OBJECTIVES-To assess the relationship between performance-and informant-based measures of activities of daily living (ADLs) in patients with early dementia and burden or psychological distress experienced by the patients' caregivers. DESIGN-Descriptive study. SETTING-Ambulatory center.PARTICIPANTS-Thirty-four patient-caregiver dyads in which the patient had mild dementia (Mini-Mental State Examination score ≥ 17).MEASUREMENTS-A performance-based ADL measure (the Direct Assessment of Functional Status (DAFS)) was administered to patients with mild dementia. Caregivers completed an informant-based measure of patient functional status (instrumental activities of daily living). Caregivers also completed the Caregiver Burden Inventory (CBI) and the Brief Symptom Inventory (BSI).RESULTS-Significant correlations were found between the informant-based ADL measure and caregiver burden (CBI) and psychological distress (BSI) (correlation coefficient (r) = −0.34 to −0.71, all P < .05). Alternatively, fewer and weaker relationships were observed between the DAFS (performance-based) ADL measure and caregiver burden or distress ratings (r = −0.32 to −0.43, all P < .05). Of the seven tasks assessed using the DAFS, impairments in orientation, communication, financial, and transportation skills in patients were associated with greater time and developmental burden and greater hostility in caregivers. Impairment in financial skills in patients was the strongest Address correspondence to Jill Razani, PhD, Department of Psychology, California State University, Northridge, 18111 Nordhoff Street, Northridge, CA 91330. E-mail: jill.razani@csun.edu. Author Contributions: Jill Razani: design, acquisition of subjects, implementation of study, data analyses, and preparation of the manuscript. Bernadette Kakos: implementation, data analyses, and preparation of the manuscript. Carla Orieta-Barbalace: acquisition of subjects, implementation, data analyses, and preparation of the manuscript. Jennifer T. Wong and Rachel Casas: acquisition of subjects, implementation, and preparation of the manuscript. Po Lu and Cathy Alessi: acquisition of subjects and review and critique of drafts of the manuscript. Karen Josephson: acquisition of subjects and review and critique of drafts of the manuscript. Sponsor's Role:The role of the sponsor (NIH) was to provide funding to the first author (JR) in order to conduct the current study. The sponsor was not involved in the design or implementation of the study. A growing body of literature on the caregivers of patients with dementia indicates that these individuals experience physical, psychological or emotional, social, and financial problems. 4 A study 5 using a brief screening measure to characterize cognitive impairment in patients with Alzheimer's disease found that patients' cognitive scores played a significant role in predicting the amount of time caregivers spent caring for the patient. A number of recent studies have found that caregivers of patients with dementia frequently report physical a...
There is very little research regarding the relationship between tests of executive functioning and actual functional ability in patients with dementia. Thirty-three patients diagnosed with dementia and 35 age-and education-matched healthy controls were administered tests of executing functioning and an observation-and informant-based activities of daily living (ADL). As expected, the results revealed that the controls outperformed the dementia patients on the executive and ADL tests. Additionally, executive functioning correlated significantly with aspects of functional ability in patients with dementia. This relationship was strongest for tests of verbal fluency (i.e., FAS) and a complex test of cognitive flexibility and reasoning ability (i.e., WCST). These findings suggest that some executive function tests are more sensitive than others for predicting specific functional abilities and that they may be most useful to healthcare professionals for treatment planning. Keywordsactivities of daily living; functional ability; executive functioning; dementia; Alzheimer's disease It has been well established that tests of executive functioning are useful in characterizing frontal lobe brain lesions and various forms of dementia (Kramer et al., 2005;Kennedy, 2004;Razani, Boone, Miller, Lee, & Sherman, 2001; Walker, Meares, Sachdev, & Bodaty, Correspondence: Jill Razani, Ph.D., Department of Psychology, California State University, Northridge, 18111 Nordhoff Street, Northridge, CA 91330-8255, jill.razani@csun.edu, (818) 677-4623, (818) Most available studies have examined the relationship between ADLs and brief cognitive screening measures (e.g., MMSE) and ADLs (Vitaliano et al, 1984;Winograd, 1984) and