Brief Memory and Executive Test: evaluation of a new screening test for cognitive impairment due to small vessel disease

Brookes, Rebecca L.; Hannesdóttir, Kristín; Lawrence, Robert M.; Morris, Robin G.; Markus, Hugh S.

doi:10.1093/ageing/afr172

Cited by 35 publications

(59 citation statements)

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“…Patients were all studied at least 3 months after any stroke to avoid the influence of effects due to acute ischaemia on cognition. Since it was of interest to explore awareness of functioning in patients who showed clear neuropsychological deficit, the group were also were screened for overall neuropsychological impairment; designated as performance being 1.5 SD below the control mean on any four of the eight tests from the Brief Memory and Executive Test Battery (BMET) (Brookes, Hannesdottir, Lawrence, Morris, & Markus, 2012; described next). This created further subgroups of 21 (47%) SVD patients with neuropsychological impairment (mean ( SD ) age 71.1 (9.1) years; 10 males, 11 females) and 24 (53%) without impairment (mean ( SD ) age 68.4 (7.4) years; 15 males, 9 females).…”

Section: Methodsmentioning

confidence: 99%

“…In this study, we investigated awareness deficits in a well‐phenotyped population of patients with SVD ( n = 45; 21 with defined concomitant neuropsychological impairment) and made comparisons with 24 Alzheimer's disease (AD) patients and a further 80 control participants. Awareness of performance on a range of neuropsychological measures was examined based on the Brief Memory and Executive Test Battery (BMET) (Brookes, Hannesdottir, Lawrence, Morris, & Markus, 2012), exploring the relationship between awareness and memory and executive function. The results revealed significant awareness deficits in both the SVD and AD groups.…”

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confidence: 99%

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Lack of awareness of neuropsychological deficit in cerebral small vessel disease: The relationship with executive and episodic memory functions

Brookes

Hannesdóttir

Markus

et al. 2012

Journal of Neuropsychology

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A common cause of neuropsychological impairment in older adults is cerebral small vessel disease (SVD), but little is known as to whether lack of awareness of neuropsychological impairment is a feature of this clinical condition. In this study, we investigated awareness deficits in a well-phenotyped population of patients with SVD (n= 45; 21 with defined concomitant neuropsychological impairment) and made comparisons with 24 Alzheimer's disease (AD) patients and a further 80 control participants. Awareness of performance on a range of neuropsychological measures was examined based on the Brief Memory and Executive Test Battery (BMET) (Brookes, Hannesdottir, Lawrence, Morris, & Markus, 2012), exploring the relationship between awareness and memory and executive function. The results revealed significant awareness deficits in both the SVD and AD groups. When splitting the SVD group into those with or without concomitant neuropsychological impairment, only those with neuropsychological impairment showed reduced awareness. For the SVD group, executive function was significantly correlated with awareness but memory was not. By comparison, memory was significantly correlated with awareness in the AD group, with executive function showing a trend but remaining non-significant. The results show that lack of awareness of deficit is a clinical feature of SVD and indicate that there are distinct neuropsychological associations with awareness deficit for SVD and AD.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Lack of awareness of neuropsychological deficit in cerebral small vessel disease: The relationship with executive and episodic memory functions

Brookes

Hannesdóttir

Markus

et al. 2012

Journal of Neuropsychology

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“…Comparing 6 acute studies 20,21,31,37,38,43 and 6 nonacute studies 22,30,34,39,46,50 ; gave a relative sensitivity, 0.73 (95% CI, 0.58-0.93) and relative specificity, 1.12 (95% CI, 1.01-1.25). These data suggest that accuracy varies with assessment timing and context, with acute testing yielding higher sensitivity and lower specificity.…”

Section: Heterogeneitymentioning

confidence: 99%

“…We tabulated summary descriptors for studies using clinical diagnosis reference standard (n=11 articles) 22,24,34,[37][38][39]43,47,49,51,52 and those using detailed neuropsychological assessment (n=21 ; Tables 1-2). 21,23,[25][26][27][28][29][30][31][32][33]35,36,[40][41][42][44][45][46]48,50 There was considerable heterogeneity in study population: setting and test strategy.…”

