Objective: This study aimed to present a virtual day center (VDC) program offered as a preventive strategy to reduce the damage caused by social isolation and interruption of treatment imposed by the pandemic. Methods: The experience report, describing the feasibility of a VDC program, offered to 26 PwD and their caregivers, during the first year of the pandemic. The VDC held individual and group meetings with PwD and their families and psychoeducational support groups for caregivers. Results: The attendance rate in group activities was 80%, and that in the caregiver group was 68%, showing a good virtual interaction. Throughout the year, three PwD interrupted the service due to difficulties of the caregivers to reconcile the schedules of the activities with their professional commitments and the absence of a support network, three others died, and two were institutionalized. PwD remained physically, socially, and cognitively active through daily virtual activities. Guidance and support for caregivers contributed to the organization of routines and adaptation to the isolation and maintenance of the bond. Family meetings made it possible to mediate conflicts and expand the support network. Conclusions: VDC is a promising modality to assist the needs and demands of PwD and their caregivers. VDC can contribute to the expansion of this intervention to individuals and families who do not have access to face-to-face treatment.

Sociodemographic factors associated with public knowledge of dementia in a Cuban population

ABSTRACT International organizations estimate that a new dementia is diagnosed every 3 s. Objectives: To explore the knowledge and beliefs among a cross-section of the adult population of Cuba with regard to dementia risk factors and to determine the demographic variables related with it. A cross-sectional survey was carried out on 1,004 Cubans. Methods: The survey measured the importance placed on dementia, risk reduction knowledge, and the actions to prevent it. Logistic regression was undertaken to identify variables associated with knowledge. Results: Many respondents (47.5%) believe that dementia risk reduction should start before the age of 40. Cognitive stimulation and physical activities were selected with major frequency. Being older than 48 years, having previous contact with dementia, and university education increases the probability of having healthy lifestyles. Conclusions: The exploration of demographic variables allows the prediction of likelihood to know about or have positive beliefs in relation to dementia. They should be contemplated into strategies for dementia prevention in Cuban population.