have generally found strong correlations (Ford, Haley, Thrower, West, & Harrell, 1996;Reed, Jagust, & Seab, 1989;Warren et al., 1989). Similarly, few studies have examined the relationship between ADLs and larger neuropsychological test batteries. Cahn-Weiner et al. (2000) found that executive measures accounted for more variance in ADL performance than demographic variables such as age, health status, and education level in a community-dwelling group of elderly. The authors suggest that of the cognitive domains assessed, decline in executive abilities associated with normal aging may be the best predictor of functional deterioration. Boyle et al. (2003) found that that executive dysfunction on the Dementia Rating Scale alone explained 17% of the variance in instrumental ADLs (e.g., handling finances, managing medications) in patient with Alzheimer's disease. However, the executive measures used in this study were brief and the ADL test was informant rated, which is less reliable than observation-based measures (Pearson, 2000). Back-Madruga et al. (2002) found that a group of frontal-variant Alzheimer's disease patients performed worse on ADL tasks than the typical Alzheimer's patients.In the most comprehensive study to date assessing cognitive functioning and ADLs, Farias, Harrell, Neumann, and Houtz (...
Lack of knowledge about psychosis, a condition oftentimes associated with serious mental illness, may contribute to disparities in mental health service use. Psychoeducational interventions aimed at improving psychosis literacy have attracted significant attention recently, but few have focused on the growing numbers of ethnic and linguistic minorities in countries with large immigrant populations, such as the United States. This paper reports on two studies designed to evaluate the effectiveness of a DVD version of La CLAve, a psychoeducational program that aims to increase psychosis literacy among Spanish-speaking Latinos. Study 1 is a randomized control study to test directly the efficacy of a DVD version of La CLAve for Spanish-speakers across a range of educational backgrounds. Fifty-seven medical students and 68 community residents from Mexico were randomly assigned to view either La CLAve or a psychoeducational program of similar length regarding caregiving. Study 2 employed a single-subjects design to evaluate the effectiveness of the DVD presentation when administered by a community mental health educator. Ninety-three Spanish-speakers from San Diego, California completed assessments both before and after receiving the DVD training. Results from these two studies indicate that the DVD version of La CLAve is capable of producing a range of psychosis literacy gains for Spanish-speakers in both the United States and Mexico, even when administered by a community worker. Thus, it has potential for widespread dissemination and use among underserved communities of Spanish-speaking Latinos and for minimizing disparities in mental health service use, particularly as it relates to insufficient knowledge of psychosis.
The primary objective of this study was to investigate empirically whether using an interpreter to conduct neuropsychological testing of monolingual Spanish speakers affects test scores. Participants included 40 neurologically normal Spanish-speakers with limited English proficiency, ages 18–65 years (M= 39.7, SD =13.9), who completed the Vocabulary, Similarities, Block Design, and Matrix Reasoning subtests of the Wechsler Adult Intelligence Scale-III in two counterbalanced conditions: with and without an interpreter. Results indicated that interpreter use significantly increased scores on Vocabulary and Similarities. However, scores on Block Design and Matrix Reasoning did not differ depending upon whether or not an interpreter was used. In addition, the findings suggested a trend toward higher variability in scores when an interpreter was used to administer Vocabulary and Similarities; this trend did not show up for Block Design or Matrix Reasoning. Together, the results indicate that interpreter use may significantly affect scores for some tests commonly used in neuropsychological practice, with this influence being greater for verbally mediated tests. Additional research is needed to identify the types of tests that may be most affected as well as the factors that contribute to the effects. In the meantime, neuropsychologists are encouraged to avoid interpreter use whenever practically possible, particularly for tests with high demands on interpreter abilities and skills, with tests that have not been appropriately adapted and translated into the patient’s target language, and with interpreters who are not trained professionals.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.