Section: -53mentioning

confidence: 99%

Test Accuracy of Cognitive Screening Tests for Diagnosis of Dementia and Multidomain Cognitive Impairment in Stroke

Lees

Selvarajah

Fenton

et al. 2014

Stroke

162

149

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S troke-survivors are at particular risk of cognitive decline. Three month dementia prevalence is ≥30%, and even minor stroke events have cognitive sequel.1,2 Poststroke cognitive impairment is associated with increased mortality, disability, and institutionalization. 3 The importance of cognitive change is highlighted by stroke-survivors themselves. In a national priority setting exercise, cognitive impairment was voted the single most important topic for stroke research. 4 A first step in management of cognitive problems is recognition and diagnosis. Informal clinician assessment will miss important cognitive problems, 5 and formal cognitive testing is recommended. [6][7][8] The ideal would be expert, multidisciplinary assessment informed by comprehensive investigations. This approach is not feasible at a population level. In practice, a 2-step system is adopted, with baseline cognitive testing used for screening or triage and specialist assessment to define the cognitive problem offered depending on the results.Although there is general agreement on the merits of poststroke cognitive assessment, there is no consensus on a preferred testing strategy. [6][7][8] Various cognitive screening tools are available with substantial variation in test used. 9,10 The clinical meaning of cognitive problems after stroke will vary according to test context. Cognitive impairment diagnosed in the first days post stroke may reflect a mix of delirium, strokespecific impairments, and prestroke cognitive decline. 2,11,12 In the longer term, assessments aim to make or refute a dementia diagnosis. Common to all test situations is a final diagnosis of presence/absence of clinically important impairments. A screening assessment should detect this clinical syndrome of all-cause, poststroke multidomain cognitive impairment.Background and Purpose-Guidelines recommend screening stroke-survivors for cognitive impairments. We sought to collate published data on test accuracy of cognitive screening tools. Methods-Index test was any direct, cognitive screening assessment compared against reference standard diagnosis of (undifferentiated) multidomain cognitive impairment/dementia. We used a sensitive search statement to search multiple, crossdisciplinary databases from inception to January 2014. Titles, abstracts, and articles were screened by independent researchers. We described risk of bias using Quality Assessment of Diagnostic Accuracy Studies tool and reporting quality using Standards for Reporting of Diagnostic Accuracy guidance. Where data allowed, we pooled test accuracy using bivariate methods. Results-From 19 182 titles, we reviewed 241 articles, 35 suitable for inclusion. There was substantial heterogeneity: 25 differing screening tests; differing stroke settings (acute stroke, n=11 articles), and reference standards used (neuropsychological battery, n=21 articles). One article was graded low risk of bias; common issues were case-control methodology (n=7 articles) and missing data (n=22 Lees et al Cognitive Screening in S...

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“…Kanskje er det i realiteten den generaliserte karsykdommen som er den bakenforliggende årsak til tidlig død (32). Oksala og medarbeidere fant at over halvparten av dem med akutt hjerneslag hadde alvorlig småkarssykdom med forandringer i hvit substans -dette var en uavhengig prediktor for tidlig død (33) En alternativ forklaring er at eksekutiv svikt påvirker dødsrisikoen gjennom redusert funksjon i dagliglivet, mindre effektiv behandling og rehabilitering og økt risiko for traumer (12).…”

Section: Diskusjonunclassified

Eksekutiv svikt etter hjerneslag

Engstad¹,

Engstad²,

Davanger³

et al. 2013

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Brief Memory and Executive Test: evaluation of a new screening test for cognitive impairment due to small vessel disease

Abstract: the BMET is a simple and quick to administer clinical tool for the detection of VCI in SVD and its differentiation from AD impairment. Further multicentre studies are required to evaluate and compare it with other existing screening tests.

Cited by 35 publications

References 19 publications

Lack of awareness of neuropsychological deficit in cerebral small vessel disease: The relationship with executive and episodic memory functions

Lack of awareness of neuropsychological deficit in cerebral small vessel disease: The relationship with executive and episodic memory functions

Test Accuracy of Cognitive Screening Tests for Diagnosis of Dementia and Multidomain Cognitive Impairment in Stroke

Eksekutiv svikt etter hjerneslag

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